Step Test Research Articles

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.

Accelerometer-Measured Physical Activity, Fitness and Indicators of Cardiometabolic Risk among Rural Adolescents: A Cross-Sectional Study at 15-Year Follow-up of the MINIMat Cohort.

Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among rural adolescents in low- and middle-income countries. Thus, we examined the associations of PA and fitness with selected cardiometabolic indicators along with potential gender-based differences in a birth cohort of rural adolescents from southeast Bangladesh. We utilized data from the 15-year follow-up of Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort (n = 2253). Wrist-worn ActiGraph wGT3x-BT accelerometers were used to estimate sedentary time (ST) and PA. Fitness was assessed using: handgrip strength, standing long jump, and Chester Step Test. Anthropometric parameters, systolic blood pressure (SBP), and fasting lipid, insulin and glucose levels were measured. We calculated insulin resistance using the Homeostasis Model Assessment equation (HOMA-IR). Linear regression and isotemporal substitution models were fitted. The adolescents spent 64min/day (inter-quartile range: 50-81) in moderate-to-vigorous physical activity (MVPA). A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% confidence interval (CI): 2.9-6.8%) lower waist circumference (WC), 3.2 mmHg (95% CI: 1.5-4.8) lower SBP, 10.4% (95% CI: 2.9-17.3%) lower TG, and 24.4% (95% CI: 11.3-34.9%) lower HOMA-IR. MVPA showed similar associations of notably smaller magnitude. Except for WC, the associations were more pronounced among the boys. Substituting ST with VPA of equal duration was associated with lower WC, SBP, triglyceride and HOMA-IR. Grip strength was favorably associated with all indicators, displaying considerably large effect sizes. Our findings indicated beneficial roles of PA- particularly VPA- and muscular fitness in shaping cardiometabolic profile in mid-adolescence. VPA and grip strength may represent potential targets for preventive strategies tailored to adolescents in resource-limited settings.

To Observe the Dynamic Balance Problem in Deaf Children`s Via Four Square Step Test

Background: Hearing loss is often associated with challenges in dynamic balance among children, impacting their daily activities and quality of life. This study aims to explore the relationship between varying degrees of hearing loss and dynamic balance capabilities among children, addressing a gap in current research on the physiological impacts of auditory impairments. Objective: To assess and compare the dynamic balance of children with different severities of hearing loss and to establish if there is a linear relationship between hearing loss severity and balance performance. Methods: A total of 302 children aged 4 to 15 years with varying degrees of hearing loss were recruited for this study. Participants were categorized into subgroups labeled as profound, severe, moderate, and minor hearing loss based on stop-watch tests. The Four Box Step Test was employed to measure each participant's dynamic balance. Data normality was verified using the Kolmogorov-Smirnov test, and differences among groups were analyzed using two-way ANOVA and Tukey's post hoc test. Results: This study assessed the dynamic balance in children with varying degrees of hearing loss, analyzing data from 172 participants aged 4 to 15 years. The analysis revealed significant gender differences in dynamic balance, with males generally outperforming females. The age-based assessment demonstrated a negative linear trend, indicating that dynamic balance decreases as age increases, with significant variances across different age groups (F(2, 166) = 3.91, p = 0.022). Two-way ANOVA confirmed no significant interaction between gender and age on dynamic balance (F(2, 166) = 2.82, p = 0.062), highlighting that while age significantly affects balance, gender alone does not show a substantial impact. Conclusion: Dynamic balance decreases as the severity of hearing loss increases, with males generally outperforming females. This study underscores the importance of incorporating balance training in rehabilitation programs for children with hearing loss to enhance their motor performance and safety.

The effects of L-DOPA on gait abnormalities in a unilateral 6-OHDA rat model of Parkinson's disease

Parkinson's Disease (PD) is a neurodegenerative movement disorder characterized by dopamine (DA) cell loss in the substantia nigra pars compacta (SNc). As PD progresses, patients display disruptions in gait such as changes in posture, bradykinesia, and shortened stride. DA replacement via L-DOPA alleviates many PD symptoms, though its effects on gait are not well demonstrated. This study aimed to assess the relationship between DA lesion, gait, and deficit-induced reversal with L-DOPA. To do so, Sprague–Dawley rats (N = 25, 14 males, 11 females) received unilateral medial forebrain bundle (MFB) DA lesions with 6-hydroxydopamine (6-OHDA). An automated gait analysis system assessed spatiotemporal gait parameters pre- and post-lesion, and after various doses of L-DOPA (0, 3, or 6 mg/kg; s.c.). The forepaw adjusting steps (FAS) test was implemented to evaluate lesion efficacy while the abnormal involuntary movements (AIMs) scale monitored the emergence of L-DOPA-induced dyskinesia (LID). High performance liquid chromatography (HPLC) assessed changes in brain monoamines on account of lesion and treatment. Results revealed lesion-induced impairments in gait, inclusive of max-contact area and step-sequence alterations that were not reversible with L-DOPA. However, the emergence of AIMs were observed at higher doses. Post-mortem, 6-OHDA lesions induced a loss of striatal DA and norepinephrine (NE), while prefrontal cortex (PFC) displayed noticeable reduction in NE but not DA. Our findings indicate that hemiparkinsonian rats display measurable gait disturbances similar to PD patients that are not rescued by DA replacement. Furthermore, non-DA mechanisms such as attention-related NE in PFC may contribute to altered gait and may constitute a novel target for its treatment.

Physical function as a predictor of chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

BackgroundA growing body of research indicates that poor functional status before chemotherapy may be correlated with the severity of chemotherapy-induced peripheral neuropathy (CIPN) after the neurotoxic treatment. However, little is known about the associations between pre-chemotherapy physical function and CIPN in patients with pancreatic cancer.PurposeTo identify the predictors of CIPN in relation to pre-chemotherapy physical function in patients with pancreatic cancer.MethodsThis secondary analysis included data from patients with pancreatic cancer who participated in a longitudinal research study at National Cheng Kung University Hospital, Tainan, Taiwan. Four physical function tests (i.e., grip strength, Timed Up and Go (TUG), 2-minute step test (2MST), and Romberg test) and two questionnaires (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 [EORTC QLQ-C30] and Chemotherapy-Induced Peripheral Neuropathy Module [CIPN20]) were assessed at baseline (i.e., before first chemotherapy session) and 2-, 3-, 4-, and 6-month follow-up. Multiple linear regression with adjustment for confounding factors was used to assess the associations between the four functional tests at baseline and the CIPN20 total score and individual subscale scores (sensory, motor, and autonomic) at 6-month follow-up.ResultsData from a total of 209 pancreatic cancer patients (mean age: 64.4 years, 54.5% male) were analyzed. The findings showed that the severity of CIPN at 6-month follow-up was significantly associated with the baseline TUG completion time (β = 0.684, p = 0.003). The TUG completion time was also positively correlated with the 6-month CIPN sensory and autonomic subscales. In addition, a baseline positive Romberg test (β = 0.525, p = 0.009) was a significant predictor of the severity of motor neuropathy at 6-month follow-up.ConclusionThe TUG completion time and positive Romberg test before chemotherapy may be predictive factors of the CIPN severity 6 months after the commencement of chemotherapy. Accordingly, the incorporation of TUG and Romberg tests into the clinical assessment protocol emerges as imperative for individuals diagnosed with pancreatic carcinoma undergoing chemotherapy regimens.

Visual behavior of racing bike cyclists in multi-tasking situations

Distracted biking can have serious repercussions for the rider such as accidents. The purpose of the present experiment was to determine the effect of visually monitoring two parameters, the cadence, and the heart rate on a bike computer fixed on a racing bike, and simultaneously detect hazardous traffic situations. Individuals (n = 20) were instructed to ride a racing bike that was fitted onto a roller trainer. After conducting a bicycle step test to assess the maximal heart rate (HFmax), participants were assigned to a within subject-design on a separate day. They were instructed to perform the riding task in two single-task conditions (only watching the traffic at the video with occluded or without occluded bike computer), two multi-tasking conditions (monitoring the cadence of 70 RPM or 90 RPM, monitoring the heart rate, and observing the traffic) and one control condition (no instructions). Percentage dwell time of the eye movements, the constant error from the target cadence, keeping the heart rate in an interval of 50% - 70% of the HFmax, and percentage of the recognized hazard traffic situations were analyzed. The analysis indicated that monitoring the parameters on the bike computer induced no significant decline in perceived hazardous traffic situations.

Moving together - benefits of an online dance program on physical and mental health for older women: an exploratory mixed-method study

BackgroundPrevious studies show that in-person dance training is a beneficial form of physical activity that involves mental, social, and physical dimensions. This exploratory study investigated the benefits of a 12-week online dance training intervention on mental and physical health outcomes for older women.MethodsA convergent parallel mixed-method design was used. Forty-five older adults (74.0 ± 5.3 yrs old, 44 women) were recruited through advertisements at activity and rehabilitation centers in the North Denmark region. The intervention consisted of two weekly 60-min classes of improvisation and salsa delivered online through video call applications. Changes in physical health outcomes (body mass and composition, resting blood pressure, Senior Fitness Test battery) and self-rated health and wellbeing (health-related quality of life (HRQOL), feelings of loneliness) were assessed prior to and after 12 weeks of dancing. Focus group interviews were conducted post-intervention to further explore the benefits as well as the participant’s experience of the intervention. Thematic analysis of the qualitative data was conducted.ResultsThirty-two participants (all women) completed the study. Significant improvements in fitness were found for the number of arm curls performed (baseline: 12.3 ± 3.0; post-intervention: 13.7 ± 3.0, P = 0.005), 2-min step test performance (baseline: 66.5 ± 20.0 reps.; post-intervention: 73.8 ± 22.6 reps., P = 0.016), and chair sit-and-reach (baseline: 0.4 ± 11.3 cm; post-intervention: 5.5 ± 10.1 cm, P < 0.001). There was a significant increase in body mass from baseline to post-intervention (P < 0.015). The themes from the focus groups included (1) Participation, (2) Challenges, (3) Progression, (4) Motivation, (5) Perceived health and wellbeing, and (6) Online dance instruction. No significant changes were reported in HRQOL and loneliness from the quantitative data, although the qualitative data did reveal improved feelings of physical health and wellbeing.ConclusionsThe intervention improved several aspects of fitness in older women and improved the participants’ perceptions of their own physical abilities and wellbeing. While most participants found the online intervention enjoyable, several participants missed the feedback from the instructors that naturally occurs with in-person instruction.

WALKING WITH BLOOD FLOW RESTRICTION: A NOVEL METHOD TO IMPROVE PHYSICAL FITNESS IN OLDER ADULTS?

INTRODUCTION AND AIMS Alternative physical activity modalities and methods are needed to combat low adherence among older populations. Therefore, we are investigating whether blood flow restricted (BFR) walking improves measures of lower limb strength, and functional performance, compared to traditional walking in older adults. METHODS Healthy adults ≥60 years were randomised into BFR (n=5) or non-BFR (n=4) walking groups. Both groups walked outdoors, 3 days/week for 12 weeks starting at 4km/h and increasing walking speed by 0.5km/h every 4 weeks. The BFR group walked for 25min with BFR applied (60% arterial occlusion pressure) to the lower limbs in 2x 10mins bouts (separated by 5mins walking without occlusion). The non-BFR group walked for 50mins without occlusion, matching current best practice for low-moderate intensity physical activity. Participants were assessed at baseline and post-intervention (12 weeks) for knee extension maximal voluntary torque (MVTpeak) and functional capacity (four square step test [4SST], 5x sit-to-stand [STS], timed up and go [TUG], gait speed, and 6-minute walk test [6mWT]). RESULTS There were no differences at baseline between groups (p&amp;gt;0.05). Both groups improved across all measures from baseline to post-intervention, with significant effects for time observed for: 4SST (7.92±1.2s – 6.83±1.39s; p=0.035), TUG (6.16±0.81s – 5.58±0.9s; p=0.04), STS (11.30±1.70s – 10.14±1.7s; p=0.032), but not for gait speed (3.98±0.69s – 3.71±0.69s; p=0.456), 6mWT (564.72±72.13m – 601.27±64.2m; p=0.129) and MVTpeak (112.33±25.8Nm – 120.55±23.5Nm; p=0.995). No group x time effect was observed from baseline to 12 weeks (p&amp;gt;0.05). SUMMARY The current results demonstrate significant improvements in functional measures (4SST, TUG, STS) from baseline to post-intervention, with no differences observed between groups. This indicates that low-intensity BFR walking may provide comparable physical fitness improvements to non-BFR walking while completing only 50% of the volume.

Investigating the Relationship between Maximum Aerobic Capacity and Cognitive Ability and Employees’ Workability in a Dairy Factory

Abstract Aim: Considering the importance and necessity of physical and mental fitness of the employees with their job demands, this study aimed to estimate the levels of aerobic capacity among the workers and determine the factors that might affect these levels. The relationship between the aerobic capacity levels and the values of workers’ cognitive function and workability was also investigated. Materials and Methods: Sixty healthy male employees from a dairy factory were recruited using a random sampling method. The study design consisted of the completion of checklists containing personal data, anthropometric measurements, and evaluation of job ability, maximum aerobic capacity along with the cognitive ability of the participants using the Workability Index (WAI) standard questionnaire, Queen’s College step test, and psychomotor vigilance test (PVT), respectively. Results: The mean values of VO2 max, reaction time (RT), and WAI of workers were 45.54 ± 6.13 mL/kg/min, 337.82 ± 29.93 ms, and 42.76 ± 5.02, respectively. Based on the Pearson correlation test, a weak statically significant correlation was observed between PVT and VO2 max (r = 0.3, P = 0.02) as well as PVT and physical work capacity (r = 0.263, P = 0.04). The findings of this study showed that there was a significant relationship between height, weight, body mass index, RT, and error percentage with maximal aerobic capacity (VO2 max). Conclusion: According to the physiological criteria, the employees’ capabilities and job requirements are not in balance; particularly for those working in laboratory, office, or service departments. Therefore, using standardized recruitment tests, providing sports facilities and developing integrated indicators are a principal element of establishing an ergonomic balance in this workplace.

DELIVERING GROUP-BASED TELE-EXERCISE SESSIONS FOR PEOPLE WITH TYPE 2 DIABETES: RESULTS AND EXPERIENTIAL INSIGHTS OF A PILOT STUDY

INTRODUCTION &amp; AIMS Delivery of group-based tele-exercise is an emerging treatment option for people with type 2 diabetes (T2D), but best practice is not yet understood. We evaluated the results and experiential insights of a pilot study investigating this model of care. METHODS Sixteen people with T2D (age 58.7±12.6, 63% male, duration of T2D 10.0±8.4years) underwent an 8-week tele-exercise intervention. Participants were assessed at baseline (in-person and via telehealth; results compared using intra-class correlations coefficients) and post-intervention (in-person only). The program was delivered in groups of 3-5, by an Accredited Exercise Physiologist using Zoom. Sessions were held once weekly and incorporated whole-body aerobic and resistance exercise (45min) and health behaviour change education (15min), reflecting the structure of Medicare-subsidised group exercise physiology sessions. Semi-structured interviews were conducted to gain participant and clinician feedback. Adverse events were monitored throughout. RESULTS The intervention demonstrated efficacy, with improvements in HbA1c (mean change -0.3±0.5%), fasting glucose (-0.8±0.8mmol/L), systolic blood pressure (-6.4±8.4mmHg), waist circumference (-0.8±4.2cm), muscular strength (30sec sit-to-stand score 1.6±2.9; 30sec bicep curl score 5.6±3.0) and fitness (2min step test score 24.5±11.9). Clients could reliably self-assess outcomes such as waist circumference (ICC 0.98, 95%CI 0.95-0.99), 30sec sit-to-stand (0.94, 0.82-0.98), and 2min step test (0.96, 0.87-0.99) when supervised by the clinician via telehealth, negating the need for in-person consults. No serious adverse events were reported. Key experiential insights include 1) Technological issues were minimised by providing clients with a guide for using Zoom, and conducting individual Zoom familiarisation sessions, prior to program start. 2) Client confidentiality could be managed by using breakout rooms for private conversations. 3) Creative exercise selection (e.g., TheraBand anchor points, non-traditional equipment) allowed participants to envision exercising in their home, which assisted in self-management. CONCLUSION This study contributes practical insights to optimise the delivery of group-based tele-exercise interventions to people with T2

PREHABILITATION BEFORE GASTROINTESTINAL CANCER SURGERY (PREHAB-GI): AN IMPLEMENTATION STUDY

BACKGROUND Surgery continues to be the primary treatment option for early-stage colorectal and upper gastrointestinal (UGI) cancers. However, up to 30-40% will experience a major complication. Prehabilitation aims to improve preoperative functional reserves through physical, nutritional, and/or psychological interventions. We aimed to evaluate the implementation of a multimodal prehabilitation program in gastrointestinal cancer surgery patients. METHODS A single-arm implementation study using a pre-post design. Colorectal or UGI cancer patients scheduled for curative intent surgery at Concord Hospital with ≥14 days pre-surgery were recruited. The intervention was face-to-face or by telehealth (COVID adaptations): a 2-4-week program consisting of i) supervised exercise, ii) dietary education and protein supplements, iii) nursing support. The primary outcome was implementation using the RE-AIM (Reach/Effectiveness/Adoption/Implementation/Maintenance) framework. Secondary outcomes included functional, nutritional, and surgical outcomes. RESULTS Over 16 months, 181 were screened; 95 (52%) were eligible. Reach: 77/95 recruited (64 colorectal, 13 UGI). The median age was 70 years; 46 (60%) were males. Median intervention duration was 16 days. Effectiveness: Functional capacity using the 6-minute walk test and 2-minute step test improved from baseline to pre-surgery; 9.3m (p=0.038) and 6.5 steps (p=&amp;lt;0.001), respectively. Self-reported moderate, vigorous and resistance training statistically increased from baseline to pre-surgery. Hospital length of stay decreased by 1.9 days (p=0.010). There was no difference in total complications and readmissions. Adoption: 91% of referrals were directly from surgeons. Implementation: 72 completed the intervention; 5 withdrew after baseline assessment. 34% of assessments and intervention were delivered by telehealth. Adherence to the intervention was high; 94% exercise, 97% nutrition, 98% nursing. Overall, participant and clinician satisfaction was high. Maintenance: The program has been adopted as standard care with modifications post-study completion. CONCLUSIONS Our study shows that multimodal prehabilitation can be successfully implemented in a real-world setting, with a trend to improve functional and surgical outcomes.

The Relationship Between Insomnia And Fitness Level In Medical Faculty Students Of Universitas Muhammadiyah Purwokerto

Physical fitness is a condition in which a person can carry out daily activities in a healthy and fit condition without quickly experiencing fatigue. Several factors can affect fitness level, such as a decrease in the hormone melatonin caused by insomnia. It will affect circadian rhythms and reduce a person's physical activity, thus affecting fitness level. To observe the relationship between insomnia and fitness level in Medical Faculty students of Universitas Muhammadiyah Purwokerto. This study used a cross-sectional analytic observational study design. Primary data was obtained from the results of the Harvard Step Test and the Insomnia Severity Index (ISI) questionnaire. The subjects were selected through a non-probability sampling technique by purposive sampling. The statistical tests used were Fisher’s test and logistic regression. The result is 42 male students were selected from all Medical Faculty students of Universitas Muhammadiyah Purwokerto. The bivariate analysis showed that the percentage of non-insomnia respondents with poor fitness level was 73.9% and those with good fitness level was 26.1%. While the percentage of insomnia respondents with poor fitness level is 84.2% and those with good fitness level is 15.8%. Fisher’s analysis results showed a p-value 0.477 (p&gt;0.05). There is no relationship between insomnia and fitness level in Medical Faculty students of Universitas Muhammadiyah Purwokerto.

EFFECTS OF DAILY 5-MINUTE ECCENTRIC-BIASED EXERCISES ON PHYSICAL FITNESS, BODY COMPOSITION, CRITICAL HEALTH MARKERS AND WELL-BEING IN SEDENTARY INDIVIDUALS

INTRODUCTION Exercise is fundamental for maintaining and improving health and fitness; however, many individuals do not participate in regular exercise, with perceived lack of time a key barrier. Minimal dose strategies, which reduce weekly exercise volumes to less than recommended guidelines, might improve health outcomes with minimal time investment. However, minimal dose strategies and their effects on health and fitness are still unclear. Therefore, we developed a bodyweight eccentric-biased exercise program consisting of 4 exercises (1 set of 10 repetitions each), which took just 5-min to complete, and investigated the effects of the program performed daily for 4 weeks on health and fitness outcomes in sedentary individuals. METHODS We recruited 22 healthy but sedentary individuals (32 – 69 years) whose daily steps were &amp;lt;5000. Participants completed a two-week control period, followed by a 4-week daily exercise intervention. Muscular strength, physical fitness, body composition and critical health markers were assessed before (PRE-1) and after the control period (PRE-2), as well as after the intervention (POST). RESULTS Participants adhered to the exercise program &amp;gt;90%. No significant changes in any measures were observed from PRE-1 to PRE-2. Following the exercise intervention, no significant changes in body mass, bone mineral density, fat mass, lean mass, heart rate, blood pressure, grip strength, squat jump or countermovement jump were evident. However, isometric mid-thigh pull, representing lower limb muscle strength (13%), push-ups (42%) and sit-ups (44%), representing upper body strength and sit and reach, representing flexibility (12%) increased significantly (P&amp;lt;0.05), and the increase in heart rate from a 3-minute step test was attenuated (8%) from PRE-2 to POST (P&amp;lt;0.05). Finally, mental health assessed by SF-36 significantly improved (15%) (P&amp;lt;0.05). CONCLUSION These results suggest that the 5-min eccentric exercise program was effective for improving physical fitness and mental health of sedentary individuals when performed every day for 4 weeks.