Test 6MWT Research Articles

Efficiency of complex rehabilitation in patients with lung cancer

Objective. To evaluate the effectiveness of a comprehensive rehabilitation program including physiotherapy, magnetic therapy and psychological support to improve quality of life and reduce symptoms in patients with lung cancer. Material and methods. The study was conducted for 6 months and included 26 patients with stage I–III lung cancer, who were randomly assigned to the study (n = 14) and control (n = 12) groups. Patients in the study group underwent complex rehabilitation, including: psychological support to reduce anxiety and depression, physiotherapy to increase the distance in the 6‑minute walk test (6MWT) and improve the forced expiratory volume in 1 second (FEV1), as well as magnetic therapy to reduce the level of inflammation. The effectiveness was assessed using the HADS scale, spirometry, a standard 6MWT test, and laboratory tests. Results. Patients in the study group demonstrated a 34.8 % decrease in anxiety and depression (p < 0.05), an increase in the 6MWT distance by 15.1 %, and an increase in forced expiratory volume (FEV1) by 14.9 % (p < 0.05). The C-reactive protein level decreased by 28.4 % (p < 0.05). In the control group, changes in all studied parameters were statistically insignificant. Conclusion. A comprehensive rehabilitation program including psychological support, physiotherapy, and magnetic therapy had a significant positive effect on the physical and psychoemotional state of patients with lung cancer. The data confirm the effectiveness of an integrated approach to improving the quality of life and recovery of patients during treatment.

The one-minute sit-to-stand test is an alternative to the 6-minute walk test in patients with atrial fibrillation: A cross-sectional study and ROC curve analysis

BackgroundThe one-minute sit-to-stand test (1STST) is an easy-to-administer, space and time-saving test for determining functional exercise capacity in cardiac disease. This study aimed to investigate the 1STST -test-retest reliability and convergent validity and compare its physiological responses to the six-minute walk test (6MWT) in patients with Atrial fibrillation (AF). MethodsForty-five patients with AF were included in this study. Functional exercise capacity was evaluated using the 1STST and 6MWT. For assessing test-retest reliability, the intraclass correlation coefficient and Bland-Altman plots were utilised. Convergent validity was determined by correlation analysis 1 STST and 6MWT, age, European Heart Rhythm Association score, ejection fraction, and quality of life. The cut-off point of 1STST was defined using ROC analysis. ResultsWith an intraclass correlation coefficient value of 0.975 [95 % confidence interval (CI) 0.954–0.986], the 1STST demonstrated excellent-test-retest reliability. Physiological responses after tests were similar in the 1STST and 6MWT (p > 0.05). The number of 1STST repetitions was strongly associated with 6MWT distance (r = 0.809; p < 0.001). A cut-off value of ≤13 repetitions in the number of 1STST repetitions was defined as functional impairment related to an increased risk of clinical events [sensitivity: 100 %, specificity: 84.6 %; AUC:0.94; 95 % CI 0.82 to 0.98; p < 0.001]. ConclusionsThe 1STST is a reliable and valid assessment tool that produced comparable hemodynamic responses to the 6MWT in patients with AF. Considering its feasibility and time efficiency, healthcare professionals can use the 1STST rather than the 6MWT test to measure functional exercise status in a constrained environment for this patient group.

Exploring the Impact of Instrument-Assisted Soft Tissue Mobilization on Functional Measures and Quality of Life in Knee Osteoarthritis Patients: A Randomized Controlled Trial

Background: Knee osteoarthritis (KOA) is a prevalent disabling condition characterized by pain, stiffness, and functional limitations, significantly impacting quality of life, particularly among older adults. Instrument-assisted soft tissue mobilization (IASTM) is a technique that has shown promise in reducing pain and increasing the range of motion. Objectives: This study aimed to investigate the effects of IASTM on functional measures and quality of life in KOA patients. Methods: Thirty participants with unilateral KOA were randomized into IASTM and sham groups. The intervention consisted of four sessions over two weeks, combining IASTM with exercise therapy. Functional performance was assessed using the 6-minute walking test (6MWT) and the timed up and go test (TUG). Quality of life was evaluated using the 36-item short-form health survey (SF-36) and the Lequesne Algofunctional Index (LAI) Questionnaires. Results: A mixed ANOVA revealed significant improvements in functional performance in both groups after treatment in the 6MWT (P &lt; 0.001) and TUG (P = 0.003) tests. Significant improvements were observed in the SF-36 subgroups for physical functioning (P = 0.002), role limitations due to physical problems (P &lt; 0.001), energy/vitality (P &lt; 0.001), pain (P &lt; 0.001), and total score (P &lt; 0.001). There was also a significant time*group interaction effect for role limitations due to emotional problems (P = 0.005), with the IASTM group showing improvement after treatment while the sham group experienced a decline. The LAI questionnaire also indicated significant improvements in both groups (P &lt; 0.001) after treatment. Conclusions: Both IASTM and sham interventions, combined with exercise therapy, led to improvements in functional measures and quality of life. However, the IASTM group exhibited a more pronounced positive trend in the 6MWT and TUG tests, as well as a significant interaction effect for emotional role limitations. These findings suggest that while exercise alone can improve function and quality of life, the addition of IASTM may further enhance these outcomes, supporting its integration into KOA management strategies to improve activities of daily living and overall quality of life.

Use of the ECG-Controlled Six-Minute Walk Test to Assess Exercise Capacity: a Comparative Cohort Study

INTRODUCTION. In clinical practice, stress tests are carried out to draw up an individual patient rehabilitation plan, assess tolerance and optimize the load, and evaluate its clinical effectiveness. The Six-minute walk test (6MWT), in the presence of contraindications to the bicycle ergometer test or the impossibility of performing it, is a tool for assessing the response of the cardiovascular and respiratory systems to the load being performed. There is no description in the literature of the relationship between the distance traveled during 6MWT and the peak metabolic equivalent (MET) assessed during the bicycle ergometer test. AIM. Study the relationship between 6MWT indicators and the results of bicycle ergometer test in patients who have suffered a myocardial infarction. MATERIALS AND METHODS. During the examination, 56 patients underwent a symptom limited bicycle ergometer test and 6MWT, the peak MET and the distance traveled during 6MWT, as well as changes in the ECG during both tests were assessed. RESULTS AND DISCUSSION. The average values of maximum heart rate during the bicycle ergometer test and ECG-controlled 6MWT did not differ significantly. The distance in meters during 6MWT and the power of the exercise performed during bicycle ergometer test in MET have a significant relationship, which indicates the comparability of the data from these tests as a criterion of exercise tolerance. CONCLUSION. The use of 6MWT and bicycle ergometer test allows us to assess various aspects of cardiorespiratory function and physical fitness in patients undergoing a cardiac rehabilitation program. Further study of the possibility of using ECG-controlled 6MWT in the early stages of rehabilitation is necessary to create the most effective and safe physical training for patients who have suffered a myocardial infarction.

Systemic Inflammatory Changes in Spinal Cord Injured Patients after Adding Aquatic Therapy to Standard Physiotherapy Treatment.

Spinal cord injury (SCI) is a severe medical condition resulting in substantial physiological and functional consequences for the individual. People with SCI are characterised by a chronic, low-grade systemic inflammatory state, which contributes to further undesirable secondary injuries. This study aimed to evaluate the effect of adding aquatic therapy to the standard physiotherapy treatment, implemented in two different schedules, on systemic inflammation in SCI patients. Additionally, the relationship between cytokine blood levels and changes in functionality (measured with the 6MWT, 10MWT, WISCI, BBS, and TUG tests) throughout the study was assessed. A quantitative multiplexed antibody assay was performed to measure the expression level of 20 pro- and anti-inflammatory cytokines in blood samples from SCI patients at three time points: baseline, week 6, and immediately post-intervention (week 12). This study identified a complex signature of five cytokines (IL-12p70, IL-8, MCP-1, IL-1α, and IP10) associated with the time course of the two physiotherapy programs. Two other cytokines (IL-4 and TNF-α) were also associated with the functional recovery of patients. These could be important indicators for SCI prognosis and provide a basis for developing novel targeted therapies.

Seguridad y eficacia de un programa de ejercicio terapéutico en jóvenes intervenidos de hernia diafragmática congénita

Introduction and objectivePatients with congenital diaphragmatic hernia (CDH) can have up to 40 times more frequency of muskuloskeletal deformities and decreased perception of physical activity tan their pairs. The objective of this study is to evaluate the safety and efficacy of an individualized exercise program in late adolescents and young adults with repaired CDH, as well as a description of their basal status. Material and methodsNon randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student's t test for paired samples and Wilcoxon test were used. Results77% (n=10) were male with a mean age of 19.23±2.13 years. In baseline BIA, 62% (n=8) had truncal sarcopenia that improved in −0.43±0.58, and P=.016. MIP, MEP, 6MWT and QoL tests increased by −7.27±8.26 cmH2O, P=.008; −11.91±10.20 cmH2O, P=.002; −70.63±17.88 m, P=.001; −42,19±26.79, P=.00 respectively. The IPAQ did not change significantly (P=0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported. ConclusionsA personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.

Rehabilitation of cardiological patients with post-COVID syndrome: morphofunctional data report

INTRODUCTION. Post-COVID is a common complication of COVID-19, occurring in more than a third of patients, and condition will persist for more than 3 months after infection with the SARS-CoV-2. AIM. To evaluate impact and potential effectiveness of a comprehensive physical rehabilitation program on health of cardiac patients with complications of a previously suffered new coronavirus infection SARS-CoV-2 COVID-19. MATERIALS AND METHODS. The study involved 128 cardiology patients with post-COVID syndrome. The study participants comprised three groups depending on the 12-week physical rehabilitation program. The effectiveness of rehabilitation was assessed through parameters of cardiopulmonary testing, as well as the 6-minute walk exercise test and the degree of dyspnea according to modified mMRC dyspnea questionnaire. RESULTS. The mMCR index in CPR group was 1.0 [0.0–1.0] point, compared with 2.0 [1.0–2.0] in control and comparative groups (p 0.05); exercise tolerance VO2max increased by 8.3 ± 3.8 % (p 0.05); normalization of heart rate and blood pressure in response to physical activity after 12 weeks in intervention group was 5.0 ± 2.1 % compared to comparative and control groups; 6MWT test results 688 m, in the intervention group, versus 490 m, for participants in control group (p 0.05). DISCUSSION. A comparative analysis of previously conducted studies confirmed pattern between the inclusion of combined cardiorespiratory training in the protocol for 12-week rehabilitation of post-COVID complications among cardiac patients, and a decrease in the degree of shortness of breath, as well as an increase in exercise tolerance. CONCLUSIONS. Based on experimental data obtained, it is advisable to analyze the effects of Cardiopulmonary Physical Rehabilitation program in the framework of larger randomized clinical trials. This will allow a more detailed assessment of the clinical consequences, as well as the ability to adjust mode and dose of physical activity of proposed rehabilitation program.

Evaluation of Lung Function Tests in the Follow-up of COVID-19 Patients Discharged From Razi Hospital in Rasht, Iran

Background: The COVID-19 pandemic has been a significant concern for the global health community since its onset. This study aimed to evaluate lung function tests in the follow-up of COVID-19 patients discharged from Razi Hospital in Rasht, Iran, in 2020. Materials and Methods: This cross-sectional study evaluated lung functional tests, including spirometry and the six-minute walking test (6MWT), in the follow-up of 239 hospitalized COVID-19 cases. All demographical and clinical data, along with the lung performance test results of the patients, were recorded, and statistical data were analyzed using SPSS, version 24. Results: The mean age of the patients was 51.69±13.98 years, and most of them were females. About 60.25% of patients had underlying diseases. The frequency of positive 6 MWT tests during the first three, six, and nine months after discharge was 7.96%, 8.70%, and 14.29%, respectively. In the first trimester after discharge, the 6MWT test was more positive among females. In addition, forced expiratory volume (FEV1)/forced vital capacity (FVC) showed a significant positive relationship with diastolic blood pressure (DBP) and heart rate (HR). After six months, positive 6MWT results were significantly associated with older ages and underlying diseases. The amount of FVC was positively associated with DBP, distance traveled in the 6MWT test, and HR, but it was negatively related to age. Conclusion: The findings revealed that older age, female gender, and underlying diseases were associated with positive 6MWT results, decreased pulmonary function, and higher DBP and HR.

Comparing the Efficacy of Inhaled Corticosteroid (ICS) Treatment in COPD Patients Based on Blood Eosinophilia: A Clinical Trial Study

Background: Inhaled corticosteroids (ICSs) have been widely used in the maintenance therapy of chronic obstructive pulmonary disease (COPD). Eosinophilic airway inflammation is a recognized inflammatory endotype in COPD. Nevertheless, the benefits and risks of ICS treatment remain controversial. Objectives: Therefore, in this study, we determine the frequency of eosinophilia in COPD patients and compare the effects of ICSs in patients with and without eosinophilia referring to the lung clinics of Zahedan University of Medical Sciences. Methods: In this study, 58 COPD patients were examined. Peripheral blood smears (PBS) were collected from all patients, and they were randomly divided into 2 groups. First, a 6-minute walking test (6MWT) was performed on all patients. Thereafter, two groups of patients received standard treatment with the Symbicort spray for 3 months. They were followed for this period, and the 6MWT was performed again at the end of the 3 months. Results: The mean results of the 6MWT test before and after intervention in the eosinophilia-positive group were 164.02 meters and 192.11 meters, respectively. Therefore, there was a significant difference in patient activity levels before and after ICSs (P = 0.017). In the eosinophilia-negative group, there was a significant difference in patient activity levels based on the 6MWT test before and after taking ICSs (P &lt; 0.001). However, there was no difference in activity levels between the two groups before and after the intervention (P = 0.68 and P = 0.36). Conclusions: Our finding showed that treatment with inhaled β2-agonists plus corticosteroids did not affect the response to this treatment in subjects' groups with and without eosinophilia compared to the pre-treatment conditions.

Exercise capacity prior to major cancer surgery: A cross-sectional observational study of the validity of the 6-minute walk and 30-second sit-to-stand tests.

Cardiopulmonary exercise testing (CPET) is the gold standard for measuring exercise capacity, however, it is resource intensive and has limited availability. This study aimed to determine: 1) the association between the 6-min walk test (6MWT) and the 30-s sit-to-stand test (30STS) with CPET peak oxygen uptake (VO2peak) and anaerobic threshold (AT) and 2) 6MWT and 30STS cut points associated with a higher risk of postoperative complications. A cross-sectional study, retrospectively analyzing data collected from a tertiary cancer center over a 23-month period. Measures included CPET VO2peak and AT, 6MWT and 30STS test. Correlations were used to characterize relationships between variables. Receiver operating characteristic curve analyses determined 6MWT and 30STS cut points that aligned with CPET variable cut points. Note that, 156 participants were included. The 6MWT and 30STS displayed moderate correlations with VO2peak, rho=0.65, p=0.01 and rho=0.52, p<0.005 respectively. Fair correlations were observed between AT and 6MWT (rho=0.36, p=0.01) and 30STS (rho=0.41, p<0.005). The optimal cut points to identify VO2peak<15mL/kg/min were 493.5m on the 6MWT and 12.5 stands on the 30STS test and for AT<11mL/kg/min were 506.5m on the 6MWT and 12.5 stands on the 30STS test. Both the 6MWT and 30STS test could be used as alternative tools for measuring exercise capacity preoperatively in the cancer setting where CPET is not available. A range of 6MWT and 30STS cut points, according to sensitivity and specificity levels, may be used to evaluate risk of postoperative outcomes.

The relationship between muscle strength and quality with functional performance in women mid- to long-term after Roux-en-Y gastric bypass

BACKGROUND: The reduction of muscle mass and strength commonly observed after bariatric surgery might negatively affect the individual physical function. Muscle quality is also of functional relevance in different populations, but its significance in patients who underwent bariatric surgery has yet to be explored. OBJECTIVE: To examine the association between muscle strength and quality with physical function in women mid- to long-term after Roux-en-Y gastroplasty (RYGB). METHODS: In this cross-sectional study, 133 women (43.7± 9.9 years) who have undergone RYGB at least two years before the study were included. All participants underwent body composition evaluation using DEXA and knee extensors peak moment (PM) using an isokinetic dynamometer. Muscle quality (MQ) was obtained through the ratio between absolute PM and dominant leg fat-free mass. Physical function was measured through the 30-second sit-to-stand (30-STS), 6-minute walking (6-MWT), and timed up-and-go (TUG) tests. RESULTS: Differences between PM tertiles were observed for 30-STS and 6-MWT tests. However, statistical significance disappeared when adjusting for age. Regarding PM relative to body weight, all functional tests were significantly different between tertiles. Comparing functional performance according to MQ tertiles, differences were found for 30-STS and 6-MWT tests, but significance disappeared when adjusting for age. Absolute PM was correlated to the 30-STS performance and 6-MWT, while PM relative to body mass and MQ were correlated with all functional tests. CONCLUSIONS: Muscle strength and quality seem to be associated with physical function in women mid-to-long-term after RYGB, but strength relative to bodyweight outperformed absolute strength and MQ.

Patrones de seguimiento y manejo clínico multidisciplinario en pacientes con Mucopolisacaridosis tipo IVA en Colombia

Background: There is limited data on the follow-up and management of patients with mucopolysaccharidosis IVA (MPS-IVA) undergoing enzyme replacement therapy (ERT) in Colombia. Objective: We aim to assess the real-world data of patients with MPS-IVA undergoing ERT in Colombia to understand patient profiles, follow-up patterns, and treatment dynamics. Methods: A convenience sample of geneticists and pediatric neurologists were recruited from November-2020 to January-2021. The physicians responded to a questionnaire-based report for each patient under their care regarding the patient profiles, follow-up patterns, and treatment dynamics. Results: A total of 24 physicians (geneticists [92%] and pediatric neurologists [8%]) provided data on 107 patients with MPS-IVA. Patients were diagnosed through molecular (36%) and/or enzymatic assays (97%). The mean age of patients was 19.5 years and 51% were male. The average time from first symptom to diagnosis was 7.1 years. The mean age at first symptoms was 4 years and at diagnosis was 11 years, further, the mean age at first ERT was 15 years. There was an increase in assessments after ERT initiation; parameters most frequently evaluated were weight, height, and echocardiography; quality of life, 6MWT, and 3-minute stair-climb test were the least frequent. ERT interruptions &gt;2 months were observed in 63% patients. Conclusions: Monitoring of MPS-IVA patients receiving ERT remains suboptimal in Colombia. Establishing national management guidelines and implementing centralized reference centers, where patients can receive comprehensive care are warranted for ensuring appropriate systems, services, and support as a priority, with a potential positive effect in the course of the disease.

Abstract MP15: Developing and Validating VO 2 Prediction From 6-Minute Walk Test (6MWT) and Association With Cardiovascular Health and Risk Scores: Coronary Artery Risk Development in Young Adults (CARDIA)

Introduction: Cardiorespiratory fitness (CRF) is a valuable diagnostic and prognostic measure. Yet, assessing VO 2 max (indicator of CRF) in population-based studies can be challenging due to requiring sophisticated equipment and trained personnel. Thus, we built and validated a model to estimate VO 2 max from a 6MWT, which is less burdensome for participants (submaximal effort). We tested the hypothesis that our model provides valid estimates of VO 2 max that are associated with cardiovascular health - AHA’s Life’s Simple 7 (LS7) and ASCVD scores. Methods: Data are from 576 CARDIA participants [60% female; 40% Black; mean ± SD age = 61.5 ± 3.6; BMI = 28.6 ± 5.7 kg/m 2 ] who attended the Year 35 follow-up exam (2020-22) and completed VO 2 max and 6MWT tests. The study sample was split randomly into a training (2/3) or test (1/3) set. The prediction equation was developed using stepwise multiple linear regression models in the training set. We evaluated accuracy of the model using student's t-test and Pearson correlation coefficients (r) by examining the difference between the observed and predicted VO 2 max in the test dataset. Linear regression models adjusted for age, and sex were used to examine associations of VO 2 max estimates with cardiovascular health and risk indices. Results: The prediction equation included 6MWT distance, sex, age, BMI, physical activity status, and smoking status (R 2 adj = 0.55, RMSE = 4.84). No significant difference was observed between predicted and measured VO 2 max (26.2 ± 5.4 vs 26.0 ± 7.5 mL/kg/min; p =0.76) and the measures were strongly correlated (r=0.80, p &lt;.001) with Bland-Altman plot is presented (Figure). Predicted VO 2 max explained more variance in LS7 score (R 2 adj = 0.55) compared to measured (R 2 adj = 0.37), while explaining similar variance in ASCVD risk (R 2 adj = 0.40 vs 0.38). Conclusions: This prediction equation provides a convenient and useful estimate of CRF estimate of CRF from 6MWT and may provide utility in clinical practice to screen and monitor CRF when direct measurement is not feasible.

Assessment of rehabilitation effectiveness in patients with COPD as part of the project "PulmoRehab – Access to healthcare services through a personalized care system for patients with COPD, including remote monitoring and tele-rehabilitation based on Artificial Intelligence methods"

Introduction. In the project “PulmoRehab – Access to Healthcare Services through a Personalized Patient Care System for COPD including Remote Monitoring and Tele-rehabilitation Based on Artificial Intelligence Methods,” SP ZOZ Specialized Hospital Ministry of Internal Affairs and Administration in Głuchołazy and 10 partners conducted research on tele-rehabilitation for people suffering from Chronic Obstructive Pulmonary Disease (COPD). The tele-rehabilitation program, based on personalized approach and technology, allowed patients to use therapy at home or a convenient location. The project aimed to reduce social inequalities in healthcare by providing remote access to health services for COPD patients. Materials and Methods. The study involved 80 patients aged 50 to 76 years, hospitalized at Ministry of Internal Affairs and Administration’s Specialist Hospital of St. John Paul II, meeting specific criteria. Qualification for the tele-rehabilitation program took into account the assessment of exercise tolerance, dyspnea, fatigue, lung ventilatory function, and saturation. The program included exercises adapted to the individual needs of the patients. Results. Analysis of the results conducted using XLSTAT software 2021.2.2 showed statistically significant differences between spirometric values before and after rehabilitation. Similarly, significant improvement was observed in the results of the 6MWT test and blood saturation. The tele-rehabilitation program proved effective in improving respiratory health parameters in COPD patients. Conclusions. 1. The tele-rehabilitation program improves lung ventilatory function in people with COPD. It reduces the feeling of dyspnea, decreases fatigue, improves SpO2, and increases exercise tolerance, demonstrating the beneficial effects of the rehabilitation applied. 2. The obtained results encourage further research on a representative group with the use of randomization.

Validation of the Lithuanian Version of the Walking Impairment Questionnaire in Patients with Peripheral Arterial Disease.

Background and Objectives: The Walking Impairment Questionnaire (WIQ) is a short and simple tool to measure walking impairment for patients with peripheral arterial disease requiring no special equipment or trained staff. The aim of this study was to assess the validity and reliability of the culturally adapted Lithuanian WIQ version in patients with intermittent claudication. Materials and Methods: In total, 40 patients with intermittent claudication and ankle-brachial index < 0.90 participated in this study. Reliability and internal consistency of the questionnaire were assessed by the intra-class correlation coefficient (ICC) and Cronbach's alpha (α), respectively. Validity was determined by correlations between the WIQ scores and a subjective test (Quality of Life 5 Dimension Questionnaire 3 Level Version (EQ-5D-3L)) and objective tests (6 min walk test (6MWT), treadmill test, and ankle-brachial index). Results: The test-retest reliability was assessed as excellent with an intraclass correlation coefficient of 0.90. The values of Cronbach's alpha were 0.957 (I time) and 0.948 (II time) and indicated an excellent internal consistency. Statistically significant Spearman correlations were detected between the WIQ and walking distances on the 6MWT (rho 0.514, p < 0.001) and treadmill test (rho 0.515, p < 0.001). Higher WIQ scores were associated with longer walking distances and duration. Moderate negative and low negative correlations were found between the WIQ and EQ-5D-3L scores. Conclusions: The Lithuanian version of culturally adapted WIQ demonstrates reliability and validity for patients with intermittent claudication, supported by two different walking tests showing statistically significant moderate Spearman correlations.

Pain, quality of life, proprioception and physical function in patient with knee osteoarthritis: Comparison of different grades

This study aimed to determine the differences in pain, quality of life and functional status of individuals with Knee Osteoarthritis (KOA) between grades. The study included 90 patients with different grades (Grades 1, 2, and 3) of KOA. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lower Extremity Functional Scale (LEFS), Berg Balance Scale (BBS), Knee Injury and Osteoarthritis Outcome Score-Physical Function Shortform (KOOS-PS), Short Form Health (SF-12), Oxford Knee Score (OKS) and Visual Analogue Scale (VAS) scales were applied. Timed Up and Go test (TUG), Five Times Sit to Stand Test (5STS), Stair Climb Test (SCT), 6-minute Walking Test (6MWT) and proprioception measurements were performed for functional assessments. Foot Posture Index (FPI-6), Navicular Drop Test (NDT) and Foot Function Index (FFI) tests were used for foot posture evaluations. In the functional tests performed in the study, a significant decrease in test performance was observed in the 6MWT and SCT tests as the grade level increased (P&lt;0.05). In TUG and 5STS tests, a significant decrease in performance was detected only in Grade 3 compared to other grades (P&lt;0.05). Similarly, there were significant differences between the grades in all scales applied (P&lt;0.05). In proprioception evaluations, similar medians were found between sides (P&gt;0.05). In FFI averages, significant differences were found especially in pain (P=0.036) and insufficiency (P=0.008) parameters compared to grade 3. This study revealed noticeable differences in knee scores, pain, quality of life scales and functional tests at different stages of KOA. These differences were generally negative as grade levels increased. However, consistent with previous research, conflicting results were identified, emphasizing the need for a nuanced understanding of KOA.

Early rehabilitation challenges of surgical patients with COVID-19 infection - a single-arm study

Background/Aim. A very limited amount of data regarding the rehabilitation outcome of surgical patients with COVID-19 is available in the current literature. The aim of this study was to point out the characteristics of early rehabilitation of these patients and determine the predictors of rehabilitation outcomes. Methods. The study was designed as a prospective clinical trial. It included patients who had surgical treatment from April 1, 2022, to March 31, 2023, at the University Clinical Center of Vojvodina, Serbia and either had positive results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperatively or developed coronavirus disease 2019 (COVID-19) within 72 hrs after surgery. The rehabilitation program was planned for each patient according to the type of surgical treatment, age, clinical presentation and severity of the COVID-19, length of immobilization, and comorbidities. Rehabilitation treatment (RT) started with a minimum of one 30-minute daily session, up to three 30-minute sessions daily. Patients were assessed at the beginning of RT and discharge. Outcomes were assessed with the Modified Borg Scale (MBS) for dyspnoea, Barthel index (BI) for activities of daily living, Six-Minute Walk Test (6MWT) for exercise tolerance, and Timed up and Go (TUG) test for balance and lower limb mobility. Results. A total of 81 patients were included in the study. RT was successful for 42 patients (24 female and 18 male) with an average age of 62.10 ? 20.07 years. These patients exhibited significant functional improvement, which was measured by all tests that assessed rehabilitation outcome at discharge: BI (p &lt; 0.001), MBS (p &lt; 0.001), 6MWT (p &lt; 0.001), and TUG test (p &lt; 0.001). The remaining 31 patients had unsuccessful RT. The binary logistic regression analysis has shown that age (p = 0.009), cardiovascular disease (p = 0.017), and malignancy (p = 0.022) were significant predictors of rehabilitation outcome. Conclusion. Results of the present study implicate that individually tailored RT during the acute phase of COVID-19 in surgical patients is very challenging. Advanced age, cardiovascular disease, and malignancy are predictors of unfavorable outcomes, and careful consideration is needed when planning the treatment for these patients.

Um estudo observacional piloto para identificar valores de referência para o teste de caminhada de 6 minutos em hipertensos brasileiros

Abstract Introduction Systemic arterial hypertension (SAH) is responsible for 9.5 million deaths in the global popu-lation. Lifestyle factors, including physical inactivity, are important modifiable risk factors in the development of SAH. Thus, physical exercise has been shown to be effective to control SAH and before the prescription, the six-minute walk test (6-MWT) has been commonly used to assess the physical capacity. Objective To propose reference values for the 6-MWT test in Brazilian people with SAH. Methods A cross-sectional observational study was conducted with 302 hypertensive subjects (62.61 + 10.93 years) admitted to a cardiac rehabilitation program. Participants were divided into different age quartiles and submitted to 6-MWT. The walking distance data was compared between the quartiles and adjusted by mul-tiple linear regression analysis. Results The hypertensive subjects walked 388.07 + 115.03 m during the 6-MWT. No significant difference between the genders was found. However, when the age quartiles were compared, for the 46–59 age group, the women walked less than the men. Intra-group comparisons showed that the distance walked in the 6-MWT decreased with the increase in age, in both men and women. Conclusion The present study provides reference values for the 6-MWT, both for Brazilian men and women of different age groups. This data may be an important parameter for future clinical studies, prevention strategies, and clinical intervention.

Body composition and functional activity in men with heart failure

Aim. To assess the body composition and functional activity (FA) parameters in men with heart failure (HF) of various nature depending on the stage, class and echocardiographic characteristics of the disease.Material and methods. The study included 100 men aged 23-70 years. The main group consisted of 60 men with HF, the control group — 40 men without HF. Quantitative body composition assessment (fat, lean and bone body mass) was carried out using dual-energy X-ray absorptiometry (DXA). Physical activity was assessed using handgrip test, short physical performance battery (SPPB) test, 6-minute walk test (6MWT), and Timed Up and Go (TUG) test.Results. In the HF group, there were a significant decrease in total bone mass, trunk and limb bone mass, total muscle mass, trunk and limbs’ muscle mass, appendicular skeletal muscle index (ASMI), and FA as HF class increased. Fat mass did not differ in individuals with different HF class and stage. HF class was an independent factor in the reduction of total bone mass (b=-301,9, p=0,015), total muscle mass (b=-1903, p=0,03), limb bone mass (b=-147,6, p=0,013) and appendicular muscle mass (AMM) (b=-1903, p=0,001). Total bone mass (b=-2,637, p=0,02) and AMM (b=-3,512, p=0,01) were independently associated with the Vasilenko-Strazhesko HF stage. AMM also had an independent association with left ventricular ejection fraction (LVEF) (b=0,274, p=0,03). The average body composition scores did not differ between the study and control groups, while the scores of handgrip test, 6MWT, SPPB and TUG test were significantly worse in the HF group. NYHA HF class, stage of HF, LVEF, left ventricular end-diastolic volume (LVEDV) and pulmonary artery systolic pressure (PASP) made an independent contribution to FA decrease in men with HF.Conclusion. In patients with HF, there was deterioration in musculoskeletal parameters depending on HF class, stage and LVEF, without significant differences compared to the control group. There was no association of fat mass with the disease, clinical and echocardiographic characteristics. The average parameters of muscle strength and tests of FA were reduced in men with HF compared with the control group and depended on the NYHA class and stage of HF, LVEF, LVEDV, and PASP.

SMART System in the Assessment of Exercise Tolerance in Adults.

Health-oriented physical activity should meet two key criteria: safety and an optimal level of exercise. The system of monitoring and rationalization of training (SMART) was designed to meet them. SMART integrates a custom-configured inertial measurement unit (IMU) and a sensor with real-time heart rate measurement (HR) using a proprietary computer application. SMART was used to evaluate the safety and exercise load with 115 study participants: 51 women (44.35%) and 64 men (55.65%) aged 19 to 65 years. The exercise test was the 6MWT test. In 35% of the participants, the mean HR exceeded the recognized safe limit of HR 75% max. Ongoing monitoring of HR allows for optimal exercise and its safety. Step count data were collected from the SMART system. The average step length was calculated by dividing the distance by the number of steps. The aim of the present study was to assess the risk of excessive cardiovascular stress during the 6MWT test using the SMART system.