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At least 379 records · Page 21Linked to original sources

PubMed2004

Effects of a 6-month exercise program on patients with multiple sclerosis: a randomized study.

OBJECTIVE: To improve walking and other aspects of physical function with a progressive 6-month exercise program in patients with multiple sclerosis (MS). METHODS: MS patients with mild to moderate disability (Expanded Disability Status Scale scores 1.0 to 5.5) were randomly assigned to an exercise or control group. The intervention consisted of strength and aerobic training initiated during 3-week inpatient rehabilitation and continued for 23 weeks at home. The groups were evaluated at baseline and at 6 months. The primary outcome was walking speed, measured by 7.62 m and 500 m walk tests. Secondary outcomes included lower extremity strength, upper extremity endurance and dexterity, peak oxygen uptake, and static balance. An intention-to-treat analysis was used. RESULTS: Ninety-one (96%) of the 95 patients entering the study completed it. Change between groups was significant in the 7.62 m (p = 0.04) and 500 m walk tests (p = 0.01). In the 7.62 m walk test, 22% of the exercising patients showed clinically meaningful improvements. The exercise group also showed increased upper extremity endurance as compared to controls. No other noteworthy exercise-induced changes were observed. Exercise adherence varied considerably among the exercisers. CONCLUSIONS: Walking speed improved in this randomized study. The results confirm that exercise is safe for multiple sclerosis patients and should be recommended for those with mild to moderate disability.

Adult↗

PubMed2006

[Parkinson gait analysis using in-shoe plantar pressure measurements].

INTRODUCTION: The literature reports some studies describing the walking pattern of patients with Parkinson's disease, its deterioration with disease severity and the effects of various treatments. Other studies concerned the plantar pressure distribution when walking. The aim of this study was to validate the use of baropodometric measurements for gait analysis of parkinsonian patients at various stages of disease severity and in on and off phases. METHODS: Fifteen normal control subjects and fifteen parkinsonian patients equipped with a plantar pressure measurement system performed walking tests. The parkinsonian patients performed the walking tests in off phase then in on phase. A clinical examination was performed to score the motor handicap on the UPDRS scale. RESULTS: Analysis of the plantar pressures of the parkinsonian subjects under various footprint areas detected significant baropodometric differences compared with controls, between groups with different UPDRS scores, and before and after L-Dopa treatment. CONCLUSIONS: Plantar pressures measurements allow a sufficiently fine discrimination for using it to detect parkinsonism and monitor patients with Parkinson's disease.

Aged↗

PubMed2005

Can individualized rehabilitation improve functional independence in elderly patients with COPD?

STUDY OBJECTIVES: The aims of this study were to establish whether pulmonary rehabilitation (PR) improves domestic function and daily activity levels in COPD and whether individually targeted exercise is more effective than general exercise. DESIGN: Prospective randomized, controlled trial. SETTING: Outpatient PR program in secondary care. PARTICIPANTS: One-hundred eighty patients (mean [+/-SD] age, 68.3 +/- 8.6 years; FEV1, 0.95 +/- 0.4 L; FEV1/FVC ratio, 0.51 +/- 0.15; 111 male patients; 69 female patients) with stable COPD. One hundred twenty-one patients completed the study. INTERVENTIONS: Patients were randomized to a conventional 7-week general exercise program ([GEP] n = 90) or an individually targeted exercise program ([ITEP] n = 90). MEASUREMENT AND RESULTS: Daily activity was measured using ambulatory activity monitors (Z80 -32k V1 Int; Gaehwiler Electronics; Hombrechtikon, Switzerland). These were lightweight devices, which contained a uniaxial accelerometer. Domestic function was assessed by the Canadian Occupational Performance Measure (COPM). Exercise performance was assessed by the incremental shuttle walk test (ISWT) and the endurance shuttle walk test and health status by the chronic respiratory questionnaire-self-reported. Activity monitor counts increased by 29.18% (95% confidence interval [CI], 3.19 to 55.17; p = 0.03) for the GEP and 40.63% (95% CI, 7.42 to 73.83; p = 0.02) for the ITEP. Mean COPM performance scores increased by 1.71 (95% CI, 1.37 to 2.05; p = 0.0001) for the GEP and 1.46 (95% CI, 1.05 to 1.87; p = 0.0001) for the ITEP. Mean COPM satisfaction scores increased by 2.27 (95% CI, 1.74 to 2.81; p = 0.0001) for the GEP and 2.04 (95% CI, 1.56 to 2.52; p = 0.0001) for the ITEP. ISWT scores increased by 81.72 m (range, 63.83 to 99.62) for the GEP and by 85.52 m (range, 67.62 to 103.42) for the ITEP. No statistically significant difference was found between the general exercise group and the individually targeted exercise group for any outcome measure. CONCLUSIONS: Pulmonary rehabilitation improves domestic function and physical activity. This study also demonstrates that general exercise training is as effective as individually targeted training.

Activities of Daily Living↗

PubMedDate not supplied

A comparison of autogenic drainage and the active cycle of breathing techniques in patients with chronic obstructive pulmonary diseases.

PURPOSE: The effects of a long-term treatment of autogenic drainage (AD) and the active cycle of breathing techniques (ACBT) were evaluated in patients with chronic obstructive pulmonary disease (COPD). METHODS: Thirty clinically stable male COPD patients were randomly assigned to AD or the ACBT treatment for a 20-day treatment period. Patients were assessed through pulmonary function tests, arterial blood gases, a 6-minute walking test, and a modified Borg Scale before, and immediately after the walking test. RESULTS: Autogenic drainage improved forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow rate, forced expiratory volume from 25 to 75%, chronic hypercapnia, arterial oxygenation, exercise performance, and dyspnea perception during exercise. The ACBT increased forced vital capacity, peak expiratory flow rate, arterial oxygenation and exercise performance. Peak expiratory flow rate increased in AD more than in ACBT. In AD treatment, the increase in oxygen saturation was significantly higher than in ACBT treatment. Chronic hypercapnia improved significantly in AD treatment than in ACBT. No differences were found in other lung function parameters. CONCLUSIONS: Autogenic drainage is as effective as the ACBT in cleaning secretions and improving lung functions. These techniques can be used in stable COPD patients according to the patients' and the physiotherapists' preferences.

Aged↗

PubMed2000

Conditioning effects of repetitive mild neurotrauma on motor function in an animal model of focal brain injury.

A weight drop model of brain injury was used to determine the effects of repetitive mild brain injury on motor function, heat shock protein and glial fibrillary acidic protein expression in the anesthetized, adult male, Sprague-Dawley rat. Repetitive mild brain injury was produced when animals received a series of three mild injuries spaced three days apart. A separate group of repetitive mild injured animals also received a subsequent severe brain injury between three and five days after the last mild injury. All animals were trained on a beam-walking test prior to surgery. The mild, repetitive mild and repetitive mild plus severe brain injury groups showed no motor deficits in the beam-walking test, whereas the animals with only severe brain injury showed significant motor deficits (increase in number of footslips) in the beam-walking test that recovered within eight days after injury. Both repetitive mild plus severe injury and severe injury only animals had cortical necrotic cavities of similar size in the region of the hindlimb motor cortex. Both the repetitive mild and severe brain-injured animals had marked heat shock protein 27kDa and glial fibrillary acidic protein staining in the cerebral cortex. Fluoro-Jade, heat shock protein 27kDa and 72kDa labeling indicated that there were widespread effects on cortical, subcortical and spinal neurons and glial cells after repetitive mild brain injury. These results suggest that repetitive mild brain injury conditions the brain so that subsequent brain injury at the same site has no effect on motor function. Furthermore, repetitive mild injury-induced activation of processes distant to the primary injury site may have a role in activation of secondary sites involved in recovery of motor function.

Animals↗

PubMed2003

The effect of pulmonary rehabilitation in patients with post-tuberculosis lung disorder.

STUDY OBJECTIVES: Although the benefit of pulmonary rehabilitation (PR) has been demonstrated for patients with COPD, the benefit for patients with non-COPD lung disorders is still unclear. In the present study, we compared the effect of PR on patients with post-tuberculosis (TBC) lung disorders and patients with COPD. DESIGN: We performed a prospective nonrandomized open trial over a 9-week period. PATIENTS AND METHODS: Thirty-two patients with post-TBC lung disorders (thoracoplasty, 25 patients; mean [+/- SD] age, 71 +/- 5 years; FEV(1), 0.84 +/- 0.29 L) and 32 age-matched and FEV(1)-matched COPD patients were enrolled in the study. First, we compared the exercise tolerance between groups using a 6-min walking test. Next, we trained the patients using a 9-week outpatient PR program. We assessed improvement using clinical dyspnea ratings, a daily activity score, and the results of a 6-min walking test. RESULTS: When age and FEV(1) were matched, the distance covered during the 6-min walking test did not differ between the groups. After rehabilitation, significant improvement was observed in both the post-TBC group and the COPD group in terms of Medical Research Council dyspnea grade, transition dyspnea index, activity score, and 6-min walking distance (42 m [p < 0.01] vs 47 m [p < 0.01], respectively). The magnitudes of the improvement in these parameters were comparable between the groups. CONCLUSIONS: PR is as beneficial in post-TBC lung disorder patients as in COPD patients if the severity of the disability is similar.

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PubMed2006

A potential role for sildenafil in the management of pulmonary hypertension in patients with parenchymal lung disease.

BACKGROUND: Sildenafil offers potential to treat patients with pulmonary hypertension by selectively inhibiting phosphodiesterase type five pathways in the lung. It is recommended for selected patients with pulmonary arterial hypertension, but its role in the management of pulmonary hypertension associated with parenchymal lung disease is unclear. PATIENTS AND METHODS: Seven patients (68-86 years) with end stage chronic obstructive pulmonary disease (COPD, 4) and idiopathic pulmonary fibrosis (IPF, 3) were referred to our unit. All patients had a long-term history of chronic lung disease and were on maximal appropriate therapy prescribed by their referring pulmonologist. Thromboembolic disease was excluded by pulmonary angiography and all patients had had high resolution thoracic CT scan. At assessment right heart catheterisation, 2D echocardiography and 6-min walk test were performed prior to commencement of sildenafil 50mg tds. Their medication was otherwise unchanged. After 8 weeks treatment, right heart catheterisation, 2D echocardiography and 6-min walk test were repeated. RESULTS: The pulmonary vascular resistance was reduced in six patients (from 13, 3, 3, 6.5, 3.5 and 10.5 wood units to 9.7, 2.5, 2.8, 4.4, 2.5 and 5.4 wood units, respectively). Six-minute walk test increased in six patients (from 110 m, 210 m, 80 m, 30 m, 210 m and 80 m to 130 m, 312 m, 120 m, 82 m, 244 m and 100 m, respectively). One patient with COPD did not demonstrate a favourable response although their cardiac output increased on sildenafil therapy. 2D echocardiography showed a reduction in estimated PA pressure in six patients with an improvement in right ventricular systolic function in two COPD patients. CONCLUSION: Our results suggest that sildenafil may have a role for selected patients with COPD and IPF who have pulmonary hypertension.

Aged↗

PubMed2001

Induction of heat shock proteins and motor function deficits after focal cerebellar injury.

A weight drop model of focal cerebellar injury was used to identify heat shock protein induction and motor function deficits in the anesthetized, adult male, Sprague-Dawley rat. All animals were trained on a beam walking test prior to surgery. Groups of animals received severe, mild or sham weight drop injury to the lateral/paravermal region of the cerebellum. The mild and sham-injured animals showed no motor deficits in the beam walking test, whereas animals with severe cerebellar injury showed significant motor deficits in the beam walking test that approached recovery of motor function 20 days after injury. Following severe injury, induction of heat shock protein of 27kDa was observed in Purkinje cells and in neurons of the deep cerebellar nuclei, as well as Bergmann glial cells, glial cells located in the granule cell layer and the underlying white matter. Following mild injury, heat shock protein of 27kDa induction was observed in Purkinje cells and glial cells, but not in neurons of the deep cerebellar nuclei. The labeled Purkinje cells were widely distributed in the ipsilateral cerebellar cortex. Many of the glial cells that were immunostained with heat shock protein of 27kDa co-localized with cells immunoreactive for glial fibrillary acidic protein. After severe injury, heat shock protein of 72kDa was localized mainly in granule cells at the site of the trauma and in the ipsilateral deep cerebellar nuclei whereas, after mild injury, light labeling was observed only in the granule cell layer. The results demonstrate that focal cerebellar injury has profound effects on motor behavior and induces different families of heat shock proteins in specific groups of neurons and glial cells in the cerebellum.

Anesthesia, General↗

PubMed2005

A pilot study of the effect of aerobic exercise on people with moderate disability multiple sclerosis.

OBJECTIVE: A pilot study to investigate the effect of aerobic exercise on the mobility and function of people with moderate disability multiple sclerosis (MS). DESIGN: A small group, comparative, pre- and post-intervention study. SETTING: A gymnasium within a general hospital. SUBJECTS: Eight subjects, all female, average age 45 years (range 33-61) with moderate disability MS (Kurtzke scale 4-6), were recruited; six completed the study. INTERVENTION: Intervention consisted of bi-weekly sessions of 30 min cycling on a static bike at their maximal level of exertion for 12 weeks. MAIN MEASURES: The stability of each individual's condition was established pre-intervention using three baseline assessments over two weeks. A battery of tests (the 10-metre and 6-min walk tests, the Functional Reach, the Gulick and the Guys Neurological Disability Scale) were completed pre and post intervention. Potential negative effects were recorded on the Fatigue Severity Scale and the Modified Ashworth Scale. An independent rater completed assessments post intervention. Inter-rater reliability was found to be acceptable. RESULTS: Comparisons pre and post intervention (Wilcoxon signed ranked test) showed significant improvement on the Guys Neurological Disability Scale (p = 0.026), with the mean score reducing from 13 to 9, and the 6-min walk test (p = 0.046), with the mean distance increasing from 200 m to 261 m. Other measures failed to reach significance. CONCLUSIONS: Findings from this pilot study suggest overall disability and mobility improved with the aerobic training. A positive treatment effect in this small study suggests the need for a larger trial. Knowledge of how to establish predictive heart rate and how to monitor the effects of cycling with people with MS will be used to inform future clinical trials.

Adult↗

PubMed2005

Leisure Time Physical Activity Instrument and Physical Activity at Home and Work Instrument. Development, face validity, construct validity and test-retest reliability for subjects with fibromyalgia.

PURPOSE: A new instrument measuring leisure time physical activity (LTPAI) in populations predominately engaging in low intensity activities and a new instrument measuring the Physical Activity at Home and Work (PAHWI) were designed. METHODS: Patients with long-lasting pain and expert physiotherapists participated in the development of the two instruments. Test-retest reliability was evaluated for the LTPAI and the PAHWI. Construct validity was evaluated for the LTPAI by comparing it with an instrument measuring physical activities for older people, six-minute walk test and aerobic capacity. POPULATION: 37 women with FM, with the mean age of 46 years (SD 8.4) and mean symptom duration of 11 years (SD 5.9) were recruited to the study. RESULTS: The mean time that the study population spent in physical activities during leisure time was 5.2 hours (SD 4.0) a week. Satisfactory test-retest reliability was found for the total score of LTPAI (ICC 0.86, CI 0.79 - 0.93) and for the PAHWI (ICC 0.91, CI 0.82 - 9.96). A significant association between the LTPAI and the six-minute walk test (rs 0.40, p = 0.02) and another physical activity instrument (rs 0.39, p = 0.02) was found. As expected, LTPAI did not have any association with aerobic capacity. CONCLUSIONS: Face validity of the instruments was ensured during the development process. Satisfactory test-retest reliability was found for the LTPAI and the PAHWI. Significant but low associations were found between the LTPAI and the six-minute walk test and an instrument designed for older people, respectively, while no association was found between the LTPAI and aerobic capacity.

Adult↗

PubMed1994

Effects of cast-bracing of the knee on physical performance in healthy subjects.

Effects of application of a hinged cast-brace on thigh muscle strength and physical performance tests were studied in eight healthy volunteers. The cast-brace was applied to one leg for four weeks. The subjects were free to move around. The extra loading by the cast-brace was determined in a progressive uphill walk test on a treadmill with measurements of oxygen uptake, heart rate and plasma lactate concentration. Submaximal oxygen uptake in the uphill walk test was raised significantly (average 9%) on the day after application. After four weeks of cast-brace wearing the submaximal oxygen uptake in the uphill walk test had decreased, but remained elevated (average 4%) even one day after removal. Heart rate was significantly higher (average 7%) during cast application and after removal. Plasma lactate concentration, however, was not influenced. To investigate the effect of four weeks cast-bracing various performance tests to judge the thigh muscle function were taken before application and after removal. No significant changes in peak torque of knee flexion and extension, in physiologic variables at submaximal running pace during treadmill exercise, maximal running speed, 60 m dash, or in jump height were found. In conclusion, cast-bracing of a healthy knee for four weeks has no significant effects on physical performance after removal.

Adult↗

PubMed2004

The acute effects of in-patient physiotherapy program on functional capacity in type II diabetes mellitus.

PURPOSE: This study was planned to evaluate the acute effects of a short-term in-patient physiotherapy program on functional capacity in hospitalised type II diabetic patients. METHODS: Forty four hospitalised type II diabetic patients in continuing medical care at Dokuz Eylül University Hospital were included in this study. Twenty three of the 44 patients were randomised to an exercise rehabilitation group and 21 to a control group. Patients in the exercise group were assigned to an average 12.0+/-2.4 days low-intensity exercise rehabilitation program during hospitalisation. The control group did not receive any exercise advice. Before and after the exercise rehabilitation program all patients' functional capacity was evaluated by the 6 min walking test. RESULTS: There were no significant differences in the main measured parameters among groups and in the 6 min walking test at baseline. At the end of the rehabilitation program, the resting heart rate (HR) decreased by 4.1% (P<0.05) in the exercise group by and 2.1% in control group. Resting systolic (SBP) and diastolic blood pressure (DBP) decreased (6.2 and 2.6%) significantly in the exercise group but there were no significant changes in the control group (0.9 and 0.7%). The distance walked in the 6 min test increased significantly more in the exercise group than in the control group ( 18.0% versus 10.2%; P<0.05). Estimated VO2 max also increased more (28.6% versus 3.5%, P<0.05). Moreover, the exercise group described the 6 min walk test as easier than before exercise rehabilitation. The Borg scale did not change in the control group. CONCLUSION: Supervised in-patient exercise rehabilitation is a safe and effective intervention in type II diabetic patients, which reduces physical impairment and improves functional ability.

Blood Pressure↗

PubMed2005

[Changes in exercise tolerance, health related quality of life, and peripheral muscle characteristics of chronic obstructive pulmonary disease patients after 6 weeks' training].

OBJECTIVE: This study was designed to assess changes in skeletal muscle characteristics after 6 weeks' high-intensity physical training of patients with moderate to severe chronic obstructive pulmonary disease (COPD) and to determine how the changes were related to improvements in exercise tolerance and health related quality of life (HRQL). PATIENTS AND METHODS: Ten patients with a mean (SD) age of 60 (10) years and a forced expiratory volume in 1 second of 32% (9%) were enrolled. The effect of training on the 6-minute walk test, HRQL questionnaires, and skeletal muscles was examined for the 8 patients who completed the program. The structural and chemical characteristics of skeletal muscles before and after training were studied in vastus lateralis muscle biopsies. RESULTS: Training significantly modified the 6-minute walk test (P<.01), HRQL (P<.05), and citrate synthetase activity (P<.05). Changes in distances walked during the 6-minute walk test were significantly related to changes in the mean area of fibers (r=0.81). CONCLUSIONS: The results of this study indicate that 6 weeks of high-intensity physical training of COPD patients produces moderate changes in skeletal muscles which could partly explain improvements observed in exercise tolerance after respiratory rehabilitation.

Aged↗

PubMedDate not supplied

The contribution of peripheral muscle function to shuttle walking performance in patients with chronic obstructive pulmonary disease.

PURPOSE: The contribution of muscle strength and mass to incremental and endurance walking performance in chronic obstructive pulmonary disease (COPD) is unknown. This study analyzes the relationship between field incremental and endurance walking performance and indices of peripheral muscle mass and strength. METHODS: Eighty-five stable COPD patients (53 males; mean [SD] age = 67 [9] years; mean [SD] forced expiratory volume in 1 second [FEV1] = 35 [14] [% predicted]) were studied prior to participation in pulmonary rehabilitation. Isometric quadriceps and handgrip strength were measured. Total body and lower limb lean muscle mass were estimated using dual energy x-ray absorptiometry. Exercise performance was measured using the incremental shuttle walk test (ISWT) and the endurance (ESWT) shuttle walk test. RESULTS: ISWT was related to muscle strength (r = 0.467, P </= .001) but not to whole body or lower limb lean mass. There was no association between muscle strength or mass and ESWT. In a multivariate linear regression analysis, the only variables significantly contributing to ISWT were age (P < .001), FEV1 (% predicted) (P < .001) and quadriceps strength (P < .001). Variables contributing to ESWT were FEV1 (% predicted) (P < .001) and ISWT performance (P < .001). CONCLUSIONS: We conclude that muscle strength is related to incremental but not endurance shuttle walking performance. Muscle mass and strength are not synonymous in their effects on exercise performance in patients with COPD.

Absorptiometry, Photon↗

PubMed1998

Modulation of ventricular rate in permanent atrial fibrillation: randomized, crossover study of the effects of slow-release formulations of gallopamil, diltiazem, or verapamil.

BACKGROUND: The management of permanent atrial fibrillation (PAF) consists primarily of long-term anticoagulation with either aspirin or warfarin to prevent systemic embolization, and modulation of ventricular rate (VR) to improve cardiac function by prolonging the ventricular diastolic filling time. HYPOTHESIS: The effects of slow-release formulations of gallopamil (100 mg b.i.d.), diltiazem (120 mg b.i.d.), or verapamil (120 mg b.i.d.) on VR were evaluated in 18 patients with PAF without organic heart disease. METHODS: In all patients, each treatment was administered randomly, was compared with oral digoxin, and was assessed by 24-h Holter monitoring during daily life and by a 6-min walking test. RESULTS: There were no significant differences in mean and minimum VR recorded during 24-h Holter monitoring among the four treatments. Peak heart rates recorded during the 6-min walking test with digoxin treatment was 167 +/- 12 beats/min. This was significantly reduced by gallopamil (149 +/- 23 beats/min, p = 0.01), diltiazem (142 +/- 24 beats/min, p < 0.001), and verapamil (137 +/- 30 beats/min, p < 0.001). There were no significant differences in peak VR during the walking test among the three calcium antagonists. Pauses of > 3 s were observed in 3 of 18 (17%) patients who received digoxin (max 3.4 s) and in 5 of 18 (28%) patients who received diltiazem (max 3.4 s); p = NS. Periods of bradycardia < 30 beats/min were observed in 5 of 18 (28%) patients during digoxin treatment, and in 3 of 18 (17%) patients during treatment with gallopamil, diltiazem, and verapamil; p = NS. CONCLUSION: Gallopamil, diltiazem, or verapamil are superior to digoxin in controlling VR during mild exercise in patients with PAF without organic heart disease. The reduction of peak VR is obtainable without further slowing of resting VR. However, gallopamil appears to be the least effective calcium blocker at controlling resting and exercise VR; thus, there are no advantages over the other calcium blockers in its use in the clinical setting.

Administration, Oral↗

PubMed2005

Improving walking assessment in subjects with an incomplete spinal cord injury: responsiveness.

STUDY DESIGN: Prospective longitudinal study. OBJECTIVES: To investigate the responsiveness of the Walking Index for Spinal Cord Injury II (WISCI II), 6-Min Walk (6MWT) and 10-Meter Walk Tests (10MWT) for the assessment of walking capacity in incomplete spinal cord injury (iSCI) and to validate these tests with the lower extremity motor score (LEMS). SETTING: European Multicenter Study of Human Spinal Cord Injury. METHODS: The walking tests of 22 iSCI subjects who achieved functional ambulation and could stand or walk within 1 month after iSCI were analyzed at 3, 6 and 12 months after injury. Responsiveness was assessed by determining differences between the time intervals, and Spearman's correlation coefficient was calculated to quantify validity. RESULTS: All walking tests were able to assess the improvement of walking capacity within the first 3 months after injury. Between 3 and 6 months, only the 10MWT and 6MWT were responsive to the ongoing improvement in locomotor capacity. Overall, correlations between the tests were good within the first month, but became poorer over time. CONCLUSION: The 6MWT and 10MWT were more responsive in demonstrating an improvement in walking capacity compared to the WISCI II. The testing of functional outcome after iSCI as provided by the ordinal ASIA motor score can be improved by interval scaled measures. This allows increasing the responsiveness of functional outcome measures and should be advantageous in assessing therapeutical approaches in iSCI subjects. In iSCI subjects with walking ability, we recommend the additional use of timed tests to monitor improvement in locomotor capacity.

Adolescent↗

PubMed1979

Assessment of respiratory function in patients with chronic obstructive airways disease.

The reproducibility of some respiratory function tests and a simple self-paced walking test were assessed in 13 patients with stable chronic obstructive airways disease by making observations on six occasions at two to three weekly intervals. The coefficients of variation of the various tests were as follows: forced expiratory volume in one second, +/- 14.8%; forced vital capacity, +/- 11.1%; transfer factor (single breath carbon monoxide), +/- 15%; total lung capacity, +/- 8.8% by helium dilution and +/- 8.3% by body plethysmography; increase in heart rate and minute ventilation for an increase in oxygen uptake of 0.5 1 min-1, +/- 19.4% and +/- 16.3%; distance covered in a 12-minute walking test, +/- 8.2%. The 12-minute distance increased significantly over the first three studies. The considerable variations in the result of these tests in subjects with apparently stable clinical states and without changes in treatment should be considered when assessing the results of changes in treatment.

Humans↗

PubMed2003

Beneficial effects of biventricular pacing in patients with a "narrow" QRS.

Congestive heart failure (CHF) patients with LBBB and QRS duration > 150 ms are considered the best candidates to biventricular pacing (Biv-P). However, patients with a narrow (120-150 ms) QRS may also benefit from Biv-P since true ventricular dyssynchrony may be underestimated by considering only QRS enlargement. From October 1999 to April 2002, 158 CHF patients (121 men, mean age 65 years, mean LVEF 0.29, mean QRS width 174 ms) underwent successful Biv-P implantation and were then followed for a mean time of 11.2 months. According to basal QRS duration, patients were divided in two groups, with wide QRS (> or = 150 ms, 128 patients, 81%) and with narrow QRS (< 150 ms, 30 patients, 19%). In the wide QRS group, LVEF improved from 29% to 39% (P < 0.0001), 6-minute walk test from 311 to 463 m (P < 0.0001), while NYHA Class III-IV patients decreased from 86% to 8% (P < 0.0001). In the narrow QRS group LVEF improved from 30% to 38% (P < 0.0001), 6-minute walk test from 370 to 506 m (P < 0.0001), and NYHA Class III-IV patients decreased from 60% to 0% (P < 0.0001). The data showed that in wide and narrow QRS patients, Biv-P significantly improved clinical parameters (NYHA class, 6-minute walk test, quality-of-life, and hospitalization rate) and main echocardiographic indicators. Furthermore, narrow QRS patients had a better survival rate, rapidly regained left ventricular function, and only a few patients remained in a higher NYHA class during follow-up. These patients should not be excluded "a priori" from cardiac resynchronization therapy.

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