Changes In Functional Capacity Research Articles

High survivorship and excellent 5-year outcomes in patients older than 40years undergoing arthroscopy for femoroacetabular impingement.

To assess 5-year clinical outcome, in adults > 40years of age, following hip arthroscopy for femoroacetabular impingement compared to a younger, matched, control group. All primary arthroscopies for FAI between 2009 and 2016 were considered (n = 1762). Hips presenting with Tönnis > 1, lateral centre edge angle < 25°, or prior hip surgery were excluded. Younger (< 40years) and older hips (> 40years) were matched for gender, Tönnis grade, capsular repair and radiological parameters. Survival (avoidance of total hip replacement {THR}) was compared between the groups. Patient reported outcome measures (PROMs) were also completed at baseline and 5years to assess changes in functional capacity. Additionally, hip range of motion (ROM) was assessed at baseline and review. The minimal clinically important difference (MCID) was determined and compared between groups. Ninety-seven older hips were matched to 97 younger controls (78% male in both groups). The average age of the older group at the time of surgery was 48.0 ± 5.7years, compared to 26.7 ± 6.0. Six (6.2%) of the older hips and 1 (1%) of younger hips converted to THR (p = 0.043, effect size = 0.74, large). There were statistically significant improvements in all PROMs. At follow-up, there were no differences in PROMs between groups; significant improvements in hip ROM were also observed with no difference in ROM between groups at either time point. Similar achievement of MCIDs was observed in both groups. Older patients experience a high survivorship rate at 5years, although this may be lower than younger patients. Where THR is avoided, large clinically significant improvements in pain and function are observed. Level IV.

Time-Course of Changes in Multidimensional Fatigue and Functional Exercise Capacity and Their Associations during a Short Inpatient Pulmonary Rehabilitation Program

This study aimed to assess the time-course of changes in multidimensional fatigue and functional exercise capacity and their associations during an inpatient pulmonary rehabilitation (PR) program. Seventy COPD patients from three centres were enrolled for a four-week PR program and were evaluated before (T0) and at the end of each week (T1, T2, T3, and T4). Weekly change in multidimensional fatigue was assessed by the multidimensional inventory questionnaire (MFI-20) and functional exercise capacity by the 6-minute walking distance (6MWD). Reaction time (RT) and heart rate variability (HRV) were also assessed as complementary markers of fatigue. HRV did not change during the study (all p > 0.05). MFI-20 score and RT decreased during the first part of the program (p < 0.001) and levelled off at T2 (all p > 0.05 compared with each preceding time). While 6MWD improved by almost 70% during the first part of the PR, it continued to increase, albeit at a greatly reduced pace, between T2 and T4 (p < 0.05). In parallel, a negative association was found between MFI-20 score and 6MWD at each evaluation time (r ranged from 0.43 to 0.71), with a significantly stronger T3 correlation compared with the other time periods (all p < 0.05). The strengthening of the association between fatigue and functional exercise capacity at T3, which occurred concomitantly with the slowdown of functional exercise capacity improvement, is consistent with a role for fatigue in the limitation of performance changes during PR. The limitation of fatigue during PR is thus an interesting aspect to improve the magnitude of performance changes.

Prehabilitation in elective patients undergoing cardiac surgery: a randomised control trial (THE PrEPS TRIAL) – a study protocol

IntroductionPrehabilitation prior to surgery has been shown to reduce postoperative complications, reduce length of hospital stay and improve quality of life after cancer and limb reconstruction surgery. However, there are...

Pulmonary endarterectomy and balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: Comparison of changes in hemodynamics and functional capacity.

The treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). Balloon pulmonary angioplasty (BPA) is an emerging option for inoperable patients. Comparisons of the hemodynamic and functional outcome between these treatments are scarce. In this single-center observational cohort study, we compared hemodynamics by right heart catheterization and peak oxygen consumption before and 5 months (±14 days) after either PEA or BPA. Comprehensive evaluation and selection for PEA or BPA was performed by an expert CTEPH team. Fourty-twoand fourty consecutive patients were treated with PEA or BPA, respectively. Demographics were similar between groups. Both PEA and BPA significantly reduced mean pulmonary artery pressure (from 46 ± 11 mmHg at baseline to 28 ± 13 mmHg at follow-up; p < 0.001 and from 43 ± 12 mmHg to 31 ± 9 mmHg; p < 0.001) and pulmonary vascular resistance (from 686 ± 347 dyn s cm-5 at baseline to 281 ± 197 dyn s cm-5 at follow-up; p < 0.001 and from 544 ± 322 dyn s cm-5 to 338 ± 180 dyn s cm-5; p < 0.001), with significantly lower reductions for both parameters in the former group. However, cardiopulmonary exercise testing revealed no significant between group differences in exercise capacity. Diffusion capacity for carbon monoxide at baseline was the only follow-up predictor for peak VO2. In our study, PEA reduced pulmonary pressures more than BPA did, but similar improvements were observed for exercise capacity. Thus, while long term data after BPA is lacking, BPA treated CTEPH patients can expect physical gains in line with PEA.

ACCEPTABILITY OF A VIDEOCONFERENCE-BASED MULTICOMPONENT EXERCISE PROGRAM (VIVIFRAIL) FOR THE OLDEST-OLD

Abstract Introduction Previous studies have shown the effectiveness of supervised multicomponent exercise programs on counteract age-related changes in functional capacity and quality of life in the oldest-old. During the quarantine imposed by COVID-19 pandemic, social isolation has been a barrier to implement face-to face exercise programs. Objective: To study the acceptance and adequacy of an exercise protocol in oldest-old. Methodology: Quasi-experimental study with initial, intermediate and post-intervention evaluation. The functional capacity assessment was carried out by the Vivifrail test (Short Physical Performance Battery and 4 falls risk assessment tests), by videoconference at the three moments of the project. For twelve weeks, the older adults performed multicomponent ViviFrail exercises with monitoring and acceptance assessment (with a maximum score of 24 points) by weekly contact by videoconference. Results This study concluded 14 oldest-old (89.07 ± 6.30 years). In the 12 weeks, the participants showed an average increase of 4.2 points in acceptance, with a significant correlation (p &amp;lt; 0.001). It was possible to observe an improvement in the functional capacity of the oldest old, although not significant, with a decrease in the time to perform the Time Up and Go tests, sit and stand, and in walking time, which is the most evident change. Conclusions This study demonstrated that a home training program with weekly monitoring by videoconference was well accepted and suitable for oldest-old people in a period of social isolation imposed by COVID-19. In addition, it proved to be an effective intervention for maintaining and improving the functional capacity of oldest-old people.

Rehabilitación pulmonar y componente educativo individual/grupal con seguimiento telefónico en pacientes con enfermedad pulmonar obstructiva crónica (EPOC)

Introduction: chronic obstructive pulmonary disease (COPD) causes progressive dyspnea in patients. Components of pulmonary rehabilitation (PR) include physical exercise, education, and behavior change. Adding telephone educational follow-up could cause additional improvements. Objective: to determine the changes in dyspnea, functional capacity and health-related quality of life in patients with COPD who underwent PR; in turn, to determine the changes in the educational needs of the patients who received individual/group educational component and telephone follow-up. Methods: patients with COPD were linked to a PR program with an individual/group educational component and telephone follow-up in a clinic in the city of Cali-Colombia. Dyspnea was assessed according to the modified Medical Research Council scale (mMRC), the distance covered in the 6-minute walk test (6MWT), Saint George's Respiratory Questionnaire (SGRQ) and education needs with the Lung Information Needs. Questionnaire (LINQ) before and after completing the program. Results: 22 patients were linked to the study, a greater number of men with 68.2%, mean age 64.9 years; there were changes in dyspnea mMRC 0.91±0.29; p=0.002, distance traveled 51.37±21.22; p=0.007, SGRQ domains symptoms, activities and total (p&lt;0.05), as well as the knowledge, self-care, exercise and total domains of the LINQ. Conclusion: COPD patients who underwent PR presented improvements in the distance traveled, dyspnea and quality of life; additionally, the individual/group educational component and telephone follow-up caused improvements in patient education.

Heart rate variability: A biomarker of frailty in older adults?

Frailty is a state of critical loss of physiological complexity resulting in greater vulnerability to stressors and has been characterized as a debility syndrome in the older adult. Changes in functional capacity and the cardiovascular system during aging are the most significant and relevant for this population, including the clinically healthy. In this sense, this review aims to investigate methods to monitor the performance of older adults, such as heart rate variability and verify how it can be related to frailty. It contributes to understanding that the changes in heart variability can be a marker for frailty in older adults.

Changes in functional capacity after a cardiac rehabilitation program in Spain: defining the profile of those who improve

Abstract Background Improvement in functional capacity (FC) is one of the most notable benefits patients experience after cardiac rehabilitation (CR) and it is highly important as low levels of FC are associated with a high risk of cardiovascular (CV) disease and all cause mortality. Purpose To study the changes in FC after a CR program in Spain and to define the profile of those patients that improve. Methods Single-centre observational study from 793 patients with ischaemic heart disease (15.3% women, age 61.79±10.70 years), participating in a CR program from 2015 to 2020 with a stress test performed, both at beginning of CR (conventional stress test, n=436; CPET, n=340; imaging stress test, n=17) and at end of CR (conventional stress test, n=468; CPET, n=322; imaging stress test, n=3). A comparative analysis of patients with “improved FC” and “non-improved FC” at end of CR, was performed. Relevant clinical improvement was defined as a 10% increase of VO2, in accordance with reviewed literature. Additionally, a descriptive analysis of patient exercise capacity parameters was performed at beginning of CR and at end CR, for the complete sample. Results A total of 1586 exercise tests were analysed. All exercise capacity parameters analysed showed significant improvement at end of CR, with p values &amp;lt;0.01, (Graph 1). Clinically relevant FC improvement was observed in 54.2% of patients that participated in CR; 45.5% of all women and 55.8% of all men. Patients that improved FC completed significantly more CR training sessions (p&amp;lt;0.05) than those who did not improve FC (21.39±4.53, 20.37±5.84). Those who improved FC were significantly older (62.74±10.90), presented with significantly more STEMI (n=197, 45.8%), and achieved significantly less METS (7.42±3.01) at baseline, (p&amp;lt;0.05, Table 1). Conclusions Our CR rehabilitation program improves patient's functional capacity significantly. Patients with clinically relevant functional capacity improvement, are significantly older patients with STEMI as diagnosis at CV event, complete significantly more CR training sessions and showed significantly worst physical performance (METS) at baseline. Funding Acknowledgement Type of funding sources: None.

High-quality metagenome-assembled genomes from proximal colonic microbiomes of synbiotic-treated korean native black pigs reveal changes in functional capacity

Synbiotics are feed supplements with the potential to promote health and productivity in pigs partly, through modulation of the intestinal microbiome. Our study used shotgun sequencing and 16S rRNA gene sequencing techniques to characterize the effect of a synbiotic containing three Lactobacillus species and a fructo-oligosaccharide on the proximal colonic microbiome of 4- to 7-month-old Korean native black gilts. With shotgun sequencing we constructed unique metagenome-assembled genomes of gut microbiota in Native Black Pig for the first time, which we then used for downstream analysis. Results showed that synbiotic treatment did not alter microbial diversity and evenness within the proximal colons, but altered composition of some members of the Lactobacillaceae, Enterococcaceae and Streptococcaceae families. Functional analysis of the shotgun sequence data revealed 8 clusters of orthologous groups (COGs) that were differentially represented in the proximal colonic microbiomes of synbiotic-treated Jeju black pigs relative to controls. In conclusion, our results show that administering this synbiotic causes changes in the functional capacity of the proximal colonic microbiome of the Korean native black pig. This study improves our understanding of the potential impact of synbiotics on the colonic microbiome of Korean native black pigs.

Cardiovascular Functional Capacity Is Impaired Within The First Year Of Maintenance Dialysis

Purpose: The transition to dialysis imposes new cardiovascular challenges and leads to a staggering spike in the risk of cardiovascular death in patients with advanced chronic kidney disease (CKD). Despite this, it is unknown if the initiation of dialysis alters cardiovascular functional capacity. Herein, we evaluate changes in cardiovascular functional capacity associated with initiating dialysis. Methods: We conducted a cross-sectional study of 96 CKD stage 5 patients wait-listed for kidney transplantation. All patients underwent cardiopulmonary exercise testing and echocardiography. Our primary endpoint was peak oxygen consumption (VO2Peak) during cycle ergometer exercise; secondary endpoints included ventilatory indices, peak workload, and left ventricular geometric measures. Results: Of the 96 patients (age = 44.8 ± 15.6 y; 56 [58.3%] male), 42 patients were pre-dialytic (mean eGFR of 14.2 mL·min–1·1.73 m–2) and 54 had a dialysis vintage ≤12 months. No significant group differences in age, body mass index, or hypertension status were observed. Dialysis patients with ≤12-month vintage exhibited a significantly impaired VO2Peak (18.7 ± 5.8 mL·min–1·kg–1) compared to predialysis (22.7 ± 5.2 mL·min–1·kg–1; p < 0.001) patients. Patients with ≤12-month vintage also exhibited reduced peak workload (p = 0.006), impaired peak heart rate (p = 0.027), reduced circulatory power (p = 0.012), and increased left ventricular mass index (LVMI; p = 0.003) compared to predialysis. VO2Peak in dialysis vintage ≤12 months was significantly correlated with C-Reactive Protein (CRP; r = -0.395; p = 0.023), hemoglobin (r = 0.310; p = 0.027), and peak workload (r = 0.550; p < 0.001). In predialysis, VO2Peak was significantly correlated with CRP (r = -0.476; p = 0.003), LVMI (r = 0.348; p = 0.028), and peak workload (r = 0.586; p < 0.001). Conclusion: Initiation of dialysis is associated with a significant impairment of cardiovascular functional capacity in the first year. The VO2Peak observed in dialysis patients is impaired beyond the proposed threshold for increased risk of functional dependence. Declines in VO2Peak in dialysis patients appears related to oxygen carrying capacity and inflammation. Further longitudinal studies evaluating changes in exercise responses following the initiation of dialysis are needed.

Feasibility and Safety of Whole-Body Electromyostimulation in Frail Older People-A Pilot Trial.

Whole-body electromyostimulation (WB-EMS) induces high-intense stimuli to skeletal muscles with low strain on joints and the autonomic nervous system and may thus be suitable for frail, older people. However, if trained at very high intensities, WB-EMS may damage muscles and kidneys (rhabdomyolysis). This study aimed at investigating the feasibility, safety and preliminary efficacy of WB-EMS in frail, older people. Seven frail (81.3 ± 3.5 years), 11 robust (79.5 ± 3.6 years), 10 young (29.1 ± 6.4 years) participants completed an eight-week WB-EMS training (week 1–4: 1x/week; week 5–8: 1.5x/week) consisting of functional exercises addressing lower extremity strength and balance. Feasibility was assessed using recruitment, adherence, retention, and dropout rates. The satisfaction with WB-EMS was measured using the Physical Activity Enjoyment Scale for older adults (PACES-8). In week 1, 3, and 8 creatine kinase (CK) was assessed immediately before, 48 and 72 h after WB-EMS. Symptoms of rhabdomyolysis (muscle pain, muscle weakness, myoglobinuria) and adverse events were recorded. Functional capacity was assessed at baseline and after 8 weeks using the Short Physical Performance Battery (SPPB), Timed Up-and-Go Test (TUG), Choice Stepping Reaction Time Test (CSRT), 30-second Chair-Stand Test (30-STS), maximum isometric leg strength and handgrip strength. The recruitment rate of frail individuals was 46.2%, adherence 88.3% and the dropout rate 16.7%. All groups indicated a high satisfaction with WB-EMS. CK activity was more pronounced in young individuals with significant changes over time. Within older people CK increased borderline-significantly in the frail group from baseline to week 1 but not afterwards. In robust individuals CK increased significantly from baseline to week 1 and 3. No participant reached CK elevations close to the threshold of ≥5,000 U/l and no symptoms of rhabdomyolysis were observed. With the exception of the TUG (p = 0.173), frail individuals improved in all tests of functional capacity. Compared to the young and robust groups, frail individuals showed the greater improvements in the SPPB, handgrip strength, maximum isokinetic hip-/knee extension and flexion strength. WB-EMS is feasible for frail older people. There were no clinical signs of exertional rhabdomyolysis. WB-EMS proved to be sufficiently intense to induce meaningful changes in functional capacity with frail individuals showing greater improvements for several measures.

The role of work conditions on the functional decline in senior workers in the automotive industry.

The aging of the workforce is changing, but working conditions have not changed at the same exponential growth rate for senior workers. Such a situation can compromise the worker's physical and cognitive capability, reducing the ability to perform work activities. This study aims to understand the main functional capacity changes in senior workers in the automotive industry and to determine the contribution of working conditions on the decline of the functional capacity in senior workers. To achieve the objectives of the study, a set of questionnaires (Sociodemographic Data, COPSOQ, Nordic Questionnaire, and Par-Q) and a battery of 4 functional capacity tests were used. Work conditions, namely awkward postures, force demands and manual material handling, and age, were statistically associated to the functional decline in workers. Additionally, multiple linear regression showed that height, weight, seniority, and strength have predictive value to the handgrip decline (both positions HG2 and HG5). These results suggest that workers' handgrip assessment should be considered as a future measure as an indicator of strength ability in the occupational field.

Video game-based exercise in children and adolescents with non-cystic fibrosis bronchiectasis: A randomized comparative study of aerobic and breathing exercises.

Video game-based systems have been proposed to improve effectiveness and compliance with exercise training in children and adolescents with noncystic fibrosis bronchiectasis (NCFB). This study aimed to investigate the effects of aerobic and breathing video game-based exercises (VGE) on pulmonary function, respiratory and peripheral muscle strength, functional capacity, and balance in children and adolescents with NCFB. Thirty-nine children and adolescents aged between 8 and 18 years with NCFB were randomly allocated into three groups as "home-based chest physiotherapy group" (CP), "aerobic VGE given in addition to home-based chest physiotherapy group" (CP + aerobic VGE), and "breathing VGE given in addition to home-based chest physiotherapy group" (CP + breathing VGE). All three groups performed chest physiotherapy program twice a day for 7 days per week for 8 weeks. Pulmonary function, respiratory and peripheral muscle strength, functional capacity, and balance were assessed at baseline and after 8 weeks of training. The improvement in maximum expiratory pressure and balance scores were significantly higher in both CP + aerobic and CP + breathing VGE groups. The significant improvement in maximum inspiratory pressure was greater in the CP + breathing VGE group. The changes in peripheral muscle strength and functional capacity were significantly higher in the CP + aerobic VGE group. The present study showed that aerobic VGE provides additional benefits in improving peripheral muscle strength and functional capacity, while breathing VGE provides further increase in improving respiratory muscle strength. In addition, both aerobic and breathing VGE were effective in improving balance, but they were not superior to each other.

Effects of pre‐surgical aerobic dance‐based exercise on lower extremity in people with morbid obesity awaiting bariatric surgery: Randomized controlled study

To investigate what are the effects of pre-surgical aerobic dance-based exercise programme (PSADBE) and physical activity counselling (PAC) programme on lower extremity functions after surgery in people with morbid obesity awaiting bariatric surgery (PMOABS). This study was a single-blind, randomized controlled study. Groups were divided into Group I (PSADBE and PAC) and Group II (PAC). Both groups received PAC, Group I completed the PSADBE programme accompanied by music for 60 min/2 days/8 weeks. Thirty-four PMOABS were included in the study. The 6-Minute Walking Test, as primary outcomes, and The Stair Climbing Up-Down Test for evaluating functional capacity, Biodex Isokinetic Test and Exercise System® for evaluating muscle strength were used. Besides, muscle endurance, physical activity (PA) level, fatigue and quality of life (QoL) were also assessed. All measurements were repeated three times; pre-treatment, post-treatment and the fifth-month post-surgery. After 8 weeks, significant changes were found in functional capacity, muscle strength and endurance, PA level, fatigue and QoL in both groups (p < .05). Comparing the groups, the changes in functional capacity, muscle strength and endurance, PA and fatigue scores after treatment and the fifth-month post-surgery were statistically superior in Group I (p < .05). Adding an 8-week PSADBE programme to PAC is an effective treatment option for improving postoperative functional capacity, muscle strength and endurance, PA level and fatigue in PMOABS.

The Consequences of Assisted Reproduction Technologies on the Offspring Health Throughout Life: A Placental Contribution.

The use of assisted reproductive technologies (ART) worldwide has led to the conception and birth of over eight million babies since being implemented in 1978. ART use is currently on the rise, given growing infertility and the increase in conception age among men and women in industrialized countries. Though obstetric and perinatal outcomes have improved over the years, pregnancies achieved by ART still bear increased risks for the mother and the unborn child. Moreover, given that the first generation of ART offspring is now only reaching their forties, the long-term effects of ART are currently unknown. This is important, as there is a wealth of data showing that life-long health can be predetermined by poor conditions during intrauterine development, including irregularities in the structure and functioning of the placenta. In the current review, we aim to summarize the latest available findings examining the effects of ART on the cardiometabolic, cognitive/neurodevelopmental, and behavioral outcomes in the perinatal period, childhood and adolescence/adulthood; and to examine placental intrinsic factors that may contribute to the developmental outcomes of ART offspring. Altogether, the latest knowledge about life outcomes beyond adolescence for those conceived by ART appears to suggest a better long-term outcome than previously predicted. There are also changes in placenta structure and functional capacity with ART. However, more work in this area is critically required, since the potential consequences of ART may still emerge as the offspring gets older. In addition, knowledge of the placenta may help to foresee and mitigate any adverse outcomes in the offspring.

Submaximal Walking Tests: A Review of Clinical Use

ABSTRACT Though graded exercise testing is the gold standard for assessing cardiorespiratory fitness, submaximal exercise testing is also useful to assess cardiorespiratory status and functional capacity when maximal testing is not feasible. Submaximal walking tests are advantageous as they have less risk, lower cost, require less time and equipment, and walking is a familiar activity that is easy to do in most environments. A number of submaximal walking tests exist for both overground and treadmill walking. Regression equations to predict V̇o2max values based on walking time, distance, and other variables that influence exercise tolerance have been developed for some submaximal tests, including the Rockport Fitness Walking Test and the Single-Stage Treadmill Walk Test. The 6-Minute Walk Test is a common test used in clinical populations to predict prognosis and assess change in functional capacity after intervention. Determining which submaximal walking test to use depends on purpose and setting, subject characteristics, equipment availability, space, and time. This review will provide clinicians with an overview of submaximal walking test protocols and provide reference equations and minimal clinically important difference values to interpret results.

Incremental shuttle walking test to assess functional capacity in cardiac rehabilitation: a narrative review

Background/AimsLow functional capacity has been recognised to be the most important predictor of overall mortality compared to all other cardiovascular risk factors in patients with cardiovascular disease. Walk tests, such as the incremental shuttle walking test and the 6-Minute Walk Test, are used to assess functional capacity in patients, the effectiveness of a cardiac rehabilitation programme and the prognosis of cardiovascular diseases. The aim of this review was to provide a narrative review of the literature and identify the key features of the incremental shuttle walking test as a measure of functional capacity testing in cardiac rehabilitation patients.MethodsThe PubMed, MEDLINE, Elsevier and Google Scholar databases were searched for relevant scientific articles published up to March 2021 with no restriction on start day. The key words defined by researchers were ‘incremental shuttle walking test’, ‘exercise test’, ‘functional capacity’, ‘cardiovascular disease’, ‘cardiac rehabilitation’, ‘reliability’ ‘prediction; ‘walk tests’. A final set of 31 articles was included in this narrative review.ResultsEvidence-based findings suggest that the incremental shuttle walking test is a valid, reliable, sensitive, useful tool for detecting and predict cardiorespiratory capacity.ConclusionsClinicians can be confident that they can use the incremental shuttle walking test to monitor changes in functional capacity in patients with cardiovascular disease.

Specific nutrition evaluation of patients with advanced chronic liver disease: Development and validation.

Malnutrition is frequently identified in patients with advanced chronic liver disease (ACLD), and its early identification is necessary for effective nutrition treatment. The aim of this study was to develop and validate a tool for specific nutrition evaluation of patients with ACLD (SNE-ACLD). SNE-ACLD was developed by consensus among experts using Delphi technique. The initial proposal for the SNE-ACLD had six domains (history of weight loss, changes in food intake, gastrointestinal symptoms, changes in functional capacity, presence of complications of liver disease, and a nutrition-focused physical examination) and 11 items. Fifteen experts participated in content validation. In a cross-sectional study design, the new tool was applied to 129 inpatients and outpatients from a gastrohepatology unit. Nutrition status was evaluated with SNE-ACLD and subjective global assessment by one researcher. Content validation and semantic analysis were obtained by content validity index. To verify accuracy of SNE-ACLD, the sensitivity, specificity, Youden index, and area under the receiver operating characteristic curve (AUC) were calculated. After five evaluative sequences conducted by experts, experts excluded the domain for history of weight loss and its respective item. The final version of SNE-ACLD consists of five domains and 10 items. The new instrument showed good accuracy in identifying any level of malnutrition (AUC = 0.83; 95% CI, 0.76-0.91) and severe malnutrition (AUC = 0.90; 95% CI, 0.79-1.00). SNE-ACLD can be used in nutrition assessment of patients with liver disease. Future works should investigate its agreement with other methods and its predictive value.

Resveratrol Reduces Arterial Stiffness and Improves Functional Capacity in Patients with COPD

IntroductionChronic Obstructive Pulmonary Disease (COPD) is the 3rd leading cause of death worldwide and is strongly associated with the development of cardiovascular disease (CVD). Large artery stiffening is recognized as a major CVD risk factor that contributes to diminished myocardial blood supply and reduced functional capacity, a marker of disease severity in COPD. Elevated oxidative stress plays a pivotal role in the etiology of both COPD and CVD. Apart from the body’s endogenous ability to counteract oxidative stress, the consumption of exogenous antioxidants also enhances the capacity to scavenge free radicals and reduce arterial stiffness. Whether or not antioxidants can reduce arterial stiffness and improve functional capacity in patients with COPD, however, has yet to be elucidated.PurposeThis study sought to test the hypothesis that oral resveratrol, a powerful antioxidant, will reduce arterial stiffness and improve functional capacity in patients with COPD.MethodsTen patients with COPD (GOLD Stage II‐IV) participated in this study and completed 6 weeks of oral resveratrol (500 mg/daily) or placebo (PLC) treatment. Arterial stiffness was evaluated via tonometry (SphygmoCor) before and after RES or PLC to assess augmentation index (AIx), AIx normalized to a heart rate of 75 beats per minute (AIx75), and diastolic pressure time index (DPTI). Functional capacity was measured via six‐minute walk test to evaluate distance walked.ResultsA single dose of RES significantly (p&lt;0.01) improved markers of arterial stiffness (AIx75: ∆RES=‐8±2% vs. ∆PLC=‐4±2%) while increasing myocardial perfusion (DPTI: ∆RES=158±79 mmHg vs. ∆PLC=‐23±18 mmHg p=0.04). No changes (p=0.171) in functional capacity were observed after a single dose of RES or PLC. However, six weeks of RES significantly (p=0.01) reduced AIx75 (∆RES=‐9±3% vs. ∆PLC=‐3±2%), while it improved myocardial perfusion (DPTI: ∆RES=166±85 mmHg vs. ∆PLC=‐36±18 mmHg; p=0.04) and distance walked (∆RES=25±13m vs. ∆PLC=‐2±4m; p=0.04).ConclusionFor the first time, we have identified that the antioxidant resveratrol reduces markers of arterial stiffness and improves myocardial perfusion in patients with COPD. In addition, six weeks of daily intake of this natural antioxidant also improved functional capacity in this population. Future studies are warranted to investigate the long terms effects of resveratrol in cardiovascular health in patients with COPD.

Comparison of Ratings of Perceived Exertion and Target Heart Rate-Based Exercise Prescription in Cardiac Rehabilitation: A RANDOMIZED CONTROLLED PILOT STUDY.

Although ratings of perceived exertion (RPE) are widely used to guide exercise intensity in cardiac rehabilitation (CR), it is unclear whether target heart rate ranges (THRRs) can be implemented in CR programs that predominantly use RPE and what impact this has on changes in exercise capacity. We conducted a three-group pilot randomized control trial (#NCT03925493) comparing RPE of 3-4 on the 10-point modified Borg scale, 60-80% of heart rate reserve (HRR) with heart rate (HR) monitored by telemetry, or 60-80% of HRR with a personal HR monitor (HRM) for high-fidelity adherence to THRR. Primary outcomes were protocol fidelity and feasibility. Secondary outcomes included exercise HR, RPE, and changes in functional exercise capacity. Of 48 participants randomized, four patients dropped out, 20 stopped prematurely (COVID-19 pandemic), and 24 completed the protocol. Adherence to THRR was high regardless of HRM, and patients attended a median (IQR) of 33 (23, 36) sessions with no difference between groups. After randomization, HR increased by 1 ± 6, 6 ± 5, and 10 ± 9 bpm ( P = .02); RPE (average score 3.0 ± 0.05) was unchanged, and functional exercise capacity increased by 1.0 ± 1.0, 1.9 ± 1.5, 2.0 ± 1.3 workload METs (effect size between groups, ηp2 = 0.11, P = .20) for the RPE, THRR, and THRR + HRM groups, respectively. We successfully implemented THRR in an all-RPE CR program without needing an HRM. Patients randomized to THRR had higher exercise HR but similar RPE ratings. The THRR may be preferable to RPE in CR populations for cardiorespiratory fitness gains, but this needs confirmation in an adequately powered trial.