Physical Functional Capacity Research Articles

Functional capacity and risk of falls in the elderly with metabolic syndrome

Introduction: Metabolic syndrome (MetS) is the most common metabolic abnormality in the population that predisposes to cardiovascular events and may be related to poor physical fitness and low functional capacity in the elderly. The objective of this study was to evaluate the interference of metabolic changes in functional capacity and risk of falls in the elderly. Methods: A cross-sectional study was carried out with 126 elderly subjects, 58 presented MetS and 68 without MetS, according to the criteria of the International Diabetes Federation. Katz Index, Tinetti Index, Timed Up and Go test and Berg Scale were applied to evaluate the functional capacity. Falls Efficacy Scale-International scale (FES-I-Brazil) was used to evaluate the fear of falling. For statistical analysis, the Mann-Whitney, Chi-square and Spearman correlation tests were used. Results: There was an association between the MetS and non-MetS groups in relation to the risk strata of the TUG index [p=0.02; OR=0.38; 95%CI (0.16-0.91)]. Between these two groups, there was a significant difference in the mean of the following markers: Berg scale (p=0.03); TUG (p=0.03); FES-I-Brazil (p=0.02). The Kats and IPAQ index did not show any significant association. Conclusions: Elderly patients with MetS presented higher risk and fear of falls when compared to patients without MetS. However, there was no variation in walking ability or balance.

Physical activity and serious adverse events in patients with atrial fibrillation and/or atrial flutter treated with catheter ablation

BackgroundAtrial fibrillation (AF) and atrial flutter (AFL) are cardiac arrhythmias associated with cardiovascular morbidity. Physical activity (PA) can trigger AF and AFL recurrence, but can also improve physical functional capacity in this patient group. Guidelines do not include concrete recommendations regarding PA for this patient group. ObjectiveTo assess the impact of the level of PA on risk of serious adverse events (SAEs) in patients with AF and/or AFL treated with catheter ablation. MethodsA prospective cohort study including 462 patients with AF and/or AFL treated with catheter ablation from the CopenHeart Survey. The International Physical Activity Questionnaire (IPAQ) was used to explore patients’ self-reported level of PA. SAEs were identified in the Danish National Patient Register and the Danish Civil Registration System one year after study onset. Cox regression analysis was carried out to assess the risks of SAE. ResultsDuring the one-year follow-up period, 98 patients (21.8%) experienced at least one SAE. Patients with a moderate-high PA level had a 36% lower risk of experiencing SAEs during the follow-up period, compared to patients in the low PA group, after adjusting for confounders. ConclusionA moderate-high vs. low level of PA was found to be associated with a lower incidence of SAEs in patients undergoing AF and/or AFL ablation.

Are there differences in the physical activity level and functional capacity among children and adolescents with and without asthma?

ObjectiveThe aim of this study was to analyze the physical activity level, using two tools, and the functional capacity of children and adolescents with asthma and with different levels of disease control, and to compare them to those of individuals without asthma. MethodsCross-sectional study with children and adolescents with (asthma group, AG) and without asthma (WAG), aged from 7 to 17 years. All participants performed the six-minute walk test (6MWT), the Glittre Activities of Daily Living test (Glittre-ADL), the International Physical Activity Questionnaire (IPAQ), and daily record of steps on a pedometer. ResultsThe study included 145 individuals with asthma and 173 individuals without asthma. The WAG walked a greater distance in the 6MWT and performed the Glittre-ADL in less time than the AG. Individuals with uncontrolled, partially controlled, and controlled asthma presented the same functional capacity. A difference was observed in the IPAQ classification, with 13.9% of participants from the WAG being sedentary, compared with 26.2% in the AG. The mean quantity of steps measured by the pedometer was higher in the WAG. ConclusionThere was a difference in the performance of individuals with and without asthma in the physical activity and functional capacity tests. The AG presented worse performance in the physical activity tests and, regardless of the level of asthma control, presented worse functional capacity.

Identification of cardiovascular and molecular prognostic factors for the medium-term and long-term outcomes of sepsis (ICROS): protocol for a prospective monocentric cohort study.

IntroductionSepsis is one of the most prevalent life-threatening conditions in the intensive care unit. Patients suffer from impaired organ function, reduced physical functional capacity and decreased quality of life even after surviving sepsis. The identification of prognostic factors for the medium-term and long-term outcomes of this condition is necessary to develop personalised theragnostic approaches. Sepsis can cause cardiac impairment. The impact of this septic cardiomyopathy on patient’s long-term outcome remains unclear. This study aims to evaluate cardiovascular risk factors, particularly the occurrence of septic cardiomyopathy, regarding their suitability as prognostic factors for the short-term and long-term outcomes of septic patients. Additionally, the study seeks to validate preclinical pathophysiological findings of septic cardiomyopathy in the clinical setting.Methods and analysisIn this prospective monocentric cohort study, patients will be clinically assessed during the acute and postacute phase of sepsis and two follow-ups after 6 and 12 months. To determine the effect of septic cardiomyopathy and concomitant cellular and molecular changes on patient mortality and morbidity, a comprehensive cardiovascular and molecular deep phenotyping of patients will be performed. This includes an echocardiographic and electrocardiographic assessment, and the evaluation of heart rate variability, body composition, mitochondrial oxygen metabolism, macrocirculation and microcirculation, and endothelial barrier function. These analyses are complemented by routine immunological, haematological and biochemical laboratory tests and analyses of the serum metabolome and lipidome, microbiome and epigenetic modifications of immune cells. The reversibility of patients’ organ dysfunction, their quality of life and physical functional capacity will be investigated in the follow-ups. Patients with cardiomyopathy without infection and healthy subjects will serve as control groups.Ethics and disseminationApproval was obtained from the Ethics Committee of the Friedrich Schiller University Jena (5276-09/17). The results will be published in peer-reviewed journals and presented at appropriate conferences.Trial registration numbersDRKS00013347; NCT03620409.

P294 The level of physical activity, lung function and exercise capacity of children and adolescents with cystic fibrosis compared to healthy controls

P294 The level of physical activity, lung function and exercise capacity of children and adolescents with cystic fibrosis compared to healthy controls

P0648LEVELS OF PHYSICAL ACTIVITY FOLLOWING AN EPISODE OF STAGE 3 AKI ARE ASSOCIATED WITH RENAL RECOVERY

Abstract Background and Aims Acute kidney injury (AKI) is a known risk factor for the development of chronic kidney disease (CKD). Animal studies have demonstrated the potentially reno-protective effects of physical activity, both against the development of AKI and in promoting renal recovery. However, this has not been investigated in humans. The aim of the study was to investigate the association between physical activity levels and recovery in kidney function, measured by eGFR and creatinine, following an episode of stage 3 AKI. Method Twelve hospitalised participants with non-obstructive stage 3 AKI (as per KDIGO criteria) were asked to complete two questionnaires; the General Practitioner Physical Activity Questionnaire (GPPAQ), a measure of physical activity and; the Duke Activity Status Index, a measure of functional capacity. Baseline questionnaires were completed whilst in hospital (where participants were asked to recall their physical activity and functional capacity levels before hospitalisation) and again at 6-months post discharge. In addition, participants wore a pedometer for 7 consecutive days following discharge to ascertain their daily step count. Baseline renal function was collected using eGFR and creatinine measurements within the 12-months prior to admission; further readings were collected 25 ± 46 days after discharge as a measure of renal recovery (referred to as recovered creatinine). Results Data from the 12 participants who provided step count information were analysed. At diagnosis of stage 3 AKI, participants had a mean creatinine of 547 ± 280 with their mean baseline and recovered creatinine as follows; 95 ± 35 and 172 ± 83. A higher daily step count after discharge was associated with both a higher baseline eGFR (r=0.73, p<0.01) and significant improvements to their renal recovery (r=0.69, p=0.01). There were positive associations between renal recovery and physical activity levels measured using the GPPAQ (r=0.55, p=0.06) and functional capacity (0.17, p=0.6), although not to statistical significance. The participants were divided into two groups based on their recovered creatinine levels. Those who recovered renal function back to within 25% of baseline (n=5) had a higher mean step count compared to those whose renal recovery was less pronounced (n=7); (3712 ±3960 vs 3334 ± 2254, respectively). Conclusion These results show a positive association between physical activity levels and renal recovery following an episode of AKI. This suggests that higher levels of physical activity may be protective and promote recovery of renal function following an episode of AKI. Physical activity and exercise interventions should be tested in the setting of AKI to see whether they are efficacious in promoting renal recovery.

Long-term changes of exercise hemodynamics and physical capacity in chronic thromboembolic pulmonary hypertension after pulmonary thromboendarterectomy

BackgroundA substantial number of chronic thromboembolic pulmonary hypertension (CTEPH) patients experience dyspnea on exertion and limited exercise capacity despite surgically successful pulmonary endarterectomy (PEA). We sought to prospectively evaluate resting and peak exercise hemodynamics before, 3 and 12 months after PEA in consecutive CTEPH-patients and correlate it to physical functional capacity. Methods and resultsTwenty consecutive CTEPH-patients were examined. Twelve months after PEA, 75% of patients with severely increased pre-PEA mean pulmonary arterial pressure (mPAP) at rest had normal or mildly increased mPAP. However, mPAP reduction was less pronounced during exercise where only 45% had normal or mildly increased mPAP at 12 months. Hemodynamic changes during exercise were tested using the pressure-flow relationship (i.e. mPAP/cardiac output (CO) slope). The average mPAP/CO slope was 7.5 ± 4.2 mm Hg/L/min preoperatively and 3.9 ± 3.0 mm Hg/L/min at 12 months (p < .005). CO reserve (CO increase from rest to peak exercise) was increased (5.7 ± 2.9 L/min) 12 months after PEA compared with pre-PEA (2.5 ± 1.8 L/min), p < .0001. However, 12 months after PEA, the CO reserve was only 49% of that of healthy controls, p < .0001. Changes in cardiac output (∆CO), calculated as the difference between CO before PEA and 12 months later, were significantly correlated with six-minute-walk-test and peak oxygen uptake (VO2), both at rest and peak exercise. ConclusionInvasive exercise hemodynamic examination in CTEPH-patients demonstrates that after otherwise successful PEA surgery, >50% of patients have a significant increase in exercise mPAP, and the CO reserve remains compromised 12 months after PEA. Improvement in physical capacity is correlated with ∆CO.

Is the Leukocyte Telomere Length Associated with Decreased Physical Functional Capacity in the Elderly?

Leukocyte telomere length in the elderly has been positively associated with healthy living and physical activity. Factors that interfere with telomere shortening are similar to those that may be associated with decreasing functional capacity. To investigate the relationship between mean leukocyte telomere length and functional capacity in community-dwelling elderly individuals, this is an observational, cross sectional, multicentric study conducted with elderly Brazilian patients. Sample characterization was performed using a sociodemographic clinical questionnaire. Telomere length was evaluated by quantitative polymerase chain reaction, and functional capacity was evaluated by the Short Physical Performance Battery (SPPB). A total of 113 elderly individuals (age 70 ± 5.4 years; 75 women and 38 men) were enrolled in this study. Unexpectedly, it was found that lower relative telomere length was associated with better physical capacity in the global SPPB score. Although telomere shortening is observed with increasing age, it is not associated with decreased functional capacity. Functionality is broad and multidimensional, involving the connection of biopsychosocial and cultural factors. While functionality may not be considered a marker of functional aging in an elderly cohort, it can still play an important role in longitudinal studies, which attempt to elucidate process theories. Future studies should use different techniques to measure telomere lengths in subpopulations of cells.

The Relationship between Physical Activity Levels and Functional Capacity in Patients with Advanced Chronic Kidney Disease.

The purpose of this study is to assess whether the functional capacity of patients with chronic kidney disease stage V (CKD-5D) is different depending on their physical activity levels. We also compared functional capacity, quality of life, and symptoms of depression depending on treatment modalities (HD vs. PD). A Cross-sectional study included 52 patients (35HD and 17PD; males 61.5%, mean age 71 years). The main measurements were physical activity level using the Human Activity Profile questionnaire (HAP), muscle strength, functional capacity, health-related quality of life (HRQoL), and depressive symptomatology. The functional tests and physical activity levels correlated significantly. Participants on HD with low physical activity levels were older (*p ≤ .039) and had worst physical function (*p ≤ .01). The HAP is a useful tool to detect subjects with low functional capacity; there were no differences between the therapy modalities in terms of functional capacity, HRQoL, or depressive symptomatology.

Physical performance and aerobic capacity of qualified wrestlers balanov

Physical performance and aerobic capacity of qualified wrestlers balanov

Effects of Brisk Walking Combined with Green Tea Extract on the Aerobic Capacity and Physical Fitness Function in Overweight and Obese Men: A Randomized, Double-Blind, Placebo-Controlled Trial

In the present study we investigated the effects of brisk walking combined with GTE ingestion on the physical fitness function and aerobic capacity of inactive overweight and obese men. Participants were randomly assigned to the GTE group (150 mg GTE/tablet, twice/day) or the placebo group. All subjects in the GTE group (n = 12) or placebo group (n = 12) took part in the 12-week intervention program, and were followed for 4 weeks post-intervention. All variables were measured at week 0, week 12 and week 16. We found a significant increase in the aerobic capacity in both groups (P P P balance.

Static balance in older adults with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation

OBJECTIVE: To compare balance between older adults with and without chronic obstructive pulmonary disease (COPD) in tasks involving proprioceptive changes and respiratory muscle load, and to investigate the association between balance, functional capacity, and peripheral and respiratory muscle strength. METHODS: Fourteen older adults with COPD undergoing pulmonary rehabilitation and nine older adults without pulmonary disease were evaluated for static balance on a force platform under four conditions: eyes open, eyes closed, eyes closed on foam, and eyes open with respiratory overload. Differences between groups, among conditions and group/condition interactions, were tested using two-way ANOVA. Associations were explored using Pearson’s correlation coefficient. RESULTS: No differences in the posturographic variables were found in the group/condition interactions (p ≥ 0.23). The COPD group exhibited greater total displacement (F = 8.79, p = 0.003), mediolateral sway (F = 4.01, p = 0.04) and anteroposterior velocity (F = 4.28, p = 0.04) in the group effect analysis. Significant differences were found between eyes closed on foam and other conditions for all posturographic variables: anteroposterior sway (F = 13.39), mediolateral sway (F = 28.58), total displacement (F = 59.4), area (F = 37.68), anteroposterior velocity (F = 26.42), and mediolateral velocity (F = 33.29), in the condition effect analysis (p &lt; 0.001, post-hoc). In the COPD group, significant correlations were found between the Glittre-ADL test, anteroposterior sway (r = 0.68, p = 0.01), and anteroposterior velocity (r = 0.67, p = 0.009); the 6MWT was also correlated with anteroposterior velocity (r = 0.59, p = 0.03). CONCLUSION: Older adults with COPD present balance deficits compared to healthy individuals. The unstable surface caused greater postural instability compared to other conditions in both groups. Impaired balance was associated with reduced physical function and exercise capacity.

The Impact of Sprint Interval Training Frequency on Blood Glucose Control and Physical Function of Older Adults.

Exercise is a powerful tool for improving health in older adults, but the minimum frequency required is not known. This study sought to determine the effect of training frequency of sprint interval training (SIT) on health and physical function in older adults. Thirty-four (13 males and 21 females) older adults (age 65 ± 4 years) were recruited. Participants were allocated to a control group (CON n = 12) or a once- (n = 11) or twice- (n = 11) weekly sprint interval training (SIT) groups. The control group maintained daily activities; the SIT groups performed 8 weeks of once- or twice-weekly training sessions consisting of 6 s sprints. Metabolic health (oral glucose tolerance test), aerobic capacity (walk test) and physical function (get up and go test, sit to stand test) were determined before and after training. Following training, there were significant improvements in blood glucose control, physical function and aerobic capacity in both training groups compared to control, with changes larger than the smallest worthwhile change. There was a small to moderate effect for blood glucose (d = 0.43–0.80) and physical function (d = 0.43–0.69) and a trivial effect for aerobic capacity (d = 0.01) between the two training frequencies. Once a week training SIT is sufficient to produce health benefits. Therefore, the minimum time and frequency of exercise required is much lower than currently recommended.

THE IMPORTANCE OF FUNCTIONAL PHYSICAL TRAINING AGAINST SARCOPENIA ARISING AGING

The aging process involves physiological changes in the human body, due to lifestyle and habits adopted throughout life. Thus, the main concerns with the elderly population are guidelines for a balanced diet, prevention of falls and diseases. Maintaining a physically active lifestyle can mitigate the losses associated with the aging process, since losses are progressive and cause significant deficits. Sarcopenia is the loss of muscle mass, a natural consequence of aging that starts at age 30, in which there is greater reduction in the amount and size of muscle fibers. Functional physical training works with different physical abilities with the combination of exercises related to the specificity of daily life, aiming at improving physical capacity, muscular strength, functional capacity, gaining proprioception, resistance, flexibility, balance, motor coordination, agility and physical conditioning. Thus, the present study aims to clarify the benefits of functional physical training for the elderly population as a safe and effective modality capable of improving sarcopenia and functionality. A bibliographical survey was carried out through the literary review, national articles related to the theme in the main databases. Before the research it was noticed that the prevention / reduction of sarcopenia is of paramount importance for the work of the professional of physical education for prescription and correct orientation of the physical exercises to be carried out with this population.

Validation of the King\u2019s Brief Interstitial Lung Disease questionnaire in Idiopathic Pulmonary Fibrosis

BackgroundHealth-related quality of life (HRQL) is impaired in patients with idiopathic pulmonary fibrosis (IPF). The King’s Brief Interstitial Lung Disease questionnaire (K-BILD) is a validated measure of HRQL, but no previous studies have focused on the validity of K-BILD in IPF. Moreover, the relationship between K-BILD and dyspnoea or the 6-min walk test (6MWT) has not been assessed. The aim of this study was to validate K-BILD in the largest cohort of patients with IPF to date and assess how K-BILD correlates to dyspnoea and 6MWT.MethodsFirstly, K-BILD was translated into Danish using validated translation procedures. Consecutive patients with IPF were recruited. At baseline, patients completed K-BILD, the IPF-specific version of St. Georges Respiratory Questionnaire, University of California, San Diego Shortness of Breath Questionnaire (SOBQ) Short Form-36, and pulmonary function tests and 6MWT were performed. After 14 days, K-BILD and Global Rating of Change Scales were completed. Internal consistency, concurrent validity, test-retest reliability and known groups validity were assessed. Analyses were also performed in subgroups of patients with different time since diagnosis.ResultsAt baseline, 150 patients with IPF completed the questionnaires, and 139 patients completed the questionnaires after 14 days. K-BILD had a high internal consistency (Cronbach’s α = 0.92). The concurrent validity was strong compared to SOBQ (r = − 0.66) and moderate compared to 6MWT (r = 0.43). Intraclass correlation coefficients (ICC = 0.91) and a Bland Altman plot demonstrated a good reliability. K-BILD was also able to discriminate between patients with different stages of disease (p < 0.002, Δscore > 7.4) and most results were comparable in patients with different time since diagnosis.ConclusionK-BILD is a valid and reliable instrument in patients with IPF and in patients with different time since diagnosis. To a major extent, K-BILD scores reflected the impact of dyspnoea on HRQL and the impact of physical functional capacity measured by the 6MWT to a moderate degree. Compared to PFTs alone, K-BILD provides additional information on the burden of living with IPF, and importantly, K-BILD is simple to implement in both research and clinical contexts.Trial registrationClinicaltrials.org (NCT02818712) on 30 June 2016.

The Relationship Between Army Physical Fitness and Functional Capacities in Infantry Members of the Slovenian Armed Forces.

Šimenko, J, Kovčan, B, Pori, P, Vodičar, J, Vodičar, M, and Hadžić, V. The Relationship between army physical fitness and functional capacities in infantry members of the Slovenian Armed Forces. J Strength Cond Res 35(12): 3506-3512, 2021-The primary purpose of this study was to determine the relationship between traditional army physical fitness test (APFT) and a novel functional testing battery that included countermovement jump (CMJ) testing, stork balANce test, pUll-ups, single leg hAmstring bridge test, and loaded prone pLank test-MANUAL battery. The secondary purpose was to explore additional baseline fitness aspects traditionally not covered by APFT. This cross-sectional study involved 181 Slovenian Armed Forces (SAF) infantry members (age 31.4 ± 6.1 years) that were tested using both the regular annual APFT and the MANUAL battery (testing was conducted 2 weeks apart). At the significance level of p ≤ 0.05, significant but weak associations between the MANUAL testing battery and APFT battery (0.2 ≤ r < 0.5; p ≤ 0.05) were observed. The MANUAL battery has highlighted possible hamstring (less than 20 repetitions on a single leg bridge test in 26% of SAF infantry members) and posterior shoulder pull-up muscle weakness (mean score 5 ± 4 pull-ups). Functional predictors from the MANUAL explained only 33.6% of the APFT score (R2 = 0.336). Significant predictors of APFT score were single leg hamstring left (p = 0.048), loaded plank (p = 0.049), number of pull-ups (p < 0.001), CMJ (p = 0.01), and loaded CMJ (p = 0.026). The findings suggest that higher APFT marks are associated with better performance on the MANUAL tests and indicate the problem of hamstring and pull-up muscle weakness. The general recommendation is that the physical condition military programs should include more exercises to strengthen those muscle groups.

Efficacy of Enhanced External Counter Pulsation on Clinical Parameters and Health-Related Quality of Life in Coronary Heart Disease patients with Diabetes Mellitus

To assess the effect of Enhanced External Counter Pulsation (EECP) treatment on clinical parameters and health related quality of life (HRQoL) in Coronary Heart Disease (CHD) patients with Diabetes Mellitus. This was a pretest-posttest designed prospective study among 163 diabetic and non-diabetic coronary heart disease patients enrolled from SAAOL Heart Center, New Delhi, India. Patients were divided into two groups- diabetic CHD group and non-diabetic CHD group. EECP treatment was given to both the groups for 35 day. After EECP treatment physical and clinical profile along with HRQoL of study participants was assessed. The physical profile of study participants was assessed using Cooper’s 12 minutes’ walk test, Canadian Cardiovascular Society (CCS) angina scale and Medical Research Council (MRC) dyspnea scale and HRQoL was assessed through SF-36 (short form) and Seattle Angina Questionnaire (SAQ) scale. The follow-up of both groups was done at 6th and 12th months. Collected data were assessed through IBM, SPSS software v 21. Descriptive analysis with sample t-test for two independent groups and paired sample t-test for EECP effectiveness within the group was done. A significant improvement was observed in blood pressure; heart rate, lipid profile angina and MRC score in both the groups at 6th and 12 month follow-up. A significant reduction was observed in blood sugar fasting, blood sugar postprandial (PP) and glycosylated hemoglobin (HbA1c) in diabetic CHD patients. A significant improvement was also observed in all health domains of SF-36 &amp; SAQ scale HRQoL after EECP treatment. EECP therapy is an effective non-invasive method to treat diabetic and non–diabetic CHD patients. This therapy may improve both physical (physical functional capacity, angina, dyspnea) and clinical profile (lipid profile, lower the blood glucose level) in diabetic CHD patients. EECP may also improve clinical symptoms of CHD patients and lower the blood glucose level in diabetic CHD patients this may directly improve overall HRQoL of CHD patients with DM.

TRANSCRIPTOME ALTERATIONS ASSOCIATED WITH AGE-RELATED DECLINE IN PHYSICAL FUNCTION.

One inevitable consequence of the effect of age on our bodies is the graduated deterioration of physical function and exercise capacity, driven, in part by the adverse effect of age on muscle tissue. Our primary purpose was to determine the relationship between patterns of gene expression in skeletal muscle and loss of physical function. We hypothesized that some genes that change expression with age would correlate with functional decline, or conversely with preservation of function. Male C57Bl/6 mice [adults (6-7 months old, n=9), older (24-25 months old, n=9), and elderly (28+ months of age, n=9) were tested for physical ability using a comprehensive functional assessment battery [CFAB, a composite scoring system: comprised of the rotarod (overall motor function), grip strength (fore-limb strength), inverted cling (4-limb strength/endurance), voluntary wheel running (activity rate/volitional exercise), and treadmill tests (endurance)]. We extracted RNA from the tibialis anterior muscles, ran RNAseq to examine the transcriptome using an Illumina NextSeq 550, comparing adults (n=7) to older (n=7) and elderly mice (n=9). Age resulted in gene expression differences of 1.5 log2 fold change or greater (p<0.01) in 46 genes in the older mice and in 252 genes in the elderly (both compared to adults). Current ongoing work is examining the physiological relevance of these genes to age-related loss of physical function. We are in the process of using linear regression to determine which of the genes with age-related changes in expression are associated (R>0.5 and p<0.05) with functional status as measured by CFAB.

Health-related quality of life and exercise-based cardiac rehabilitation in contemporary acute coronary syndrome patients: a systematic review and meta-analysis.

To review the literature on health-related quality of life (HRQoL) outcomes for exercise-based cardiac rehabilitation (EBCR) in contemporary acute coronary syndrome (ACS) patients. Electronic databases (CENTRAL, MEDLINE, Embase, and CINAHL) were searched from January 2000 to March 2019 for randomised controlled trials (RCTs) comparing EBCR to a no-exercise control in ACS patients recruited after year 2000, follow-up of at least 6months, and HRQoL as outcome. Potential papers were independently screened by two reviewers. Risks of bias were assessed using the Cochrane Tool. Data analyses were performed using RevMan v5.3, random effects model. Fourteen RCTs (1739 participants) were included, with eight studies suitable for meta-analyses. EBCR resulted in statistically significant and clinically important improvements in physical performance (mean difference [MD] 7.09, 95% CI 0.08, 14.11) and general health (MD 5.08, 95% CI 1.03, 9.13) (SF-36) at 6months, and in physical functioning (MD 9.82, 95% CI 1.46, 18.19) at 12months. Statistically significant and sustained improvements were also found in social and physical functioning. Meta-analysis of two studies using the MacNew Heart Disease HRQoL instrument did not show any significant benefits. Of the six studies unsuitable for meta-analyses, five reported significant changes in overall HRQoL, general physical activity levels and functional capacity, or quality-adjusted life-years (QALYs). In an era where adherence to clinical practice guidelines has improved survival, EBCR still achieves clinically meaningful improvements in physical performance, general health, and physical functioning in the short and long term in contemporary ACS patients.

ICON 2019—International Scientific Tendinopathy Symposium Consensus: There are nine core health-related domains for tendinopathy (CORE DOMAINS): Delphi study of healthcare professionals and patients

BackgroundThe absence of any agreed-upon tendon health-related domains hampers advances in clinical tendinopathy research. This void means that researchers report a very wide range of outcome measures inconsistently. As a...