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PubMed2004

[The Dijon Physical Activity Score: reproducibility and correlation with exercise testing in healthy elderly subjects].

PURPOSE: To validate a French physical activity score for current use in healthy elderly people. PATIENTS AND METHODS: A brief questionnaire was developed for healthy elderly subjects older than 72 years. Questions asked about self-assessed physical fitness (1), daily activity (2), leisure and sport activity (5) and rest time (1). Correlations were searched between the score and several parameters of physical fitness: maximal exercise stress test (peak VO(2)), six-minute walk test, 200-meter long walk test, timed up an go test. RESULTS: A total of 57 subjects were studied (mean age, 77.6 +/-3.6 years; 28 females and 29 males). The mean time to complete the questionnaire was 3.96 minutes. Reproducibility was 0.606, as determined by Spearman's coefficient. Correlations were found between the physical activity score and peak VO(2) (0.302, P <0.05) and peak power (0.257, P <0.10). CONCLUSIONS: This easily obtained physical activity score provides a new way to assess physical activity in active elderly subjects. The physical score correlated in part with maximal ability but must be validated in several diseases.

Activities of Daily Living↗

PubMed2005

Reliability of physical functioning measures in ambulatory subjects with MS.

BACKGROUND AND PURPOSE: One of the primary reasons for measuring outcomes during rehabilitation is to determine the effect of physiotherapy. Repeated measurement situations are susceptible to several sources of error, including inconsistencies caused by the subject, the procedure, the instrument and the examiner. Therefore, the reliability of the measures needs to be examined. METHOD: The present study used a repeated-measures design. Two studies were undertaken to examine the test-retest and inter-rater reliability for physical functioning measures. The interval between the measurements was one week. The sample consisted of 19 ambulatory subjects with multiple sclerosis (MS) in the test-retest and nine subjects in the inter-rater reliability study. The measures were selected to assess different domains of the World Health Organization International Classification of Functioning, Disability and Health (WHO, 2001). Several parameters of the Box and Block Test (BBT), the Berg Balance Scale (BBS), the Kela Coordination test, the postural stability test, the timed 10-metre gait test, the six-minute walk test, the shoulder tug test, grip strength, maximal isometric force of the knee extensors, muscle endurance tests, the modified Ashworth Scale and passive straight leg raise test were examined in terms of reliability. RESULTS: The intra-class coefficient (ICC) values for test-retest reliability were >0.80 in 17 of 23 parameters, and correspondingly so in 20 out of 26 parameters for inter-rater reliability. Poor reliability (defined as ICC < or = 0. 60) was obtained only for the patient classification index (PCI) of the six-minute walk test in the test-retest reliability study. In general, the coefficient of variation was good. A moderate amount of variability was discovered for the Kela Coordination test, and for postural stability and muscle endurance tests. The data obtained from the modified Ashworth Scale and the shoulder tug test were highly skewed and the percentage of agreement ranged between 63.9% and 93.4%. CONCLUSIONS: The study revealed acceptable test-retest and inter-rater reliability of these measures in ambulatory subjects with MS, with the exception of the Modified Ashworth Scale and the shoulder tug test.

Adult↗

PubMed2003

Secular trends in body dimensions and physical fitness among adolescents in Sweden from 1974 to 1995.

AIM: To investigate changes over time in body dimensions, and muscular and aerobic fitness in a representative sample of 16-year-old-girls and boys in secondary schools in Sweden from 1974 to 1995 (n = 855). METHOD: Height and weight were measured and five tests were performed: run-walk, two-hand-lift, Sargent jump, sit-ups, and bench-press. RESULTS: In 1995, girls and boys had higher body mass index (BMI) than in 1974. Girls and boys performed less well in bench-press, sit-ups, and run-walk-tests in 1995. Boys, but not girls, performed better in Sargent jump in 1995 than in 1974. Girls and boys performed better in two-hand-lift in 1995 than in 1974. However, after adjustment for body dimensions, there were no differences in performance in two-hand-lift or run-walk-tests between 1974 and 1995. CONCLUSION: There was a decreased aerobic fitness and an increased maximal static strength among adolescents in Sweden between 1974 and 1995. These changes were partly due to increased BMI. However, decreased daily physical activity level cannot be excluded as a contributing factor to the decreased aerobic fitness. The reduced performance in muscular endurance in 1995 was not related to increased BMI. Instead, it is suggested that it is to be related to a specific decrease in hip flexion and arm muscle endurance.

Adolescent↗

PubMed2004

Influence of foot pain on walking ability of diabetic patients.

OBJECTIVE: To assess foot pain and its correlation with walking ability in diabetic patients. SUBJECTS: Two groups of type 2 diabetic patients (30 with symptomatic neuropathy and 30 without symptomatic neuropathy) and 30 healthy volunteers were studied. METHODS: Pain was assessed by the pain sub-scale of the Foot Function Index. Internal consistency for the pain sub-scale was tested. Walking ability was assessed by the 6-minute walking test. RESULTS: The pain was worse in diabetic patients, the pain sub-scale scores differed between the groups (p < 0.05). High internal consistency was found for the pain sub-scale of the Foot Function Index. Results of the 6-minute walking test differed among the 3 groups: healthy volunteers performed best, and diabetic patients with symptomatic neuropathy worst (p < 0.001). Foot pain correlated moderately with the result of walking test (r = -0.449, p < 0.001). CONCLUSION: The pain sub-scale of the Foot Function Index is suitable for the assessment of pain in diabetic patients. Patients with severe foot pain have more difficulties when walking long distances than patients with less severe or without any pain.

Aged↗

PubMedDate not supplied

Effectiveness of salmeterol in stable COPD.

Thirty patients of stable chronic obstructive pulmonary disease (COPD) were studied for evaluation of effectiveness of inhaled salmeterol in a double blind, randomised, placebo controlled trial for seven days. Baseline spirometery and breathlessness score after 6 minutes walk test were assessed in all patients. Bronchial asthma was excluded in each patient by reversibility test with 200 ug of salbutamol inhalation. After inhalation of two puffs from a given inhaler through spacer device in the morning, spirometery was carried out 1, 3, 6 and 12 hrs after inhalation on day 1, 3 and 7 of trial. Six minutes walk test and breathlessness score were assessed after 3 hrs of inhalation on days 1, 3 and 7. The maximum bronchodilator response to salmeterol was observed on 7th day at three hours after inhalation. The mean increase in FEV1 was 29.2% of baseline value, which was significant as compared to placebo where the mean increase in FEV1 was 3.3% of the baseline value. The peak rise in FEV1 was observed at three hours after inhalation on all the three days. The bronchodilator effect of salmeterol persisted for upto 12 hours. The mean maximum increase in walking distance in 6 minutes walk test was observed on 7th day in salmeterol group, which was 50.7 metres whereas in placebo group it was 12.2 meters. The patients in salmeterol group perceived less breathlessness after the six minutes walk test. The study concluded that salmeterol 50 micrograms twice a day is effective in improving lung functions in patients with stable COPD and can be recommended as maintenance therapy for stable COPD patients.

Administration, Inhalation↗

PubMedDate not supplied

[Head-to-head comparison of clinical, biochemical and functional effects of fosinopril and enalapril in patients with systolic heart failure].

INTRODUCTION: The aim of this study was to evaluate short-term clinical, biochemical and functional effects of fosinopril versus enalapril in patients with heart failure. MATERIAL AND METHODS: 59 consecutive patients (mean age 57 +/- 8 years, EF 18.9 +/- 6.3%, NYHA III or IV class 19/59) were randomized to receive fosinopril or enalapril for three months. All patients underwent echocardiography, metabolic testing, and a 6-minute walk test and completed the Minnesota questionnaire on inclusion and three months later. Additionally, serum creatinine, BUN, total cholesterol and triglycerides were measured. Kaplan-Meier curve was created to assess event-free survival for cardiac death and hospitalization for heart failure. RESULTS: There was no statistically significant difference in event-free survival between patients on fosinopril and enalapril (86.7% vs. 82.8%, log rank 4.21 p=0.43). However, time to the event was longer in patients on fosinopril (77.0 +/- 25.35 vs. 40.2 +/- 6.8 days, p=0.04). At the end of the study, no difference between fosinopril and enalapril group existed with respect to maximal oxygen consumption (20.90 +/- 4.47 vs. 20.89 +/- 6.86 ml/kg/min), ejection fraction (20.5 +/- 7.4 vs. 21.4 +/- 7.8%), distance during the 6-minute test walk (313 +/- 74 vs. 352 +/- 129 meters) and quality of life (23.8 +/- 15.8 vs. 25.6 +/- 20.3 points), but patients on enalapril had higher creatinine (99 +/- 13 vs. 113 +/- 17 micromol/L, p=0.002) and BUN (7.28 +/- 1.7 vs. 8.89 +/- 2.39 mmol/L, p=0.01) levels. Increase in fosinopril dose during the study was higher than increase in enalapril dose (24.1% +/- 23.8% vs. 9.5 +/- 24.5%, p=0.04). CONCLUSIONS: Fosinopril and enalapril have similar short-term effects on event-free survival, ejection fraction, functional capacity and quality of life in patients with heart failure. Patients on fosinopril presented with longer survival without event and had lower creatinine and BUN at the end-of the follow-up. Additionally, fosinopril can be easily titrated to the maximum therapeutic dose.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2005

[Thermal imaging properties of toes after walking stress test in diabetic patients].

In consecutive 50 diabetic patients hospitalized for medical education, without subjective symptoms of autonomic neuropathy (DM group), performed treadmill walking stress test and thermography, for clarify the feature of the pattern typical of diabetic autonomic neuropathy. Thermal images were collected, before, immediately after, 3, 6, 12 minutes after walking. The mean temperature of toes fell more than 1 degree C than that of baseline level and returned within 0.5 degrees C of baseline level within 6 minutes (N type) in 66% of 30 normal subjects (C group) and 24% of DM group. In 10% of C and 24% of DM, the temperature fell but not returned within 0.5 degrees C of baseline level in 6 minutes (D type). In 17% of C and 38% of DM, the temperature changed within 0.5 degrees C (F type), or rose more than 0.5 degrees C after exercise (U type) in 7% in C and 14% in DM groups. Pts D, F group, have more complications (HbA1c, nephropathy, retinopathy or somatic neuropathy), but not so in C, U type. We concluded D, F types were the typical thermographic features of the toes of pts with diabetic autonomic neuropathy.

Aged↗

PubMed2004

Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y.

BACKGROUND: Vitamin D may improve muscle strength through a highly specific nuclear receptor in muscle tissue. OBJECTIVES: We investigated whether there is an association between 25-hydroxyvitamin D [25(OH)D] concentrations and lower-extremity function in ambulatory older persons, whether that association differs by activity level, and, if so, whether there is an identifiable threshold in the association. DESIGN: The study was a population-based survey of the ambulatory US population aged 60 to > or =90 y (n = 4100). Lower-extremity function according to serum 25(OH)D concentrations was assessed by linear regression analyses and regression plots after control for activity level (inactive or active) and several other potential confounders. Separate analyses were performed for the timed 8-foot (ie, 2.4 m) walk test and a repeated sit-to-stand test. RESULTS: The 8-foot walk test compared subjects in the lowest and highest quintiles of 25(OH)D; the latter group had an average decrease of 0.27 s [95% CI: -0.44, -0.09 s (or 5.6%); P for trend < 0.001]. The sit-to-stand test compared subjects in the lowest and highest quintiles of 25(OH)D; the latter group had an average decrease of 0.67 s [95% CI: -1.11, -0.23 s (or 3.9%); P for trend = 0.017]. In the 25(OH)D reference range of 22.5-94 nmol/L, most of the improvement occurred in subjects with 25(OH)D concentrations between 22.5 and approximately 40 nmol/L, and further improvement was seen in the range of 40-94 nmol/L. Stratification by activity level showed no significant effect modification. CONCLUSION: In both active and inactive ambulatory persons aged > or =60 y, 25(OH)D concentrations between 40 and 94 nmol/L are associated with better musculoskeletal function in the lower extremities than are concentrations < 40 nmol/L.

Aged↗

PubMed2006

Comorbidity and physical function: results from the aging and longevity study in the Sirente geographic area (ilSIRENTE study).

BACKGROUND: Physical function measures have gained increased importance in the evaluation of older persons. The presence of comorbidity is a major and growing issue in geriatrics. OBJECTIVE: To evaluate the relationship between comorbidity and physical function in community-dwelling older persons. METHODS: Data are from baseline evaluation of the ilSIRENTE study (n = 364). Physical performance was assessed using the Short Physical Performance Battery (SPPB) and the 4-meter walking test. Muscle strength was measured by hand-grip strength. Functional performance was assessed using Basic and Instrumental Activities of Daily Living (ADLs and IADLs, respectively). Comorbidity was defined as >or=3 clinical conditions. Analyses of covariance and linear regressions were performed to evaluate the relationship between comorbidity and physical function. RESULTS: The mean age of participants was 85.9 (SD = 4.9) years. About one third (37.4%) of participants reported >or=3 clinical conditions. Participants with comorbidity had significantly worse results in all the physical function tests. Participants with comorbidity had significantly lower adjusted results for the 4-meter walking test (0.444 m/s) and the SPPB score (6.131) compared to those without comorbidity (0.531 m/s and 7.221; all p = 0.001, respectively). Participants with comorbidity were more IADL-impaired (3.152) than participants without comorbidity (2.767; p = 0.04). No significant association of ADLs and hand-grip strength with comorbidity was reported. Similar strengths of association for the 4-meter walking test (per SD increase, beta = -0.280; p = 0.001) and the SPPB (per SD increase, beta = -0.285; p = 0.001) with comorbidity were reported. CONCLUSIONS: Physical function measures, especially walking speed and SPPB, are associated with comorbidity. Physical performance measures may improve the clinical evaluation of older persons.

Activities of Daily Living↗

PubMed2002

Symptomatic improvement in patients treated with intermittent infusion of inotropes: a double-blind placebo controled pilot study.

The safety and benefit of outpatient inotrope infusions in intractable heart failure remains controversial. Accordingly a prospective double blind, crossover randomization scheme was utilized in stable patients with heart failure but intractable symptoms. A total of 29 patients (mean age 66 +/- 13 years, with a mean left ventricular systolic function of 18 +/- 9%, New York Heart Association class 3.6 +/- 0.5) met all the inclusion and none of the exclusion criteria to receive intravenous milrinone, dobutamine, or matching placebo. Safety evaluations including routine laboratory studies, physical examinations, electrocardiographic monitoring, vital signs, assessment of quality of life scores using the Minnesota Living with Heart Failure questionnaire, six-minute walk tests, and echocardiographic assessments were performed. All 29 patients completed the weaning protocol without adverse events (mean of 27.3 +/- 11.8 treatments per patient). Patients initially assigned to milrinone received fewer treatment sessions (19 +/- 8 versus 31 +/- 12 (dobutamine) and 33 +/- 10 (placebo); p<0.02. Furthermore, only 10% of the patients treated with milrinone required crossover randomization compared to 27% patients assigned to dobutamine and 75% patients assigned to placebo. A statistically significant reduction in quality of life scores (60 +/- 20 versus 35 +/- 18; p < 0.00001) with an increase in 6-minute walk test assessments (959 +/- 431 versus 1269 +/- 469; p < 0.01) was noted. Most importantly, in patients assigned to inotropes a 23% increase in 6-minute walk test scores was noted at the end of the study when compared to baseline scores. In contrast, a reduction of -1% (p < 0.001) was noted in patients assigned to placebo. Finally, a trend that although did not reached statistical significance was noted in patients assigned to milrinone in terms of improvement in left ventricular systolic function, reduction in the severity of mitral regurgitation and estimated right ventricular systolic pressure. These results demonstrate that outpatient infusion of inotropes appear to be safe and effective in improving heart failure symptoms, reducing need for hospitalizations and emergency room visits. Furthermore, infusion of inotropes resulted in a significant improvement on 6-minute walk test scores than placebo. It also appears that milrinone confers all these benefits sooner than dobutamine.

Aged↗

PubMed1985

Effects of a large carbohydrate load on walking performance in chronic air-flow obstruction.

The purpose of this study was to determine whether a single large liquid carbohydrate (CHO) load (920 calories) affects walking performance in patients with chronic air-flow obstruction (CAO). Walking performance was measured using the 12-min walking test. Fifteen patients with stable CAO (FEV1, 1.30 +/- 0.41 L; FVC, 3.26 +/- 0.46 L) underwent 12-min walking tests 40 min after ingestion of either CHO or placebo on consecutive days in randomized double-blind fashion. Three practice walks were performed on a preliminary day in order to eliminate learning effects. Resting measurements of ventilation (VE) and carbon dioxide output (VCO2) were obtained prior to each walking test. Carbohydrate significantly increased both VCO2 (from 0.288 +/- 0.060 to 0.372 +/- 0.057 L/min, p less than 0.001) and VE (from 15.2 +/- 3.5 to 18.5 +/- 3.1 L/min, p less than 0.001) at rest. The total 12-minute walking distance decreased from 894 +/- 199 to 847 +/- 191 m following CHO (p less than 0.005). This distance decreased in 14 of the 15 study patients. The decrease in walking distance ranged from 1.5 to 168 m (0.2 to 15.2%). From this study we conclude that a large liquid carbohydrate load adversely affects walking performance in patients with CAO. This potential impairment of functional capacity should be considered when caloric intake is increased in attempts to improve nutritional status in this patient population.

Aged↗

PubMed2001

Utilization of the walking oximetry test to allow safe ambulation after pulmonary resection.

Supplemental oxygen therapy after pulmonary resection can generally be tapered according to arterial blood gases at rest or pulse oximetry (SpO2). However, detecting exercise-induced oxygen desaturation can be difficult. We developed the walking oximetry test (WOT) so that thoracotomy patients could be rehabilitated without the risk of undetected ambulatory hypoxemia. The subjects were 58 patients who had undergone pulmonary resection and could walk at the bedside, with oxygen at 3 l/min via a nasal cannula. Patients with a value of more than 100 torr were allowed to walk with assistance for 6 min in the corridor. The oxygen flow rate was kept at 3 l/min and the walking pace was less than 50 m/min. SpO2 was determined using a wristwatch pulse oximeter. The test was stopped if the SpO2 fell below 90% or there was a score of 5 or more on the Borg scale (range 1-10). Oxygen desaturation occurred in six patients (10%) during the WOT. These patients underwent ambulatory training with sufficient oxygen supplementation and were then tested again. Patients whose SpO2 values remained higher than 90% and who showed no more than 5% desaturation were permitted to walk in the corridor with oxygen at 3 l/min via a nasal cannula. All these patients had a Borg score of 4 or lower. The WOT is a reliable, nonvasive method for detecting exercise-induced oxygen desaturation during ambulation after pulmonary resection.

Exercise Test↗

PubMed2003

Comparison of permanent left ventricular and biventricular pacing in patients with heart failure and chronic atrial fibrillation: a prospective hemodynamic study.

BACKGROUND: Left ventricular pacing (LVP) and biventricular pacing (BVP) have been proposed as treatments for patients with advanced heart failure complicated by discoordinate contraction due to intraventricular conduction delay. For patients in sinus rhythm, BVP works in part by modulating the electronic atrial-ventricular time delay and thus optimizing contractile synchrony, the contribution of atrial systole, and reducing mitral regurgitation. However, little is known of the mechanisms of BVP in heart failure patients with drug-resistant chronic atrial fibrillation. HYPOTHESIS AND METHODS: LVP differs from BVP because hemodynamic and clinical improvement occurs in association with prolongation rather than shortening of the QRS duration. We sought to determine if LVP or BVP improves mechanical synchronization in the presence of atrial fibrillation. Thirteen patients with chronic atrial fibrillation, severe heart failure and QRS >or=140 ms received (after His bundle ablation) a pacemaker providing both LVP and BVP. The mean age was 62 +/- 6 years and left ventricular ejection fraction was 24 +/- 8%. After a baseline phase of one month with right ventricular pacing, all patients underwent in random order 2 phases of 2 months (LVP and BVP). At the end of each phase, an echocardiogram, a hemodynamic analysis at rest and during a 6-minute walking test and a cardio-pulmonary exercise test were performed. RESULTS: LVP and BVP provided similar performances at rest (p = ns). The 6-minute walking test revealed similar performances in both pacing modes but patients were significantly more symptomatic at the end of the test with LVP ( p = 0.035). The cardio-pulmonary exercise test showed higher performances with BVP (92 +/- 34 Watts) vs. LVP (77 +/- 23; p = 0.03). LVP was associated with significantly more premature ventricular complexes recorded during the 6 minute walking test (49 +/- 71) than BVP (10 +/- 23; p = 0.04). CONCLUSIONS: In this small series of patients with atrial fibrillation, congestive heart failure and a prolonged QRS duration, LVP and BVP provided similar hemodynamic effects at rest whereas BVP was associated with better hemodynamic effects during exercise and fewer premature ventricular complexes. Although the mechanisms for the observed differences are uncertain, it is possible that there is worsening of right ventricular function due to a rise in left-to-right electromechanical delay during exercise. Increased catecholamines release might contribute to the lower exercise tolerance and greater number of premature ventricular complexes recorded during exercise observed during LVP compared to BVP. RECOMMENDATIONS: Patients with atrial fibrillation, heart failure and QRS prolongation who are candidates for His-bundle ablation and cardiac resynchronization therapy may respond better to BVP rather than to LVP.

Atrial Fibrillation↗

PubMed2001

Clinical exercise testing.

Clinical exercise testing is increasingly being utilized in clinical practice because of the valuable, often unique information that it provides in patient diagnosis and management. This is also due to a growing awareness that resting cardiopulmonary measurements provide an unreliable estimate of functional capacity. A continuum of exercise testing modalities for functional evaluation from "low tech" to "high tech" will be discussed. These include the six minute walk test, shuttle walk test, exercise induced bronchoconstriction test, cardiac stress test, and cardiopulmonary exercise testing. The main focus of this article will be cardiopulmonary exercise testing including indications, important measurements, salient methodological considerations, and interpretation.

Exercise Test↗

PubMed1988

Autonomic changes after treatment of agoraphobia with panic attacks.

Twenty-three patients meeting DSM-III criteria for agoraphobia with panic attacks and 14 age-, race-, and sex-matched nonanxious controls were tested in the laboratory and on a test walk in a shopping mall. The patients were tested before and after about 15 weeks of treatment with placebo and exposure therapy, imipramine and exposure therapy, or imipramine and initial antiexposure instructions. Controls were tested twice at a similar interval, but without any treatment. On test day 1, patients compared to controls showed higher average heart rate and skin conductance levels and greater numbers of skin conductance fluctuations in the laboratory, and higher heart rates before and during the test walk. Between pretreatment and posttreatment tests, clinical ratings improved and skin conductance levels decreased in all treatment groups. Heart rate levels in the laboratory, on the other hand, decreased in patients on placebo and rose in patients on imipramine. Thus, imipramine compromises the usefulness of heart rate as a measure of emotional arousal. Higher pretreatment heart rates predicted greater clinical improvement.

Adult↗

PubMedDate not supplied

The functional impact of an individualized, graded, outpatient pulmonary rehabilitation in end-stage chronic obstructive pulmonary disease.

OBJECTIVE: To evaluate the functional impact of an individualized outpatient pulmonary rehabilitation program in end-stage chronic obstructive pulmonary disease (COPD). METHODS: Patients with end-stage COPD were admitted into a 6-week comprehensive outpatient pulmonary rehabilitation program that was "packaged" for each patient. We compared spirometric parameters, exercise tolerance, level of breathlessness, and intensity of work before and after rehabilitation. RESULTS: Of 45 eligible patients, only 14 consented to participate in the study. All 14 patients had forced expiratory volume in 1 second <35% of predicted, and 10 patients (72%) had a 6-minute walk test <180 m. The level of breathlessness was between 7 (moderate to severely breathless) and 10 (maximally breathless) on the Visual Analogue Scale in all patients. After the program, there was significant improvement in the FEV 1 P = 0.04), forced vital capacity P = 0.0045), 6-minute walk test P = 0.00047), and shuttle-walk test (9 of 14 patients). All patients had some improvement in level of dyspnea. CONCLUSIONS: Individualized outpatient pulmonary rehabilitation in end-stage COPD can produce a measurable improvement in spirometry and exercise tolerance with a favorable impact on the level of physical activity.

Aged↗

PubMed2001

Validity and reliability comparison of 4 mobility measures in patients presenting with neurologic impairment.

OBJECTIVE: To establish the reliability and validity of 4 mobility measures in neurologically impaired adults undergoing rehabilitation. DESIGN: Repeated assessment of same patients. SETTING: Two specialized neurologic centers in England. PATIENTS: Forty-six patients with neurologic disabilities selected from inpatient and outpatient rehabilitation centers who were able to stand and walk at least 10 meters, with some aid if needed. INTERVENTIONS: Patients were assessed twice, at an interval of 7 days, by the same person at the same location. Validity and reliability of each measure were compared by means of scatterplots, Bland-Altman method, and correlation coefficients. Validity was also established by comparing groups of patients expected to differ in mobility. MAIN OUTCOME MEASURES: The Rivermead Mobility Index (RMI) standard version and a version with 4 levels of answer, the 10-meter timed walk, and the 2-minute walk test. RESULTS: The measures showed significant intercorrelation, suggesting that all were valid mobility measures. Each was reasonably reliable, with no evidence of systematic bias. The revised RMI was less sensitive to differences. The distance covered in the 2-minute walk test was significantly decreased for patients using aids (p <.0005) and those with impaired leg sensation (p =.02). CONCLUSIONS: All 4 measures tested (2 RMI versions, 1-meter timed walk, 2-minute walk test) showed similar validity and reliability, and the 4-level RMI version failed to show an increased ability to detect differences. All measures showed more disability in patients using aids and those with sensory impairment.

Activities of Daily Living↗

PubMed1992

[Use of walking in the evaluation of aerobic fitness].

The reliability and validity of assessment of the maximal oxygen consumption as a criterion of aerobic fitness by the 2000 m walking test was established in 38 students of the military secondary school (mean age 17.8 +/- 0.4 years). The reliability of the 2000 m walking test is very high, during repeated estimations in the course of one week we find a correlation coefficient of r = 0.82 (p < 0.001). There is also a close correlation of 2000 m walking time and 2000 m running time (r = 0.67, p < 0.001). A group of 18 students selected at random from the above group was examined in the laboratory on a treadmill up to vita maxima. A close correlation was found between the results during walking and the maximal oxygen consumption (VO2max.kg-1) (r = -0.59 and -0.60) and also the 2000 m running time and VO2max.kg-1 (r = 0.59), p < 0.01 in all instances. The standard error of the mean of the maximal oxygen consumption estimate from the 2000 m walk is 3.44 ml.kg-1 x min-1 (5.7%) and from the running time of the same distance 3.49 ml.kg-1 x min-1 (5.8%). These results justify the conclusion that the 2000 m rapid walking test (normal style) is a simple alternative way for estimating the maximal oxygen consumption and thus also for evaluating the level of aerobic fitness with an accuracy which matches that, when running is used for the test.

Adolescent↗