Six-minute Walk Research Articles

Intelligent system of training data sets for current reported normality levels and physical fitness analysis

The purpose of this study was to examine the relationship between current reported normality levels of human (mental stress level) and physical fitness variables using a nationwide study conducted on adults and elderly persons. This study included 2830 adults (1683 men, 1147 women) aged 20–64 years, and 628 elderly subjects (263 men, 365 women) aged over 65 years who participated in the Survey of National Physical Fitness project conducted by the Korea Institute of Sport Science and the Korea Ministry of Culture, Sports and Tourism in 2015. The current reported normality levels of participants were recorded using self-report questionnaires. The physical fitness variables of the participants in the adult group were measured using exercises including grip strength, sit-ups, standing long jump, 50 m dash, sit-and-reach, and 20 m shuttle-run. The physical fitness variables of the participants in the elderly group were measured using exercises including grip strength, sit-up, sit-to-stand, sit-and-reach, back scratch, one leg standing with eyes open, and six-minute walk. There were no significant differences in any of the physical fitness variables of adult men under different normality levels of human ( P > 0.05); however, adult women showed significant differences in grip strength ( P < 0.001), standing long jump ( P = 0.048), and sit-and-reach ( P = 0.013) according to their normality levels of human. Both elderly men and women under different normality levels of human showed no significant differences in all physical fitness variables ( P > 0.05). This study showed that there is little or no significant difference in the physical fitness variables of adult and elderly Koreans under different normality levels of human ( P > 0.05). In this paper, we concluded that current reported normality levels of human are not associated with physical fitness level data set variables. Le but de cette étude était d’examiner la relation entre les niveaux de normalité actuellement rapportés des variables de la condition physique humaine et physique à l’aide d’une étude nationale menée sur des adultes et des personnes âgées. Cette étude a inclus 2830 adultes (1683 hommes, 1147 femmes) âgés de 20 à 64 ans et 628 sujets âgés (263 hommes, 365 femmes) âgés de plus de 65 ans qui ont participé au projet de l’enquête nationale sur la condition physique mené par l’Institut coréen des sciences du sport et le ministère coréen de la Culture, des Sports et du Tourisme en 2015. Les niveaux de normalité actuellement déclarés des participants ont été enregistrés à l’aide de questionnaires d’auto-évaluation. Les variables de la condition physique des participants du groupe d’adultes ont été mesurées à l’aide des tests, tels que la force de préhension, les redressements assis, le saut en longueur debout, le tiret de 50 m, assis et atteindre et la course navette de 20 m. Les variables de la condition physique des participants du groupe des personnes âgées ont été mesurées à l’aide d’exercices comprenant la force de préhension, la position assise, assis-debout, assis-debout, le dos égratigné, une jambe debout avec les yeux ouverts et une marche de six minutes. Il n’y avait pas de différences significatives dans toutes les variables de la condition physique des hommes adultes sous différents niveaux de normalité humaine ( p > 0.05); cependant, les femmes adultes ont montré des différences significatives de force de préhension ( p < 0.001), de saut en longueur debout ( p = 0.048) et de position assis et atteindre ( p = 0.013) en fonction de leurs niveaux de normalité humaine. Les hommes et les femmes âgés sous différents niveaux de normalité humaine n’ont montré aucune différence significative dans toutes les variables de la condition physique ( p > 0.05). Cette étude a montré qu’il y a peu ou pas de différence significative dans les variables de la condition physique des Coréens adultes et âgés sous différents niveaux de normalité humaine ( p > 0.05). Dans cet article, nous avons conclu que les niveaux de normalité actuels rapportés chez l’homme n’associent pas les variables des ensembles de données sur le niveau de condition physique.

Vitamin D Supplementation Is Associated with a Reduction in Self-Reported Falls among Older Adults with Previous Fall History - Feasibility Study.

Vitamin D insufficiency contributes to muscle weakness and a higher risk of falls in older adults. This study explored the impact of vitamin D supplementation on self-reported falls and physical function in older adults with low vitamin D levels and a recent fall history. Twenty-five older adults ≥ 70 years with two or more falls during the past year, low vitamin D blood levels (≥10 ng/ml and < 30 ng/mL), and slow gait speed (1.2 m/s) participated in a 6-month vitamin D supplementation (800 IU/day) study. A modified version of the Morse Fall Scale questionnaire was used to assess frequency of falls over one-year prior to study enrollment. Functional outcomes (short physical performance battery, handgrip strength, gait Timed Up and Go, and six-minute walk), and vitamin D levels were assessed at baseline and 6-month follow-up. Based on diaries and pill counts, participants were generally adherent to the intervention (6 of 7 days per week). Supplementation with 800 IU/day of vitamin D for 6 months increased blood vitamin D levels from 23.25±4.8 ng/ml to 29.13±6.9 ng/ml (p<0.001). Self-reported number of falls decreased from an average of 3.76 ± 2.2 falls in one-year to 0.76 plusmn; 1.4 falls (p <0.0001) over the 6-month intervention. No changes in functional outcome measures were observed. Vitamin D supplementation at the currently recommended dose of 800 IU/day increased blood vitamin D levels and reduced frequency of falls in older adults with low vitamin D levels and a recent fall history.

Effect of cardiovascular training on functional capacity in post-acute rehabilitation of COVID-19 patients

Introduction: In the overall strategy of developing the optimal treatment of patients after COVID-19 infection, recommended by the World Health Organization, rehabilitation plays one of the key roles in improving the functional capacity of these patients and thus their quality of life. The aim of this study was to investigate the effect of cardiovascular training during post-acute rehabilitation on the functional capacity of patients after moderate COVID-19 pneumonia. Methods: The prospective study included 84 patients of both sexes, mean age 57.92 ± 11.79 years, who were hospitalised at the Institute of Physical Medicine and Rehabilitation ''Dr Miroslav Zotović'' Banja Luka due to moderate pneumonia caused by the COVID-19 virus and after they finished acute rehabilitation. All patients underwent cardiovascular training three times per week and occupational therapy during 28 days of stationary post-acute rehabilitation. The follow-up parameter was a six-minute walk (6-MWT) test at admission and discharge from post-acute rehabilitation. Student t-test for paired samples was used for statistical analysis, and the value of p &lt; 0.05 was taken as statistical significance. Results: The functional capacity of the cardiovascular and respiratory system was statistically significantly improved at discharge compared to admission (p &lt; 0.05). Conclusion: Targeted cardiovascular training during post-acute rehabilitation leads to improvement of functional capacities of patients after moderate COVID-19 pneumonia.

An Evaluation of Symmetries in Ground Reaction Forces during Self-Paced Single- and Dual-Task Treadmill Walking in the Able-Bodied Men

Gait is a complex autonomous activity that has long been viewed as a symmetrical locomotion, even when it adapts to secondary concurrent attention-demanding tasks. This study aimed to evaluate the symmetry of the three ground reaction forces (GRFs) in able-bodied individuals during self-paced treadmill walking with and without concurrent cognitive demands. Twenty-five male participants (age: 34.00 ± 4.44 years) completed two gait assessment sessions, each of whom were familiarized with the walking trials during their first session. Both sessions involved six-minute self-paced treadmill walking under three conditions: single-task walking and walking while concurrently responding to auditory 1-back and 2-back memory tasks. The symmetry of the GRFs was estimated using a nonlinear approach. Changes in the symmetry and walking speed across conditions in both sessions were assessed using inferential statistics. Results demonstrated that the three GRFs deviated from perfect symmetry by ≥10%. Engaging working memory during walking significantly reduced the symmetry of the vertical GRF (p = 0.003), and its detrimental effects on walking speed were significantly reduced in the second session with respect to the first session (p &lt; 0.05). The findings indicate imperfect gait symmetry in able-bodied individuals, suggesting that common perceptions of gait symmetry should be reconsidered to reflect its objective importance in clinical settings.

Creating and Keeping Exercise Gains Into Your 70s, 80s and 90s

Background: Gerofit, an exercise program for older Veterans, is undergoing national dissemination (17 sites in 6 years). Four sites have accrued 4-year functional outcomes (gait speed, 8-foot-up-and-go, 30-second chair stand, and six-minute walk). Methods: Functional assessments were administered quarterly in first year and annually thereafter. Individuals with baseline and at least two follow up measures were included for analysis (n=587). Means were gathered across each timepoint. Results: Mean values for functional assessments from baseline to 4 year were as follows: gait speed m/s- 1.04, 1.12, 1.13, 1.13, 1.09, 1.07, 1.13; 8 ft-up-and-go seconds- 7.6, 6.82, 6.69, 6.69, 7.29, 7.29, 7.51; 30 second chair stands 11.88, 14.06, 14.72, 14.89, 14.69, 14.71, 14.96; and six-minute-walk yards- 499, 532, 541, 544, 531, 530, 556. All follow up measures were significantly improved over baseline (P<.01) and superior to normative age-related decline. Implications: Results indicate that exercise promotes compression of morbidity and improved functional health.

Examining Cardiovascular Disease Risk Profiles Among Older Adults With and Without Fibromyalgia

Introduction: Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality in the United States. Preexisting chronic health conditions may be confer increased CVD risk, specifically fibromyalgia (FM), a chronic condition characterized by widespread pain, fatigue, stiffness, and concentration problems. CVD risk increases with normal aging; however, characteristics of FM are suggested to exacerbate health profiles in normal aging processes that may contribute to increased CVD risk. Method: The sample included 221 older adults (M=63.40, SD=8.86; 82% female; 88% White/European American) and 55% reported an FM diagnosis. CVD risk factors were entered separately in a five-block hierarchical binary logistic regression model as predictors and included: cardiorespiratory fitness using the six-minute walk, BMI, standing and lying mean arterial pressure (MAP), and depression using the Beck Depression Inventory. Results: Logistic regression analyses revealed that poorer cardiorespiratory fitness (OR=.99, 95% CI=.99-1.00, p=.001), greater depressive symptoms (OR=1.35, 95% CI=1.19-1.53, p< .001) and lower standing MAP (OR=.98, 95% CI=.96-1.00, p=.036) were associated with higher odds of an FM diagnosis. However, no differences in lying MAP (OR=1.02, 95% CI=1.00-1.04, p=.137) or BMI (OR=1.02, 95% CI=.95-1.10, p=.644) for an FM diagnosis emerged. Discussion: These data support the importance of examining the health profiles of persons with FM in the context of CVD risk. Experiences of FM may produce distinct health profiles with characteristics that serve as both protective and risk factors in the context of CVD.

Abstract 14290: Treadmill Exercise Training Reduces the Systolic Blood Pressure Response to Walk Exercise in Patients With Peripheral Artery Disease

Introduction: Supervised exercise therapy (SET) improves functional capacity in people with peripheral artery disease (PAD). However, the effects of SET on improving cardiovascular health remain unclear. This study investigated the effects of a 6-month SET intervention on the blood pressure (BP) response to walking exercise in patients with PAD. Methods: Participants with PAD randomized to either SET or control group in the NHLBI sponsored PROPEL clinical trial were included. The SET intervention consisted of 3X weekly supervised treadmill exercise for 6 months. Participants in the control group attended weekly education sessions for 6 months. A Gardner-Skinner treadmill test (GSTT) and six-minute walk (6MW) test were completed at baseline and 6-month follow-up. BP was measured at the end of each 2-min stage of the GSTT. Mixed-effects regression models compared the 6-month change in systolic BP (SBP) &amp; diastolic BP (DBP) between groups for each of the first 5 stages of the GSTT. Pearson correlation coefficients were used to relate the average 6-month change in DBP &amp; SBP for the first 5 stages of the GSTT with the 6-month change in 6MW distance. Results: Ninety-seven participants with PAD (67 ± 9 years, 39 (40%) female, 65 (67%) black) completed a 6-month GSTT. Compared to the control group, SET significantly decreased SBP at stage 1, stage 2, stage 3, and stage 4 of the GSTT (Table 1). There were no effects of SET on DBP (Table 1). A greater reduction in SBP during the first 5 stages the GSTT test was associated with significantly greater improvement in 6MW distance at 6-month follow-up of SET (Pearson’s r = -0.37; 95%CI: -0.52, -0.19; p &lt; 0.001). However, there were no associations of reduction in DBP with improvement in 6MW distance. Conclusions: These results show that SET improves cardiovascular health in people with PAD. Furthermore, results suggest that improved CV health in part explains the improved 6MW in response to SET in people with PAD.

Clinical and radiological profile of patients with spinal muscular atrophy type 4.

Spinal muscular atrophy (SMA) is the most important cause of motor neuron disease in childhood, and continues to represent the leading genetic cause of infant death. Adulthood-onset SMA (SMA type 4) is rare, with few isolated cases reported. The objective of the present study was to describe a cohort of patients with SMA type 4. A cross-sectional study was conducted to characterize clinical, genetic, radiological and neurophysiological features of patients with adulthood-onset SMA. Correlation analysis of functional assessment with genetic, radiological and neurophysiological data was performed. Twenty patients with SMA type 4 were identified in a Brazilian cohort of 227 patients with SMA. The most common clinical symptom was limb-girdle muscle weakness, observed in 15 patients (75%). The most frequent neurological findings were absent tendon reflexes in 18 (90%) and fasciculations in nine patients (45%). Sixteen patients (80%) had the homozygous deletion of exon 7 in the SMN1 gene, with 12 patients (60%) showing four copies of the SMN2 gene. The functional scales Hammersmith Functional Motor Scale Expanded, Amyotrophic Lateral Sclerosis Functional Rating Scale Revised, Revised Upper Limb Module and Spinal Muscular Atrophy Functional Rating Scale, as well as the six-minute walk and the Time Up and Go tests showed a correlation with duration of disease. Motor Unit Number Index was correlated both with duration of disease and with performance in functional assessment. Radiological studies exhibited a typical pattern, with involvement of biceps femoris short head and gluteus minimus in all patients. This study represents the largest cohort of patients with SMA type 4 and provides functional, genetic, radiological and neurophysiological features that can be used as potential biomarkers for the new specific genetic therapies for SMA.

Comparison of a Multi-Component Physical Function Battery to Usual Walking Speed for Assessing Lower Extremity Function and Mobility Limitation in Older Adults.

To compare a composite measure of physical function that comprises locomotor and non-locomotor tests (i.e., the Mobility Battery Assessment (MBA)) with traditional measures of mobility (4-m usual gait speed (UGS), six-minute walk (6MW) gait speed, and short physical performance battery (SPPB) score) for assessing lower extremity function and discriminating community dwelling older adults with and without mobility limitations. Cross-sectional, observational study. Laboratory-based. 89 community-dwelling older adults (74.9±6.7). Using principal component analysis we derived an MBA score for 89 community-dwelling older adults, and quantified 4-m UGS, 6MW gait speed, and SPPB score. The MBA score was based on five lab-based tests. We also quantified self-reported lower extremity function/mobility using the Neuro-QOL Lower Extremity Function-Mobility instrument. Based on this data a continuous score was derived and subjects were classified as "mobility limited" or "non-mobility limited". Correlations between the mobility measures and the Neuro-QOL score were calculated, and ROC curves were constructed to determine the AUC for the mobility measures ability to predict mobility limitations. The MBA had the largest AUC (0.92) for discriminating mobility limitations and exhibited the strongest correlation (0.73) with the Neuro-QOL Lower Extremity Function-Mobility Scale. The worst performing predictors were the 4-meter UGS and stair climb power both with an AUC of 0.8 for discriminating mobility limitations, and a low correlation with Neuro-QOL Lower Extremity Function Scale of 0.39 and 0.46, respectively. The MBA score moderately improves the magnitude of correlation and discrimination of mobility limitation in older adults than singular, standard tests of mobility.

Percent body fat, but not lean mass, is associated with objectively measured physical function in middle-aged women

ObjectivesThe relationship between components of body composition and physical function is not well characterized among middle-aged women. This cross-sectional study examined the strength of the associations between lean mass and percent fat and physical function in middle-aged women. Study DesignBody composition, physical function and physical activity were objectively measured in 80 women (mean age 52.58 ± 6.10 years; range = 40−63 years). Main Outcome MeasuresAdiposity (%Fat) and lean mass were measured via dual-energy x-ray absorptiometry. Steps/day and minutes of low-, moderate- and vigorous-intensity physical activity were assessed via accelerometer. Physical function was measured via a seated transfer task, 30-second chair stand, a six-minute walk task, 8-foot timed up and go, and a lift and carry task. Results: When controlling for steps/day, measures of lean mass were related to performance on the seated transfer task (r = .25) and 30-second chair stand (−.26) (both p > 0.05), while %Fat was related to performance on the seated transfer task (r = .53), 8-foot timed up and go (r = .32), 30-second chair stand (r = −.35), and six-minute walk (r = −.48; all p ≤ 0.05). Linear regression analyses revealed: (1) age, steps/day, and %Fat were independently related to performance on the seated transfer task and 30-second chair stand (both p ≤ 0.05), (2) %Fat was associated with six-minute walk and 8-foot up-and-go performance (p ≤ 0.01); none of the variables included were associated with lift and carry. ConclusionsAdiposity but not lean mass was associated with objectively measured physical function in middle-aged women. Interventions that focus on reducing body fat may be an effective method for improving functional performance among women in this age group.

Long-Term Neurocognitive Outcomes in LVAD Recipients

Data on long-term cognitive outcome in patients with LVAD is limited. We examined the neurocognitive outcome in patients receiving the HeartwareTM HVADTM system for destination therapy. HVAD patients enrolled in the ENDURANCE and ENDURANCE Supplemental trials were eligible. Cognition domains were evaluated through 24 months with Hopkins Verbal Learning Test, Trail Making Tests, Clock Drawing, and Boston Naming Test. Change in neurocognitive function, quality of life, and functional capacity were examined at 2 years and compared to baseline. Patients were further categorized into two groups: those having neurologic events and those having none. For HVAD patients enrolled in the trials (n=604), 178 (29.5%) had neurologic events (both stroke and non-stroke) on original device. Neurocognitive, functional capacity, and quality of life measures are listed in Table 1. Examining the entire cohort reveals that most measures improved from baseline through 24 months. Patients who suffered at least one stoke also showed improvement from baseline to 24 months in some domains, Hopkins Trail 2 (6.3 vs 6.7, p=0.04), Total for Learning Trial (18.3 vs 19.5, p=0.02), Delayed Recall (6.2 vs 7.1, p=0.009), Delayed Recognition Discrimination Correct (10.4 vs 10.9, p=0.04), Six-minute Walk (107.7 vs 196.1 m, p<0.0001) and KCCQ (39.9 vs 66.1, p<0.0001) (Table 1). There were no differences in neurocognitive outcome between ENDURANCE and ENDURANCE Supplemental patients despite the blood pressure difference. Neurocognitive function, quality of life, and functional capacity improved for all patients on HVAD support surviving to 24 months even among those that suffered neurologic events.

SLEEP AND CHILDHOOD MENTAL HEALTH: ROLE OF PHYSICAL ACTIVITY AND CARDIORESPIRATORY FITNESS

ABSTRACT Introduction: Sleep is considered an important health indicator and plays a key role in brain development and plasticity. Objective: To ascertain whether there is a relationship between sleep quality and mental health indicators and whether organized physical activity (PA) or cardiorespiratory fitness (CRF) act as moderators of this association. Methods: This is a cross-sectional study with a quantitative approach. The sample consisted of 226 students between six and 11 years of age, male and female, in the early years of elementary education at a public school in Porto Alegre, Brazil, which was selected for convenience. CRF was measured by running test and six-minute walk. Sleep quality and organized physical activity outside of school were verified through an anamnesis, socioeconomic status through an adaptation of the ABEP (Brazilian Association of Research Companies) questionnaire, and mental health indicators with the assistance of the Strengths and Difficulties Questionnaire, all answered by parents. Frequencies, means, standard deviations and generalized linear models were used for the data analysis, while a 95% confidence interval was used for the analyses. Results: Sleep quality was associated with total difficulties (β=7.659, p&lt;0.001), emotional symptoms (β= 1.754; p=0.001), hyperactivity/inattentiveness (β=3.054, p &lt;0.001), conduct problems (β=1.619, p&lt;0.001) and peer relationship problems (β=1.231; p=0.007) in boys. In girls it was related to total difficulties (β=3.421; p=0.006), and conduct problems (β=1.235; p=0.003). However, the interactions were not significant. Conclusion: Although they occur independently, stress is placed on the importance of sleeping well, engaging in organized PA and having good CRF levels for the improvement and maintenance of mental health. Level of evidence III; Case-control study.

The association between breakfast consumption patterns and physical fitness

Summary Aim The purpose of this study was to examine the association between breakfast consumption patterns and physical fitness variables based on a nationwide study in Korea focused on non-elderly and elderly adults. Methods A total of 2798 adults (men = 1662, women = 1136; aged 20–64 years) and 625 elderly people (men = 263, women = 362; aged over 65 years) participated in The Survey of National Physical Fitness in 2015, conducted by the Korea Institute of Sport Science and Korea Ministry of Culture, Sports and Tourism. The breakfast consumption pattern was collected via the self-report survey. Physical fitness variables in the adult group (grip strength, sit-ups, standing long jump, 50 m dash, sit-and-reach, and 20 m shuttle-run) and the elderly group (grip strength, sit-ups, sit-to-stand, sit-and-reach, back scratch, one-leg standing with eyes open, and six-minute walk) were directly measured. The association between breakfast consumption patterns and physical fitness variables were then evaluated by conducting one-way analysis of variance and post-hoc testing of Tukey. Results and conclusion Adult men showed significant differences in sit-ups (P = 0.043), standing long jump (P = 0.005), 50 m dash (P = 0.008), and sit-and-reach (P = 0.047) among the four breakfast pattern groups. Adult women showed significant differences in sit-ups (P = 0.018), standing long jump (P = 0.007), and 50 m dash (P = 0.044). However, both elderly men and women showed no significant differences in all physical fitness variables (P > 0.05). In Korean adults, the physical fitness variables, sit-ups (muscular endurance), standing long jump (power), and 50 m dash (speed), could be differentiated based on breakfast consumption patterns. However, in the elderly population, physical fitness variables showed no significant differences based on breakfast consumption patterns.

STUDY OF SIX MINUTE WALK TEST IN PATIENT OF METABOLIC SYNDROME

15Nov 2019 STUDY OF SIX MINUTE WALK TEST IN PATIENT OF METABOLIC SYNDROME Tulika Kumari , Shyam Chand Choudhary , Kauser Usman , K.K. Sawlani , Avinash Agrawal , M.L. Patel , D. Himanshu , K.K. Gupta and Ajay Verma Department of Internal Medicine, King Georgs Medical University, Lucknow, Uttar Pradesh, India Department of Critical Care Unit, King Georgs Medical University, Lucknow, Uttar Pradesh, India Department of Pulmonary Medicine, King Georgs Medical University, Lucknow, Uttar Pradesh, India

FEAR AND DYNAMIC INFLAMMATORY RESPONSE TO MOVEMENT AMONG OLDER ADULTS WITH LOW BACK PAIN: A FEASIBILITY ANALYSIS

Low back pain (LBP) is a prevalent cause of disability, with higher prevalence among older adults. However, the level of LBP disability cannot be explained by either pain intensity or LBP pathology (bone degeneration). We hypothesize that older adults with LBP are susceptible to disability based on the combination of two factors: fear of movement and dynamic inflammatory response to movement (DIR). In this feasibility study, we are measuring these two factors among 30 older adults aged 60-85 with LBP. Participants attend a laboratory session to complete four performance tasks: 30-second chair rises, seated trunk rotation, standing forward reach, and Six-Minute Walk. Fear of movement is tested using the Tampa Scale for Kinesiophobia and Situational Catastrophizing Questionnaire. DIR is tested by drawing blood via a peripheral venous catheter before and after performance tasks, and assessing changes in six inflammatory markers: IL-6,8,10; TNF-alpha, c-reactive protein, and substance P. LBP disability is assessed using the Late-life Functional Disability Instrument (LLFDI) and 7-day ecological momentary assessment (EMA) via smartphone application. Participants have tolerated all laboratory testing procedures and have adequately reported LBP disability in the home and community using EMA. We will test for exploratory associations between fear of movement, DIR, and LBP disability measures using ordinary least squares regression analyses. The overarching goal of this research line is to determine if the combination of fear of movement and DIR are an actionable clinical risk phenotype of downstream LBP disability among older adults.

Companion Dog Foster Caregiver Program for Older Veterans at the VA Maryland Health Care System: A Feasibility Study.

Veterans experience mental health conditions at a disproportionate rate compared to their civilian counterparts, and approximately 60% of older veterans who receive their care through the United States Department of Veterans Affairs (VA) do not meet physical activity (PA) recommendations. We tested the Veterans as Foster Ambassadors program at the VA Maryland Health Care System to examine whether fostering a companion dog would improve PA and function, heart rate variability (HRV), balance, and quality of life (QOL) in older veterans. Participants wore an accelerometer for ≥10 days during each phase (30 day baseline vs. 60 day foster period) to measure daily PA (n = 4). Six-minute walk (6MW) and balance testing (n = 4) and 24 h heart rate (HR) and HRV (n = 2) were determined at baseline and during the foster period. Compared to baseline, there were significant increases in (a) distance during the 6MW, (b) daily steps, and (c) time spent in moderate activity during the foster period. 24 h HR decreased and time- and frequency-domain measures of HRV significantly increased in a veteran with post-traumatic stress disorder during the foster period compared to baseline. All veterans offered positive feedback about the program and indicated that it was beneficial to them. The results from this pilot study provide evidence that fostering a companion dog can improve PA, health, and QOL in older veterans. Future research conducted with a larger sample size to validate the results is warranted.

The effect of extension assist orthosis with pneumatic bladders on pain and function for patients with early knee osteoarthritis.

There are few non-invasive treatment options to slow the progression of osteoarthritis (OA). Recently, a novel knee unloader brace with knee extension assist has become commercially available. Therefore, the purpose of this study was to evaluate the preliminary effectiveness of using a novel unloader brace with extension assist to improve pain and functional outcomes for patients with knee OA. Thirty subjects (17 control group, 13 brace group) completed baseline and 6-week follow up testing with no brace. Patients were randomized into a Brace or No Brace group after baseline testing. Functional tests [timed up and go (TUG), stair climbing test (SCT) and six-minute walk (6MW)], self-reported measures [Knee Outcome Survey (KOS), pain, Patient Specific Functional Scale (PSFS)] and isometric knee extension strength were assessed. Repeated measure ANOVAs were used to identify differences in group and time. Pearson correlation coefficients were calculated for both average number of steps in the brace and exercises compliance compared to change in clinical scores for each group. There was a significant interaction effect for "worst pain" (P=0.002), the brace group improved from a 7.3/10 to 4.7/10 at follow-up (P=0.006) while the control group had no change. There was an effect of time for the SCT (P=0.02), "best knee pain" (P=0.050), and knee extension range of motion (ROM) (P=0.041). There were no significant correlations between exercise compliance and change in outcomes, but when the groups were collapsed there was a significant correlation between compliance and change in knee extension ROM (r=0.526; P=0.025). The extension assist pneumatic unloader brace group demonstrated a significant and important reduction in the "worst knee pain". This may indicate that wearing the brace was able to reduce painful flares. Both groups improved over time for the SCT, "best knee pain", and knee extension ROM, which can be attributed to the stretching protocol. This unloader brace is a promising non-invasive treatment option for patients with knee OA when combined with a stretching program.

Exercise Interventions in Huntington's Disease: An Individual Patient Data Meta-Analysis.

Physical activity may be beneficial in Huntington's disease (HD); however, studies to date have been underpowered to detect change. We combined data from five randomized controlled feasibility trials using individual patient data meta-analyses. All trial interventions comprised a combination of supervised and self-directed physical activity, with varied emphasis on aerobic, strength, endurance, flexibility, and task training. Duration ranged from 8 to 16 weeks. The primary outcome was the modified Unified Huntington's Disease Rating Motor Score. Secondary outcomes included the Symbol Digit Modality Test, Berg Balance Scale, 30-second Chair stand, Timed Up and Go, Gait Speed, Physical Performance Test, Six-Minute Walk, International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale, EuroQol Health Utility Index, and Short-Form 36 Health Related Quality of Life Scale. The primary analysis utilized a two-stage approach. A one-stage approach was explored as a sensitivity analysis using a cross-classified (by study site) linear mixed-effects model. One hundred twenty-one participants provided complete data. Risk of bias was moderate; however, primary outcomes were blind assessed. Primary pooled effect estimates adjusted for baseline modified motor score (95% confidence interval) were 0.2 (-2.1 to 2.6) favoring control. There was considerable heterogeneity between the studies. There was no evidence of an exercise effect on the modified motor score in these relatively short-duration interventions. Longer-duration trials incorporating supervised components meeting frequency, intensity, time, and type principles are required. Lack of common outcomes limited the analysis and highlight the importance of a core outcome set for evaluating exercise in HD.

The effect of pulmonary rehabilitation on carotid chemoreceptor activity and sensitivity in chronic obstructive pulmonary disease.

Recent work demonstrates that carotid chemoreceptor (CC) activity/sensitivity is elevated in patients with chronic obstructive pulmonary disease (COPD) compared with healthy controls, and this elevated chemoreception appears to contribute to increased cardiovascular risk. Exercise training has been shown to normalize CC activity/sensitivity in other populations, and therefore, the purpose of this study was to determine whether pulmonary rehabilitation (PR) can reduce CC activity/sensitivity in COPD. Forty-five COPD patients [mean FEV1 (forced expiratory volume in 1 s) = 56.6% predicted] completed PR, while 15 COPD patients (mean FEV1 = 74.6% predicted) served as non-PR controls. CC activity was determined by the reduction in ventilation while breathing transient hyperoxia ([Formula: see text] = 1.0); CC sensitivity was evaluated by the increase in ventilation relative to the drop in arterial saturation while breathing hypoxia. Dyspnea, six-minute walk and autonomic function data were also obtained. PR improved 6-minute walk distance (P < 0.001) and dyspnea (P = 0.04); however, there was no effect on CC activity (P = 0.60), sensitivity (P = 0.69), or autonomic function (P > 0.05 for all). Subgroup analyses indicated that PR reduced CC activity in those with elevated baseline CC activity, independent of changes in autonomic function. No change in dyspnea (P = 0.24), CC activity (P = 0.19), sensitivity (P = 0.80), or autonomic function (P > 0.05 for all) was observed in the control group. Despite improvements in exercise tolerance and dyspnea, PR appears to be generally ineffective at reducing CC sensitivity in stable COPD patients; while PR reduced CC activity in those with elevated basal CC activity, the physiological significance of this is unclear. Further investigations aimed at improving CC function in COPD are needed.NEW & NOTEWORTHY While work in other chronic diseases has shown that exercise training may help normalize carotid chemoreceptor (CC) activity/sensitivity, the current study found that exercise training through pulmonary rehabilitation did not consistently reduce CC activity/sensitivity in patients with chronic obstructive pulmonary disease (COPD). These results suggest that other interventions are needed to normalize CC activity/sensitivity in COPD.

Abstract 160: Comparison of Baseline Characteristics Among World Health Organization Groups in Pulmonary Hypertension

Background: The epidemiology of pulmonary hypertension (PH) is changing with increasing numbers of patients diagnosed with non-group 1 pulmonary arterial hypertension (PAH). The average age of patients diagnosed with PAH is older, and patients are living longer. As a result, patients with PAH frequently have non-PH related comorbidities that make the diagnosis of group 1 PAH challenging. Many patients evaluated for PAH are ultimately diagnosed with non-group 1 PAH, and comorbidities may impact disease progression and treatment response. Understanding presenting clinical characteristics and comorbidities of patients referred to a Pulmonary Hypertension Comprehensive Care Center has the potential to offer insights into the evolving characteristics of patients with PH. Methods: In order to better understand the clinical differences between the patients presenting in different WHO groups, several functional assessments were analyzed from the period surrounding their baseline clinic visit. Using 280 newly diagnosed patients from the University of Michigan’s pulmonary hypertension databasethat were either group I, II, III, or multifactorial, the groups’ mean body mass index (BMI), WHO functional class (WHO FC), six-minute hall walk distance (6MW), diffusing capacity for carbon monoxide (DL CO ), and B-type natriuretic peptide (BNP) were compared. Additionally, the prevalence of ten comorbidities were collated to evaluate differences by etiology: chronic obstructive pulmonary disease, obstructive sleep apnea, interstitial lung disease, diabetes, arrhythmia, hypothyroidism, chronic kidney disease, hypertension, coronary artery disease, and obesity. Results: Two hundred and eighty newly diagnosed PH patients were analyzed (Group 1 = 67, Group 2 = 51, Group 3 = 35, multifactorial = 127). All of the comorbidities except for diabetes and thyroid disease yielded statistically significant differences among the WHO groups. Newly diagnosed Group I patients have the lowest mean BMI (27.97, p &lt;.001) and number of comorbidities (2.55, p &lt;.001), while the multifactorial patients had the most comorbidities (3.95, p &lt;.001) and highest average BMI (34.26, p &lt;.001). Group III patients had the lowest percent predicted DL CO (38.7, p &lt;.001) and lowest mean 6MW distance (220.2m, p &lt;.05). There were no statistically significant differences among groups for WHO FC, 6MW, and BNP. Conclusion: Patients with Group 1 PAH present with lower BMI and fewer comorbid conditions, whereas multifactorial PH patients present with the most comorbidities and highest BMI. The long-term effect of higher BMI and number of comorbidities in multifactorial PH is unknown. Group II and Group III PH patients did not demonstrate statistically significant differences in any of the baseline parameters. Further study including longitudinal follow up and response to treatment is warranted in each of the WHO Groups.