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Relation between preoperative aerobic fitness estimated by steep ramp test performance and postoperative morbidity in colorectal cancer surgery: prospective observational study.
Cuijpers, ACM, Heldens, AFJM, Bours, MJL, van Meeteren, NLU, Stassen, LPS, Lubbers, T, Bongers, BC
The British journal of surgery. 2022;(2):155-159
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Abstract
Steep ramp test (SRT) performance provides an estimation of preoperative aerobic fitness that is associated with postoperative outcomes. Patients with a better SRT-estimated aerobic fitness are less likely to develop postoperative complications and more likely to experience a shorter time to recovery. The SRT might be a useful and clinically accessible tool in preoperative risk assessment to identify patients at risk of postoperative morbidity and who might benefit from preoperative exercise interventions.
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Cardiorespiratory optimal point during exercise testing is related to cardiovascular and all-cause mortality.
Laukkanen, JA, Kunutsor, SK, Araújo, CG, Savonen, K
Scandinavian journal of medicine & science in sports. 2021;(10):1949-1961
Abstract
Cardiorespiratory optimal point (COP) during exercise may be a potentially clinically useful cardiopulmonary exercise testing (CPET) variable, but its prognostic relevance for adverse cardiovascular disease (CVD) outcomes is unknown. We aimed to assess the association of COP during exercise with fatal mortality outcomes and the extent to which COP could improve the prediction of CVD mortality. Cardiorespiratory optimal point, the minimum value of the ventilatory equivalent for oxygen (VE/VO2) in a given minute of a CPET, was defined in 2,205 men who underwent CPET. Hazard ratios (HRs) (95% confidence intervals [CIs]) for outcomes and measures of risk discrimination for CVD mortality were calculated. During a median follow-up of 28.8 years, 402 fatal CHDs, 607 fatal CVDs, and 1,348 all-cause mortality events occurred. COP was continually associated with each outcome in a dose-response manner. On adjustment for established and emerging risk factors, the HRs (95% CIs) for fatal CHD, fatal CVD, and all-cause mortality were 3.05 (1.94-4.81), 2.82 (1.91-4.18) and 2.46 (1.85-3.27), respectively, per standard deviation increase in COP. After further adjustment for high sensitivity C-reactive protein, the HRs were 2.82 (1.78-4.46), 2.57 (1.73-3.81), and 2.27 (1.70-3.02), respectively. Addition of COP to a CVD mortality risk prediction model containing established risk factors was associated with a C-index change of 0.0139 (0.0040 to 0.0238; p = 0.006) at 25 years. COP during exercise is directly associated with fatal cardiovascular and all-cause mortality events in dose-response fashions. COP during exercise may improve the prediction of the long-term risk for CVD mortality.
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Short Physical Performance Battery: Response to Pulmonary Rehabilitation and Minimal Important Difference Estimates in Patients With Chronic Obstructive Pulmonary Disease.
Stoffels, AA, De Brandt, J, Meys, R, van Hees, HW, Vaes, AW, Klijn, P, Burtin, C, Franssen, FM, van den Borst, B, Sillen, MJ, et al
Archives of physical medicine and rehabilitation. 2021;(12):2377-2384.e5
Abstract
OBJECTIVE To determine the response to a pulmonary rehabilitation (PR) program and minimal important differences (MIDs) for the Short Physical Performance Battery (SPPB) subtests and SPPB summary score in patients with chronic obstructive pulmonary disease (COPD). DESIGN Retrospective analysis using distribution- and anchor-based methods. SETTING PR center in the Netherlands including a comprehensive 40-session 8-week inpatient or 14-week outpatient program. PARTICIPANTS A total of 632 patients with COPD (age, 65±8y; 50% male; forced expiratory volume in the first second=43% [interquartile range, 30%-60%] predicted). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Baseline and post-PR results of the SPPB, consisting of 3 balance standing tests, 4-meter gait speed (4MGS), and 5-repetition sit-to-stand (5STS). The chosen anchors were the 6-Minute Walk Test and COPD Assessment Test. Patients were stratified according to their SPPB summary scores into low-performance, moderate-performance, and high-performance groups. RESULTS 5STS (∆=-1.14 [-4.20 to -0.93]s) and SPPB summary score (∆=1 [0-2] points) improved after PR in patients with COPD. In patients with a low performance at baseline, balance tandem and 4MGS significantly increased as well. Based on distribution-based calculations, the MID estimates ranged between 2.19 and 6.33 seconds for 5STS and 0.83 to 0.96 points for SPPB summary score. CONCLUSIONS The 5STS and SPPB summary score are both responsive to PR in patients with COPD. The balance tandem test and 4MGS are only responsive to PR in patients with COPD with a low performance at baseline. Based on distribution-based calculations, an MID estimate of 1 point for the SPPB summary score is recommended in patients with COPD. Future research is needed to confirm MID estimates for SPPB in different centers.
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Is Motorized Treadmill Running Biomechanically Comparable to Overground Running? A Systematic Review and Meta-Analysis of Cross-Over Studies.
Van Hooren, B, Fuller, JT, Buckley, JD, Miller, JR, Sewell, K, Rao, G, Barton, C, Bishop, C, Willy, RW
Sports medicine (Auckland, N.Z.). 2020;(4):785-813
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Abstract
BACKGROUND Treadmills are often used in research, clinical practice, and training. Biomechanical investigations comparing treadmill and overground running report inconsistent findings. OBJECTIVE This study aimed at comparing biomechanical outcomes between motorized treadmill and overground running. METHODS Four databases were searched until June 2019. Crossover design studies comparing lower limb biomechanics during non-inclined, non-cushioned, quasi-constant-velocity motorized treadmill running with overground running in healthy humans (18-65 years) and written in English were included. Meta-analyses and meta-regressions were performed where possible. RESULTS 33 studies (n = 494 participants) were included. Most outcomes did not differ between running conditions. However, during treadmill running, sagittal foot-ground angle at footstrike (mean difference (MD) - 9.8° [95% confidence interval: - 13.1 to - 6.6]; low GRADE evidence), knee flexion range of motion from footstrike to peak during stance (MD 6.3° [4.5 to 8.2]; low), vertical displacement center of mass/pelvis (MD - 1.5 cm [- 2.7 to - 0.8]; low), and peak propulsive force (MD - 0.04 body weights [- 0.06 to - 0.02]; very low) were lower, while contact time (MD 5.0 ms [0.5 to 9.5]; low), knee flexion at footstrike (MD - 2.3° [- 3.6 to - 1.1]; low), and ankle sagittal plane internal joint moment (MD - 0.4 Nm/kg [- 0.7 to - 0.2]; low) were longer/higher, when pooled across overground surfaces. Conflicting findings were reported for amplitude of muscle activity. CONCLUSIONS Spatiotemporal, kinematic, kinetic, muscle activity, and muscle-tendon outcome measures are largely comparable between motorized treadmill and overground running. Considerations should, however, particularly be given to sagittal plane kinematic differences at footstrike when extrapolating treadmill running biomechanics to overground running. Protocol registration CRD42018083906 (PROSPERO International Prospective Register of Systematic Reviews).
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Rating of perceived exertion - a valid method for monitoring light to vigorous exercise intensity in individuals with subjective and mild cognitive impairment?
Stuckenschneider, T, Rüdiger, S, Abeln, V, Askew, CD, Wollseiffen, P, Schneider, S, ,
European journal of sport science. 2020;(2):261-268
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Abstract
In rehabilitation settings, exercise intensity is often monitored with Borg's rating of perceived exertion (RPE). However, previous studies showed that severe cognitive impairment may limit the usability of the RPE. The aim of this study was to assess the relationship between RPE and heart rate (HR), and to establish whether a target RPE can be used to achieve exercise intensity based on an individual's HR-RPE in people with early cognitive impairment. 97 participants (74.7 ± 6 years) with early cognitive impairment completed an incremental exercise test. Of these, 54 were tested during a single, RPE guided exercise session. RPE and HR were monitored throughout. Correlations between HR and RPE were assessed using Spearman's correlation. Mean differences between measured HR and target HR were calculated and compared using a two-way ANOVA with factors cognition and exercise mode. Bland-Altman plots were constructed to analyse the agreement between target and measured HR. HR and RPE correlated moderately with each other (p < 0.001; r = 0.555) and no differences between target and measured HR were observed. Bland-Altman plots revealed a mean difference of 1.2 bpm and a 95% level of agreement was between 24.4 and -22.1 bpm. No differences in rating accuracy were observed between different cognitive impairment levels nor between different exercise modes. Bland-Altman plots revealed some variance between the participants with almost half of them missing target HR by 10bpm or more. Therefore, the RPE should only be applied with caution and, if possible, with other measurements (e.g. heart rate monitors) to ensure that target intensity is reached.
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Home-based or remote exercise testing in chronic respiratory disease, during the COVID-19 pandemic and beyond: A rapid review.
Holland, AE, Malaguti, C, Hoffman, M, Lahham, A, Burge, AT, Dowman, L, May, AK, Bondarenko, J, Graco, M, Tikellis, G, et al
Chronic respiratory disease. 2020;:1479973120952418
Abstract
OBJECTIVES To identify exercise tests that are suitable for home-based or remote administration in people with chronic lung disease. METHODS Rapid review of studies that reported home-based or remote administration of an exercise test in people with chronic lung disease, and studies reporting their clinimetric (measurement) properties. RESULTS 84 studies were included. Tests used at home were the 6-minute walk test (6MWT, two studies), sit-to-stand tests (STS, five studies), Timed Up and Go (TUG, 4 studies) and step tests (two studies). Exercise tests administered remotely were the 6MWT (two studies) and step test (one study). Compared to centre-based testing the 6MWT distance was similar when performed outdoors but shorter when performed at home (two studies). The STS, TUG and step tests were feasible, reliable (intra-class correlation coefficients >0.80), valid (concurrent and known groups validity) and moderately responsive to pulmonary rehabilitation (medium effect sizes). These tests elicited less desaturation than the 6MWT, and validated methods to prescribe exercise were not reported. DISCUSSION The STS, step and TUG tests can be performed at home, but do not accurately document desaturation with walking or allow exercise prescription. Patients at risk of desaturation should be prioritised for centre-based exercise testing when this is available.
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Determining the reliability and usability of change of direction speed tests in adolescent female soccer players: a systematic review.
Pardos-Mainer, E, Casajús, JA, Julián, C, Bishop, C, Gonzalo-Skok, O
The Journal of sports medicine and physical fitness. 2020;(5):720-732
Abstract
INTRODUCTION This review aimed 1) to describe the most common tests used for assessing change of direction (COD) performance; 2) to detail the reliability of current COD tests; 3) to provide an overview of current intervention strategies used to improve COD performance in adolescent female soccer players. EVIDENCE ACQUISITION A computerized search was conducted in the PubMed, Cochrane Plus and Web of Science (from 1995 to January 2020) for English and Spanish language and peer-reviewed investigations. EVIDENCE SYNTHESIS A total of 221 studies were identified, with only 16 meeting the specific search criteria. The main findings were that eleven different tests have been used to assess COD performance with intraclass correlation coefficient and coefficient of variation values between 0.72-0.99 and 1-10.6%, respectively. The number of CODs performed during each test ranged from 1 to 9 within a range of 45º to 180º and with a duration <5 s, 5-9 s and >10 s. CONCLUSIONS Findings indicate that the reliability of the COD tests seems to depend on: the equipment used, the surface tested on and the technical level of the soccer player. These results should be interpreted with caution as they may be influenced by the period of growth and maturation, the playing position of the player and the period of the soccer season. Finally, strength and power drills could be considered as appropriate to improve COD performance.
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Caffeine mouth rinse has no effects on anaerobic energy yield during a Wingate Test.
Marinho, AH, Mendes, EV, Vilela, RA, Bastos-Silva, VJ, Araujo, GG, Balikian, P
The Journal of sports medicine and physical fitness. 2020;(1):69-74
Abstract
BACKGROUND The purpose was to investigate the effect of caffeine (CAF) mouth rinse on peak power (PP), mean power (MP), peak power relative to body mass (rel PP), mean power relative to body mass (rel MP), fatigue index (FI) and anaerobic contribution in the Wingate Test. METHODS Ten healthy men (age: 24.8±3.7 years; body mass: 71.0±7.8 kg; height: 170±3 cm; body fat: 17.02±4.9%; VO2max: 44.15±5.5 ml·kg-1·min=) were recruited. A randomized, double-blind, cross-over design was employed. Participants were instructed to complete Wingate Test in the fastest time possible under 2 conditions: CAF (25 ml of mint syrup with 1.2% of CAF, equivalent to 300 mg of CAF) and placebo (PLA) (25 ml of mint syrup without CAF). RESULTS There was no difference at PP (P=0.66), MP (P=0.16), rel PP (P=0.82), rel MP (P=0.18), FI (P=0.19), anaerobic alactic (P=0.71), anaerobic lactic (P=0.25), total energy expenditure (P=0.41) and peak plasma lactate concentration (P=0.57). CONCLUSIONS CAF mouth rinse did not increase peak power (PP), mean power (MP), peak power relative to body mass (rel PP), mean power relative to body mass (rel MP), Fatigue Index (FI) nor anaerobic contribution in the Wingate Test.
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Implications of Cardio-Respiratory Fitness on the Performance of Exercise Tests.
Jelinek, M, Hossack, K
Heart, lung & circulation. 2019;(4):e64-e66
Abstract
In 2016, the American Heart Association (AHA) produced a position paper on cardiorespiratory fitness (CRF) which defined CRF as the most important cardiac risk factor in the assessment of prognosis in a wide variety of clinical states [1]. The aim of the paper was to improve patient management and to encourage life-style based strategies designed to improve cardiovascular risk. The authors showed that: In this Brief Communication, we expand on how CRF can be assessed and reported in exercise testing.
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A Systematic Review and Meta-Analysis of Crossover Studies Comparing Physiological, Perceptual and Performance Measures Between Treadmill and Overground Running.
Miller, JR, Van Hooren, B, Bishop, C, Buckley, JD, Willy, RW, Fuller, JT
Sports medicine (Auckland, N.Z.). 2019;(5):763-782
Abstract
BACKGROUND Treadmills are routinely used to assess running performance and training parameters related to physiological or perceived effort. These measurements are presumed to replicate overground running but there has been no systematic review comparing performance, physiology and perceived effort between treadmill and overground running. OBJECTIVE The objective of this systematic review was to compare physiological, perceptual and performance measures between treadmill and overground running in healthy adults. METHODS AMED (Allied and Contemporary Medicine), CINAHL (Cumulative Index to Nursing and Allied Health), EMBASE, MEDLINE, SCOPUS, SPORTDiscus and Web of Science databases were searched from inception until May 2018. Included studies used a crossover study design to compare physiological (oxygen uptake [[Formula: see text]O2], heart rate [HR], blood lactate concentration [La]), perceptual (rating of perceived exertion [RPE] and preferred speed) or running endurance and sprint performance (i.e. time trial duration or sprint speed) outcomes between treadmill (motorised or non-motorised) and overground running. Physiological outcomes were considered across submaximal, near-maximal and maximal running intensity subgroups. Meta-analyses were used to determine mean difference (MD) or standardised MD (SMD) ± 95% confidence intervals. RESULTS Thirty-four studies were included. Twelve studies used a 1% grade for the treadmill condition and three used grades > 1%. Similar [Formula: see text]O2 but lower La occurred during submaximal motorised treadmill running at 0% ([Formula: see text]O2 MD: - 0.55 ± 0.93 mL/kg/min; La MD: - 1.26 ± 0.71 mmol/L) and 1% ([Formula: see text]O2 MD: 0.37 ± 1.12 mL/kg/min; La MD: - 0.52 ± 0.50 mmol/L) grade than during overground running. HR and RPE during motorised treadmill running were higher at faster submaximal speeds and lower at slower submaximal speeds than during overground running. [Formula: see text]O2 (MD: - 1.25 ± 2.09 mL/kg/min) and La (MD: - 0.54 ± 0.63 mmol/L) tended to be lower, but HR (MD: 0 ± 1 bpm), and RPE (MD: - 0.4 ± 2.0 units [6-20 scale]) were similar during near-maximal motorised treadmill running to during overground running. Maximal motorised treadmill running caused similar [Formula: see text]O2 (MD: 0.78 ± 1.55 mL/kg/min) and HR (MD: - 1 ± 2 bpm) to overground running. Endurance performance was poorer (SMD: - 0.50 ± 0.36) on a motorised treadmill than overground but sprint performance varied considerably and was not significantly different (MD: - 1.4 ± 5.8 km/h). CONCLUSIONS Some, but not all, variables differ between treadmill and overground running, and may be dependent on the running speed at which they are assessed. PROTOCOL REGISTRATION CRD42017074640 (PROSPERO International Prospective Register of Systematic Reviews).