Functional Capacity In Patients Research Articles

Impact of Multidisciplinary Prehabilitation Interventions on Postoperative Hospital Length of Stay and Functional Capacity in Patients Undergoing Resection of Colorectal Cancer: A Systematic Review and Meta-analysis

BACKGROUND: While surgery is commonly regarded as the primary curative treatment for colorectal cancer, it could potentially be associated with postoperative morbidity and mortality. OBJECTIVE: Determining the pooled effect of exercise and multidisciplinary prehabilitation interventions on postoperative hospital length of stay and functional capacity in patients undergoing resection of colorectal cancer. DATA SOURCES: A systematic search was conducted in MEDLINE (via PubMed) and Web of Science databases from inception to November 2022. STUDY SELECTION: The original systematic search retrieved 2,005 studies. After removal of duplicates and screening by title and abstract, 77 eligible full‐text documents were evaluated for the final inclusion in the meta‐analysis. A total of 12 randomized controlled trials (RCTs), 5 non-randomized controlled trials and 3 uncontrolled before‐and‐after studies were selected. MAIN OUTCOME MEASURES: Postoperative hospital length of stay (in days), and functional capacity (assessed with the peak of oxygen consumption [VO2 peak] and 6 minutes walking test [6MWT]). RESULTS: The meta‐analysis was conducted on a total of 20 studies (3805 participants). RCTs and non-randomized controlled trials showed significant reductions on postoperative hospital length of stay (d = -0.10, nearly 2 days) and significant increments of VO2 peak (d = 0.27) and 6MWT (d = 0.31). Regarding the before‐and‐after studies, the pooled effect of multidisciplinary prehabilitation interventions was positively significant on VO2 peak (d = 0.29) and 6MWT (d = 0.29). There was no risk of publication bias (Egger's test: p > 0.05), being as 0.71 (from 0 to 1) on average. LIMITATIONS: There was a high between-studies heterogeneity, and several outcomes did not have the required number of studies for a desirable statistical power. CONCLUSIONS: These findings suggest that multidisciplinary prehabilitation interventions might be effective at decreasing postoperative hospital length (nearly 2 days) of stay and improving functional capacity. STUDY REGISTRATION: PROSPERO registration number CRD42022373982.

Delivering effective, comprehensive, multi-exercise component cardiac rehabilitation (CR) for chronic heart failure patients in low resource settings in sub-Saharan Africa: Queen Elizabeth Central Hospital-(QECH-CR) randomised CR study, Malawi.

The delivery of Cardiac Rehabilitation (CR) and attaining evidence-based treatment goals are challenging in developing countries, such as Malawi. The aims of this study were to (i) assess the effects of exercise training/ CR programme on cardiorespiratory and functional capacity of patients with chronic heart failure (CHF), and (ii) examine the effectiveness of a novel, hybrid CR delivery using integrated supervised hospital- and home-based caregiver approaches. A pre-registered (UMIN000045380), randomised controlled trial of CR exercise therapy in patients with CHF was conducted between September 2021 and May 2022. Sixty CHF participants were randomly assigned into a parallel design-exercise therapy (ET) (n = 30) or standard of care (n = 30) groups. Resting hemodynamics, oxygen saturation, distance walked in six-minutes (6MWD) and estimated peak oxygen consumption (VO2 peak) constituted the outcome measures. The exercise group received supervised, group, circuit-based ET once weekly within the hospital setting and prescribed home-based exercise twice weekly for 12 weeks. Participants in both arms received a group-based, health behaviour change targeted education (usual care) at baseline, 8-, 12- and 16-weeks. Most of the participants were female (57%) with a mean age of 51.9 ±15.7 years. Sixty-five percent (65%) were in New York Heart Association class III, mostly with preserved left ventricular ejection fraction (HFpEF) (mean Left Ventricular Ejection Fraction 52.9 ±10.6%). The 12-weeks ET led to significant reductions in resting haemodynamic measures (all P <0.05). The ET showed significantly higher improvements in the 6MWD (103.6 versus 13.9 m, p<0.001) and VO2 peak (3.0 versus 0.4 ml·kg-1·min-1, p <0.001). Significant improvements in 6MWD and VO2 peak (both p<0.001), in favour of ET, were also observed across all follow-up timepoints. This novel, randomised, hybrid ET-based CR, delivered to mainly HFpEF patients using an integrated hospital- and home-based approach effectively improved exercise tolerance, cardiorespiratory fitness capacities and reduced perceived exertion in a resource-limited setting.

The burden of spine structural damage on the function in patients with axial spondyloarthritis: adaptation-mediated uncoupling?

To investigate the association between spinal damage and functional capacity in patients with axial spondyloarthritis (axSpA) and to compare the performance of two radiographic scores [modified Stoke AS Spine Score (mSASSS) and Combined AS Spine Score (CASSS)]. Radiographs from 101 axSpA patients were scored according to de Vlam et al. for cervical facet joints (CFJ) and mSASSS for vertebral bodies. CASSS was calculated as the sum of both scores. Physical function was assessed by BASFI; disease activity by BASDAI and AS Disease Activity Score (ASDAS); mobility by BASMI; and quality of life by AS Quality of Life (ASQoL). Univariate and multivariate analyses were performed to investigate the association between possible explanatory variables and outcomes. BASFI correlated strongly with ASQoL (Spearman ρ 0.66) and BASDAI (ρ 0.70), moderately with BASMI (ρ 0.46) and ASDAS (ρ 0.59), and weakly with mSASSS (ρ 0.29) and CASSS (ρ 0.28). A best-fit multivariate model for BASFI, adjusted for symptom duration, age, sex, and smoking status, included BASDAI (B 0.76; P < 0.001), BASMI (B 0.62; P < 0.001) and history of total hip arthroplasty (B 1.22; P = 0.05). Radiographic scores were predictors of BASFI only when BASMI was removed from the model: mSASSS (B 0.03; P = 0.01) and CASSS (B 0.02; P = 0.005). Spinal damage was independently associated with physical function in axSpA but to a lesser extent than disease activity and mobility. Moreover, incorporating CFJ assessment in the mSASSS did not improve the ability to predict function.

The impact of goal-directed prehabilitation therapy on functional capacity in patients undergoing hepatobiliary and pancreatic surgery: A randomized clinical trial

BackgroundEmerging evidence has supported the idea that goal-directed prehabilitation is a promising approach to boost functional capacity in preoperative patients. However, its usefulness has not been tested in the hepatobiliary and pancreatic fields. The objective of this trial was to investigate the efficacy of goal-directed prehabilitation for improving functional capacity in patients who were planned to undergo major hepatobiliary and pancreatic operations. MethodsThis assessor-blinded, parallel-arm, randomized clinical trial recruited patients who were scheduled for major hepatobiliary and pancreatic surgeries for malignancy. Patients were randomly allocated into the step goal-directed prehabilitation group as the test group and into the conventional prehabilitation group as the control group. Patients in the goal-directed prehabilitation group participated in a walking prehabilitation program with an intergrading goal of the step count. Patients in the conventional prehabilitation group received standard physical and nutritional prehabilitation. The primary outcome was change in the 6-minute walking distance, which ranged from the time before starting prehabilitation (baseline) to the time after completing prehabilitation (immediately before surgery). ResultsAmong 180 randomized patients, 144 patients were included in the primary analysis (73 patients in the conventional prehabilitation group and 71 patients in the goal-directed prehabilitation group). The mean change in the 6-minute walking distance was 27 meters in the conventional prehabilitation group and 31 meters in the goal-directed prehabilitation group (P = .633). ConclusionIn patients undergoing major hepatobiliary and pancreatic surgeries for malignancies, a goal-directed prehabilitation program did not result in a significantly greater increase in functional capacity than did conventional prehabilitation. Registration number: UMIN000038791 (https://www.umin.ac.jp/).

Assessment of chronic pain and its association with functional capacity in patients with HTLV-1.

Assessment of chronic pain and its association with functional capacity in patients with HTLV-1.

Commentary on the article «Validation of a questionnaire for measuring functional capacity in patients with heart failure in Colombia»

Commentary on the article «Validation of a questionnaire for measuring functional capacity in patients with heart failure in Colombia»

Machine Learning-Based Prediction of Changes in the Clinical Condition of Patients With Complex Chronic Diseases: 2-Phase Pilot Prospective Single-Center Observational Study.

Functional impairment is one of the most decisive prognostic factors in patients with complex chronic diseases. A more significant functional impairment indicates that the disease is progressing, which requires implementing diagnostic and therapeutic actions that stop the exacerbation of the disease. This study aimed to predict alterations in the clinical condition of patients with complex chronic diseases by predicting the Barthel Index (BI), to assess their clinical and functional status using an artificial intelligence model and data collected through an internet of things mobility device. A 2-phase pilot prospective single-center observational study was designed. During both phases, patients were recruited, and a wearable activity tracker was allocated to gather physical activity data. Patients were categorized into class A (BI≤20; total dependence), class B (20<BI≤60; severe dependence), and class C (BI>60; moderate or mild dependence, or independent). Data preprocessing and machine learning techniques were used to analyze mobility data. A decision tree was used to achieve a robust and interpretable model. To assess the quality of the predictions, several metrics including the mean absolute error, median absolute error, and root mean squared error were considered. Statistical analysis was performed using SPSS and Python for the machine learning modeling. Overall, 90 patients with complex chronic diseases were included: 50 during phase 1 (class A: n=10; class B: n=20; and class C: n=20) and 40 during phase 2 (class B: n=20 and class C: n=20). Most patients (n=85, 94%) had a caregiver. The mean value of the BI was 58.31 (SD 24.5). Concerning mobility aids, 60% (n=52) of patients required no aids, whereas the others required walkers (n=18, 20%), wheelchairs (n=15, 17%), canes (n=4, 7%), and crutches (n=1, 1%). Regarding clinical complexity, 85% (n=76) met patient with polypathology criteria with a mean of 2.7 (SD 1.25) categories, 69% (n=61) met the frailty criteria, and 21% (n=19) met the patients with complex chronic diseases criteria. The most characteristic symptoms were dyspnea (n=73, 82%), chronic pain (n=63, 70%), asthenia (n=62, 68%), and anxiety (n=41, 46%). Polypharmacy was presented in 87% (n=78) of patients. The most important variables for predicting the BI were identified as the maximum step count during evening and morning periods and the absence of a mobility device. The model exhibited consistency in the median prediction error with a median absolute error close to 5 in the training, validation, and production-like test sets. The model accuracy for identifying the BI class was 91%, 88%, and 90% in the training, validation, and test sets, respectively. Using commercially available mobility recording devices makes it possible to identify different mobility patterns and relate them to functional capacity in patients with polypathology according to the BI without using clinical parameters.

Prehabilitation in Adults Undergoing Cancer Surgery: A Comprehensive Review on Rationale, Methodology, and Measures of Effectiveness.

Cancer surgery places a significant burden on a patients' functional status and quality of life. In addition, cancer surgery is fraught with postoperative complications, themselves influenced by a patient's functional status. Prehabilitation is a unimodal or multimodal strategy that aims to increase a patient's functional capacity to reduce postoperative complications and improve postoperative recovery and quality of life. In most cases, it involves exercise, nutrition, and anxiety-reducing interventions. The impact of prehabilitation has been explored in several types of cancer surgery, most commonly colorectal and thoracic. Overall, the existing evidence suggests prehabilitation improves physiological outcomes (e.g., lean body mass, maximal oxygen consumption) as well as clinical outcomes (e.g., postoperative complications, quality of life). Notably, the benefit of prehabilitation is additional to that of enhanced recovery after surgery (ERAS) programs. While safe, prehabilitation programs require multidisciplinary coordination preoperatively. Despite the existence of numerous systematic reviews and meta-analyses, the certainty of evidence demonstrating the efficacy and safety of prehabilitation is low to moderate, principally due to significant methodological heterogeneity and small sample sizes. There is a need for more large-scale multicenter randomized controlled trials to draw strong clinical recommendations.

The Beneficial Impact of Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis: A Review of the Current Literature.

Idiopathic pulmonary fibrosis (IPF) is a chronic and irreversible fibrotic disease whose natural history is characterised by a progressive worsening of the pulmonary function, exertional dyspnoea, exercise intolerance, reduced physical activity, and health-related quality of life (HRQOL) impairment. Pulmonary rehabilitation (PR) is a comprehensive, multi-disciplinary programme that uses a combination of strength training, teaching, counselling, and behaviour modification techniques to reduce symptoms and optimise functional capacity in patients with chronic lung disease. Based on the well-documented effectiveness of PR in chronic obstructive pulmonary disease (COPD), over the years supportive evidence of its benefits for other respiratory diseases has been emerging. Although the latest rehabilitation guidelines recognised PR's efficacy for interstitial lung disease (ILD) and IPF in particular, this comprehensive approach remains underused and under-resourced. In this review, we will discuss the advantages and beneficial effects of PR on IPF, analysing its impact on exercise capacity, disease-related symptoms, cardiovascular outcomes, body composition, and HRQOL.

The impact of short-term multimodal prehabilitation on functional capacity in patients with gynecologic malignancies during the perioperative period: A prospective study

PurposeTo explore the effect of a short-term, hospital-based, multimodal preoperative prehabilitation intervention on perioperative functional ability of patients with gynecological malignant tumors. MethodsAccording to the order in which they underwent surgery, 97 patients were divided into the control group (48 cases) and the intervention group (49 cases). The control group was given routine preoperative guidance, whereas the intervention group was given short-term multimodal prehabilitation guidance on the basis of the control group intervention. The 6-min walk test was performed on the day of admission to the hospital, the day before surgery, and the 30th day after surgery. ResultsCompared with the control group, the intervention group had significantly better 6-min walk distance and superior physical and psychological status on the day before surgery and the 30th day after surgery (P < 0.001). For three consecutive days after surgery, the quality of recovery in the intervention group was significantly higher than that in the control group (P < 0.001), and the first ambulation time and exhaust time were achieved earlier in the intervention group than in the control group (P < 0.05). ConclusionThe preoperative intervention group showed improved preoperative exercise ability and reduced anxiety in patients with gynecological cancer. Furthermore, this intervention improved the overall health of patients and accelerated their postoperative recovery.

Impact of Slow Deep Breathing Exercises using Incentive Spirometry on Functional Capacity among Patients with Coronary Artery Disease

Introduction A condition known as coronary artery disease occurs when the myocardium does not receive enough blood or oxygen. It is caused by blockage of the coronary arteries and is characterized by an imbalance in the supply and demand of oxygen. Usually, it involves blood flow obstruction caused by plaques that form in the coronary artery lumen. It is the leading global cause of death. Methods Participants in this quasi-experimental research design included patients with coronary artery diseases. Patients with severe respiratory conditions, a history of coughing, difficulty breathing deeply, non-pulmonary status at first examination, and inability to complete the study were among the exclusion criteria. the participants in the study were 50 samples (25 research groups and 25 control groups), the research groups were given an incentive spirometer in addition to hands-on instruction on how to use it and collect accurate measurements. Patients were told to lie down or sit in order to breathe in and out through the tube 10 times. Patients were instructed to do this exercise three times every eight hours for a duration of three weeks. Findings: Three weeks following the intervention, a re-assessment of the functional capacity, revealed an improvement in factional capacity solely in the study groups relative to the pre-test. Conclusion Using an innovative spirometer, the study demonstrated the impact of various deep breaths on the functional capacity of patients with CAD. Nearly all patients demonstrated a significant short-term improvement in their functional capacity, and no significant side effects were found. Consequently, this methodology can be applied in subsequent research to examine long-term impacts for weeks or months. Because it is simple to use and the measurement is non-intrusive, this method is perfect for self-monitoring at home.

Impact of a Semi-Rigid Knee Orthotic Intervention on Pain, Physical Activity, and Functional Capacity in Patients with Medial Knee Osteoarthritis.

Background: The effectiveness of knee orthoses as part of conservative treatment for patients with medial knee osteoarthritis has not been fully explored. The purpose of this study was to evaluate the effects of a novel semi-rigid knee orthosis on pain, physical activity, and functional capacity. Methods: Pain levels, physical activity, and functional capacity were assessed in 24 participants experiencing symptomatic medial knee osteoarthritis one week before (i.e., pretest) initiating a six-week orthosis intervention and again during the final week of the intervention (i.e., post-test). Results: Night pain, pain during walking, pain during stair climbing, and pain during sitting consistently decreased by 41% to 48% while wearing the knee orthosis. Device-based measured physical activity showed a 20.2-min increase in vigorous physical activity during the post-test, while light and moderate physical activity did not show significant changes. After six weeks of orthosis application, there was a 5% increased distance for the six-minute walk test, and participants reported fewer limitations both in everyday and athletic activities, as well as an enhanced quality of life. Conclusions: These findings highlight the potential effectiveness of a semi-rigid knee orthosis to enhancing functional capacity and quality of life. More extensive and longer clinical trials are needed to improve confidence in these findings and understand their impact on disease progression.

Effect of six-week core strengthening exercises on inspiratory muscle strength and functional capacity in patients with chronic kidney disease undergoing haemodialysis

This study aims to evaluate the effect of core strengthening exercises on inspiratory muscle strength and functional capacity in patients with CKD undergoing Haemodialysis. The study included 10 patients with CKD undergoing hemodialysis according to the eligibility criteria. All patients performed core strengthening exercises for 6 weeks (2 times/week). The outcome measures are assessed before and after the intervention using inspiratory muscle strength and functional capacity. We found significant improvements in inspiratory muscle strength (p=0.150) and functional capacity (p=0.004) after the core strengthening exercises. At the end of the result, we concluded that the core strengthening exercise program improves the inspiratory muscle strength and functional capacity in patients with CKD undergoing Haemodialysis.

Feasibility of Introducing a Prehabilitation Program into the Care of Gynecological Oncology Patients-A Single Institution Experience.

Prehabilitation is an upcoming strategy to optimize patient's functional capacity, nutritional status, and psychosocial well-being in order to reduce surgical complications and enhance recovery. This study aims to assess the feasibility of implementing a multimodal prehabilitation program into the standard care of gynecological oncology patients at an academic hospital in terms of recruitment, adherence, and safety, which were assessed by the number of patients eligible, recruitment rate, participation rate, and adherence to individual modalities. Data were derived from the F4S PREHAB trial, a single-center stepped-wedge trial implementing a multimodal prehabilitation program among various surgical specialties. All patients undergoing elective surgery as part of treatment for ovarian, uterine, and vulvar cancer at the Radboudumc, an academic hospital in The Netherlands, between May 2022 and September 2023 were considered eligible for the F4S PREHAB trial and, consequently, were included in this cohort study. The multimodal prehabilitation program comprised a physical exercise intervention, nutritional intervention, psychological intervention, and an intoxication cessation program. A total of 152 patients were eligible and approached for participation of which 111 consented to participate, resulting in a recruitment rate of 73%. Participants attended an average of six exercise sessions and adhered to 85% of possible training sessions. Respectively, 93% and 98% of participants adhered to the prescribed daily protein and vitamin suppletion. Ten participants were referred to a psychologist and completed consultations. Out of nine active smokers, two managed to quit smoking. A total of 59% adhered to alcohol cessation advice. No adverse events were reported. This study demonstrates that introducing a multimodal prehabilitation program into the standard care of gynecological oncology patients is feasible in terms of recruitment and adherence, with no serious adverse events.

Regional Anaesthesia Techniques for Orthopaedic Surgery at Tertiary Care Teaching Hospital

Background: Regional anaesthesia has found its uses in many aspects of orthopaedic surgery including more recently, spine surgery. Neuraxial or regional anaesthesia are often the preferred techniques for surgical anaesthesia in patients with multiple comorbidities. For instance, osteoporosis-related complications such as hip fractures are common in the growing geriatric population. Orthopaedic surgery aims to recover functional capacity in patients but it carries a specific morbidity and mortality. Orthopaedic surgery conveys several challenges for the anaesthesiologist, including prevention of thromboembolic complications, reduction of peri- and postoperative bleeding and management of autologus blood transfusion and postoperative pain. Material and Methods: This is a prospective study was conducted in the Department of orthopaedic and Anaesthesia at Shadan Institute of Medical Sciences, Teaching Hospital and Research Center. Three hundred and ten consecutive cases posted for orthopaedic surgeries were taken up for study. Anaesthesia technique was decided based on the nature of surgery, willingness and medical status of the patient and experience of the anaesthesiologists. RA was planned whenever possible. In the morning of operation the RA technique was explained to the patients and intravenous (IV) access established. Preoperative medication was given using IV fentanyl and midazolam in titrated doses. Ketamine was used in children and appropriate block given using standard technique. Nerve stimulator was used wherever applicable Results: Age of the patients ranged from three months to 92 years. Maximum number of patients belonged to the age group of 21- 50 years (63.2%). As per the demographic data. In our study, Knee arthroscopy and repair was 28.38%, Femoral was 17.41%, Radius and ulna was 15.16% and least were Ankle and foot, Wrist and hand surgery was 1.93%. In our study Subarachnoid block was 40.96% followed by Combined spinalepidural 17.09%, General anaesthesia 12.90%. Conclusion: In a conclusion, the use of regional anesthesia techniques for postoperative outcomes in orthopedic surgeries has been investigated in lots of clinical studies and case reports. Most of the authors proposed that regional anesthesia in orthopedic patients may be associated with better postoperative pain control and a reduction in intraoperative blood loss when compared with general anesthesia. In the future regional anesthesia techniques will be more preferable anesthetic technique in orthopedic surgeries

Physiotherapy Interventions in Lung Cancer Patients: A Systematic Review.

Lung cancer is a very common disease and leads to a series of sequelae such as reduced lung capacity or reduced functional capacity in patients, which are associated not only with the disease itself, but also with medical treatment. Thus, physiotherapeutic interventions are needed to improve quality of life and reduce these symptoms. To find out the effects of physiotherapy on functional capacity, lung capacity, dyspnea, pain, and quality of life in lung cancer patients. A systematic review was carried out in five databases. Randomized clinical trials published between 2019-2023 were selected, in which the physiotherapeutic treatment was physical exercise and/or respiratory physiotherapy. Nine articles were included, in which the total sample consisted of 635 lung cancer patients. When combined, respiratory physiotherapy and physical exercise improved functional capacity and lung capacity (p < 0.05). Dyspnea also improved, but less significance was shown in the included studies. Multimodal physiotherapy interventions may offer benefits for some lung cancer patients, but the extent and nature of these benefits may vary depending on the intervention applied. Therefore, it would be of great interest to carry out further scientific research to support this conclusion.

Effectiveness of using H. Kitaoka (AOFAS) scale, FFI (Italian version), Roles and Maudsley score, VAS in patients with flatfoot

Assessment of the functional capacity of the foot requires adequate tools depending on a specific nosology. Objective: to investigate the possibility of using evaluation scale of H. Kitaoka (American Orthopaedic Foot and Ankle Society (AOFAS)), Foot Function Index (FFI) (Italian version), Roles and Maudsley score, visual analog scale (VAS) in patients with flatfoot. Materials and methods. Clinical and X-ray examinations of 63 patients (78 feet) who had flatfoot were performed. Their average age was 42.5 ± 2.0 (9–72) years. X-ray and clinical indicators were used: horizontal and vertical talo-metatarsal angles (TMA), angle of valgus deviation of the calcaneus, body mass index. The assessment of the functional state of the foot was carried out according to the H. Kitaoka (AOFAS) scale, FFI (Italian version), Roles and Maudsley score, VAS. The strength of the relationship between indicators was studied ­using Pearson’s pairwise correlations; a correlation regression analysis was performed on models where the indicators of rating scales were the dependent variables. Results. There was an inverse correlation between the foot function score (AOFAS) and the age and TMA, a direct correlation between the FFI and the age and body mass index, a direct dependence of functional insufficiency (Roles and Maudsley score) and pain level (VAS) on age. A sufficient degree of correlation (0.5–0.75) was found between the applied scales. Conclusions. Sufficient criterial and construct validity of the AOFAS scale, FFI (Italian version), Roles and Maudsley score, VAS was found when used in patients with flatfoot. The use of selected scales is an adequate tool for assessing functional capacity in patients with flatfoot.

High intensity interval training vs. moderate intensity continuous training on aerobic capacity and functional capacity in patients with heart failure: a systematic review and meta-analysis.

Exercise training is commonly employed as a efficacious supplementary treatment for individuals suffering from heart failure, but the optimal exercise regimen is still controversial. The objective of the review was to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the exercise capacity, cardiac function, quality of life (QoL) and heart rate among patients with heart failure with reduced ejection fraction. A systematic search was performed using the following eight databases from their inception to July 5, 2023: PubMed, Web of Science, Embase, Cochrane Library, Clinical Trials, China Knowledge Network, Wan fang Data, and the China Biology Medicine databases. The meta-analysis results were presented as mean difference (MD) and 95% confidence interval (CI). The Cochrane Risk of Bias tool was used for the included studies. The Grading of Recommendations Assessment, Development, and Evaluations was used to assess the certainty of evidence. Thirteen randomized controlled trials were included in the study. The results showed that HIIT had a significant positive effect on peak oxygen uptake (MD = 1.78, 95% CI for 0.80-2.76), left ventricular ejection fraction (MD = 3.13, 95% CI for 1.25-5.02), six-minute walk test (MD = 28.13, 95% CI for 14.56-41.70), and Minnesota Living with Heart Failure Questionnaire (MD = -4.45, 95% CI for -6.25 to -2.64) compared to MICT. However, there were no statistically significant differences observed in resting heart rate and peak heart rate. HIIT significantly improves peak oxygen uptake, left ventricular ejection fraction, six-minute walk test, and Minnesota Living with Heart Failure Questionnaire in patients with heart failure with reduced ejection fraction. Additionally, HIIT exhibits greater effectiveness in improving peak oxygen uptake among patients with lower body mass index. https://www.doi.org/10.37766/inplasy2023.7.0100, identifier (INPLASY2023.7.0100).

Determinants and reference values of the 6-min walk distance in the general population-results of the population-based STAAB cohort study.

The 6-min walk test is an inexpensive, safe, and easy tool to assess functional capacity in patients with cardiopulmonary diseases including heart failure (HF). There is a lack of reference values, which are a prerequisite for the interpretation of test results in patients. Furthermore, determinants independent of the respective disease need to be considered when interpreting the 6-min walk distance (6MWD). The prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigates a representative sample of residents of the City of Würzburg, Germany, aged 30 to 79years, without a history of HF. Participants underwent detailed clinical and echocardiographic phenotyping as well as a standardized assessment of the 6MWD using a 15-m hallway. In a sample of 2762 participants (51% women, mean age 58 ± 11years), we identified age and height, but not sex, as determinants of the 6MWD. While a worse metabolic profile showed a negative association with the 6MWD, a better systolic and diastolic function showed a positive association with 6MWD. From a subgroup of 681 individuals without any cardiovascular risk factors (60% women, mean age 52 ± 10years), we computed age- and height-specific reference percentiles. In a representative sample of the general population free from HF, we identified determinants of the 6MWD implying objective physical fitness associated with metabolic health as well as with cardiac structure and function. Furthermore, we derived reference percentiles applicable when using a 15-m hallway.

Impact of inspiratory muscle training on respiratory muscle function and functional capacity in patients with heart failure: a scoping review

Impact of inspiratory muscle training on respiratory muscle function and functional capacity in patients with heart failure: a scoping review