Functional Capacity Variables Research Articles

Cognitive Function & Functional Capacity In Institutionalized Elderly

PURPOSE: Comparison of functional capacity according to cognitive status in institutionalized elderly. METHODS: Cross-sectional study, with a convenience sample of 152 elderly people of both sexes from 6 long-stay institutions for philanthropic elderly people in São Caetano do Sul. Cognitive function was measured by the Mini Mental State Examination (MMSE). Functional capacity was assessed by the CELAFISCS Functional Capacity Assessment Scale, consisting of the measurement of leg circumference (centimeters), elbow flexion test (repetitions), walking speed test (seconds), and stationary gait test (repetitions) with a total score of up to 16 points. The ANCOVA test adjusted for sex and age was applied, adopting a significance level of p < 0.05 using the SPSS 25.0 statistical program. RESULTS: Significant differences were found in the group with cognitive impairment according to the functional when adjusted for age and sex in the following variables: elbow flexion, maximum walking speed and 2-minute stationary gait. CONCLUSION: The institutionalized elderly with cognitive deficit presented a lower functional capacity. Functional capacity variables according to the presence of cognitive deficit in institutionalized elderly

Frailty syndrome among older adults after hospitalization: A structural equation modeling analysis

AimTo analyze the association of demographic, clinical, health and functional capacity variables as predictors of frailty in older adults after one year of hospital discharge. BackgroundThere is still insufficient research with older persons after hospital discharge that evaluated the predictive variables for an increase in the frailty score. Identifying the characteristics that result in greater risk helps to guide care and interventions. MethodsLongitudinal study involving 129 older adults who completed the follow-up. The Frailty Phenotype was used according to Fried and sociodemographic, clinical, health and functional capacity variables. Analysis was performed using structural equation modeling. ResultsAt admission, the highest percentage (53.4%) of older adults were pre-frail, followed by frail (23.3%) and non-frail (23.3%). After a year of discharge, there was a decrease in the frail condition (22.5%) and pre-frail (52.7%); and an increase in non-frail (24.8%). At baseline, 29.5% showed impairment in only one component, with an increase in the percentage at follow-up (37.2%). The highest number of morbidities and hospital readmissions and lower IADL scores were predictors of an increase in the frailty score during follow-up. ConclusionThe prevalence of frailty was high among hospitalized older adults and after follow-up. Identifying the risk factors allows early and individualized interventions with reduction of negative outcomes. During hospitalization, a multidimensional assessment of older adults should be performed, especially with regard to frailty. The recognition of frailty predictors directs the care of older persons considering their individual needs and allows the improvement and/or stability of the frailty condition.

Three workouts compared: interval training, intermittent training and steady state training for the improvement of VO2max and BMI

An optimal soccer training, among many objectives, should allow both the improvement of VO2max, or the maximum oxygen supply, and of the anthropometric data. The purpose of the study was to examine the effects of intermittent training, interval training and steady state training methodologies on VO2max and BMI of the players. The sample was made up of 30 young amateur players (age, Mean ± standard deviation [SD] = 16 ± 0.74 years old) randomly divided into three 3 groups of 10. Each group performed a different resistance training methodology for 3 months: group 1 performed intermittent training, group 2 interval training and group 3 steady state training. The parameters taken into consideration were BMI and VO2max, obtained from Gacon test. Paired Sample T Test was performed to check the difference between pre and post 12 training weeks of each group regarding VO2max and BMI. A 3x2 mixed ANOVA was used to test for differences in training programs induced changes in maximal strength and functional capacity variables. The independent variables included one between-subjects factor (training intervention) with three levels (IT, HIIT, and SST), and one within-subject factor (time) with two levels (pre- and post-intervention). A significant difference (p0.05) between pre and post all of the three training protocols on VO2max was found, but no significant interaction (p&gt;0.05) between group and time. BMI had no significant improvement (p&gt;0.05). Intermittent, interval and endurance training all were equally effective improving VO2max, but not BMI.

Short-term community-based exercise programs in low-income older women: Does exercise intensity and modality matters?

Our aim was to evaluate the effect of community-based exercise program (CBEP) intensity and modality on anthropometric, hemodynamic, and functional capacity parameters in low-income older women. Forty insufficiently active older women (68.2±7.9years) were randomly assigned to perform 12weeks of twice-weekly high-intensity interval training combined with resistance training (HIIT+RT/n=12), moderate-intensity continuous training combined with resistance training (MICT+RT/n=13), or resistance training alone (RT/n=15). Anthropometric (body mass index and waist circumference), hemodynamic (blood pressure and heart rate), and functional capacity variables (flexibility, upper and lower limb muscle strength, and mobility) were assessed before and after training programs. Waist circumference reduced similarly after all CBEP (~3 to ~4cm; P<0.05). Tendency toward reduction in diastolic blood pressure (~4mmHg; P=0.073), and improvements in flexibility (14.5%, P=0.011) and handgrip strength (15.8%; P=0.02) were found only in HIIT+RT. Indeed, only RT was effective to improve five-time sit to stand (14.1%; P=0.013). No significant difference between groups was found during follow-up in any variable. The results of present study suggest that low-income older women may improve anthropometric, hemodynamic and functional capacity variables by participating in twice-weekly short-term (i.e.: 12weeks) CBEP. However, the CBEP-effects on hemodynamic and functional capacity appears to be affected by exercise intensity (only HIIT+RT tended toward improving diastolic BP) and modality (only RT improved significantly five-time sit to stand), respectively.

Autistic Symptoms and Social Cognition Predict Real-World Outcomes in Patients With Schizophrenia.

ObjectiveReal-world functioning is a complex construct influenced by different factors. The impact of social cognition and autism spectrum disorder (ASD) symptoms on different aspects of the life of people with schizophrenia has been demonstrated independently, but it is unclear how these factors are related to functioning when considered concurrently. We hypothesized that ASD symptoms could play a major role in predicting real-world functioning in schizophrenia.MethodsExistent databases from two studies (SCOPE Phase 3 and SCOPE Phase 5), in which a total of 361 patients (mean age 41.7 years; 117 females) were assessed with measures of symptom severity, neuro- and socio-cognitive abilities, functional capacity, social skills, and informant-reported real-world functioning outcomes, were analyzed.ResultsActive social avoidance, social skills, ASD symptoms, and emotion processing emerged as predictors of real-world interpersonal relationships. Cognitive performance, positive symptoms, and functional capacity emerged as predictors of real-world participation in daily activities. Cognitive performance, emotion processing, positive symptoms severity, and social skills emerged as predictors of real-world work outcomes.ConclusionAmong other demographic, clinical, and functional capacity variables, increased ASD symptoms emerged as a significant predictor of poorer social relationships and may therefore represent a key factor in predicting real-world social functioning in schizophrenia.

Effect of water exercise in blood pressure and sleep quality of hypertensive adults

Together with ageing there is an increase in blood pressure levels. However, physical activity is one of the most recommended strategies for preventing the increase of blood pressure. Water exercise involves numerous advantages, one of which is the comfort proportioned by water temperature. The aim of this study was to evaluate the effects of a water exercise program on blood pressure, physical fitness, quality of sleep and the likelihood of having sleep apnea (SA) in hypertensive adults. We evaluated 21 sedentary hypertensive subjects of both sexes. The water exercise was conducted over 13 weeks, three times/week, 50 min/day. Resting blood pressure, height, body weight, waist and hip circumference, functional capability, as well as sleep quality and the likelihood of having sleep apnea were evaluated before and after the experimental period. There was a significant decrease in systolic and mean blood pressure. Significant increases in strength, muscular and aerobic endurance, coordination, agility, dynamic balance and flexibility were also seen. In addition, a reduction in the likelihood of sleep apnea was identified, despite a deterioration in sleep quality. Water exercise was effective in reducing systolic blood pressure, in improving functional capacity variables, and in reducing probability of sleep apnea in hypertensive subjects, however it promoted worsening of sleep quality.

Effects of Water-Based Aerobic Interval Training in Patients With COPD: A RANDOMIZED CONTROLLED TRIAL.

Chronic obstructive pulmonary disease promotes systemic repercussions, which can be minimized with physical exercise. This study investigated the effects of a water-based aerobic interval training program on the autonomic modulation of heart rate (HR), quality of life (QoL), and functional capacity (FC) of patients with chronic obstructive pulmonary disease. Nineteen patients with chronic obstructive pulmonary disease were enrolled in this randomized clinical trial and allocated to either the usual care group (n = 9) or training group (n = 10). Before and after 24 sessions of water-based physical training, the patients underwent evaluation of autonomic modulation of HR by analyzing the HR variability, QoL using the St George's Respiratory Questionnaire, and FC using 6-min walk test distance. The results showed significant improvement when comparing the variables of HR variability, QoL, and FC in the training group in the pre- and post-training conditions (P < .05). In the usual care group, there was no significant difference for any of the variables. Negative correlations were found between HR variability and QoL (r =-0. 55; P = .01) and 6-min walk test distance and QoL (r =-0.49; P = .02). Water-based physical training promoted beneficial adaptations in the autonomic modulation of HR, QoL, and FC of patients with chronic obstructive pulmonary disease.

The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review.

The purpose of this systematic review was to investigate the effect of adding the cognitive behavioral treatment (CBT) component to routine physical therapy (PT) on pain and depression reduction, improvement in quality of life, and enhanced function in patients with chronic low back pain (CLBP). TYPE: Systematic review. Google Scholar, PubMed, Ovid, ScienceDirect, ProQuest, Scopus, Cochrane Library, and Embase electronic databases were explored for the key terms of "behavioral (or behavioural) treatment" OR "behavior (behaviour) treatment" OR "behavior (behaviour) therapy" OR "cognitive behavior (or behaviour) treatment" OR "cognitive treatment" OR "cognitive therapy" OR "operant behavior (or behaviour) treatment" OR "respondent behavior (or behaviour) treatment" AND "physical therapy" OR "physiotherapy" OR "exercise therapy" OR "electrotherapy" OR "electrical therapy" OR "manual therapy" OR "myofascial therapy" OR "rehabilitation" AND "low back pain" OR "lower back pain" OR "back pain" OR "chronic back pain" OR "chronic lower back pain", with no limitation on language, through January 2018. All randomized controlled trials that statistically compared the effectiveness of CBT + PT and PT were included for quality analysis. Studies were rated by high to poor quality, using Hailey's classification, based on their design and performance. Of the 10 included studies, 7 were rated as high quality and 3 as good quality. Although CBT + PT was found to be superior to PT for pain, disability, quality of life, and functional capacity variables in some of the included studies, no extra benefit from CBT was documented in other investigations. The included studies also failed to show any advantage of CBT + PT over PT in reducing depression, and PT was even found to be superior to CBT + PT in one high-quality study. Although appearing to be advantageous by reducing pain and disability and enhancing functional capacity and quality of life, CBT effects on depression cannot be teased out from the effects of PT. I.

Clinical evaluation of functional capacity in treatment resistant schizophrenia patients: Comparison and differences with non-resistant schizophrenia patients

Treatment resistant schizophrenia (TRS) is defined by poor or non-response to conventional antipsychotic agents. Functional capacity is defined as the baseline potential of a patient to function in the community, irrespective of actual achievements gained, and has never been studied in TRS. Here, we screened 182 patients with psychotic symptoms and separated them in TRS (n = 28) and non-TRS (n = 32) ones, to evaluate whether they exhibited differential extents and predictive clinical variables of functional capacity. Functional capacity was measured by the UCSD Performance-Based Skills Assessment (UPSA). Psychotic symptoms by PANSS, social functioning by PSP and SLOF, clinical severity of the illness, cognitive functioning, and neurological soft signs (NSS) were assessed. TRS patients had non-significant lower UPSA scores compared to non-TRS (t-test: p > 0.05). In TRS, UPSA score correlated with multiple clinical variables. The highest effect sizes were observed for PANSS negative score (r = −0.67, p < 0.005); SLOF Area1 score (r = 0.66, p < 0.005); NSS severity (r = −0.61, p < 0.005). Multivariate analysis showed that main predictors of UPSA score in TRS patients were PANSS negative score, education years, NSS, Problem Solving performances, and PSP score (F = 11.12, R2 = 0.75, p < 0.0005). These variables were not predictive of UPSA score in non-TRS patients. Hierarchical analysis found that variance in UPSA score mainly depended on negative symptoms, NSS, and problem solving (F = 15.21, R2 = 0.65, p < 0.0005). Path analysis individuated two separate paths to UPSA score. These results delineate a limited and independent group of candidate predictors to be putatively accounted for therapeutic interventions to improve functional capacity, and possibly social functioning, in TRS patients.

Effects of an exercise program on the physiological, biological and psychological profiles in patients with mood disorders: a pilot study

Objective: The objective of this study is to assess the impact of an 8-week physical training program on physiological, biological and psychological profiles in individual with mood disorders.Methods: Seven patients participated in the study. Patients were trained twice weekly (75 min/session) for 8 weeks. The training program aimed to improve muscular and cardiorespiratory reserves as well as functional capacity. Bioassays were also measured (lipid profile, blood glucose and cortisol). Depression, sleep quality and body image dissatisfaction were assessed. All measures were administrated at pre/post-intervention.Results: At post-intervention, 13 of the 15 physiological fitness, muscular strength and functional capacity variables improved significantly (p < .05). In addition, change in cortisol levels represented a medium to large effect size (Cohen’s d = −0.67) which indicates a clinical reduction of stress-related symptoms. Depression was significantly improved (Cohen’s d = −0.47; p = .027). Sleep and body image showed a trend-level improvement.Conclusions: An 8-week periodised training program improved physiological, biological and psychological profiles in patients with mood disorders.

Functional capacity in a rat model of heart failure: impact of myocardial infarct size

What is the central question of this study? To the best of our knowledge, no studies have evaluated oxygen uptake, carbon dioxide production and exercise tolerance in rats that have undergone myocardial infarction classified by myocardial infarct (MI) size. What is the main finding and its importance? Oxygen uptake and exercise intolerance are MI size dependent, and classification based on MI size can distinguish rats with functional capacity impairment. Rats with a large MI (>40% of the left ventricle) might provide a good model for the testing of new therapies that have the potential to modify the variables of functional capacity. Oxygen uptake (V̇O2) and exercise tolerance in rats classified by myocardial infarct (MI) size are underexplored. The aim of this study was to evaluate V̇O2, carbon dioxide production (V̇CO2) and exercise tolerance in rats that had undergone myocardial infarction. Fourteen weeks after myocardial infarction or sham surgery, rats underwent an integrated approach to evaluation of left ventricular function and V̇O2/V̇O2V̇CO2V̇CO2, exercise tolerance and skeletal muscle weight. Based on determination of MI size, rats were assigned to sham-operated controls (Sham, n=12), small myocardial infarction (SMI, n=8) and large myocardial infarction (LMI, n=5) groups. The LMI rats showed lower systolic (ejection fraction and fractional shortening) and diastolic (E/A ratio) left ventricular function compared with SMI. Maximal V̇O2 (∼24%, P<0.05), V̇O2 reserve (∼30%, P<0.05), time to exhaustion (∼36%, P<0.05) and maximal velocity (∼30%, P<0.05) were lower in LMI compared with sham-operated control animals, with no difference between SMI rats and sham-operated controls. Maximal V̇CO2 and respiratory exchange ratio showed no significant difference between MI rats and sham-operated control rats. The LMI rats demonstrated lower gastrocnemius weight (∼12%, P<0.05) and soleus weight (∼19%, P=0.07) compared with sham-operated control rats. Significant correlations between MI size, left ventricular end-diastolic pressure, right ventricle hypertrophy, pulmonary congestion, ejection fraction and fractional shortening with maximal V̇O2 and distance run were observed. Oxygen uptake and exercise intolerance are MI size dependent.

Association Between 6-Minute Walk Test Distance and Objective Variables of Functional Capacity After Exercise Training in Elderly Heart Failure Patients With Preserved Ejection Fraction: A Randomized Exercise Trial

ObjectiveTo evaluate the change in the 6-minute walk test (6-MWT) distance relative to changes in key functional capacity measures after 16 weeks of exercise training in older patients (≥65y) who have heart failure with preserved ejection fraction (HFpEF). DesignProspective, randomized, single-blinded (by researchers to patient group) comparison of 2 groups of HFpEF patients. SettingHospital and clinic records; ambulatory outpatients. ParticipantsParticipants (N=47) randomly assigned to an attention control (AC) (n=24) or exercise training (ET) (n=23) group. InterventionThe ET group performed cycling and walking at 50% to 70% of peak oxygen uptake (V˙o2peak) intensity (3d/wk, 60min each session). Main Outcome MeasuresV˙o2peak, ventilatory threshold (VT), and 6-MWT distance were measured at baseline and after the 16-week study period. ResultsAt follow-up, the 6-MWT distance was higher than at the baseline in both the ET (11%, P=.005) and AC (9%, P=.004) groups. In contrast, V˙o2peak and VT values increased in the ET group (19% and 11%, respectively; P=.001), but decreased in the AC group at follow-up (2% and 0%, respectively). The change in V˙o2peak versus 6-MWT distance after training was also not significantly correlated in the AC group (r=.01, P=.95) or in the ET group (r=.13, P=.57). The change in 6-MWT distance and VT (an objective submaximal exercise measure) was also not significantly correlated in the AC group (r=.08, P=.74) or in the ET group (r=.16, P=.50). ConclusionsThe results of this study challenge the validity of using the 6-MWT as a serial measure of exercise tolerance in elderly HFpEF patients and suggest that submaximal and peak exercise should be determined objectively by VT and V˙o2peak in this patient population.

Abstract 18801: Light-intensity Physical Activity After Discharge Predicts 6-month Postdischarge Adverse Events in Older Japanese Patients With Heart Failure

Introduction: Moderate physical activity (PA) is recommended in patients with heart failure (HF). However, patient’ characteristics in those with low PA and the impact of light-intensity PA on postdischarge major adverse cardiovascular events (MACE) remain unclear in older Japanese HF patients. Methods: Thirty seven patients (Stage C/D: 76±5 yrs, 21m) who had been admitted due to HF and 23 Stage A/B patients (73±5 yrs) with risk factors were enrolled. PA was measured using the Omuron HJ350IT accelerometer from the day of discharge for 7 days. Light-intensity PA at an intensity of 1.5-3.0 metabolic equivalents (METs), moderate-intensity PA (≥3METs), and total PA were determined. At discharge, knee-extensor muscle strength, 6-min walking distance (6MWD),SF-36 score, and left ventricular (LV) structure by echocardiography were evaluated. Stage C/D patients were stratified into High-PA and Low-PA according to the median total PA value of 8.4 METs·hour/day. Stage A/B patients underwent these measurements, and values were compared. Factors related to the 6-month postdischarge MACE were assessed. Results: Stage C/D patients were anemic, took fewer steps per day, and had higher brain natriuretic peptide (BNP) than Stage A/B patients. Patients in Low-PA were less likely to engage in household work, and had shorter active time, fewer steps per day, and lower light- and moderate-intensity PA than those in High-PA. No differences were observed in 6MWD (263±110 vs. 303±77 m), knee-extensor muscle strength, BNP (405±346 vs. 267±179 pg/ml), SF-36 physical composite score, or LV ejection fraction between Low-PA and High-PA. Light-intensity and total PA, but not moderate-intensity PA, were associated with the 6-month postdischarge MACE through univariate analyses. Multivariate regression analysis showed that total PA was the independent predictor of the 6-month postdischarge MACE (odds ratio: 0.66) among functional capacity variables including 6MWD and knee-extensor muscle strength. Conclusions: Physical activity, especially at light-intensity, is inversely associated with the 6-month postdischarge MACE in older HF patients. Our results may indicate that postdischarge PA assessed by accelerometer is useful to distinguish those at high risks for MACE.

Capacidade funcional e sua associação com idade e sexo em uma população idosa

The objective this study was to check the association of functional capacity with age and sex in an elderly population. This study is a cross-sectional household survey conducted with elderly people of both sexes enrolled in the Family Healthcare Strategy of Campina Grande, Brazil, from August 2009 to July 2010. Variables were checked for functional capacity (handgrip strength [HS], flexibility/mobility, and balance) and demographic (sex and age). The association of functional capacity with sex and age group was verified by bivariate analysis using Pearson´s chi-squared test (χ2), with the significance set at p <0.05. Were evaluated 420 elderly (68.1% women), whose ages ranged from 60 to 104 years. In the HS test, a higher proportion of both women (45.6%) and men (47.8%)showed regular scores. In the flexibility/mobility test, 63.0% of women and 57.4% of men had a regular score. Balance tests showed a similar percentage in all scores, in both sexes. In the bivariate analysis between indicative variables of functional ability and sex, only flexibility / mobility showed significant association (p<0.05). In the association between markers of functional capacity and age, balance showed a significant association with age in both sexes (p <0.01), and flexibility only in females (p<0.05). The elderly in this study showed satisfactory performance for the variables of functional capacity. There was a significant association of sex only with flexibility. The age group showed significant influence on balance, in both sexes, and on flexibility in women.

Functional and psychological variables both affect daily physical activity in COPD: A structural equations model

Daily physical activity (DPA) level is reduced in patients with COPD. The aim of this study was to investigate the association of DPA with functional and psychological variables in these patients. 155 COPD patients (102 males, median (IQR) age 62 years (54-69 years), predicted FEV1 60% (40-75%) were included. We assessed DPA (DigiWalker SW-200), functional capacity and psychological factors. DPA level was significantly associated with all functional capacity variables and two psychological variables (Perceived Physical Ability Subscale, depression subscale of the Hospital Anxiety and Depression Scale). The six-minute walking distance and St. George Respiratory Questionnaire activity score explained 37% of the variance of DPA in a regression analysis. A structural equations model revealed that psychological variables indirectly explained DPA through functional capacity variables. DPA was stronger associated with functional capacity variables and weaker with psychological variables in patients with lower functional status than in patients with higher functional status. Higher levels of DPA are associated with better functional capacity, but interestingly, DPA is also affected by psychological factors, though only indirectly, via functional capacity. The effect of specific treatment addressing psychological factors on DPA level and exercise tolerance needs further investigation. ClinicalTrials.gov, NCT00614796.

Influencia de la capacidad funcional sobre el perfil lipídico, daño muscular y perfil bioquímico en personas mayores no institucionalizadas

ObjectiveTo analyze the influence of functional capacity on the biochemical profile and muscle damage and to test the level of relationship between these variables among community-dwelling elderly people. MethodA cross-sectional, observational study with 43 participants (19 males and 24 women) was performed. Functional capacity (including 6MWT, TUG test, CST test and Hand grip strength test), and biochemical profile (including total cholesterol, HDL, LDL, triglycerides, glucose, GOT, GPT, creatine and CK) were assessed. Differences on biochemical profile-related variables regarding the functional capacity level were analyzed. The level of relationship between the variables comprising these two domains was also assessed. ResultsThose participants with a better results in functional capacity variables also achieved the better results in regard of the biochemical parameters measured (p < 0,05). These differences were also maintained after a gender-based analysis. Moreover, relationships between muscle damage and functional capacity variables were also achieved. ConclusionThis study shows the influence of the functional capacity on the biochemical parameters (mostly associated to cardiovascular and metabolic diseases) along with the influence that such variables have on the muscle damage and suggest the needed on the implementation of both aerobic and strength training for elderly.

The influence of demographic factors on functional capacity and everyday functional outcomes in schizophrenia

Patients with schizophrenia have impaired everyday living and social outcomes. Performance-based measures, including neuropsychological (NP) performance and functional capacity (FC) measures have demonstrated usefulness in predicting these outcomes. We examined the correlation of demographic factors (race, age, and education) and FC measures, and the relative ability of NP performance, FC, and demographic factors to predict real-world outcomes in social, vocational, and residential domains in 194 outpatients with schizophrenia. Age, education, sex, and racial status were significantly, but modestly, associated with performance-based measures of everyday functioning, while, in addition, age and education had a similar modest relationship with social competence. Age, but none of the other demographic variables, contributed to the prediction of all three domains of everyday functioning. Functional capacity variables predicted everyday outcomes even when demographic variables were entered into a predictive equation first. These data suggest a similar and modest but detectable effect of demographic factors on performance-based measures of functional capacity as seen with NP performance in schizophrenia populations. Older age contributed to poorer everyday functioning even after consideration of functional capacity, which seems similar to findings in healthy populations without clinically notable cognitive decline.

The Effects of an Outdoor Recreational Exercise Program on Selected Physical Abilities Among Elderly

This study evaluated the effects of a 12 week outdoor recreational exercise program on the functional capacity of 45 sedentary elderly people, aged 60 to 75 years. The functional capacity variables were comprised of dynamic balance, muscular endurance, sit and reach flexibility, and muscular coordination. Participants were allocated to one exercise group (n= 30) and one control group (n=15). Exercise was performed for one hour twice a week for the experimental group, whereas the control group did not participate in any kind of exercise. Participants were pre and post-tested for the selected variables. Significant differences (p<. 05) were found between the exercise and nonexercise groups. The main effects of the training program were significant for all four variables examined, indicating that subjects who participated in the exercise program had a significant higher level of physical abilities than the control group. Findings are discussed in terms of design and measurement improvements and the need to focus research efforts on multiple components of wellbeing in relation to fitness level in the elderly.

Validation of the Spanish Version of the Minnesota Living With Heart Failure Questionnaire

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is the most commonly used instrument for evaluating quality of life in patients with heart failure. It comprises 21 items and two dimensions: the physical and the emotional. The aim of this study was to assess the psychometric properties of the Spanish version of the MLHFQ. The MLHFQ and the 36-item short form (SF-36) questionnaire were administered one and two months after discharge to 677 patients who had been hospitalized for heart failure. Patients were classified as either stable (n=245) or unstable (n=103) on the basis of New York Heart Association (NYHA) functional class and three other functional capacity variables. Reliability was evaluated using measures of internal consistency (Cronbach's alpha) and reproducibility (the intraclass correlation coefficient [ICC]). Validity was assessed by looking at the scores by NYHA class, and at correlations between scores on MLHFQ and SF-36 dimensions. Responsiveness to change was evaluated using the effect size. Cronbach's alpha was > OR =0.8 for the three MLHFQ scores, and the ICC was also large (0.74-0.83). In addition, MLHFQ scores varied significantly with functional class (P< .001), and there were intermediate-to-high correlations with the assumed corresponding SF-36 dimensions (0.74-0.52). The observed effect sizes were small or intermediate (0.09-0.44). The Spanish version of the MLHFQ demonstrated adequate metric properties, comparable to the original. These results support the use of the MLHFQ in Spanish heart failure patients, although it would be advisable to re-evaluate its responsiveness to change.

Subjective and objective quality of life in schizophrenia

Objective Quality of life (QOL) is considered an important outcome in the treatment of schizophrenia, but the determinants of QOL are poorly understood in this population. Furthermore, previous studies have relied on combined measures of subjective QOL (usually defined as life satisfaction) and objective QOL (usually defined as participation in activities and relationships). We examined separately the clinical, functional, and cognitive predictors of subjective and objective QOL in outpatients with schizophrenia. We hypothesized that better subjective QOL would be associated with less severe negative and depressive symptoms, better objective QOL, and greater everyday functioning capacity, and that better objective QOL would be associated with less severe negative and depressive symptoms, better cognitive performance, and greater functional capacity. Method Participants included 88 outpatients with schizophrenia or schizoaffective disorder who completed a comprehensive series of assessments, including measures of positive, negative, and depressive symptoms; performance-based functional skills; a neuropsychological battery; and an interview measure of subjective and objective QOL. Results In the context of multiple predictor variables, more severe depressive symptoms and better neuropsychological functioning were independent predictors of worse subjective QOL. More severe negative symptoms predicted worse objective QOL. Functional capacity variables were not associated with subjective or objective QOL. Conclusion Treatments to improve QOL in schizophrenia should focus on negative symptoms and depressive symptoms.