Step Test Research Articles

Application of residual network based on multispectral attention mechanism in stepped eddy current thermography defect detection

The stepped eddy current thermography nondestructive testing technique has a low and uneven temperature rise under weak excitation conditions, which brings great challenges to the quantitative analysis of defects in the inner wall of pressure vessels. To solve the above problems, this paper proposes a multi-spectral channel attention residual network model based on a Gramian angular difference field (GADF) for automatic detection and quantification. Firstly, the noise reduction and compression of temperature time series data are accomplished by singular value decomposition and piecewise aggregate approximation. Secondly, three infrared feature strategies commonly used for quantitative analysis were transformed by GADF and Gramian angular sum field (GASF) techniques to filter out the infrared feature data sets that contain the most defective feature information. Finally, the frequency domainization of the feature map is realized by embedding the multispectral channel attention in the residual network. The global dependencies and relevant essential features of infrared data are effectively captured, and the redundant feature information generated by deep learning feature maps is suppressed. The effectiveness of the model is verified by comparing several time-series models with advanced deep-learning models. The results show that the proposed model has excellent performance in terms of accuracy, stability, and generalization ability. Meanwhile, the model can effectively extract the defects in the region of uneven temperature rise.

The effects of Baduanjin exercise on physical fitness and mental health of female college students

Background and Study Aim. In the context of increasing stress and declining health among female college students, there is an urgent need for effective methods to enhance their physical and mental well-being. The aim of this study is to analyze the impact of Baduanjin exercise on the physical fitness and mental health of female college students. Materials and methods. Sixty female college students at University were randomly selected from 150 volunteers to participate in this study. They were equally divided into an experimental group and a control group, with 30 students in each. All 60 participants completed the experiment. The study's protocol was conducted in accordance with ethical standards and was approved by the Institutional Review Board of University. Informed consent was obtained from all individual participants involved in the study. The experimental group received a 16-week intervention of traditional Baduanjin exercise, while the control group engaged in other unfixed sports activities synchronously. Results. After the experiment, the average weight of the experimental group decreased significantly from 52.41±6.35 kg to 50.06±5.46 kg (P<0.01). Body mass index, waist circumference, and other indicators also showed significant improvements. The step test index in the experimental group increased from 45.09±4.45 to 50.72±4.46, which was significantly different from the baseline (P<0.01). Improvements were noted in vital capacity, grip strength, and sit-up performance, all showing significant differences from baseline measures (P<0.01). The standing long jump and 800 m running performances in the experimental group showed significant improvement compared to pre-experiment measurements (P<0.05). Additionally, all mental health indicators in the experimental group demonstrated a downward trend, with significant differences in 10 indicators such as somatization, obsessive-compulsive symptoms, interpersonal sensitivity, and depression (P<0.05 or P<0.01). Moreover, there was a significant inter-group difference in motor skills and physical fitness between the experimental and control groups in the 800 m run (230.78±30.61 vs. 231.32±32.15) and standing long jump (1.81±0.33 vs. 1.78±0.42) after the intervention (P<0.05). Furthermore, significant differences were observed in mental excitement and participation in the experimental group before and after the Baduanjin exercise as assessed by Baduanjin’s Self-Perception Inventory (P<0.01). Conclusions. This study demonstrates that a 16-week program of traditional Baduanjin exercise significantly improves both physical and mental health parameters among female college students. These findings suggest that Baduanjin exercise can be an effective intervention for enhancing physical fitness and alleviating psychological distress in this population. The results underscore the potential of integrating traditional physical activities into health promotion strategies for young adults in educational settings.

Development of physical test norms for early age Pencak Silat

Background and Study Aim. The evaluation serves as a cornerstone in the continuous improvement of sports, significantly relying on the analysis of measurement data. The primary objective of this research is to develop tailored norms for physical tests specifically designed for early-age Pencak Silat practitioners. Material and Methods. The development of the test consisted of several key stages: design of the instrument, testing of the instrument, and finally, assembly of the instrument. The study included a total of 210 participants, with a breakdown of 111 male and 109 female martial artists. The techniques for data collection involved a variety of tests and measurements. The instruments used in this research included: sit-and-reach test for assessing flexibility, 30-meter sprint for speed evaluation, side step test for agility, sit-ups for abdominal strength, push-ups for arm and chest strength, wall sit test for leg muscle strength, and beep test for cardiovascular endurance. Data analysis was performed using a technique that grouped values into five standard categories, aided by the use of Microsoft Excel. Results. The findings of the study led to the establishment of norms for each component of the physical tests tailored to early-age Pencak Silat practitioners. These components have been classified into five distinct levels: very poor, poor, average, good, and excellent. Conclusions. The outcomes of this research facilitate the development of specific norms for each test item, incorporating weighting for every physical test component. These weightings have been meticulously adjusted in accordance with the primary energy systems utilized in the sport of Pencak Silat.

Effect of Character Dance Steps in Turkish Folk Dances on Some Physical Fitness Levels

This research was conducted in öder to examine the effect of character dance steps determined from Kırşehir region dances, which are applied within the folk dance trainings held regularly for eight weeks, on the physical fitness of the athletes. A total of 20 volunteers were included in the sample group of the study (male; n=10, age;11±08, female; n=10 age 11±08). The sample size of the study was determined by Gpower analysis. The effectiveness of the character dance steps determined from the Kırşehir region dances on the physical levels of the participants was the subject of the research. In the experimental research, some physical fitness tests were applied to the participants. In assessing aerobic fitness; Harvard step test is used to evaluate strength; Hand grip test and leg strength test are used to evaluate agility; T test, in measurements of balance performance; Standing Strong and flamingo balance tests. Jump Test was used to evaluate anaerobic power. All data were analyzed in the IBM-SPSS 25 statistical program. The findings obtained in this study; In the trainings conducted with character dance steps determined from the Kırşehir regional dances, significance was observed in the aerobic capacities, strength variables and agility abilities of male and female Folk Dance performance athletes aged 11-14 who were trained at the secondary education level (p < α=0.05). These results showed that the selected character dance steps studies significantly improved physical fitness in the participants.

Effect of Coenzyme Q10 on Physical Performance in Older Adults with Statin-Associated Asthenia: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial.

Background: Available evidence from randomized clinical trials is contrasting and definitely inconclusive in determining whether or not CoQ10 dietary supplementation is advisable in patients with statin intolerance or poor statin tolerability. Methods: This randomized, double-blind, placebo-controlled clinical study aimed at investigating the effect of chronic dietary supplementation with coenzyme Q10 (CoQ10) phytosome on physical performance in older adults with a ≥3-month history of statin-associated asthenia. The study's participants were randomized to either a placebo or 300 mg daily CoQ10 phytosome (equivalent to 60 mg CoQ10; Ubiqsome®, Indena SpA, Milan, Italy). Asthenia, handgrip strength (HGs), 2-min step test (2MST), and 1-min sit-to-stand (STS) repetitions were assessed at baseline and at 8-week follow-up. Results: After the first 4 weeks of dietary supplementation, individuals taking CoQ10 phytosome showed a greater improvement in asthenia compared to the placebo group (p < 0.05). Even more significantly, at 8-week follow-up, participants receiving CoQ10 showed substantial improvements in asthenia (-30.0 ± 20.0%), HGS (+29.8 ± 3.6%), 2MST (+11.1 ± 1.8%), and 1-min STS repetitions (+36.4 ± 3.9%) compared to both baseline and placebo (p < 0.05). Conclusions: According to our findings, chronic dietary supplementation with CoQ10 phytosome significantly enhances physical performance in older adults with statin-associated asthenia. This could have relevant implications for improving the compliance of older adults with statin treatment.

Development of Active Wind Vane for Low-Power Wind Turbines

This paper proposes the development of an active control system to control the power output of a low-power horizontal-axis wind turbine (HAWT) when operating at wind speeds above the rated wind speed. The system is composed of an active articulated vane (AAV) in charge of the orientation of the wind turbine, which is driven by an electric actuator that changes the angle of the AAV to maintain a constant power output. Compared with the passive power regulation systems most often used in low-power HAWTs, active systems allow for better control and, therefore, greater stability of the delivered power, which reduces the structural stresses and allows for controlled braking in any wind condition or during system failures. The control system was designed and simulated using MATLAB R2022b software, and then built and evaluated under laboratory conditions. For the control design, the transfer function (TF) between the pulse width modulation (PWM) and the AAV angle (θ) was determined via laboratory tests using MATLAB’s PIDTurner tool. For the simulation, the relationship between the power output and the AAV angle was determined using the vector decomposition of the wind speed and wind rotor area. Wind speed step and ramp response tests were performed for proportional–integral–derivative (PID) control. The results obtained demonstrate the technical feasibility of this type of control, obtaining settling times (ts) of 6.7 s in the step response and 2.8 s in the ramp response.

The Relationship between Physical Fitness Level with Body Mass Index of Medical Students at Indonesian Christian University, Jakarta

Aims: This research aims to understand the relationship between physical fitness level and body mass index (BMI) of students at the Faculty of Medicine, Indonesian Christian University, especially the class of 2021. Study Design: The research design used in this study was observational with a cross-sectional approach. Place and Duration of Study: This research will be conducted at the Faculty of Medicine, Indonesian Christian University Laboratory in December 2022. Methodology: The population in this study were all students from the Faculty of Medicine, class of 2021. The research sample consisted of 57 students from the Faculty of Medicine, class of 2021, who were selected using a sampling technique, namely consecutive sampling. The physical fitness test uses the Harvard Step Test. Results: From the research results, it was found that the physical fitness level of 57 students registered at the Faculty of Medicine, Indonesian Christian University could be categorized as follows: 44 students (77.2%) were in the less ability, 8 students (14.0%). included in the moderate ability, and 5 students (8.8%) were included in the good ability. Apart from that, an analysis of the body mass index (BMI) of students at the Faculty of Medicine, Indonesian Christian University, Class of 2021, showed that the largest proportion consisted of individuals who were classified as having a normal weight, namely 31 people (54.4%), obesity, 12 people (21 .1%), underweight as many as 6 people (10.5%), overweight as many as 4 people (7.0%) and Obesity II as many as 4 people (7.0%). Based on bivariate analysis, the results showed that there was no significant relationship between Physical Fitness and Body Mass Index. This was concluded by obtaining a chi-square value, namely p = 0.740. Conclusion: From the research results, it can be concluded that the Body Mass Index is not a determining factor that guarantees physical fitness, likewise other moderate variables such as age and gender also have no relationship with physical fitness.

Determination of Physical Fitness Index (PFI) among Female College Students

Physical fitness/cardiovascular fitness is considered as the best reflection of whole-body health. It can be maintained by improving the physical fitness/cardiovascular fitness levels of individuals. The current study attempted to analyze the physical fitness index (PFI) of female college students by using the Harvard step test. A cross-sectional research was conducted from June 2021 to January 2022. Non-probability convenient sampling technique was employed to choose a sample of 340 students based on inclusion and exclusion criteria. Data was collected from Government Degree College for Women, Government Post-Graduate College for Women, and Apex College Sialkot, Pakistan. The data was entered and analyzed through SPSS. PFI scores showed students who had excellent and good scores, for instance 13 (3.8%) and 39 (11.5%), respectively. High average and low average scores were 172 (50.6%) and 62 (18.2%), respectively. Students who had poor scores were 54 (15.9%). The mean PFI was 66.91± 11.23, respectively. The association of PFI with BMI showed spearman correlation value as 0.136 with p-value &lt; 0.05. The findings showed that most of the female college students had average to low PFI.

Comparison of the efficacy of intradialytic core stabilization and aerobic exercises for hemodialysis patients: randomized controlled single-blind study

Purpose This study was performed to investigate and compare the effects of intradialytic core stabilization and aerobic exercises on physical performance, fatigue, quality of life and dialysis adequacy. Materials and methods The study involved 39 individuals on hemodialysis randomized into two groups: aerobic exercise (AE, n = 20) and core stabilization (CSE, n = 19). Over 8 weeks, the AE group performed pedal ergometer exercises, while the CSE group performed 4-phase core stabilization exercises. Physical performance (five times sit to stand test, 2-min step test), quality of life (Kidney Disease Quality of Life-36; KDQOL-36), fatigue levels (Piper Fatigue Scale), and dialysis adequacy (Kt/V and URR) were assessed. Results After training, a significant improvement was observed in the physical performance, fatigue levels, and some parameters of KDQOL-36 of the patients (p < 0.05). However, no significant changes were observed in dialysis adequacy indicators (Kt/V and URR) (p > 0.05). When the amount of development obtained in both treatment groups is compared, kidney disease burden only in the subparameter of KDQOL-36 was statistically significantly improved in the CSE group compared to the AE group (p < 0.05). Conclusions According to the results of the study, intradialytic core stabilization exercises appear to have similar effects to aerobic exercises and can be performed by HD patients.

Exercise capacity in COVID-19 surviving patients: impact of physical rehabilitation

Background: At least 65 million individuals worldwide have Long COVID and despite efforts to explain the effects of exercise prescription on the recovery of these individuals, there is a need to explore its effects on exercise tolerance and cardiorespiratory fitness. Therefore, our main objective was to evaluate the effect of the Physical Rehabilitation Program (PRP) on muscle strength and physical exercise capacity of COVID-19 survivors. Methods: The cohort included 28 patients post COVID-19, each participant performed a comprehensive and multisystem evaluation in two visits, in the pre- and post-PRP: 1st visit = clinical evaluation periods (maximal inspiratory pressure (MIP); maximal expiratory pressure (MEP) and Duke Activity Status Index (VO2peak). 2nd visit= physical evaluation [6-minute Step Test (6MST) and Handgrip Strength (HGS)]. The PRP consisted of breathing exercises, muscle strength exercises for upper and lower limbs and aerobic exercise, 2 or 3 times/week for 03 months. Results: The post-PRP we found: improvement in peripheral [95%CI 2.7 (2.0-3.4), p=0.001, Huge] and respiratory [MIP 95%CI 1.6 (0.9-2.3), p&lt;0.001, Very large) and MEP 95%CI 2.7 (2.0-3.4), p=0.001, Huge)] muscle strength; increase in cardiorespiratory fitness according to estimated-VO2peak [95%CI 2.3 (1.5-3.1), p&lt;0.001, Huge] and the number of steps climbed in the 6MST [95%CI 1.6 (0.9-2.3), p&lt;0.001, Very large]; adaptations resulting lower resting heart rate (HR), higher peak HR, good modulation of HR resulting from stress caused by 6MST; linear and positive association between peripheral and respiratory muscle strength and the number of steps climbed 6MST and greater HR recovery especially post-PRP; recovery-first minute HR remained unchanged post-PRP. Conclusion: In patients post COVID19, we emphasize the great effect of individualized and supervised PRP on the increase in peripheral and respiratory muscle strength/ quality and cardiorespiratory fitness. Despite the gains obtained in PRP, the risk of death based on HR recovery did not change.

Assessment of balance and risk of falls in people over 60 years old

Introduction: Falls of the elderly are a significant problem for public health and healthcare. They are also included in the geriatric giants, and the assessment of balance and risk of falls is an important part of the comprehensive geriatric assessment (CGA). It is estimated that almost one in three people over the age of 65 living independently in a community suffers one fall per year. These estimates increase with age, and in people older than 80 years, every second senior may experience at least one fall. The aim of the study was to assess the balance and risk of falls in people over 60 years of age living independently in society. Materials and methods: The study enrolled 40 seniors over the age of 60 who agreed to participate in the study and met the inclusion criteria. Three functional tests were used to assess balance and the risk of falls among seniors: the Timed Up and Go (TUG), the Four Square Step Test (FSST) and One-leg standing (OLS). Result: The study shows that as age increases, subjects perform worse on the Timed Up and Go rho = 0.38 test; p &lt; 0.05 and in the Four Square Step Test rho = 0.53; p &lt; 0.01. No statistically significant differences were observed between genders or age groups in the One Leg Standing test (OLS), although older people scored worse than younger age groups. There were no statistically significant associations between performance test results and BMI. The average results of the clinical tests show that the seniors in the study had good balance and a low risk of falling.

Significance of Selected Posturographic Methods in Diagnosis of Balance Disorders in Patients with Early-Stage Gonarthrosis.

Degenerative joint disease is a dynamic pathological process characterised by a destabilisation of the degradation and synthesis processes of articular cartilage and subchondral bone layer. Studies suggest that individuals with gonarthrosis experience deficits in proprioception, in addition to changes within their joints, which directly affects their ability to maintain posture and increases their risk of falling. Objectives: The aim of this study was to assess the functional status of patients with gonarthrosis through a posturographic examination conducted on a stabilometric platform (force plate) and a functional clinical examination. Methods: Participants were divided into two groups-a control group (n = 125) and a study group (n = 125). During the qualification process, subjective and objective examinations were conducted, including a functional assessment by means of such tests as the "Up and Go" Test, Functional Reach Test, Five Time Sit to Stand Test, and the Step Test. Subsequently, an assessment was conducted on the force plate by means of a posturographic test-the Romberg test performed with open and closed eyes in a standing position-and balance was evaluated using the Berg Balance Scale. The obtained data were analysed with the use of the IBM SPSS Statistics software version 27.0, by means of the Mann-Whitney test, and correlations were determined by means of Spearman's test. A significance level of p = 0.05 was adopted. Results: Statistically significant differences were observed among the assessed groups as a result of both functional and posturographic examinations, along with positive correlations for disease duration, age, and BMI index. Conclusions: Patients with gonarthrosis exhibited disturbances in balance, functionality, and posture compared to healthy individuals in the control group.

Feasibility of performing the 3-minute step test with remote supervision in children and adolescents with cystic fibrosis: A comparative study.

The 3-min step test is a simple option to monitor submaximal exercise capacity, although its use via remote video monitoring has not been investigated in children with cystic fibrosis (CF). This study aimed to assess the feasibility and reproducibility of performing the 3-min step test with remote supervision. A cross-sectional study including CF patients (6-18 years) from two CF services were performed. Demographic, anthropometric, clinical, and lung function data were collected and two 3-min step tests were performed: (i) in-person supervision, and (ii) remotely supervised by video monitoring. Before and after the tests, heart rate (HR), oxygen saturation (SpO2), and the Borg score for dyspnea and lower limb fatigue were monitored. Twenty-three patients (10.7 ± 3.7 years) with a mean FEV1 of 89.5% ± 23.2% were included. There were no significant differences between tests, with mean differences (95% confidence intervals) in final HR of -3.3 (-8.9, 2.4), change in HR of -1.9 (-6.1, 2.1), final SpO2 of 0.3 (-0.4, 1.0), and final dyspnea of 0.1 (-0.8, 0.9). The intraclass correlation coefficient was 0.852 (final HR), 0.762 (final SpO2), and 0.775 (final lower limb fatigue). Significant and moderate correlations were found between tests for final HR (r = 0.75), change in HR (r = 0.61), and final SpO2 (r = 0.61). The Bland-Altman analysis showed a mean difference in final SpO2 between tests of 0.3% (limit of agreement -3.0%, 3.5%). Physiological responses between tests were similar, indicating it was feasible to perform the 3-min step test with remote supervision in CF children.

Design of four-wheel steering system based on automotive electronic control technology

Abstract With the rapid development of the automobile industry, people’s requirements for automobile handling performance and driving safety are getting higher and higher. As an important automobile power system, four-wheel steering technology can improve the maneuverability, stability, and safety of vehicles by controlling the steering angles of front and rear wheels. Therefore, the design and research of the four-wheel steering system has become one of the hotspots in the field of automotive engineering. In this paper, a two-degree-of-freedom dynamics model is established, and based on the PID control strategy of joint feedback of center-of-mass lateral deflection and traverse angular velocity, the vehicle model of a four-wheeled steering vehicle is constructed by using TruckSim, and the minimum turning radius test, serpentine test, and steering wheel angle step test project are carried out. The results show that compared with the two-wheel steering vehicle, the minimum turning diameter of the four-wheel steering vehicle is reduced by 1/3, which effectively improves the maneuverability at low speeds as well as the safety and stability at high speeds, and has better transient response.

Is the six-minute step test an alternative to six-minute walking test to assessment the functional capacity in elderly?

Is the six-minute step test an alternative to six-minute walking test to assessment the functional capacity in elderly?

Relationship between Simulated Fire Suppression Activities and Acute Cardiac and Respiratory Events in Firefighters.

Cardiac deaths account for the largest share of on-duty firefighter deaths. To help ensure duty fitness and minimize injury risk, many fire departments require the passing of an annual physical ability test, consisting of a battery of simulated fire suppression activities (sFSAs). The purpose of the study was to determine the relationship of sFSA performance to acute cardiac and respiratory events (ACREs) and the effect that estimated VO2max has on sFSA performance. The study was retrospective. As part of an annual physical ability test, five timed sFSAs were performed, summed for a composite time, and categorized into three performance levels (fast, moderate, and slow). Estimated VO2max was determined using the Forestry Step Test. A significant (p = 0.023) linear trend was observed with higher sFSA performance times being associated with a higher proportion of firefighters going on to suffer an ACRE. The estimated VO2max was significantly (p < 0.001) higher in the fast group compared to the slow group. There was not a significant (p = 0.70) difference in estimated VO2max between the moderate and slow groups. Estimated VO2max performance and sFSA performance were significantly correlated, with rs(488) = -0.272 and p < 0.001. Poorer sFSA performance was found to be associated with a higher proportion of ACREs. The results suggest that sFSA performance may be a valid indicator of ACRE injury risk and aerobic capacity.

Side differences and reproducibility of the Moxy muscle oximeter during cycling in trained men

PurposePortable near-infrared spectroscopy devices allow measurements of muscle oxygen saturation (SmO2) in real time and non-invasively. To use NIRS for typical applications including intensity control and load monitoring, the day-to-day variability needs to be known to interpret changes confidently. This study investigates the absolute and relative test–retest reliability of the Moxy Monitor and investigates side differences of SmO2 at the vastus lateralis muscle of both legs in cyclists.MethodsTwelve trained cyclists and triathletes completed 3 incremental step tests with 5 min step duration starting at 1.0 W/kg with an increase of 0.5 W/kg separated by 2–7 days. SmO2 was averaged over the last minute of each stage. For all power outputs, the intra-class coefficient (ICC), the standard error of measurement (SEM) and the minimal detectable change (MDC) were calculated. Dominant and non-dominant leg SmO2 were compared using a three-factor ANOVA and limits of agreement (LoA).ResultsANOVA showed no significant systematic differences between trials and side. For both legs and all intensities, the ICC ranged from 0.79 to 0.92, the SEM from 5 to 9% SmO2 and the MDC from 14 to 18% SmO2. The bias and LoA between both legs were −2.0% ± 19.9% SmO2.ConclusionRelative reliability of SmO2 was numerically good to excellent according to current standards. However, it depends on the specific analytical goal whether the test–retest reliability is deemed sufficient. Wide LoA indicate side differences in muscle oxygenation during exercise unexplained by leg dominance.

Assessing Maximal Oxygen Uptake: Influence of Leg Length in the Harvard Step Test and Queen’s College Step Test

Maximal oxygen uptake (VO2max) indicates cardiovascular endurance in evaluating overall health and physical performance. The CPX method is accurate, but accessibility is lower due to issues related to cost and complexity. For this reason, the Harvard Step Test and Queen's College Step Test are drawing interest. Step-based tests are influenced by factors such as leg length, requiring an investigation into the correlation between leg length and VO₂max estimation using these methods. This study investigates the influence of leg length on predicted VO₂max (pVO2max) determined through both the Harvard Step Test and the Queen's College Step Test. The assessment of VO2max was carried out using CPX on a treadmill. Measurements were obtained through the Harvard Step Test and Queen's College Step Test on steps. The participants were informed about the experimental procedure, and the experiment was conducted 24 hours later. The experiment maintained controlled conditions, and each measurement was conducted as a single trial, repeated three times for accuracy. The study found a significant positive correlation (r = 0.595, P &lt; 0.05) between CPX VO2max and lower leg length. Lower leg length was found to significantly influence exercise intensity as determined by both the Harvard Step Test pVO2max (explaining 35.4% of the variance, P &lt; 0.05) and the Queen's College Step Test pVO2max (explaining 30% of the variance, P &lt; 0.05). It is recommended to adjust the step height to the individual's body size when estimating exercise difficulty or pVO2max using step-based exercises.

#1806 Cycling is safe – effect of intradialytic cycle ergometry on cerebral oxygenation and cognitive function – a pilot study

Abstract Background and Aims Patients on chronic hemodialysis benefit from intradialytic exercise with improvements in endurance, muscle strength and health-related quality of life. It is not known whether the increased oxygen demand during intradialytic exercise negatively affects cerebral oxygenation and cerebral function. The aim of the study was to assess the risk of cerebral undersupply by measuring cerebral oxygenation, perfusion and cognitive function during and after intradialytic ergometer training. Method Twelve patience on maintenance hemodialysis (HD) trice weekly were included in the study. In an initial ramp test, using bed cycle ergometer, we first determined the maximum physical strength (Pmax) at the level of exhaustion (HD A). Then, one hour after start of a second HD (HD B), patients performed 40%, 50% and 60% of Pmax for 6 min. Pulmonary function tests, blood volume (BVM), cardiac output (by electrical cardiometry), regional cerebral oxygen saturation (rSO2) (by near-infrared spectroscopy) and cerebral blood flow (CBF, by Doppler sonography) were measured. The relative changes in rSO2, CBF and hematocrit were used to calculate cerebral oxygen supply (DO2). Cognitive tests (Stroop, Trail Making and Mini Addenbrookes Cognitive Examination Test) were performed before and after HD sessions with and, as controls, without ergometry (HD-C). Results Median age was 68 (42-85) years, 9/12 were male, complete data set was obtained in 10 patients. During step test exercise (HD B), at the highest exercise level (according to Borg (1-10) 6.75 ± 2.9), rSO2 increased (+6 ± 9%, p=0.034) without a significant change in CBF. In the meantime, relative blood volume decreased during ergometry (-5.8 ± 2.73%; p=0.002), causing a temporary increase of hematocrit. Despite a small decrease in CBF in 3 patients, the mean change of rSO2, CBF and hematocrit always had a positive trend in all patients, as a surrogate of stable cerebral oxygen supply (Table 1). In comparative cognitive tests (B vs. C), we observed no significant changes in cognitive functions. Conclusion In this pilot study, intradialytic bed-cycle ergometry during the first hour of HD for &amp;lt;20 min at 40-60% of patients’ individual maximum intensity had no negative effects on cerebral oxygenation and function. Specific studies testing the safety intradialytic exercise with different conditions, such as increasing intensity or duration, are needed.

Cognitive-Behavioral-Based Physical Therapy for Improving Recovery After a Traumatic Lower-Extremity Injury: The Results of a Randomized Controlled Trial.

Lower-extremity injuries can result in severe impairment and substantial years lived with a disability. Persistent pain and psychological distress are risk factors for poor long-term outcomes and negatively influence the recovery process following a traumatic injury. Cognitive-behavioral therapy (CBT) interventions have the potential to address these risk factors and subsequently improve outcomes. This study aimed to evaluate the effect of a telephone-delivered cognitive-behavioral-based physical therapy (CBPT) program on physical function, pain, and general health at 12 months after hospital discharge following lower-extremity trauma. The CBPT program was hypothesized to improve outcomes compared with an education program. A multicenter, randomized controlled trial was conducted involving 325 patients who were 18 to 60 years of age and had at least 1 acute orthopaedic injury to the lower extremity or to the pelvis or acetabulum requiring operative fixation. Patients were recruited from 6 Level-I trauma centers and were screened and randomized to the CBPT program or the education program early after hospital discharge. The primary outcome was the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) scale. The secondary outcomes were objective physical function tests (4-square step test, timed stair ascent test, sit-to-stand test, and self-selected walking speed test), PROMIS Pain Intensity and Pain Interference, and the Veterans RAND 12-Item Health Survey. Treatment effects were calculated using targeted maximum likelihood estimation, a robust analytical approach appropriate for causal inference with longitudinal data. The mean treatment effect on the 12-month baseline change in PROMIS PF was 0.94 (95% confidence interval, -0.68 to 2.64; p = 0.23). There were also no observed differences in secondary outcomes between the intervention group and the control group. The telephone-delivered CBPT did not appear to yield any benefits for patients with traumatic lower-extremity injuries in terms of physical function, pain intensity, pain interference, or general health. Improvements were observed in both groups, which questions the utility of telephone-delivered cognitive-behavioral strategies over educational programs. Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.