Functional Capacity Research Articles

USING ACTIVE AND PASSIVE BREAKS DURING HANDBALL GAMES ACCORDING TO SPECIALISTS

In most team sports games, only a few of the players enter the starting line of the match, and the others are bound by regulation to sit on the bench and remain inactive. The first objective of our research was to obtain an informed opinion from the coaches in Romania regarding the role of passive and active breaks in the possible evolution of reserve players in the match. In addition, we wanted to know whether specialists use programs to preserve the optimal capacity for effort during sports activities. As a research tool, we used the opinion questionnaire with 24 respondents. We analysed the data for normality and then expressed it by mean, minimum and maximum values. We appreciated the degree of correlation (rho) between the studied parameters by calculating the Spearman correlation coefficient. A value of the coefficient of statistical significance p <0,05 was considered significant. At the same time, we determined the internal consistency of the research tools by using the Alfa Cronbach coefficient for the Likert scale applied to our questionnaire. We have analysed the relationship between the „effects of passive” breaks and „opportunity of using active” breaks to see if coaches' opinion on the effects of passive breaks is correlated with their appreciation of the appropriateness of using active breaks. The conclusion of our study is that we cannot appreciate that the opinion of Romanian coaches on the effects of passive breaks on the players on the sidelines is consistent with the actual use of some pause programs active, focused on maintaining the optimal functioning capacity of the body of the player.

Cardiopulmonary exercise testing in transthyretin amyloid cardiomyopathy patients: a long-term follow-up study.

Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) experience reduced functional capacity. We evaluated changes in functional capacity over extensive follow-up using cardiopulmonary exercise testing (CPX). ATTR-CM patients underwent CPX and blood testing at baseline, first [V1, 8 (6-10) months] and second follow-up (V2) at 35 (26-41) months after start of disease-specific therapy. We included 34 ATTR-CM patients, aged 77 (±6) years (88.2% men). CPX showed two patterns with functional capacity improvement at V1 and deterioration at V2. Peak work capacity ( P = 0.005) and peak oxygen consumption (VO 2 , P = 0.012) increased at V1 compared with baseline and decreased at V2. The ventilation to carbon dioxide relationship slope (VE/VCO 2 ) increased at V2 compared with baseline and V1 ( P = 0.044). A cut-off for peak VO 2 at 14 ml/kg·min showed more events (composite of death and heart failure hospitalization): less than 14 vs. greater than 14 ml/kg·min ( P = 0.013). Cut-offs for VE/VCO 2 slope at 40 showed more events greater than 40 vs. less than 40 ( P = 0.009). ATTR-CM patients showed an improvement and deterioration in the short-term and long-term follow-up, respectively, with a better prognosis for those with peak VO 2 above 14 ml/kg·min and for a VE/VCO 2 slope below 40.

Supercooled preservation of cultured primary rat hepatocyte monolayers.

Supercooled preservation (SCP) is a technology that involves cooling a substance below its freezing point without initiating ice crystal formation. It is a promising alternative to prolong the preservation time of cells, tissues, engineered tissue products, and organs compared to the current practices of hypothermic storage. Two-dimensional (2D) engineered tissues are extensively used in in vitro research for drug screening and development and investigation of disease progression. Despite their widespread application, there is a lack of research on the SCP of 2D-engineered tissues. In this study, we presented the effects of SCP at -2 and -6°C on primary rat hepatocyte (PRH) monolayers for the first time and compared cell viability and functionality with cold storage (CS, + 4°C). We preserved PRH monolayers in two different commercially available solutions: Hypothermosol-FRS (HTS-FRS) and the University of Wisconsin (UW) with and without supplements (i.e., polyethylene glycol (PEG) and 3-O-Methyl-Α-D-Glucopyranose (3-OMG)). Our findings revealed that UW with and without supplements were inadequate for the short-term preservation of PRH monolayers for both SCP and CS with high viability, functionality, and monolayer integrity. The combination of supplements (PEG and 3-OMG) in the HTS-FRS solution outperformed the other groups and yielded the highest viability and functional capacity. Notably, PRH monolayers exhibited superior viability and functionality when stored at -2°C through SCP for up to 3days compared to CS. Overall, our results demonstrated that SCP is a feasible approach to improving the short-term preservation of PRH monolayers and enables readily available 2D-engineered tissues to advance in vitro research. Furthermore, our findings provide insights into preservation outcomes across various biological levels, from cells to tissues and organs, contributing to the advancement of bioengineering and biotechnology.

Generation and Characterization of Ex Vivo Expanded Tumor-infiltrating Lymphocytes From Renal Cell Carcinoma Tumors for Adoptive Cell Therapy.

Autologous therapeutic tumor-infiltrating lymphocyte (TIL) therapy is a promising strategy to enhance antitumor immunity. Optimization of ex vivo TIL expansion could expand current immunotherapy options. Previous attempts to generate TIL in renal cell carcinoma (RCC) have been technically challenging. We applied a second-generation manufacturing process, currently used to generate the melanoma TIL product lifileucel, in RCC. Resected primary and metastatic RCC samples were processed using the Gen 2 manufacturing process comprising of pre-Rapid Expansion Protocol (pre-REP) and REP steps. We assessed REP TILs for viability and performed phenotypic and functional characterization. We correlated the tumor immune microenvironment (TIME) with successful TIL expansion. Eight of 11 RCC samples underwent successful REP. Three failed cases demonstrated low CD8/FoxP3 ratio and high expression of PD-1 within FoxP3 cells. Expression of exhaustion markers differed between the TIME and expanded TILs; the latter had a TIM3-high/PD-1-low phenotype but retained functional capacity comparable to lifileucel. The Gen 2 manufacturing process used for lifileucel successfully expanded functional TILs from RCC samples, enabling further study in a clinical trial. TIME features such as low CD8/FoxP3 ratio and high PD-1 expression within FoxP3 cells warrant study as potential biomarkers of successful TIL expansion.

Functional parcellation of the cingulate gyrus by electrical cortical stimulation: a synthetic literature review and future directions

BackgroundThe cingulate gyrus (CG), a brain structure above the corpus callosum, is recognised as part of the limbic system and plays numerous vital roles. However, its full functional capacity is...

Functional status of Indian children with juvenile idiopathic arthritis.

The functional disability status of Indian children with juvenile idiopathic arthritis is unidentified. In this cross-sectional study functional capacity of 60 juvenile idiopathic arthritis patients was assessed by the Childhood Health Assessment Questionnaire. A total of 60 juvenile idiopathic arthritis patients aged ranges from 1 to 12 years were recruited from a teaching hospital in eastern India. A childhood health assessment questionnaire was used to assess the functional health of children. Pain, patient's/parent's global assessment of general well-being, and physician's global assessment were assessed. Childhood health assessment questionnaire disability index for oligoarticular juvenile idiopathic arthritis differed significantly from polyarticular juvenile idiopathic arthritis (P < 0.001), systemic-onset juvenile idiopathic arthritis (P = 0.018) and undifferentiated juvenile idiopathic arthritis (P < 0.001). There was a good to a strong positive correlation between the childhood health assessment questionnaire disability index with pain score, patient's/parent's global assessment score, and physician global assessment score for the total juvenile idiopathic arthritis cohort. regarding juvenile idiopathic arthritis subtypes, significant correlations were noted between the childhood health assessment questionnaire disability index with the patient's/parent's global assessment and physician's global assessment (except for enthesitis-related arthritis). Assessment and documentation of the functional health status of juvenile idiopathic arthritis patients will improve the management of the disease.

Acute Effects of Caffeine Ingestion on Postural Balance, Functional Capacity and Cognitive Function in Patients with End Stage Renal Disease.

Patients with end stage renal disease (ESRD) display many cognitive and physiological alterations resulting from renal failure and physical inactivity. Caffeine intake has been reported to improve cognitive/physical performance in several studies. However, whether the benefits of caffeine intake apply to patients with ESRD remains unknown. The aim of the present study was to explore the effect of caffeine intake on postural balance, cognitive function and functional capacity in patients with ESRD. In a randomized order, 12 patients with ESRD (age: 33.85 ± 8.57 years; Female: 45.5%) performed a battery of tests after either caffeine (CF) (400 mg) or placebo (PLA) ingestion. Postural balance was evaluated using a stabilometric platform. Functional capacity was assessed with the sit-to-stand and up-and-go tests, and for cognitive performances, reaction time test and a vigilance test were used. Results showed a significant improvement in up-and-go test (p = 0.01) and sit-to-stand test performances with CF compared to PLA (p < 0.01). Time of reaction test and vigilance test (p < 0.01) performances were significantly higher with CF. No significant difference was observed in postural balance between CF and PLA. The results of this study suggest that acute caffeine ingestion positively enhances cognitive function and functional capacity in patients with ESRD.

A Controlled Clinical Trial on the Effects of Aquatic Exercise on Cognitive Functions in Community-Dwelling Older Adults.

Several therapies have been developed to reduce cognitive decline associated with aging. Aquatic exercises, which are widely used to enhance functional capacity, may play a role in stimulating cognitive functions. This study investigated the effects of a 3-month aquatic exercise program on cognitive functions in community-dwelling older adults. In this prospective, single-blinded, controlled clinical trial, 31 participants were allocated to either the experimental (aquatic exercises) or control (no-exercise) group. The intervention program consisted of exercises conducted twice a week in a 1.2 m deep indoor pool. The main outcome measures were cognitive functions, assessed using Raven's Progressive Matrices test and the Wisconsin Card Sorting Test. A repeated-measures analysis of variance was used to assess the impact of the exercise program. The effect sizes (η2p) were reported when a level of significance was achieved (p < 0.05). Compared with the control group, the participants who underwent aquatic exercises showed positive outcomes in Raven's Progressive Matrices test (p = 0.046; η2p = 0.131) and the Wisconsin Card Sorting Test (p = 0.001, η2p = 0.589). Complementary analyses of the Wisconsin Card Sorting Test indicated that the benefits of the aquatic exercise were observed in terms of the number of trials (p = 0.001, η2p = 0.478), number of errors (p = 0.001, η2p = 0.458), and number of non-perseverative errors (p = 0.001, η2p = 0.302). The results indicate that a period of three months of aquatic exercise was beneficial for stimulating specific aspects of the cognitive function of community-dwelling older individuals. Aquatic exercise should be prescribed to this population.

Correlation of Dance Functional Status with Lower Limb Flexibility, Power and Dynamic Balance in Recreational Ballet Dancers – A Cross-Sectional Study

Background: Paediatric ballet dancers are particularly prone to injuries due to the demanding nature of their art form, exacerbated by intensive training during crucial growth and maturation phases. The prevalence of injuries, especially those affecting lower limbs, hampers dancers’ functional capacity. Unlike their professional counterparts, recreational ballet dancers lack specialized training, heightening their vulnerability. The accumulation of repetitive injuries often hampers their ability to attain the highest levels of achievement in their careers, underscoring the necessity to identify and comprehend contributing factors. The aim is to fnd a correlation between the Dance Functional Outcome Survey (DFOS) and critical factors like lower limb flexibility, power, and dynamic balance among recreational ballet dancers. Methodology: 53 recreational ballet dancers aged 10–18 years with at least one year of dance experience were included. Lower limb flexibility was assessed using the sit and reach test, ankle flexibility, and straddle in supine tests, while power and dynamic balance were evaluated through vertical jump tests and Y balance tests. The DFOS questionnaire measured health status. Result: Results revealed statistically significant weak positive correlations between DFOS and various factors: sit and reach test (r=0.3060), ankle flexibility (r=0.3830), straddle in supine (r=0.3270), vertical jump test (r=0.3250), and Y balance composite (Right: r=0.3200; Left: r=0.3420). Conclusion: This study concludes that recreational ballet dancers with greater flexibility, power, and dynamic balance in the lower limb tend to exhibit a higher dance functional status. Keywords: paediatric, ballet dancers, flexibility, power, dynamic balance, Dance Functional Outcome Survey.

Exploring Balance Impairment and Determinants in Chronic Obstructive Pulmonary Disease: A Comparative Study with Healthy Subjects.

Background: Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy subjects. The secondary aim was to investigate the potential determinants of balance in patients with COPD. Methods: This comparative study recruited 23 patients with COPD and 23 age- and comorbidity-matched healthy subjects. Participants were assessed regarding demographic and clinical data, "Postural Stability Test" (PST), "Limits of Stability Test" (LOST), "Clinical Test of Sensory Integration of Balance" (CTSIB), pulmonary function, respiratory and peripheral muscle strength, functional capacity, and cognitive function. Results: There were significant differences in all outcome measures assessing balance, pulmonary function, respiratory muscle strength, peripheral muscle strength, and functional capacity, but not cognitive function, in the COPD group compared to the healthy group (p < 0.05). The PST had a significant and strong correlation with maximal inspiratory pressure (MIP) (r = -0.630, p = 0.001) and a significant and moderate correlation with m. quadriceps strength and 6 min walk test (6MWT) distance (r = -0.472, p = 0.023; r = -0.496, p = 0.016; respectively). MIP, m. quadriceps strength, and 6MWT distance were independent predictors to explain the PST with an R2 = 0.336 (p = 0.004). Conclusions: The present study revealed that balance is impaired in adults with COPD, even if compared with age- and comorbidity-matched healthy subjects. Assessing and improving balance and its determinants, inspiratory and peripheral muscle strength, and functional capacity may be important for fall prevention and disease management in patients with COPD.

Is Spirometry a Sufficient Test for Assessing Respiratory Function after Lung Resection?

The prediction of postoperative functional status in non-small cell lung cancer patients based on preoperative assessment of physical and respiratory capacity is inadequate based on recent RCTs. Prospectively collected spirometry data and the six-minute walk test results of 57 patients treated with lobectomy for non-small cell lung cancer were analyzed. The tests were performed before surgery, and 30 and 90 days after lobectomy. All patients underwent a respiratory functional and physical capacity assessment. All 57 patients underwent lobectomy. Before surgery, mean FEV1 was 2.4 ± 0.7 L, corresponding to %FEV1 of 88.3 ± 17.3%. The mean absolute and expected 6MWT distance was 548 ± 74.6 m and 108.9 ± 14.5%, respectively. At the first postoperative evaluation 30 days after surgery, FEV1 and %FEV1 decreased significantly by an average of 0.5 ± 0.3 L and 15.1 ± 10.7%, while 6MWT and expected 6MWT decreased minimally by an average of 1.0 m and 0.8%, respectively. Three months after lobectomy, FEV1 and %FEV1, compared with the initial assessment, decreased by an average of 0.3 ± 0.3 l and 7.8 ± 10.0%, while 6MWT and its expected score increased to 564.6 ± 84.6 m and 112.8 ± 15.8%, respectively. After lobectomy, FEV1 decreased slightly and less than expected, while 6MWT increased proportionally compared to the preoperative evaluation.

Effect of Detraining on Muscle Strength, Functional Capacity, Mental Health, and Body Composition in Individuals with Spinal Cord Injury.

Spinal cord injury (SCI) is a condition that significantly affects the quality of life (QoL) of individuals, causing motor, physiological, social, and psychological impairments. Physical exercise plays a crucial role in maintaining the health and functional capacity of these individuals, helping to minimize the negative impacts of SCI. The aim of this study was to evaluate the effect of detraining (DT) (reduction or cessation of physical exercise) during the pandemic on five individuals with thoracic SCI. We assessed muscle strength using strength tests, functional capacity using a functional agility test, mental health using anxiety and depression inventories, and body composition using dual-energy X-ray absorptiometry (DEXA). The results after 33 months of DT showed significant losses in functional agility and MS, as well as a worsening in symptoms of anxiety and depression. It was observed that total body mass and fat mass (FM) exhibited varied behaviors among the individuals. Similarly, the results for lean body mass were heterogeneous, with one participant showing significant deterioration. It is concluded that DT caused by the pandemic worsened the physical and mental condition of individuals with SCI, highlighting the importance of continuous exercise for this population and underscoring the need for individual assessments to fully understand the impacts of DT.

The impact of exercise on growth factors in postmenopausal women: a systematic review and meta-analysis

BackgroundAging results in many changes in health status, body composition, muscle strength, and, ultimately, functional capacity. These changes coincide with significant alterations in the endocrine system, such as insulin-like growth factor-1 (IGF-1) and IGF-binding proteins (IGFBPs), and may be associated with many symptoms of aging. The objectives of this study is to investigate the potential influence of different types of exercise, such as resistance training and aerobic training, on IGF-1 and IGFBP-3 levels in postmenopausal women.MethodsMedline, Scopus, and Google Scholar databases were systematically searched up to November 2023. The Cochrane Collaboration tool was used to assess the risk of bias and the quality of the studies. The random-effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used to estimate the overall effect. Between-study heterogeneity was assessed using the chi-squared and I2 tests.ResultsSeventeen studies were included in the present systematic review and 16 studies were included in the meta-analysis. The pooled results from 16 studies (21 trials) with 1170 participants examining the impact of exercise on IGF-1 concentration showed a significant increase in IGF-1, and the pooled results among six studies (trials) showed a significant decrease in IGFBP-3 concentration (730 participants). In addition, resistance training and aerobic training had a significant effect on increasing IGF-1 concentration post-exercise compared with placebo.ConclusionBased on this meta-analysis, Women who have completed menopause and followed an exercise routine showed changes in IGF-1 and IGFBP-3 levels that can indirectly be associated with risk of chronic age-related conditions.

The "Sunshine Vitamin" and Its Antioxidant Benefits for Enhancing Muscle Function.

Pathological states marked by oxidative stress and systemic inflammation frequently compromise the functional capacity of muscular cells. This progressive decline in muscle mass and tone can significantly hamper the patient's motor abilities, impeding even the most basic physical tasks. Muscle dysfunction can lead to metabolic disorders and severe muscle wasting, which, in turn, can potentially progress to sarcopenia. The functionality of skeletal muscle is profoundly influenced by factors such as environmental, nutritional, physical, and genetic components. A well-balanced diet, rich in proteins and vitamins, alongside an active lifestyle, plays a crucial role in fortifying tissues and mitigating general weakness and pathological conditions. Vitamin D, exerting antioxidant effects, is essential for skeletal muscle. Epidemiological evidence underscores a global prevalence of vitamin D deficiency, which induces oxidative harm, mitochondrial dysfunction, reduced adenosine triphosphate production, and impaired muscle function. This review explores the intricate molecular mechanisms through which vitamin D modulates oxidative stress and its consequent effects on muscle function. The aim is to evaluate if vitamin D supplementation in conditions involving oxidative stress and inflammation could prevent decline and promote or maintain muscle function effectively.

Predictive Validity of Intrinsic Capacity Composite Scores for Risk of Frailty at 2 Years: A Comparison of 4 Scales

ObjectiveIntrinsic capacity (IC) and frailty are complementary constructs that encapsulate functional capacities of older adults. Although earlier studies suggest the utility of composite IC scores in predicting risk of frailty, key gaps remain with the lack of direct comparative studies between different IC scales and lack of a composite score based on the World Health Organization Integrated Care for Older People (ICOPE) tool. We aimed to compare different IC scales, including an ICOPE-based scale, in their predictive ability for risk of frailty at 2 years in healthy community-dwelling older adults. DesignCohort study. Setting and ParticipantsA total of 230 participants (age: 67.2 ± 7.4 years) from the GeriLABS-2 cohort study. MethodsWe derived composite scores by summing 4 IC domains (locomotion, cognition, vitality, and psychological). We compared composite scores of 4 scales: IC1-Chew 2021, range: 0–8; IC2-Liu 2021, range: 0–4; IC3-ICOPE, range: 0–4; IC4-modified ICOPE, range: 0–8. The primary outcome was risk of frailty using the modified Fried Frailty Phenotype. We performed logistic regression to examine the association of baseline composite IC with risk of frailty. We also examined the impact of individual domains and number of impaired domains on risk of frailty. ResultsAmong 193 (83.9%) older adults who completed 2-year follow-up, 20 (10.4%) met criteria for risk of frailty. When adjusted for covariates, 2-point per domain scales (IC1/IC4) predicted increased risk of frailty (OR, 4.31; 95% CI, 1.55–11.96; OR, 5.00; 95% CI, 1.75–14.26). When further adjusted for baseline frailty, only IC4 remained significant (OR, 4.28; 95% CI, 1.45–12.60). Among the domains, impaired locomotion and vitality were associated with risk of frailty. Greater number of impaired domains predicted increased risk of frailty (IC1/IC2: β = 0.18–0.19, P < .05). Conclusions and ImplicationsBaseline composite IC score using 2-point per domain scales better predicted risk of frailty at 2 years, predicated on impaired locomotion/vitality and greater number of impaired domains. For early identification of healthy older adults at risk of frailty, an ICOPE-based scale should be considered, as it is effective and accessible.

Inflammatory bowel disease associated with primary sclerosing cholangitis is associated with an altered gut microbiome and bile acid profile.

Primary sclerosing cholangitis associated with inflammatory bowel disease (IBD-PSC) carries significant morbidity compared to IBD without PSC. Alterations in microbial composition and bile acid (BA) profiles have been shown to modulate chronic inflammation in IBD, but data in IBD-PSC is scarce. We aimed to assess the differences in gut microbiome composition as well as in the BA profile and BA-related microbial functions between IBD-PSC and IBD-only. 54 IBD-PSC and 62 IBD-only subjects were enrolled from 2012 to 2021. Baseline samples were collected for fecal DNA shotgun metagenomic sequencing, fecal and serum BA quantitation using mass spectrometry and fecal calprotectin. Liver fibrosis measured by transient elastography (TE) was assessed in the IBD-PSC group. Data was analyzed using general linear regression models and Spearman rank correlation tests. Patients with IBD-PSC had reduced microbial gene richness (p=0.004) and significant compositional shifts (PERMANOVA: R2=0.01, p=0.03) compared to IBD-only. IBD-PSC was associated with altered microbial composition and function, including decreased abundance of Blautia obeum, increased abundance of Veillonella atypica, Veillonella dispar and Clostridium scindens (q<0.05 for all), and increased abundance of microbial genes involved in secondary BA metabolism. Decreased serum sulfated and increased serum conjugated secondary BA were associated with IBD-PSC and increased liver fibrosis. We identified differences in microbial species, functional capacity and serum BA profiles in IBD-PSC compared with IBD-only. Our findings provide insight into the pathophysiology of IBD associated with PSC and suggest possible targets for modulating the risk and course of IBD in subjects with PSC.

Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled study

PurposeRefractory cancer-induced bone pain (CIBP) affects a patient’s functional capacity and quality of life, but there is limited evidence to guide opioid choice. We assessed the feasibility, tolerability and possible efficacy of methadone rotation (MR) compared to other opioid rotations (OOR) in this cohort.MethodsAdults with CIBP and worst pain intensity ≥ 4/10 and/or opioid toxicity graded ≥ 2 on the Common Terminology Criteria for Adverse Events were randomised 1:1 to methadone or another opioid rotation. Standardised assessment tools were used at pre-defined study time points up to 14 days.ResultsOf 51 eligible participants, 38 (74.5%) consented, and 29 (76.3%, MR: 14, OOR: 15) completed the fourteen days follow-up post-opioid rotation. Both groups displayed significant reduction in average (MR: d = − 1.2, p = 0.003, OOR: d = − 0.8, p = 0.015) and worst pain (MR: d = − 0.9, p = 0.042, OOR: d = − 0.6, p = 0.048) and total pain interference score (MR: d = − 1.1, p = 0.042, OOR: d = − 0.7, p = 0.007). Oral morphine equivalent daily dose was reduced significantly in MR compared to the OOR group (d = − 0.8, p = 0.05). The incidence of opioid-related adverse events following MR was unchanged but lower in the OOR group (d = 0.9, 95% CI 0.1,1.7, p = 0.022). There were no within-group or between-group differences in satisfaction with analgesia at the end of the study.ConclusionThis pilot study demonstrated that MR and OOR in patients with refractory CIBP are feasible, safe and acceptable to patients. Appropriately powered multi-centre randomised controlled studies are needed to confirm the efficacy of MR and OOR in this cohort.Trial registrationACTRN12621000141842 registered 11 February 2021.

Insights into Digital MedicRehApp Maintenance Model for Pulmonary Telerehabilitation: Observational Study.

Maintenance strategies after center-based pulmonary rehabilitation (CBPR) are currently needed. This study aimed to evaluate the feasibility and effect on the quality of life of a home-based pulmonary rehabilitation (HBPR) program delivered by a digital app. As secondary objectives, the patients' adherence, symptoms, effort tolerance changes, and safety were evaluated. This was a single-arm prospective observational monocentric study on 30 patients referred for chronic respiratory diseases. The prescription and evaluations of the HBPR programs performed at the pulmonary facility and delivery of structured exercise and counselling by the digital health tool were achieved under the supervision of a respiratory therapist. Digital capabilities included aerobic, strength, and respiratory exercises, which were monitored with a fitness tracker. The engagement rate of the HBPR after the CBPR was 1:10. The EuroQoL VAS score increased from 66.2 ± 16.28 to 75.60 ± 16.07 (p < 0.001), mainly in younger subjects. No patient was lost during the HBPR program. The global adherence session rate was 94%. The Medical Research Council dyspnea scale (MRC), COPD Assessment Test (CAT) score, and six-minute walking test (6MWT) improved from admission into the pulmonary unit to the end of the HBPR program. Between the beginning and end of the CBPR, the CAT score decreased from 14.4 ± 6.39 to 8.50 ± 5.39 (p < 0.001), the MRC decreased from 1.87 ± 0.9 to 1.17 ± 0.83 (p < 0.001), and the 6MWT increased from 451 ± 93 to 473 ± 115 m (p < 0.05). The average Technology Acceptance Model score for usability was high (145 ± 12.1) and no adverse events occurred during the HBPR program. This HBPR model seemed to be feasible and well-accepted by patients, leading to improvements in quality of life, symptoms, and functional capacity.

Influences of acidic solvents on changes in microstructure and adsorptive properties of lean coal

To study changes in the microstructures and adsorptive properties of lean coal due to acidization of different acid solutions, XRD, 13C NMR, XPS, FTIR, and LTGA-N2 were conducted on lean coal samples before and after acidization by HF, HNO3, HCl, and CH3COOH. The changes and influence mechanisms of microstructures and adsorptive properties of the coal were obtained. The results show that:HF and HNO3 increase the C molecular structures by 5.29 % and 3.17 % while HCl and CH3COOH decrease them by 15.92 % and 5.55 %; the four acid solutions reduce the N molecular structures by 53 %, 88 %, 45.9 %, and 46.3 %, respectively. The acidized coal samples have a decreased hydrogen index I1 and oxygen index I2 while showing an increased aromaticity I3;The mass and horizontal diameter La of acidized coal samples show linear negative correlations with the adsorption capacity; the inter-crystal spacing d002 and packing height Lc are linearly positively correlated with the adsorption capacity.After acidization, changes in the CO-C and Si-O contents control the relationship between the content of oxygen-containing functional groups and N2 adsorption capacity. After HF acidization, non-protonized aromatic carbon faN controls the relationship between aromatic structure f'a and adsorption capacity; after HCl, HNO3, and CH3COOH acidization, protonized aromatic carbon faH controls the relationship between aromatic structure f'a and N2 adsorption capacity.

Complex issues in vocational rehabilitation with functional capacity evaluation results

BACKGROUND: The American Physical Therapy Association (APTA) conducted a two-year process of literature review, writing, discussion, and debate within a panel of four subject matter experts in design, administration, and interpretation of Functional Capacity Evaluations (FCE). This process resulted in a Best Practice Guidelines document which was then adopted by the APTA. OBJECTIVE: This article provides additional clarification regarding best practices and standard methodology for functional capacity evaluations including standard terminology for use by physical therapists and vocational rehabilitation professionals in determining the types of work a patient has the capacity of performing. METHODS: The clarification of the role of the FCE, who is qualified to conduct an FCE, complexities such as ‘good effort’ and pain in the evaluation process, clarification of terms from different government agencies, and the implications for disability determination are discussed. RESULTS: Specific guidelines for best practice with FCE are suggested and demonstrated through case studies. CONCLUSION: The best practice guidelines are detailed here to set forth qualification standards for FCE examiners and to promote clinical excellence, accountability, and consistency in the design, administration, and interpretation of FCEs.