Good Functional Capacity Research Articles

Duke Activity Status Index cut-off scores for assessing functional capacity after stroke

Purpose To determine the Duke Activity Status Index (DASI) cut-off scores and verify if they would be able to discriminate between chronic stroke individuals, who had poor, from those who had good functional capacity (FC). Materials and methods Cross-sectional study, where 92 individuals with chronic stroke had their FC measured by DASI scores and were classified into community and non-community walkers. Both the receiver operating characteristic and the area under the curve were used to determine the best DASI cut-off values that could discriminate between individuals, who had poor, from those who had good FC. Binary logistic regression analysis is used to investigate the ability of DASI scores in predicting community walkers. Results DASI cut-off value of 31.95 showed to be sensitive and specific to differentiate between individuals, who had poor from good FC. The regression analysis revealed that the chance of individuals, who had better FC (≥ 31.95) be community walkers was 10.69 (95%CI:4–32.75) times higher than that of those who had poor FC (< 31.95). The model demonstrated good predictive ability. Conclusions The DASI cut-off value of 31.95 showed to be sensitive and specific to distinguish between chronic stroke individuals, who had poor, from those who had good FC. IMPLICATIONS FOR REHABILITATION The identification of individuals, who have good and poor functional capacity, is important for clinical reasoning and decision-making in stroke rehabilitation. The Duke Activity Status Index (DASI) is a clinically useful tool for the assessment of functional capacity, based upon the performance of common daily living activities. The DASI cut-off of 31.95 points was able to discriminate between individuals with stroke, who had poor, from those who had good functional capacity. The chance of individuals, who had good functional capacity (DASI ≥ 31.95) be community walkers was 10.69 times higher than that of those who had poor functional capacity (DASI < 31.95). The findings support the use of the DASI as a simple tool for the assessment of functional capacity, especially in low-resource settings.

¿Es útil el SPPB como método de screening de capacidad funcional en pacientes con enfermedad renal crónica avanzada?

Introduction and objectiveOne of the consequences of the CKD, is the deterioration of the functional capacity, being able to manifest from different stages of the disease, until renal replacement therapy.The objective of this study was to determine the functionality of patients with CKD through functional capacity test, valuing the usefulness of the SPPB as a screening test in parallel. Materials and methodsIt assessed the functional capacity of patients with CKD, using the test SPPB, 6MM, TUTG and STS. Also found the muscle strength with manual dynamometry. ResultsOf 121 patients who came to the CKD query, 118 presented a minimum functionality to perform tests of functional capacity, a 71.2% of the patients were able to perform 4 tests, a 28.8% only could make the SPPB test.To a 71.43% of patients who presented a low score in SPPB, not could follow assessed them with the rest of the test, while the 92.31% of which had a high score, continued with the rest of the evidence. To differentiate by age ranges, the majority of young patients have minimal limitations, finding higher rates of disability in older age ranges. A good score in SPPB meant to present good functional capacity and allowed to continue evaluating the patient, obtaining better results with the rest of test and more muscle strength. A good nutritional better status and body composition was a better functionality. ConclusionIn the absence of a consensus of what is the best method of determining the functional capacity of the kidney patient, and to assess all patients, propose to use the test SPPB as screening method, and depending on the result used as the rest of the test to more complete if it is necessary to study.

GASTROINTESTINAL STROMAL TUMOR PRESENTING AS LUNG MASS: A CASE REPORT

PURPOSE: Gastrointestinal stromal tumors (GISTs) are rare neoplasms of the gastrointestinal tract commonly seen in middle-aged and elderly adults with the most common location in the stomach and small intestine. We present a case of a 20-year-old Filipino male with a 2-week history of exertional dyspnea which on work up showed a left pulmonary mass consistent with a high grade gastrointestinal stromal tumor with no evidence of intra-abdominal GIST. METHODS: Immunohistochemistry revealed spindle cells positive for CD 117, DOG-1, and CD 56, negative for CK, TTF-1, SMA, desmin, S-100, and CD34. He underwent attempted video-assisted thoracoscopic surgery (VATS), open thoracotomy, lung mass biopsy, tumor debulking and decortication. RESULTS: The patient began treatment with oral imatinib mesylate (Gleevec) at a dose of 400mg/day but was refractory after 3 months of treatment. The patient had pulmonary infection and evidence of tumor progression at that time. He then underwent radiotherapy and a second line pazopanib 400mg/day was started. Partial response was achieved after two to three months. The patient is currently stable and with good functional capacity. CONCLUSIONS: This paper presents a rare case of a lung mass that turned out to be a gastrointestinal stromal tumor (GIST) in a 20-year old male without evidence of intra-abdominal GIST on work-up. Immunotherapy is very crucial in the diagnosis. CLINICAL IMPLICATIONS: GISTs outside the gastrointestinal tract appear to relapse more frequently. Lung GIST may have different clinical behavior and does not very well respond to first-line oral imatinib.

Characteristics of Cardiopulmonary Exercise Tests in Heart Transplantation Patients: The Importance of Chronotropic Incompetence in Predicting Exercise Capacity

Purpose The response of the transplanted heart to exercise differs from that of the native heart for many reasons, one of which is autonomic denervation, which may be associated with chronotropic incompetence (CI). We assessed cardiopulmonary exercise capacity in heart transplantation (HT) patients with the aim to identify clinical, hemodynamic and ECHO parameters associated with exercise capacity. Methods The study population comprised 70 HT patients who had undergone cardiopulmonary exercise tests at the same time as ECHO and right heart study. Good functional exercise capacity was defined as peak oxygen uptake (VO2peak) >60% of the general population (good vs low functional capacity). Age-predicted maximal heart rate (APMHR) was calculated as 164 - 0.7(age). Heart rate reserve (HRR) was defined as HRpeak - HRrest; age-predicted HRR (APHRR) as APMHR - HRrest; and CI as failure to achieve >62% of APHRR. Adjusted HRR was calculated as HRR/APHRR. Results Average VO2peak was 21 mL/kg-1min-1 corresponding to 72% of predicted. The prevalence of CI was 19%. Both adjusted HRR (r=0.46 P Conclusion The ability to perform physical activity, an important determinant of quality of life, is enabled by an increase in oxygen uptake. In this study, CI was the only independent predictor of exercise intolerance in HT patients. Lower resting HR was associated with a higher risk for CI.

Chronic diseases and objectively monitored physical activity profile among aged individuals – a cross-sectional twin cohort study

Introduction: High physical activity (PA) at old age indicates good functional capacity enabling independent living. We investigated how different disease conditions are associated with measured PA indicators in old women and men, and whether they recognize this association.Materials and methods: This cross-sectional twin cohort study in Finland comprised 779 individuals (276 complete twin pairs, including 117 monozygotic pairs), who participated in hip-worn accelerometer monitoring of PA and responded to questions on diseases and mobility limitations at mean age of 73 (range 71–75).Results: Of the participants, 23.2% reported having a disease restricting mobility. With sex and age in the regression model, the reported disease restricting mobility explained 11.8% of the variation in moderate-to-vigorous PA (MVPA) and 10.4% of the variation in daily steps. Adding stepwise other self-reported diseases and body mass index to the model increased the explanatory power for MVPA up to 18.5% and 25.5%, and for daily steps up to 16.0% and 20.7%, respectively. In the co-twin control analysis the PA differences were smaller in disease-discordant monozygotic than dizygotic pairs.Conclusions: Chronic disease conditions are associated with low PA, which individuals may not always recognize. Shared genetic factors may explain part of the associations.Key messagesAmong community-dwelling older men and women one-fourth of the variation in objectively measured moderate-to-vigorous physical activity is accounted for by age, sex, body mass index and self-reported diseases.Occurrence of chronic diseases is associated with low physical activity and individuals do not always recognize this.Healthcare professionals should pay attention to the low physical activity and mobility of individuals with chronic disease conditions before these result in limitations in independent living.

Evaluating the muscular strength, functional capacity, and risk of sarcopenia in elderly women who practice Mat Pilates

Abstract Introduction: Despite the importance of appropriate levels of muscular strength to maintain the functional capacity and a healthy life in old age, the current literature still lacks studies that investigate the profile of elderly women who practice Mat Pilates regarding these variables. Objective: This study aimed to analyze muscular strength, functional capacity, and risk of sarcopenia in elderly women who practiced Mat Pilates. Method: This is a cross-sectional study carried out with 50 elderly women who practice Mat Pilates in the city of Maringá, Paraná. Sociodemographic and health questionnaires were used, in addition to tests created by a Latin American development group for maturity called Grupo de Desenvolvimento Latino Americano para a Maturidade (GDLAM), sitting-rising test, arm curl test, and SARC-F questionnaire. For data analysis, Shapiro-Wilk and Mann-Whitney U tests, as well as Spearman’s Rank Correlation Coefficients, were used. The level of significance was p &lt; 0.05. Results: The 70-79-year-old elderly women showed worse results in the functional capacity and muscular strength tests of the upper limbs and a higher risk of sarcopenia than the individuals who were under 70 years of age. Muscular strength was inversely related to the reduction of the risk of sarcopenia, and functional capacity was directly associated with this risk. Conclusion: A good functional capacity seems to be related to the reduction of the risk of sarcopenia. Age seems to be an intervening factor for reducing muscular strength levels and functional capacity and increasing the risk of sarcopenia.

Kidney Transplant in the Era of Modern Therapy for Multiple Myeloma.

Chronic kidney disease is common in patients with multiple myeloma. Historically, individuals with end-stage renal disease and multiple myeloma did poorly with renal transplantation due to higher mortality rates from the malignancy itself or associated comorbidities. However, over the past 2 decades, there have been significant advances in the treatment of multiple myeloma with the advent of new therapeutic agents resulting in an improvement of long-term survival. As a result, more individuals with multiple myeloma are being referred for kidney transplantation, especially those with good functional capacity and minimal comorbidities. Recent literature has suggested that certain patients with multiple myeloma can successfully undergo renal transplantation after stem transplantation with consideration for maintenance therapy, although caution should be used with immunomodulating drugs due to the anecdotally reported risk of acute rejection. Therefore, having a multidisciplinary approach with the transplant team and hematology both before and after transplant is crucial in maximizing the chance of success for these individuals. This review summarizes the literature on renal transplantation in patients with multiple myeloma as well as the therapeutic advancements that have occurred which may allow certain patients to undergo successful transplantation.

Exercise recommendations in patients with valvular heart disease.

Valvular heart disease affects 1%-2% of young individuals, many of whom aspire to partake in competitive sport or high intensity recreational exercise. There are limited reports on the impact of intensive physical activity on the progression of valvular heart disease; therefore, current recommendations are based on consensus opinion. The management of exercising individuals with valvular heart disease requires a structured approach that incorporates several key factors including symptomatic status, functional capacity, type and nature of the valvular lesion, impact on ventricular structure and function and effect on pulmonary artery pressure. Asymptomatic individuals with minor valvular abnormalities may engage in all forms of competitive sport, whereas those with lesions of moderate severity may exercise intensively if an exercise stress test tailored to the relevant physical activity reveals good functional capacity without myocardial ischaemia, haemodynamic disturbances or arrhythmia. Symptomatic athletes and those with severe valvular heart disease, impaired ventricular function, pulmonary hypertension and arrhythmias should refrain from most competitive sports. Athletes with a bicuspid aortic valve and aortic root diameter >40 mm should avoid sport with a strong isometric component even with minimal valvular dysfunction. There is an association between mitral valve prolapse and sudden cardiac death in the general population; however, there is limited evidence of increased risk with competitive sport. Athletes undergoing corrective surgery may return to exercise after 3 months if ventricular function and exercise capacity are preserved. Individuals anticoagulated for mechanical bioprosthetic valves should avoid contact or collision sport to minimise the risk of bleeding.

Fatores associados a prática de atividade física em idosos usuários de academia da terceira idade de Maringá-PR

Este estudo teve o objetivo de investigar a associação do nível de atividade física com as variáveis sociodemográficas e de saúde, a capacidade funcional e a força muscular de idosos. Participaram deste estudo transversal 73 idosos fisicamente ativos, usuários das Academias de Terceira Idade do município de Maringá/PR. Os instrumentos utilizados foram o International Physical Activity Questionnaire, a Escala de Latws, Escala de Lawton e os testes Flexão de cotovelo e Levantar e sentar. Houve correlação das atividades básicas com as instrumentais (r=0,26) e com a força muscular de membro inferior (r=0,25), além de relação entre a força muscular de membro superior com a de membro inferior (r=0,44). Conclui-se que idosos praticantes de atividade física (independente do nível) apresentam boa capacidade funcional. Entretanto, aqueles com maior força muscular apresentam maior independência funcional.

Patients with congenital heart disease presenting for non-cardiac surgery

No abstract available.

Evaluation of Everyday Activities in Patients after Brain Tumor Surgery

Introduction. Functional fitness enables satisfying and performing basic everyday needs in a safe and independent way. Its assessment is currently the basic component of the overall assessment of the patient.Aim. The aim of the study was to evaluate the functional capacity of patients after brain tumor surgery. The analysis included selected factors that may affect patient’s performance after the surgery.Material and Methods. The study included 165 patients of neurosurgical wards hospitalized for a brain tumor. Surgeries were performed in all of them — and consisted in partial or complete removal of the pathological mass by craniotomy. Patient’s functional assessment on the day of admission and on the discharge day was analyzed with the use of FCS, KPS, BI, FIR, GOS scales.Results. The largest number of respondents on the day of admission were patients in the first group according to FCS scale — independent — 138 respondents (83.6%). None of the patients qualified for group IV with total dependence. In turn, on the day of discharge, the percentage of respondents qualified to group I was 127 people (77.0%), whereas 1 person became completely dependent. Similar results were obtained in other measuring tools. The observed differences in each of the tests carried out did not turn out to be statistically significant. On KPS, BI and GOS scales, the age turned out to be statistically significant at p=0.000. On the other hand, on FCS, KPS and GOS scales, the state of consciousness was also statistically significant at p=0.000.Conclusions. Most of the respondents show very good functional capacity both on the day of admission and on the day of discharge. However, patients scored slightly better on the day of admission to the ward. Such factors as age and consciousness before surgery significantly affect patient’s functional capacity on the day of discharge. (JNNN 2018;7(3):111–117)

Long-term leisure-time physical activity and other health habits as predictors of objectively monitored late-life physical activity \u2013 A 40-year twin study

Moderate-to-vigorous physical activity (MVPA) in old age is an important indicator of good health and functional capacity enabling independent living. In our prospective twin cohort study with 616 individuals we investigated whether long-term physical activity assessed three times, in 1975, 1982 and 1990 (mean age 48 years in 1990), and other self-reported health habits predict objectively measured MVPA measured with a hip-worn triaxial accelerometer (at least 10 hours per day for at least 4 days) 25 years later (mean age of 73 years). Low leisure-time physical activity at younger age, higher relative weight, smoking, low socioeconomic status, and health problems predicted low MVPA in old age in individual-based analyses (altogether explaining 20.3% of the variation in MVPA). However, quantitative trait modeling indicated that shared genetic factors explained 82% of the correlation between baseline and follow-up physical activity. Pairwise analyses within monozygotic twin pairs showed that only baseline smoking was a statistically significant predictor of later-life MVPA. The results imply that younger-age physical activity is associated with later-life MVPA, but shared genetic factors underlies this association. Of the other predictors mid-life smoking predicted less physical activity at older age independent of genetic factors.

Frequency of Appropriate and Low-Risk Noncardiac Preoperative Stress Testing Across Medical Specialties

Preoperative stress testing in asymptomatic patients is considered rarely appropriate in patients with: (1) moderate to good functional capacity (≥4 metabolic equivalent (METs)), (2) no clinical risk factors, or who are (3) asymptomatic after revascularization, normal stress test, or normal coronary angiography within 1 year. Preoperative stress testing is also not recommended in patients at low risk (<1%) for adverse cardiac events. We investigated the frequency of rarely appropriate and low-risk preoperative stress testing across medical specialties at our institution in asymptomatic patients when applying appropriate use criteria and two different perioperative risk models. We reviewed preoperative stress tests for noncardiac surgeries performed at Hershey Medical Center from January 1, 2012 to December 31, 2014. Perioperative cardiac risk was estimated using the National Surgical Quality Improvement Program Myocardial Infarction and Cardiac Arrest risk calculator and the Revised Cardiac Risk Index (RCRI) score. We analyzed 501 preoperative stress tests meeting the study criteria. When applying appropriate use criteria, we found that 336 of 501 studies (67%) were rarely appropriate. When applying the risk score models, 369 of 501 studies (74%) were determined to be low risk by the RCRI (RCRI score ≤1), and 248 of 361 stress tests (69%) were determined to be low risk by the National Surgical Quality Improvement Program Myocardial Infarction and Cardiac Arrest risk calculator. Low risk and rarely appropriate preoperative stress testing was common across all ordering specialties reviewed. In conclusion, these findings suggest that preoperative stress testing is broadly overused in asymptomatic patients and that interventions to reduce rarely appropriate and low-risk preoperative stress testing require a multispecialty approach.

Daily Step Count as a Simple Marker of Disease Severity in Hypertrophic Cardiomyopathy

Individuals with hypertrophic cardiomyopathy (HCM) may be asymptomatic or display activity-limiting symptoms. A common cause of symptoms is left ventricular outflow tract obstruction (LVOTO), which may impact the individuals' ability to undertake physical activity. This study sought to examine daily step count as a potential marker of exercise capacity, which may represent a proxy marker of disease severity in HCM. A cross-sectional study of 63 HCM patients was conducted from March to November 2015. Participants wore an ActiGraph GT3X+ (Pensacola, Florida, USA) accelerometer for 7 days. Minutes per day of light, moderate and vigorous physical activity and step count were calculated, and those with LVOTO were compared to those without. Similarly, those with good functional capacity (New York Heart Association; NYHA class I) were compared to those with NYHA class II-IV. The majority of HCM patients were male (n=45, 71%) with mean age of 48.8±14.9years. Hypertrophic cardiomyopathy patients with history of LVOTO and those NYHA class II-IV took significantly fewer steps per day (LV obstruction: 5527±2370 versus 7027±2095, p=0.01 and NYHA: 5346±1898 versus 6801±2339, p=0.03). No differences were observed across the different intensities of physical activity. Measurement of daily step count may be a useful and simple tool to determine exercise capacity and provide an indicator of disease severity in individuals with HCM.

Rethinking revascularization in patients with stable angina

ABSTRACTIntroduction: Traditional and current perception for benefit of percutaneous coronary intervention (PCI) is that patients with stable angina will obtain symptom relief as well as improved exercise capacity after percutaneous revascularization. This common clinical perception is put to test in the ORBITA trial, the first blinded, randomized placebo-controlled clinical study ever conducted.Areas covered: Coronary artery disease, percutaneous coronary intervention, medical therapy.Expert Commentary: The authors found no significant improvement in exercise time, functional status, angina relief and quality of life in the PCI group compared with placebo. A possible explanation for this neutral outcome is that PCI is overvalued in symptom relief and to some extent explained by placebo effects or transient non-cardiac causes of chest pain. However, the chosen exercise tolerance improvement may have been too optimistic in a population with good functional capacity. Also PCI was anatomic and not functional driven, and follow-up duration may have been to short to wear off the placebo effect. While the evidence is not sufficient to alter revascularization guidelines, the message of this 200-patient, high-quality study is potent and will reverberate throughout the cardiology community and warrants further study.

Sexual Activity in Patients with Cardiac Diseases.

SUMMARY – In this article, we outline the latest guidelines published by the American Heart Association on sexual activity in patients with coronary artery disease, heart failure, structural heart diseases, arrhythmias, implanted pacemakers or cardioverter defibrillators, as well as on treatment options of sexual dysfunction. Sexual activities are similar to mild/moderate physical activity during a short period. Most patients are recommended to involve in sexual activity after prior comprehensive evaluation of physical condition. Those with stable cardiac symptoms and good functional capacity are at a low risk of adverse cardiovascular events, and others require treatment or stabilization before involving in sexual activity. Stress testing is useful in evaluating safety of sexual activity in patients with questionable or undetermined risk. Treatment of sexual dysfunction includes counseling of patients and their sexual partners, and drug treatment with phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil) which have been demonstrated to be safe and effective, in men, and with serotonin reuptake inhibitors (flibanserin) and local vaginal estrogen administration in women. In conclusion, in routine clinical practice, patients should be approached individually and multidisciplinarily in order to detect and eliminate the factors that interfere with normal sexual activities and disturb the quality of life.

Abstract 325: Usefulness of Peripheral Vascular Disease Assessment on Readmission in a Heart Failure Program Cohort

Background: Peripheral arterial disease (PAD) was reported to have a relationship with functional capacity in heart failure patients. Heart failure patients presenting with a good functional capacity have been found to have better metabolic equivalents (METs). Recognizing and managing patients’ functional capacity surrogates like ankle-brachial index (ABI) and METs will be beneficial to improve the rate of readmission, however, little is known about the relationship with readmission rate in heart failure patients. We assessed readmission rate within 30 days after discharge using functional capacity assessment. Methods: 860 patients who were followed in the cardiology clinic from 2005 to 2015 were included. We analyzed the 240 patients who were admitted with a diagnosis of acute heart failure. Patients who were unable to cardiac rehabilitation or who had severe lung disease were excluded. Heart failure is classified as a reduced ejection fraction (HFrEF, EF &lt;40) and preserved ejection fraction (HFpEF, EF&gt;=50). MET (Metabolic equivalents) level was used for functional capacity. If ABI was less than 0.9 or over 1.4, patients were regarded to have peripheral arterial disease.We found no significant difference between our HFpEF and HFrEF patients (Mean METS 7.5±0.6 vs 7.4±0.7). ABI did not show any significant difference (1.1±0.2 vs 1.0±0.3). In multiple logistic regression analyses, HFpEF patients with more than 4 MET level were likely to have fewer readmissions rate compared to HFpEF patients with less than 4 METS level [odds ratio (OR): 0.54, confidence interval (CI): 0.35-0.81]. HFpEF patients with ABI between 0.9 and 1.4 had less readmission rate compared to HFpEF with less than 0.9 or more than 1.4 ABI [OR: 0.62, CI: 0.41-0.77] after related risk factors adjustment. Conclusion: In conclusion, good functional status with better METs and ABI in HFpEF patients was significantly associated with less readmission rate. ABI might be a surrogate factor for assessing functional capacity in HFpEF patients. This result implies that heart failure patients’ functional capacity might need to be assessed to decrease readmission rate.

Flourishing: Factors associated with positive mental health among young adults with neuropsychiatric disorders

Young people with Asperger's syndrome and/or ADHD face major challenges in their lives affecting their quality of life and general well-being.The aim of this study was to investigate factors that associate with positive mental health (flourishing) among young adults with neuropsychiatric disorders.The sample consisted of 188 young adults with diagnosis of Asperger's syndrome (AS) (F84.5) and/or ADHD/ADD (F90). They participated in the one-year “My Way” rehabilitation programme organized and funded by the social insurance institution of Finland. Baseline questionnaires included measures on positive mental health (SWEMWBS), provisions of social relationships (SPS), social competence (MASC) and questions about functional capacity and leisure time activities. Information on diagnosis was received from doctors’ statements.Of the study participants, 35% had a comorbid mood, anxiety or stress-related disorder (F30-F40). Among those, 14% had low, 79% moderate and 7% high positive mental health (flourishing). Higher rate of physical activity was associated with flourishing. Furthermore, flourishing was associated with high level of provisions of social relationships, social competence as well as good general functional capacity. No association was found with engagement in employment or education, or having the diagnosis of AS, ADHD/ADD or a comorbid psychiatric disorder (F30–F40).People with psychiatric disorders experience high positive mental health, too. Social relations, social competence and general functional capacity play an important role in mental well-being of young adults with neuropsychiatric disorders. Supporting them may help in reaching also other goals set for the rehabilitation, such as capacity to work or study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Trends of Physical and Functional Indicators of Junior Elite High Performance Traditional Karate Do Athletes during Transitional Period

While preparing high performance karate do athletes and aiming for the highest results at international competitions, the training of athletes is based on the fundamental sport training elements. It is relevant to know how athletes’ body functions change during all periods of training, however we have the least knowledge of how the qualification of athletes varies during a transitional period. A relevant goal for the transitional period is to create right conditions so that athletes’ body system would recover after great physical and psychological strains experienced at training sessions and competitions. It is also important to ensure that athletes’ physical, functional and technical qualification wouldn‘t decrease at a large scale during the transitional period. The aim of the study was to examine high performance level traditional karate do athletes’ changes in physical development, physical and functional capacity during the transitional period. To pursue the above stated aim, these methods of research were used: diagnostic analyses identified somatometric and physiometric indicators of physical development, also indicators of anaerobic alactic muscle capacity, psychomotoric functions and physical performance. After generalizing the survey data it was determined to form only one sample of the research subjects. The results of research were processed by mathematical statistics methods. We found that during the transitional period the functional capacity of circulatory and respiratory systems had a tendency to improve, psychomotoric reaction time and movement frequency during the time of research didn‘t change. At significantly increased height of maximal jump and a shortened time of take-off, it was seen a tendency of one-time‘s muscle contraction power growth. The indicators of a short muscle action power didn‘t change. This shows that the transitional period didn‘t have a significant influence on functional and physical capacity of athletes‘ body systems. After summer holidays most athletes start preparatory period having a good physical and functional capacity that makes the training at a preparatory period easier. Keywords: adaptation, physical load, muscle power, annual cycle, activity. DOI: http://dx.doi.org/10.15823/sm.2017.8

Relationship between Pulmonary Artery Stiffness and Functional Capacity in Patients with Heart Failure with Reduced Ejection Fraction.

Background and ObjectivesFunctional capacity varies significantly among patients with heart failure with reduced ejection fraction (HFrEF), and it remains unclear why functional capacity is severely compromised in some patients with HFrEF while it is preserved in others. In this study, we aimed to evaluate the role of pulmonary artery stiffness (PAS) in the functional status of patients with HFrEF.MethodsA total of 46 heart failure (HF) patients without overt pulmonary hypertension or right HF and 52 controls were enrolled in the study. PAS was assessed on parasternal short-axis view using pulsed-wave Doppler recording of pulmonary flow one centimeter distal to the pulmonic valve annulus at a speed of 100 mm/sec. PAS was calculated according to the following formula: the ratio of maximum flow velocity shift of pulmonary flow to pulmonary acceleration time.ResultsPAS was significantly increased in the HFrEF group compared to the control group (10.53±2.40 vs. 7.41±1.32, p<0.001). In sub-group analysis of patients with HFrEF, PAS was significantly associated with the functional class of the patients. HFrEF patients with poor New York Heart Association (NYHA) functional capacity had higher PAS compared those with good functional capacity. In multivariate regression analysis, NYHA class was independently correlated with PAS.ConclusionPAS is associated with functional status and should be taken into consideration as an underlying pathophysiological mechanism of dyspnea in patients with HFrEF.