3-minute Step Test Research Articles

Anthropometric characteristics and functional fitness of Chilean community-dwelling older adults

Anthropometry and functional fitness (FF) are fundamental aspects for functional independence conservation of older adults (OA). However, little has been investigated in chilean OA. To analyze anthropometric and FF characteristics of non-disabled OA. One hundred and sixteen subjects participated in the study. It was determined the prevalence of weight categories (Body Mass Index [BMI]) and cardiometabolic risk (CMR) (Waist Circumference [WC], Waist-Hip Ratio [WHR] and Waist-to-Height ratio [WHtR]). Additionally, "under the norm" physical performance and performance standards (Senior Fitness Test Battery [SFT]). Anthropometric and FF differences were analyzed according sex and age categories. A total of 63.8% and 73.5% of men and women respectively were overweight. The highest prevalence of CMR was obtained through WHtR and the tests with the highest prevalence of low performance were 2-minute step Test and Back scratch Test. The performance standard was reached in 29.7% and 17.3%, in men and women respectively. Men presented greater height, WHR, strength and aerobic capacity. Women had greater hip circumference, BMI, WHtR and flexibility. These results tends to be maintained in the analyzes according age categories. The studied sample presented a high prevalence of overweight, CMR and low physical performance especially in women. Due its low cost and complexity, it is proposed that integral evaluation of anthropometric and FF parameters should be implemented in primary care programs aimed to preserving functionality of OA.

Analysis of the effectiveness of ActivLife training in people over 60 years of age: A pilot study

Background One of the most important geriatric problems which increases the risk of injury and disability is falling. The consequences involve fractures of the hips and femoral neck, leading to restrictions in mobility, independence and the quality of life. Reduction of the risk is the main challenge of modern geriatrics. Aim The aim of the study was to analyze the effectiveness of training using the ActivLife system in women over 60 years of age who have declared difficulties in maintaining the balance of the body. Method The study covered a group of 14 women over 60 years of age. The experimental group participated in a 4-week program with the use of the ActivLife system and the author’s exercise program providing assistance in maintaining balance. The Fullerton Functional Fitness Test as well as measurements on a baropodometric platform were applied to assess the effectiveness of the activities. Results In the experimental group, a positive correlation (r=0.769) was observed between the results of attempting to perform the ‘Two minute step test’ and the ‘Chair Stand’ (r=0.850 in the control group). In addition, the studied group experienced a significantly negative correlation (r=-0.838) between the results of attempting to perform the ‘Up-and-Go’ and the ‘chair Stand’ (the control group presented a negative correlation of r= -0.856). In the selected attempts related to fitness and balance, dependencies between different parameters can be observed.

An investigation of the use of the Kinect system as a measure of dynamic balance and forward reach in the elderly

Objective: To investigate the reliability and correlations of Kinect-derived valuables of forward reach distance and velocity with the traditional functional reach distance, scores on posturography, and other measures of physical fitness. Design: Observational study. Setting: Community hospital. Subjects: Individuals >65 years who attended a geriatric health examination were enrolled. Main measures: The Kinect system was used to record the reach distance and velocity of the forward reach test. Center of pressure displacement was measured by posturography. Physical fitness performance was assessed using the 2-Minute Step Test, the 30-Second Chair Stand Test, the Sit-and-Reach Test, grip strength, and walking speed. Results: A total of 442 individuals were enrolled (mean age: 73.3 ± 5.2 years). Forward reach tracking using the Kinect system showed good repeatability and correlated with traditional functional reach (r = 0.719, P < 0.001); the reaching velocity correlated with scores on posturography (r = −0.257, P = 0.047). Reach distances were significantly decreased in the older group (≥75 years) than in the younger group (<75 years) (P < 0.001). Conclusion: The Kinect system provides a simple, reliable, and age-sensitive assessment of balance in older adults. The valuables correlate with the traditional functional reach, scores on posturography, and physical fitness performance. It provides alternative representation of both static and dynamic balance function.

OP21.01: Pre‐pregnancy exercise stress testing is related to normal physiological adaptation from pre‐pregnancy to mid‐pregnancy

It is suggested that maternal cardiovascular(CV) changes in pregnancy are related to pregnancy outcome, specifically failure of these important adaptive changes may result in pre-eclampsia(PE) or fetal growth restriction (FGR). To explore if maternal physiological CV maladaptation could be anticipated prior to pregnancy, we investigated pre-pregnancy (PP) exercise stress testing prior to conception, in association with subsequent pregnancy induced CV changes. We recruited non-smokers with no CV co-morbidities into a pre-conception study. PP, all participants had non-invasive measurements of cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR), heart rate (HR) and brachial blood pressure (BP) at rest. These were repeated during and after a 3-minute Dundee step test. Delta (δ) values were calculated between resting and exercise measurements to deduce exercise stress response. At 22 weeks' gestation resting CV measurements were repeated. Delta values induced by exercise PP were related to longitudinal changes induced by pregnancy (PP to 22wks). There were significant correlations between PP exercise induced CV changes, and PP to 22 weeks induced CV changes for CO, HR, BP and TPR. The strongest correlation was between the PP δTPR during exercise & the pregnancy induced adaptation of TPR from PP to 22 wks (r=0.669, p<0.001.) We explored if the δTPR relationship was also present at 6 weeks gestation and found similar results, though with weaker correlations (r=0.568, P<0.001). TPR exercise response strongly correlates to physiological change in TPR from PP to mid-pregnancy (22wks). This correlation is already present by 6 wks gestation, though to a weaker extent. There are also weaker but significant associations between PP exercise CO, BP and mid-pregnancy adaptation of the same parameters. Therefore, PP exercise testing may be valuable in providing insight into normal physiological adaptation to pregnancy.

P05.08: Differences in pre‐pregnancy stress response between healthy and PE/FGR pregnancies

It is hypothesised that maternal cardiovascular (CV) dysfunction may be present prior to conception. With pregnancy, a decompensation of CV function may manifest as pre-eclampsia (PE) or fetal growth restriction (FGR). We hypothesise that pre-pregnancy (PP) exercise stress testing is comparable to gestation related physiological stress, and may relate to pregnancy outcome. To investigate this, we prospectively examined PP exercise stress test responses in healthy women planning to conceive, in association with subsequent pregnancy outcome, specifically PE/FGR. We recruited non-smokers with no CV comorbidities into a pre-conception study. All participants had non-invasive measurements of cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR), heart rate (HR) and brachial blood pressure (BP) at rest. These tests were repeated during and after a 3-minute Dundee step test. Delta (δ) values were calculated between resting and subsequent exercise measurements to deduce exercise stress response. For data analysis, women who subsequently conceived a pregnancy affected by PE/FGR were assigned to ‘pathology’ group and those with unaffected pregnancies to a control group. Controls had significantly higher CO (mean CO 10.14 vs 8.76 L/min, p= 0.042) and SV(p=0.016) compared to the pathology group. δTPR between the groups was also statistically different(p=0.007). PE/FGR group have greater peak HR and delta HR values (peak HR[control =99.56 bpm, pathology =111/33bpm, P=0.002] and δHR response [control mean=17.87 bpm, pathology mean=26.72 bpm P=0.032]). We report differences in cardiovascular response to stress between women who subsequently conceive a pregnancy affected by PE/FGR and those with normal pregnancy outcome. Normal stress response is increased CO and reduced TPR. CO increments by increasing SV was more pronounced in controls, whereas the pathology group had more pronounced HR increase.

Exercise Capacity Impairment Can Predict Postoperative Pulmonary Complications after Liver Transplantation

Background: Postoperative respiratory complications (PRCs) are common after liver transplantation (LT) and contribute significantly to the related morbidity and mortality. Objective: The aim of this paper was to determine the incidence of PRCs after LT and the value of simple exercise capacity measures as independent predictors of PRCs. Methods: We conducted a prospective cohort study of consecutive adults submitted to LT at a University Hospital in Fortaleza Brazil from March 2013 to March 2015. At baseline, exercise capacity was assessed with the 6-minute walk test (6MWT) and the 6-minute step test (6MST), lung function was tested by spirometry, and respiratory muscle strength was measured by maximal respiratory pressure. Additional relevant pre- and intraoperative data were collected through interview and chart review, and their association with the incidence of PRCs was evaluated. Results: The study included 100 subjects, 44% of whom presented at least 1 of the PRCs. In the univariate analysis, poor 6MST and 6MWT results and a longer preoperative cold ischemia time were associated with PRCs. The logistic regression analysis showed that PRCs were less likely to occur when preoperative walking distances were longer: the odds ratio (95% CI) was reduced to 0.589 (0.357-0.971) for each 50 m walked (p = 0.03). Likewise, PRCs were more likely to occur in patients with longer preoperative cold ischemia times: the odds ratio (95% CI) increased to 1.008 (1.002-1.015) for each minute (p = 0.01). Conclusion: The incidence of PRCs is high in LT patients. A prolonged cold ischemia time and preoperative 6MWT results were independent predictors of PRCs in this patient population.

EFFECTS OF A SIX-WEEK STRENGTH TRAINING PROGRAM ON FUNCTIONAL FITNESS LEVELS AMONG OLDER ADULTS

Introduction: Muscular strength, flexibility, aerobic endurance, and balance are well-known contributors to health and quality of life among older adults. Prior research has indicated older adult participation in resistance training provides foundational strength for performance of activities of daily living. Purpose: To investigate the effects of a six-week progressive resistance training program on strength, flexibility, aerobic endurance, and dynamic balance and agility among community-dwelling older adults. Methods: From 2010–2015, ten separate sessions of a six-week progressive resistance training program were implemented and resulted in a total of 95 community-dwelling older adult participants (37 male, 58 female; M=73.5 + 7.2). The resistance-training program included bi-weekly, 1-hour sessions targeting all muscle groups. Assessments included 30-second arm curl, 30-second chair stand, back scratch, chair sit-n-reach, 2-minute step test, and 8-foot up-and-go. Statistical Analysis: The Wilcoxon Signed-Rank Test was performed to evaluate group differences between baseline and post-program for upper- and lower-body strength, upper- and lower-body flexibility, aerobic endurance, dynamic balance and agility. Results: Significant differences between pre- and post-assessments were found for upper- and lower-body strength (z = 6.81, p < .001; z = 6.46, p < .001, respectively); upper- and lower-body flexibility (z = 3.81, p < .001; z = 4.85, p < .001, respectively), aerobic endurance (z = 6.04, p < .001), and dynamic balance and agility (z = 5.52, p < .001). Conclusion: The six-week progressive resistance-training program targeting all muscle groups resulted in significant improvements in strength, flexibility, aerobic endurance, balance, and agility among community-dwelling older adult participants.

Identifying predictive motor factors for falls in post-menopausal breast cancer survivors.

ObjectiveBreast cancer treatment, including radical surgery, is also pursued as late as the 7th - 8th decade of women’s lives. Standard physical rehabilitation procedures offered to those women are predominantly focused on attenuating specific functional deficits of the upper limb and trunk. Seldom do they entail any regimens specifically aimed at recovering overall functionality, and reducing exposure to falls-risk.The study aimed to assess potential interrelationships between the self-reported falls, individual functional capabilities and appreciably reducing exposure to falls-risk in a group of post-menopausal, post-surgical breast cancer survivors.MethodsThe study recruited 102 women (aged 65–79; mean age 70.2), post-surgical breast cancer survivors. The subjects were stratified by age into three groups: Group 1 (65–69 years); Group 2 (70–74 years), and Group 3 (75–79 years). Individual functional capabilities were assessed with Eight-foot up & go test (8UG), chair stand test (CST), and 2-minute step test (2ST). Tinetti POMA test was applied to assess gait and balance disorders. Self-reported falls in the past year were ascertained through a questionnaire.ResultsAssessment of individual aerobic endurance (2ST) also demonstrated a clear deficit in the mean scores category in all respective age sub-groups, as compared against the reference values. The deficits ranged from 4.86 to 15.90 steps less than the normative values; the oldest subjects demonstrating the largest deficit. The aerobic endurance tests results significantly impacted the ultimate assessment of an individual falls-risk in the oldest group. The analysis of the number of falls sustained within the recent year indicated that 43.67% of the subjects fell victim of such incidents.ConclusionAn individual exposure to falls-risk was found to be appreciably more dependent upon individual aerobic endurance rather than overall strength of the lower part of the body in the breast cancer survivors over 75.

The association between high blood pressure, physical fitness and fatness in adolescents.

Hypertension is a health problem that is of national importance. It is a major risk factor for the occurrence of atherosclerosis and cardiovascular, cerebrovascular and renal diseases that are leading or among the leading causes of mortality and morbidity as in ours, as in the most developed and less developed countries. The purpose of this study is to analyze the relation of cardiorespiratory fitness and obesity, blood pressure and hypertension for adolescents. The research was realized on a sample of 4,051 boys and girls at the age of 11 to 14 years. Cardiorespiratory fitness was assessed by using a three minute step test, while the percentage of body fat was determined by bioelectrical impedance method. Blood pressure was measured three times at intervals of 60 seconds, and the result was the median value of the three measurements. The measurements were performed in a separate room with optimum ambient conditions. The relation between hypertension, cardiorespiratory fitness and fat was determined by correlation and multi-nominal logistic regressive analysis. Boys had higher systolic pressure and lower diastolic pressure compared to girls. The low level of cardiorespiratory fitness and high percentage of body fat were independently associated with an increased risk of blood pressure and hypertension for both boys and girls. The interaction was established between the percentage of body fat and fitness. The results should be taken into account for building strategies and recommendations for improvement of lifestyle and health for adolescents.

The Moderating Role of Insulin-Like Growth Factor 1 in the Relationship Between Cognitive and Aerobic Endurance Change.

Improvements in cognition often accompany fitness improvements in older adults, and research suggests insulin-like growth factor 1 (IGF-1) may influence this association. No prior work has examined this in mild cognitive impairment (MCI). We predicted that IGF-1 would moderate the relationship between cognition and aerobic endurance improvement, such that greater baseline IGF-1 would accompany a stronger relationship between cognition and aerobic endurance change. Twenty-seven individuals with MCI completed assessments of aerobic endurance (2-minute step test [2MST]) and global cognition (Modified Mini-Mental State [3MS]) before and after a 6-month period of twice-weekly exercise. Serum IGF-1 levels were assessed at baseline via fasted blood draw. The Johnson-Neyman technique determined whether baseline IGF-1 levels moderated the relationship between changes in aerobic endurance (Δ2MST) and cognition (Δ3MS). A significant interaction was found; however, Δ2MST was inversely associated with Δ3MS in individuals with above-average serum IGF-1 levels; this relationship was strengthened as IGF-1 increased and was not seen when IGF-1 was below average. The relationship between cognitive and aerobic endurance change varies as a function of IGF-1 in persons with MCI. Additional work is needed to clarify the mechanisms of these findings.

Validation of a 2 Minute Step Test for Assessing Functional Improvement

Introduction: Although many cardiopulmonary patients require home care services, the 6-minute walk test (6MWT) is unusable in most dwellings for objectively evaluating exercise capacity because it requires a 20 - 30 meter hallway. To meet this need, we developed a 2-minute step test (2MST): stepping up and down an 8 inch step for 2 minutes (1 step = bilateral step up + step down). Purpose: Evaluate the statistical validity, reproducibility, and sensitivity of the 2MST in assessing exercise capacity. Method: We compared the heart rate, oxygen saturation and perceived exertion obtained during performance of 2MST with those obtained during the 6MWT. Results: Comparing 2MST and 6MWT in 158 subjects for validity, r = 0.925 (P < 0.0001). They were statistically equivalent in heart rate (98 ± 4 and 94 ± 4 bpm), oxygen saturation (96 ± 0.5 and 95 ± 0.6%), rating of perceived exertion (14.6 ± 0.4 and 13.4 ± 0.4), and blood pressure (130 ± 4/62 ± 3 and 128 ± 3/62 ± 2 mmHg), (mean ± SE, 2MST and 6MWT, respectively). Reproducibility revealed small learning effects: 8% and 5% for the 2MST and 6MWT, respectively (P < 0.001). Sensitivity of the 2MST was high, based both on the number of steps achieved by inpatients (27 ± 13 steps, mean ± SD), outpatients (48 ± 14 steps), and healthy subjects (64 ± 18 steps) (P < 0.001), and by the outpatients before (36 ± 11 steps) and after (42 ± 14 steps) rehabilitation (P < 0.001). Conclusion: The 2MST is valid, reproducible, sensitive, safe, well-tolerated, and is a suitable substitute for the 6MWT.

Algorithm for Predicting Disease Likelihood From a Submaximal Exercise Test.

We developed a simplified automated algorithm to interpret noninvasive gas exchange in healthy subjects and patients with heart failure (HF, n = 12), pulmonary arterial hypertension (PAH, n = 11), chronic obstructive lung disease (OLD, n = 16), and restrictive lung disease (RLD, n = 12). They underwent spirometry and thereafter an incremental 3-minute step test where heart rate and SpO2 respiratory gas exchange were obtained. A custom-developed algorithm for each disease pathology was used to interpret outcomes. Each algorithm for HF, PAH, OLD, and RLD was capable of differentiating disease groups (P < .05) as well as healthy cohorts (n = 19, P < .05). In addition, this algorithm identified referral pathology and coexisting disease. Our primary finding was that the ranking algorithm worked well to identify the primary referral pathology; however, coexisting disease in many of these pathologies in some cases equally contributed to the cardiorespiratory abnormalities. Automated algorithms will help guide decision making and simplify a traditionally complex and often time-consuming process.

To Study the Effect of Post-Operative Physiotherapy Management in PostCABG Patients

Backround: Coronary Artery Bypass Graft (CABG) surgery is a form of heart surgery that redirects blood around clogged arteries to increase blood flow and oxygen to the heart. During CABG surgery, the surgeon uses a portion of a healthy vessel (either an artery or vein) from the leg, chest, or arm to create a bypass around the clogged artery. Patients typically receive 1 to 5 bypasses per operation depending on how many coronary arteries (and their main branches) are blocked. During CABG surgery with cardiopulmonary bypass a heart-lung machine artificially maintains blood circulation and oxygenation while the surgeon operates on the heart. Aims and Objectives: To increase cardiac efficiency, increase exercise tolerance or endurance and to get the effective and better post-operative results. Further at the end of the study we should be able to plan out an effective treatment plan for post-operative CABG patients and know the effect of Master 2-minute step test and 6- minute walk test in post–operative CABG patients. Methodology: Study was conducted in Hero DMC heart institute in Punjab. Sixty-seven study participants (aged between 40 years to 70 years) were randomly recruited to the study. Recruited study participants received treatment in two sessions that is master 2-minute step test procedure was used in morning and 6-minute walk test procedure was used in evening session. Assessment and reassessment was done before and after completion of treatment procedure on every day and data was collected using assessment format for 3rd and 7th day. Outcome measures: Primary outcome in both master 2- min step test and 6-min walk test showed that there occurs decrease in heart rate, respiratory rate, increase in oxygen saturation and decrease in exertion. Secondary outcomes included more decrease in heart rate, respiratory rate and fatigue and increase in oxygen saturation. Improvement in faster heart function elaborated from the Heart rate (p<0.05) with both procedures that is master 2-minute step test and 6- minute walk test. Conclusion: The result obtained after statistical analysis shows that both master 2-minute step test and 6-minute walk test has the additional advantage of faster recovery as analyzed from mean of the before and after exercise using Tukey’s method on both of 3rd day and 7th day.

Clinical and Functional Phenotypes of Chronic Obstructive Pulmonary Disease, the Effect on the Severity of the Disease and Prognostic Value in Assessing the Risk of Disease Progression

Chronic obstructive pulmonary disease (COPD) is characterized by progressive limitation of airflow rate, hyperergic inflammatory response of the respiratory tract, and systemic manifestations. Prognosis of the disease depends on the severity of these pathogenetic components. FEV1 which characterizes the speed limit airflow do not allow predicting the rate of COPD progression. Comparison of the prognostic significance of such clinical parameters as frequency of exacerbations and the development of comorbid diseases to assess the nature of COPD progression by using different classification approaches. The prospective comparative study included 98 patients with COPD. In the framework of the study protocol, 2 visits were required when a practitioner recruited patients who met inclusion/exclusion criteria, obtained the signed informed consent, collected the anamnestic data, and performed basic procedures of the study: spirometry, 6-minute stepper test, assessment of dyspnea on questionnaire mMRC, body plethysmography, lung diffusion capacity study, dopplerechocardiography, tomography of the chest. Visit 2 was conducted in 12 months after the first one to assess the dynamics of the disease. The dynamics of the disease was considered negative if, upon repeated examination, the patient was referred to the group with more severe COPD. Our study demonstrates that comprehensive assessment of such factors as the frequency of COPD exacerbations in the preceding 12 months and the presence of comorbid diseases in a patient is reasonable for assessment of disease severity and determination of disease prognosis. At the same time the frequency of COPD exacerbations as one of the evaluated factors is most strongly associated with disease progression. Thus, a practitioner is recommended to use the proposed additional clinical criteria to assess the severity and degree of progression of COPD.

Association of Fluid Status and Body Composition with Physical Function in Patients with Chronic Kidney Disease.

BackgroundImpairment of physical function and abnormal body composition are the major presentations in patients with chronic kidney disease (CKD). The aim of this study is to investigate the relationship between body composition and physical function in CKD patients.MethodsThis cross-sectional study enrolled 172 of CKD stages 1–5 from February 2013 to September 2013. Handgrip strength (upper extremity muscle endurance), 30-second chair-stand test (lower extremity muscle endurance) and 2-minute step test (cardiorespiratory endurance) were used as indices of physical function. Body composition, including fluid status (extracellular water/total body water, ECW/TBW), lean tissue index (LTI), and fat tissue index (FTI), was measured using a bioimpedance spectroscopy method.ResultsAll patients with high ECW/TBW had lower handgrip strength and 30-second chair-stand than those with low ECW/TBW (P<0.001 and P = 0.002). CKD patients with high FTI had lower handgrip strength and 30-second chair-stand than those with low FTI (P<0.001 and P = 0.002). These patients with low LTI had lower handgrip strength than those with high LTI (P = 0.04). In multivariate analysis, high ECW/TBW was positively associated with decreased handgrip strength (β = -41.17, P = 0.03) in CKD patients. High FTI was significantly correlated with decreased times of 30-second chair-stand (β = -0.13, P = 0.01). There was no significant relationship between body composition and 2-minute step test.ConclusionsOur results show a significant association of impaired upper and lower extremity muscle endurance with high fluid status and fat tissue. Evaluation of body composition may assist in indentifying physical dysfunction earlier in CKD patients.

Evaluation of a Laughter-based Exercise Program on Health and Self-efficacy for Exercise.

Despite health benefits of physical activity (PA) and risks of physical inactivity, many older adults do not accumulate sufficient levels of PA to achieve associated health benefits. Lack of PA enjoyment may be a barrier to PA participation. Combining simulated laughter and PA for strength, balance, and flexibility is a potential solution for helping older adults maintain independence in activities of daily living through enjoyable participation in PA. The purpose of this study is to assess whether combining simulated laughter exercises with a moderate-intensity strength, balance, and flexibility PA program (i.e., LaughActive) increases participation in PA, health, and self-efficacy for PA among older adults residing in 4 assisted living facilities (ALFs). The 12-week wait list control pilot study used pre- and 6-week post-intervention comparisons within and between groups identified by paired sample t-test results among those who participated in twice-weekly LaughActive classes (n = 27). Significant improvements (p < .05-.10) were observed in mental health (SF-36v2), aerobic endurance (2-minute step test), and self-efficacy for exercise (OEE). PA programs that elicit positive emotions through simulated laughter have the potential to improve health, physical performance, and self-efficacy for PA among older adults and may positively influence participant adherence.

Physical Activity Self-Efficacy and Fitness: Family Environment Relationship Correlates and Self-Esteem as a Mediator among Adolescents Who Are Overweight or Obese.

Little is known regarding how dimensions of the family social environment relate to fitness levels and physical activity self-efficacy (PASE) among adolescents who are overweight or obese and whether these relationships are mediated by self-esteem. Potential associations were evaluated between relationship subdomains (cohesion, conflict, expressivity) of the Family Environment Scale (FES), self-esteem (Rosenberg Self-Esteem Scale, RSES), and PASE and fitness, using recovery heart rate [RHR, beats per minute (bpm)] from a 3-minute submaximal step test at baseline. Participants were 108 adolescents who were overweight or obese and were seeking weight-loss treatment as part of the Healthy Kids, Healthy Weight 12-week multidisciplinary pediatric weight management program. Structural equation modeling (SEM) was used to simultaneously evaluate paths between these variables and test for mediation. In multivariable models, higher FES cohesion (β = -2.18, s.e. = 0.98; p = 0.02), expressivity (β = -1.97, s.e. = 0.99; p < 0.05), and PASE (β = -0.64, s.e. = 0.33; p < 0.05) scores were associated with lower RHR, which represents higher fitness. Furthermore, higher FES conflict scores were associated with lower RSES scores (β = -0.83, s.e. = 0.29; p < 0.01), and FES conflict (β = -0.63, s.e. = 0.22; p < 0.01) and RSES (β = 0.33, s.e. = 0.07; p < 0.01) were associated with PASE scores. In a good-fitting multivariate SEM [Comparative Fit Index (CFI) = 1.00; Standardized Root Mean Square Residual (SRMR) = 0.02; Tucker-Lewis index (TLI) = 1.22; Root Mean Squared Error of Approximation (RMSEA) <0.01], RSES mediated the relationship between FES conflict and PASE (sum of indirect paths: β = -0.30, s.e. = 0.11; p < 0.01) scores. Our results highlight the importance of the relationship domain of the family environment on self-esteem, PASE, and physical fitness in adolescents who are overweight or obese.

Assessment of inter-rater variability of the Senior Fitness Test in the geriatric population: A community based study

Background: Maintenance of physical activity is of paramount importance in geriatric care and it is imperative to be able to objectively assess physical activity level in the geriatric population. However, majority of the established assessment protocols are designed for relatively younger adults, and are not validated for the elderly. The Senior Fitness Test (SFT) is aimed at assessing the underlying functional fitness for older adults. Methods: A community based prospective study to assess the test-retest reliability of SFT in elderly subjects, aged 65 – 75 years. Subjects with any acute illnesses, acute musculoskeletal injury, hypertension, and with visual problems hampering test performance were excluded. The study was conducted by two observers on two days at the subject’s own locality. The Intraclass Correlation Coefficient (ICC) with 95% confidence intervals (CIs) was used as a measure of relative reliability. The standard error of measurement and minimal detectable change (MDC) were used to measure absolute reliability. Results: Thirty one participants (mean age- 68.32±2.58 years) were assessed. The ICC reflected high reliability (0.934–0.994) in all SFT items. MDC values (90% CI) for various SFT were as follows: chair sit and reach test = 1.55, back scratch test = 1.41, 30 second chair stand test = 1.15, 30-second arm curl test = 2.53, 8 foot up-and-go test = 1.47 and 2-minute step test = 1.40. Bland–Altman plots for all the tests were positively skewed and heteroscedastic. Conclusion: The SFT showed high test–retest reliability and thus is suitable for evaluating physical fitness in elderly and can be utilized in larger studies for the geriatric population.

Responsiveness and Minimally Important Difference of the 6-Minute Stepper Test in Patients with Chronic Obstructive Pulmonary Disease

Background: The validity and reproducibility of the 6-minute stepper test (6MST) have already been demonstrated in patients with chronic obstructive pulmonary disease (COPD). Objectives: The aim of this study was to evaluate the responsiveness of the 6MST to pulmonary rehabilitation (PR) in patients with COPD, to determine a minimal important difference (MID) for the 6MST, and to compare the 6MST and the 6-minute walk test (6MWT). Methods: Sixty-two patients with COPD were included in a prospective experimental study. Participants underwent a 3-week inpatient PR program. The primary outcome was the change in the number of steps during the 6MST measured before and after PR. The secondary outcome included the change in the 6-minute walking distance (6MWD) pulse oximetry, heart rate, dyspnea, and leg discomfort during the tests measured before and after PR. MID was determined by anchor-based and distribution approaches. Results: After PR, we observed a significant increase in the number of steps during the 6MST (22.5 steps; 95% CI 13.8-31.3; p < 0.0001) and in the 6MWD (26.6 m; 95% CI 17.6-35.5; p < 0.0001). The 6MST and 6MWT were improved by 10.1 and 6.5%, respectively. The number of steps during the 6MST was significantly correlated with the 6MWD before (r = 0.72; p < 0.0001) and after PR (r = 0.66; p < 0.0001). MID was estimated to be around 20 steps. Conclusion: The 6MST appears to be as responsive as the 6MWT in assessing functional improvement during PR in patients with COPD. The 6MST is a low-cost assessment and requires limited space.

Cardiopulmonary efficeincy evaluation in women between 50 and 80 years of age in Kujawsko-Pomorskie Voivodeship, Poland

One of major obstacles in social activity routines is aging and all impairments generated by this inevitable process. Thus, in order to facilitate the effective functioning of elderly people within a society, our attention should be drawn to the quickly advancing consequences of aging. The purpose of this study is to evaluate cardiopulmonary efficiency in a chosen group of women above 50 years of age in Kujawsko- Pomorskie Voivodeship. 3413 women, aged 50-80 years participated in the study. Subjects were divided into six age groups. The BMI was calculated for each participant. All women were subjected to a 2-minute step test. All participants completed the study. The results of the ‘2-minute Step’ tests showed a decrease of cardiopulmonary efficiency in women. The downslide was correlated with age. Test results indicate unmistakably that cardiopulmonary efficiency diminishes with age. Secondly, bigger cardiopulmonary efficiency will make it easier for women to cope with everyday work. Finally, cardiopulmonary efficiency is shown here to be a parameter worth improving while creating special health programs for seniors.