Cardiopulmonary Functional Capacity Research Articles

Effects of high-intensity interval robot-assisted gait training on cardiopulmonary function and walking ability in chronic stroke survivors: A multicenter single-blind randomized controlled trial.

Chronic stroke can impair cardiopulmonary function, mobility, and daily activities. This study assessed the impact of robot-assisted gait training (RAGT) on such impairments. To investigate the effects of robot-assisted gait training on cardiopulmonary function, walking ability, lower extremity function and strength, activities of daily living (ADLs), and blood test results among individuals with chronic stroke. A multicenter, prospective, single-blinded, randomized controlled trial with 22 chronic stroke participants compared RAGT against a control exercise regimen. RAGT involved three days weekly sessions of high-intensity interval training for 8 weeks (24 sessions) with a Morning Walk® device. The control group also performed home exercises. (24 sessions) Measures included VO2max, Functional Ambulatory Category, 2-minute walk test, 10-meter walk test, Motricity Index-Lower, Korean version of the Fugl-Meyer Assessment Scale, Modified Barthel Index, Berg Balance Scale, muscle strength, InBody body composition, and blood tests (cholesterol, lipid, glucose). RAGT significantly improved VO2max, gait, balance, and lower limb strength compared with controls, with significant improvements in 2-minute walk test, 10-meter walk test, Motricity Index-Lower, and Fugl-Meyer Assessment outcomes. No changes were seen in muscle mass or blood markers. RAGT enhances cardiopulmonary function and ambulatory capacity in chronic stroke patients, underscoring its potential in stroke rehabilitation.

Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure.

123Iodine-meta-iodobenzylguanidine scintigraphy is useful for assessing cardiac autonomic dysfunction and predict outcomes in heart failure (HF). The relationship of cardiac sympathetic function with myocardial remodeling and diffuse fibrosis remains largely unknown. We aimed to evaluate the cardiac sympathetic function of patients with HF and its relation with myocardial remodeling and exercise capacity. Prospectively enrolled patients with HF (New York Heart Association class II-III) were stratified into HF with preserved left ventricular ejection fraction [LVEF] ≥45%) and reduced LVEF. Ventricular morphology/function and myocardial extracellular volume (ECV) fraction were quantified by cardiovascular magnetic resonance, global longitudinal strain by echocardiography, cardiac sympathetic function by heart-to-mediastinum ratio from 123iodine-meta-iodobenzylguanidine scintigraphy. All participants underwent cardiopulmonary exercise testing. The cohort included 33 patients with HF with preserved LVEF (LVEF, 60±10%; NT-proBNP [N-terminal pro-B-type natriuretic peptide], 248 [interquartile range, 79-574] pg/dL), 28 with HF with reduced LVEF (LVEF, 30±9%; NT-proBNP, 743 [interquartile range, 250-2054] pg/dL) and 20 controls (LVEF, 65±5%; NT-proBNP, 40 [interquartile range, 19-50] pg/dL). Delayed (4 hours) 123iodine-meta-iodobenzylguanidine heart-to-mediastinum ratio was lower in HF with preserved LVEF (1.59±0.25) and HF with reduced LVEF (1.45±0.16) versus controls (1.92±0.24; P<0.001), and correlated negatively with diffuse fibrosis assessed by ECV (R=-0.34, P<0.01). ECV in segments without LGE was increased in HF with preserved ejection fraction (0.32±0.05%) and HF with reduced left ventricular ejection fraction (0.31±0.04%) versus controls (0.28±0.04, P<0.05) and was associated with the age- and sex-adjusted maximum oxygen consumption (peak oxygen consumption); (R=-0.41, P<0.01). Preliminary analysis indicates that cardiac sympathetic function might potentially act as a mediator in the association between ECV and NT-proBNP levels. Abnormally low cardiac sympathetic function in patients with HF with reduced and preserved LVEF is associated with extracellular volume expansion and decreased cardiopulmonary functional capacity.

Eight Weeks of Intermittent Exercise in Hypoxia, with or without a Low-Carbohydrate Diet, Improves Bone Mass and Functional and Physiological Capacity in Older Adults with Type 2 Diabetes.

In an increasingly aging and overweight population, osteoporosis and type 2 diabetes (T2DM) are major public health concerns. T2DM patients experience prejudicial effects on their bone health, affecting their physical capacity. Exercise in hypoxia (EH) and a low-carbohydrate diet (LCD) have been suggested for therapeutic benefits in T2DM, improving bone mineral content (BMC) and glycemic control. This study investigated the effects of EH combined with an LCD on body composition and functional and physiologic capacity in T2DM patients. Older T2DM patients (n = 42) were randomly assigned to the following groups: (1) control group: control diet + exercise in normoxia; (2) EH group: control diet + EH; (3) intervention group: LCD + EH. Cardiopulmonary tests (BRUCE protocol), body composition (DEXA), and functional capacity (6MWT, handgrip strength) were evaluated. Body mass index (kg/m2) and body fat (%) decreased in all groups (p < 0.001). BMC (kg) increased in all groups (p < 0.001) and was significantly higher in the EH and EH + LCD groups (p < 0.001). VO2peak improved in all groups (p < 0.001), but more so in the hypoxia groups (p = 0.019). Functional capacity was increased in all groups (p < 0.001), but more so in the EH group in 6MWT (p = 0.030). EH with and without an LCD is a therapeutic strategy for improving bone mass in T2DM, which is associated with cardiorespiratory and functional improvements.

Cardiopulmonary functional capacity in Taiwanese children with atrial septal defects.

Most existing studies measure atrial septal defect (ASD) outcomes based on morbidity rates such as atrial arrhythmias and heart failure rather than the functional assessment of physical capacity postprocedure. Few studies have evaluated cardiopulmonary function in ASD children. This study represents the largest sample population in the current research, encompassing a total of 122 Taiwanese children with ASD who had undergone treatment, to evaluate cardiopulmonary functional capacity through the implementation of cardiopulmonary exercise testing (CPET), and to investigate whether variations in treatment may impact their cardiopulmonary function. This is a retrospective cohort study with the data collected from January 2010 to December 2021. All patients and controls (age-, sex-, and body mass index-matched) underwent CPET and pulmonary function testing. In total, 122 ASD patients (surgically closed ASDs 27, transcatheter-closed ASDs 48, and follow-up unrepaired ASD 47) and 244 healthy controls were recruited. The ASD group exhibited lower peak metabolic equivalent (MET), peak oxygen consumption (VO 2 , p < 0.001), and peak minute ventilation ( p = 0.028) along with MET and VO 2 at the anaerobic threshold (AT) ( p = 0.012) compared to the control group. No statistically significant differences were observed in the pulmonary function test. Among surgically closed, transcatheter closed and unrepaired ASD subgroups, no significant variances were seen in CPET and pulmonary function tests. Taiwanese ASD children exhibited diminished exercise capacity and cardiopulmonary performance compared to their healthy counterparts. Differences among specific ASD treatments in cardiopulmonary tests were non-significant.

Cardiopulmonary functional capacity in Taiwanese children with ventricular septal defects.

Children with ventricular septal defects (VSDs) are considered to have no difference in cardiopulmonary functional capacity with healthy children of the same age; however, studies have shown contradictory findings. The aim of this study was to assess whether Taiwanese children with VSDs exhibited cardiopulmonary deficits. This is a retrospective cohort study with the data collected from January 2010 to December 2021. All patients and controls (age-, sex-, and body mass index -matched) underwent cardiopulmonary exercise testing (CPET) and pulmonary function test. In total, 157 VSD patients (80 patients with surgically closed VSDs, 77 patients with unrepaired VSDs) and 157 healthy controls were recruited. Pulmonary function test showed significant among-group differences in maximal voluntary ventilation (MVV) (p=0.015). The surgically closed group had lower MVV compared to the control group. Regarding CPET, we found VSD patients had lower peak oxygen uptake than the controls (surgically closed group: 30.84±6.27ml/kg/min; unrepaired group: 32.00±5.95ml/kg/min; control group: 36.76±6.50ml/kg/min, p<0.001). There was also significant among-group differences in aerobic capacity (surgically closed group: 21.20±4.39ml/kg/min; unrepaired group: 21.68±4.47ml/kg/min; control group: 26.25±4.33ml/kg/min, p<0.001). In addition, the surgically closed group had lower heart rate average at anaerobic threshold than the control group (surgically closed group: 138.11±16.42 bpm; control group: 145.78±15.53 bpm, p=0.002). Taiwanese children with VSD, whether surgically closed or not, have poorer cardiopulmonary performance than age-matched healthy children, and the results of the surgically closed group were even worse.

Effect of different intensity exercises on cardiopulmonary function and quality of life of patients with chronic heart failure : Asystematic review and meta-analysis.

Exercise-based cardiac rehabilitation has positive benefits for patients with chronic heart failure (CHF), but the choice of exercise intensity has been controversial. The aim of this systematic review and meta-analysis was to investigate the effects of different exercise intensities on cardiopulmonary function and quality of life (QoL) of patients with CHF. Randomized controlled trials (RCTs) of different exercise intensities applied to patients with CHF were searched in PubMed, Web of Science, the Cochrane Library, and Embase databases from inception to December 2021. Study selection and data extraction were performed simultaneously by two independent reviewers, using the Physiotherapy Evidence Database Scale (PEDro) for quality assessment of the included literature. The weighted mean differences (WMD) or standardized mean difference (SMD) were calculated by employing afixed or random effects model. Other statistical analyses included subgroup analysis and sensitivity analysis. Quality of evidence was evaluated by the Grade of Recommendation, Assessment, Development, and Evaluation (GRADE) method. Eight RCTs were included. Analyses reported no significant improvement in left ventricular ejection fractions (LVEF; WMD = 0.47, 95% CI [-4.10, 5.03], p = 0.841), peak oxygen uptake (peakVO2) (SMD = 0.38, 95% CI [-0.03, 0.80], p = 0.069) and 6‑min walking distance (6MWD) (WMD = 14.10, 95% CI [-9.51, 37.72], p = 0.242). Exercise interventions of varying intensity produced small-to-moderate beneficial effects on QoL (WMD = -4.99, 95% CI [-8.29, -1.68], p = 0.003), which appeared to be attenuated at long-term follow-up (WMD = 2.12, 95% CI [-2.91, 7.16], p = 0.409). High-intensity exercise does not have asignificant advantage over moderate-intensity exercise in improving cardiopulmonary function and aerobic capacity in patients with CHF. Beneficial changes in QoL from high-intensity exercise also appeared to decrease during long-term follow-up, indicating acumulative effect of the efficacy of high-intensity exercise.

Efficacy and Safety of Moderate-Intensity Continuous Training on the Improvement of Cardiopulmonary Function in Patients After Transcatheter Aortic Valve Replacement (ENERGY): A Randomized Controlled Trial

ObjectivesTo investigate the effect of moderate-intensity continuous training (MICT) on the improvement of cardiopulmonary function for patients undergoing transcatheter aortic valve replacement (TAVR). DesignRandomized controlled study. Setting and ParticipantsBetween August 20, 2021, and February 28, 2022, a total of 66 patients after TAVR were screened for inclusion and randomly divided into the MICT and control groups at a ratio of 1:1. MICT was scheduled 3 times per week for 3 months in the intervention group. Patients in the control group received one-time advice on physical activity according to the current guideline. MethodsThe primary endpoint was the 3-month change in peak oxygen consumption (peak VO2) assessed by cardiopulmonary exercise testing. The secondary endpoints included the 3-month change in 6-minute walk test (6MWT), the 12-Item Short Form Health Survey (SF-12), New York Heart Association (NYHA) class, echocardiographic parameters, and laboratory parameters. ResultsAfter 3 months, the change in peak VO2 was higher in the MICT group than that in the control group (1.63 mL/kg/min, 95% CI 0.58-2.67, P = .003). Change in 6MWT (21.55 m, 95% CI 0.38-42.71, P = .046) was higher in the MICT group compared with the control group. A significant change in favor of MICT was also observed for low-density lipoprotein cholesterol (−0.62 mmol/L, 95% CI –1.00 to −0.23, P = .002). However, there were no significant changes in other echocardiographic indices, laboratory parameters, and SF-12 between the 2 groups (all P > .05). Conclusions and ImplicationsMICT had a positive effect on the cardiopulmonary function and physical capacity of patients after TAVR.

Effects of Sacubitril/Valsartan on Exercise Capacity in Patients with Heart Failure with Reduced Ejection Fraction and the Role of Percentage of Delayed Enhancement Measured by Cardiac Magnetic Resonance in Predicting Therapeutic Response: A Multicentre Study.

Background: This study aims to evaluate the cardiopulmonary effects of sacubitril/valsartan therapy in patients with heart failure with reduced ejection fraction (HFrEF), investigating a possible correlation with the degree of myocardial fibrosis, as assessed by cardiac magnetic resonance. Methods: A total of 134 outpatients with HFrEF were enrolled. Results: After a mean follow-up of 13.3 ± 6.6 months, an improvement in ejection fraction and a reduction in E/A ratio, inferior vena cava size and N-terminal pro-B-type natriuretic peptide levels were observed. At follow-up, we observed an increase in VO2 peak of 16% (p<0.0001) and in O2 pulse of 13% (p=0.0002) as well as an improvement in ventilatory response associated with a 7% reduction in the VE/VCO2 slope (p=0.0001). An 8% increase in the ΔVO2/Δ work ratio and an 18% increase in exercise tolerance were also observed. Multivariate logistic regression analysis showed that the main predictors of events during follow-up were VE/VCO2 slope >34 (OR 3.98; 95% CI [1.59-10.54]; p=0.0028); ventilatory oscillatory pattern (OR 4.65; 95% CI [1.55-16.13]; p=0.0052); and haemoglobin level (OR 0.35; 95% CI [0.21-0.55]; p<0.0001). In patients who had cardiac magnetic resonance, when delayed enhancement >4.6% was detected, a lower response after sacubitril/valsartan therapy was observed as expressed by improvement in ΔVO2 peak, O2 pulse, LVEF and N-terminal pro-B-type natriuretic peptide. No significant differences were observed in ΔVO2/Δ work and VE/VCO2 slope. Conclusion:Sacubitril/valsartan improves cardiopulmonary functional capacity in HFrEF patients. The presence of myocardial fibrosis on cardiac magnetic resonance is a predictor of response to therapy.

EFEITO DO EXERCÍCIO AERÓBICO NOS ÍNDICES DE FUNÇÃO FÍSICA DOS IDOSOS

ABSTRACT Introduction China is currently experiencing the problem of population aging, and the health status of the elderly has become a major focus of social attention. Objective Study the effect of aerobic exercise on the indices of physical function in the elderly. Methods 40 elderly people performed aerobic exercise 5 times a week for 8 weeks. Each exercise lasted 60 minutes, including 10 minutes of warm-up, 40 minutes of aerobic exercise (running, brisk walking, square dancing, among other activities), and 10 minutes of final cool-down. Data measurement included body indices, cardiopulmonary function, blood markers, and exercise capacity. Results Aerobic exercise can effectively improve the body shape, cardiopulmonary function, and blood lipid content of the elderly, and improve their flexibility and physical quality, enhancing their activities of daily living. Conclusion The results of this study show that aerobic exercise can effectively improve the body performance of the elderly in activities of daily living, effectively optimizing cardiopulmonary and lipid indexes. Engaging the elderly to participate in aerobic exercise should be considered by community social workers. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Time of the low-level cardiopulmonary exercise test does not affect the evaluation of acute myocardial infarction in stable status.

Cardiopulmonary exercise test (CPET) provides the means to evaluate the cardiopulmonary function and guide cardiac rehabilitation. The performance of acute myocardial infarction (AMI) patients at different times is different on CPET. This was a cross-sectional study. Patients diagnosed as AMI in stable status were included and performed the low- level CPET (RAMP 10W). CPET variables at different times were compared among four groups. Sixty and one patients with AMI conducted the low-level CPET from 3 to 15 days after AMI. Patients were stratified according to quartiles of CPET's time: 5 in 3-6 days group, 34 in 7-9 days group, 14 in 10-12 days group, 8 in 13-15 days group. Only VO2/HR at rest showed statistically different among the four groups.VO2/HR at rest in 3-6 days group and 10-12 days group were higher than in 13-15 days group (3.4 ± 0.85, 3.18 ± 0.78 vs. 2.50 ± 0.49 ml/beat, p < 0.05). Patients with complete revascularization had higher peak heart rate and blood pressure product and peak breathing reserve (BR), and lower Borg score compared with incomplete revascularization. And patients with LVEF >50% had higher peak BR compared with LVEF 40-50%. It was safe and efficient to conduct the low-level CPET in stable AMI patients 3 days after onset. Time was not an effector on cardiopulmonary function and exercise capacity and prognosis in AMI during CPET. Complete revascularization and normal LVEF should be good for exercise test in AMI.

Effects of two different inspiratory muscle training devices on respiratory muscle strength, cardiopulmonary functional capacity, and quality of life of COPD patients

Inspiratory muscle weakness is one of the complications of chronic obstructive pulmonary disease (COPD). This condition has been minimized by inspiratory muscle training (IMT). Still, different IMT devices need to be compared to identify the best option. Objective: To evaluate the effects of two IMT devices on respiratory muscle strength, cardiorespiratory functional capacity, and life quality of COPD patients. Method: Before and after the IMT protocol, 17 patients were submitted to manovacuometry, six-minute walk test (6MWT), and questionnaire from the Saint George Hospital in Respiratory Disease (SGRQ) for inspiratory muscle strength, cardiorespiratory functional capacity, and life quality assessments, respectively. Afterwards, they were divided into two groups to perform IMT for four weeks, one by Threshold® IMT (IMTG) and the other by POWERbreathe® Classic (PG). Results: Maximal inspiratory pressure increased significantly from -62.00±16.03 to -75.55±22.84 cmH2O in IMTG, and from -56.00±22.01 to -71.25±27.67 cmH2O in PG. The distance covered in the 6MWT clinically increased with both IMTG and PG. The SGRQ answers showed improvements in all domains evaluated for both groups. However, the intergroup results showed no statistically significant differences. Conclusion: Both IMT devices increased inspiratory muscle strength, improved life quality, and optimized cardiorespiratory functionality in COPD patients. None was superior to the other for the analyzed parameters.

Cardiac PI3K p110α attenuation delays aging and extends lifespan.

Phosphoinositide 3-kinase (PI3K) is a key component of the insulin signaling pathway that controls cellular me-tabolism and growth. Loss-of-function mutations in PI3K signaling and other downstream effectors of the insulin signaling pathway extend the lifespan of various model organisms. However, the pro-longevity effect appears to be sex-specific and young mice with reduced PI3K signaling have increased risk of cardiac disease. Hence, it remains elusive as to whether PI3K inhibition is a valid strategy to delay aging and extend healthspan in humans. We recently demonstrated that reduced PI3K activity in cardiomyocytes delays cardiac growth, causing subnormal contractility and cardiopulmonary functional capacity, as well as increased risk of mortality at young age. In stark contrast, in aged mice, experi-mental attenuation of PI3K signaling reduced the age-dependent decline in cardiac function and extended maximal lifespan, suggesting a biphasic effect of PI3K on cardiac health and survival. The cardiac anti-aging effects of reduced PI3K activity coincided with enhanced oxida-tive phosphorylation and required increased autophagic flux. In humans, explanted failing hearts showed in-creased PI3K signaling, as indicated by increased phos-phorylation of the serine/threonine-protein kinase AKT. Hence, late-life cardiac-specific targeting of PI3K might have a therapeutic potential in cardiac aging and related diseases.

Effects of two different inspiratory muscle training devices on respiratory muscle strength, cardiopulmonary functional capacity, and quality of life of COPD patients

Introduction: Inspiratory muscle weakness is one of the complications of chronic obstructive pulmonary disease (COPD). This condition has been minimized by inspiratory muscle training (IMT). Still, different IMT devices need to be compared to identify the best option. Objective: To evaluate the effects of two IMT devices on respiratory muscle strength, cardiorespiratory functional capacity, and life quality of COPD patients. Method: Before and after the IMT protocol, 17 patients were submitted to manovacuometry, six-minute walk test (6MWT), and questionnaire from the Saint George Hospital in Respiratory Disease (SGRQ) for inspiratory muscle strength, cardiorespiratory functional capacity, and life quality assessments, respectively. Afterwards, they were divided into two groups to perform IMT for four weeks, one by Threshold® IMT (IMTG) and the other by POWERbreathe® Classic (PG). Results: Maximal inspiratory pressure increased significantly from -62.00±16.03 to -75.55±22.84 cmH2O in IMTG, and from -56.00±22.01 to -71.25±27.67 cmH2O in PG. The distance covered in the 6MWT clinically increased with both IMTG and PG. The SGRQ answers showed improvements in all domains evaluated for both groups. However, the intergroup results showed no statistically significant differences. Conclusion: Both IMT devices increased inspiratory muscle strength, improved life quality, and optimized cardiorespiratory functionality in COPD patients. None was superior to the other for the analyzed parameters.

Moderate-intensity aerobic exercise as an adjunct intervention to improve sleep quality among rotating shift nurses.

Nurses working rotating shifts (RS) are at risk of circadian rhythm disruption, which can affect sleep quality and can lead to emotional stress, anxiety, and depression. Aerobic exercise is a type of repetitive and structured physical activity that involves the metabolic system, which utilizes oxygen to produce energy and has been demonstrated to improve shift-workers' health and well-being. The main purpose of engaging in regular moderate-intensity aerobic exercise is to improve cardiopulmonary fitness and functional capacity. When engaging in moderate-intensity aerobic exercise, the increase in arterial pressure is accompanied by a simultaneous increase in heart rate, which signifi-cantly contributes to the rise in blood pressure, which is reversed after exercise due to an increase in parasympathetic activity and a decrease in sympathetic activity. Moderate-intensity aerobic exercise includes walking at a moderate pace, water aerobics, dancing, recreational swimming, gardening, table tennis, and stair climbing at a moderate pace and represents a cost-effective health promotion strategy for im-proving sleep quality and duration. Adherence to a moderate-intensity aerobic exercise program may increase both sleep quality and duration by improving melatonin concentrations, endocrine activities, heart rate and slow wave sleep among nurses working RS. Occupational medicine practitioners should consider creating a workplace health promotion program that incorporates moderate-intensity aerobic exercise for RS-nurses to minimize the impact of shift work on their sleep quality.

Diaphragm thickness, mobility and respiratory muscle strength in patients with head and neck cancer receiving chemoradiation therapy: A longitudinal pilot study

Background: Head and neck cancer is the sixth most common cancer worldwide and is also associated with many pulmonary complications. Decreased cardiopulmonary function and functional capacity is one of the major treatment related side effects of chemoradiation therapy. In this study we aimed to assess and quantify the impact of treatment related side effects on the respiratory function and functional capacity of head and neck cancer patients during chemoradiation therapy. Methods: This was a pilot longitudinal study conducted amongst 12 newly diagnosed head and neck cancer patients (stage III, IV, IVa, IVb) who were admitted to hospital care and were receiving chemoradiation therapy for seven weeks. Outcome variables assessed were diaphragmatic thickness and mobility, maximal inspiratory pressure (MIP) and maximum expiratory pressure (MEP) and functional capacity using six-minute walk test at baseline, three weeks and seven weeks of chemo radiation. Repeated measures ANOVA and Bonferroni post-hoc tests were used to identify significant differences at the three time points with a p &lt; 0.05. Results: Our data reported a decrease in all the variables and a significant decrease in diaphragm function during deep inspiration, respiratory pressures which indicate respiratory muscle strength and functional capacity by the end of the seventh week of chemo-radiation therapy (p &lt;0.05). Conclusion: We conclude that seven weeks of chemo-radiation therapy reduces the diaphragmatic thickness, mobility, respiratory muscle strength and functional capacity in head and neck cancer patients.

Reliability, validity, and reference norms of one-minute walk test in assessing cardiopulmonary functional capacity in healthy young adults: a pilot study

IntroductionAlthough the 6-minute walk test (6MWT) and 2-minute walk test (2MWT) are widely accepted tools for analysing functional capacity, in most clinical settings and populations, they may not be possible to apply owing to time and space constraints. Hence, an alternative walk test, one-minute walk test (1MWT), was introduced. There is, however, a lack of evidence on its reference norms, reliability, and validity. Thus, we aimed to estimate the reference norms, reliability, and validity of 1MWT among healthy young adults.MethodsA sample of 86 healthy adults aged 18–25 years were recruited by the simple random sampling technique for the normative study, and 14 participants for the validity and reliability study. They were asked to perform 1MWT and 6MWT in accordance with the American Thoracic Society guidelines. 1MWT was performed twice by each participant, with a minimum of 2 days to estimate test-retest reliability. The concurrent validity of 1MWT was established with 6MWT.ResultsThe reference norm of 1MWT with mean and 95% confidence interval is 74.3 (72.1–76.6) m. The test-retest reliability of 1MWT was estimated as an interclass correlation coefficient of 0.76 (0.60–0.86) with Cronbach’s alpha of 0.76. A good degree of concurrent validity exists between 1MWT and 6MWT, with Spearman’s = 0.79 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).Conclusions1MWT has a good test-retest reliability and a good degree of concurrent validity with 6MWT. The reference norms of 1MWT have also been established.

SupPoRtive Exercise Programmes for Accelerating REcovery after major ABdominal Cancer surgery trial (PREPARE‐ABC): Study protocol for a multicentre randomized controlled trial

Exercise programmes can increase cardiopulmonary reserve and functional capacity prior to surgery and can improve clinical, functional and survival outcomes after a colorectal cancer diagnosis. However, the impact of pre- and postoperative exercise on postoperative recovery outcomes and longer-term health-related quality of life are unknown; thus, there is a need for high-quality randomized controlled trials. SupPoRtive Exercise Programmes for Accelerating REcovery after major Abdominal Cancer surgery (PREPARE-ABC) is a three-arm multicentre randomized controlled trial with internal pilot. The primary objective is to assess the effects of pre- and postoperative exercise on surgical outcomes and longer-term health-related quality of life in cancer patients undergoing colorectal resection. The aim of PREPARE-ABC is to randomize 1146 patients at the individual level (1:1:1) to hospital-supervised exercise, home-supported exercise or treatment as usual. The primary outcomes are short-term (30-day) morbidity, assessed using the Clavien-Dindo classification, and longer-term health-related quality of life, assessed using the Medical Outcomes Study Health Questionnaire (36-item Short-Form Survey [SF-36]). Secondary outcomes include cardiopulmonary fitness, physical activity behaviour change, psychological health status and cost-effectiveness. A process evaluation of intervention delivery and usual care also will be undertaken. This is the first UK-based definitive randomized controlled trial to investigate the effects of pre- and postoperative exercise on short-term postoperative health outcomes and longer-term health-related quality of life in colorectal cancer patients. The trial will yield robust clinical and cost-effectiveness data to underpin clinical guidance on how exercise programmes should be implemented in the routine management of patients undergoing major colorectal cancer surgery.

MEDICAL EFFECT OF SPORTS ON IMPROVING THE MAXIMUM OXYGEN

ABSTRACT Introduction: Maximum oxygen uptake is an effective indicator of the level of human cardiopulmonary function and aerobic work capacity. Observing the effects of aerobic training and formulating scientific training plans are of considerable value. Objective: To observe the effect of physical exercise on the human body's maximum oxygen uptake and arterial blood ketone body ratio. Methods: Before and after 4 weeks of physical exercise, the maximum oxygen uptake, blood lactic acid and heart rate changes, and ketone body content in the incremental load exercise experiment was measured in the human body. Results: The subjects’ maximum oxygen uptake, maximum exercise load, heart rate, and blood lactic acid levels increased significantly after physical exercise. Conclusion: The human body's maximum oxygen uptake is enhanced under sports. Level of evidence II; Therapeutic studies - investigation of treatment results.

Cardiac Rehabilitation

Cardiac rehabilitation based on exercise therapy is a valuable treatment for patients with a broad spectrum of cardiovascular diseases. Current guidelines support its use in patients with stable chronic heart failure and coronary artery disease, after myocardial infarction, acute coronary syndrome, coronary artery bypass grafting, coronary stent placement, and valve surgery. Its use in these conditions is supported by a robust body of research demonstrating improved clinical outcomes. The significant clinical improvement obtained through the regular training in patients with cardiovascular diseases is the result of a complex interplay of different effects: 1) improved cardiopulmonary efficiency and pulmonary functional capacity; 2) amelioration of myocardial perfusion by reducing endothelial dysfunction and by inducing new vessel formation; 3) improved myocardial contractility; 4) counteract the muscle wasting and cachexia; 5) reduction of the systemic inflammation; 6) attenuation of the sympathoexcitation, a typical feature of CHF, even in the persistence of cardiac dysfunction. Despite this evidence, cardiac rehabilitation referral and attendance remains low and interventions to increase its use need to be developed.

Effects of incentive spirometry on cardiopulmonary parameters, functional capacity and glycemic control in patients with Type 2 diabetes.

Background:Patients with Type 2 diabetes mellitus (T2DM) suffer cardiopulmonary impairment and may present with weakness of the inspiratory muscles.Objective:This study was designed to determine the effects of incentive spirometry (IS) on selected cardiopulmonary parameters, functional capacity and glycemic control in patients with T2DM.Methods:Fifty-nine participants (25 males and 34 females) recruited from the out-patient clinic of the Department of Medicine of two hospitals in Lagos State, Nigeria, who were randomly assigned into two groups, completed the study. In addition to the medical management of T2DM, IS group received incentive spirometry while control group continued with the medical management of T2DM alone. Selected cardiovascular parameters, pulmonary parameters, functional capacity (using 6-min walk test) and fasting blood glucose level were assessed at baseline and at the end of eight weeks intervention period. Data were analyzed using the Statistical Package for Social Sciences (SPSS Version 21). Level of significance was set at .Results:There were statistically significant improvements in all the cardiovascular parameters () of IS group except systolic blood pressure. There were significant changes in all the pulmonary parameters, functional capacity and glycemic control () of IS group while there was none in control group. There were significant differences between the mean changes of various selected outcome measures of the two groups () except for diastolic blood pressure and blood glucose level.Conclusion:IS had positive effects in improving cardiopulmonary function, functional capacity and glycemic control in patients with T2DM.