Search

Standard cardiopulmonary exercise testing (CPET) produces a rich dataset but its current analysis is often limited to a few derived variables such as maximal or peak oxygen uptake (V̇O2). We tested whether breath-by-breath CPET data could be used to determine sample entropy (SampEn) in 81 healthy children and adolescents (age 7-18 years old, equal sex distribution). To overcome challenges of the relatively small time-series CPET data size and its nonstationarity, we developed a Python algorithm for short-duration physiological signals. Comparing pre- and post-ventilatory threshold (VT1) CPET phases, we found: (1) SampEn decreased by 9.46% for V̇O2 and 5.01% for V̇CO2 (p

INTRODUCTION: While it is well recognised that aging is a heterogeneous process, our understanding of the determinants of biological aging and its heterogeneity remains unclear. The San Diego Nathan Shock Center (SD-NSC) Clinical Cohort aims to establish a resource of biospecimens and extensive donor clinical data such as physical, cognitive and sensory function to support other studies that aim to explore the heterogeneity of normal human aging and its biological underpinnings. METHODS AND ANALYSIS: The SD-NSC Clinical Cohort is composed of 80 individuals across the adult human lifespan. Strict inclusion and exclusion criteria are implemented to minimise extrinsic factors that may impede the study of normal aging. Across three visits, participants undergo extensive phenotyping for collection of physical performance, body composition, cognitive function, sensory ability, mental health and haematological data. During these visits, we also collected biospecimens including plasma, platelets, peripheral blood mononuclear cells and fibroblasts for banking and future studies on aging. ETHICS AND DISSEMINATION: Ethics approval from the UC San Diego School of Medicine Institutional Review Board (IRB #201 141 SHOCK Center Clinical Cohort, PI: Molina) was obtained on 11 November 2020. Written informed consent is obtained from all participants after objectives and procedures of the study have been fully explained. Congruent with the goal of establishing a core resource, biological samples and clinical data are made available to the research community through the SD-NSC.

BACKGROUND: Cardiac dysfunction from pulmonary vascular disease causes characteristic findings on cardiopulmonary exercise testing (CPET). We tested the accuracy of CPET for detecting inadequate stroke volume (SV) augmentation during exercise, a pivotal manifestation of cardiac limitation in patients with pulmonary vascular disease. METHODS: We reviewed patients with suspected pulmonary vascular disease in whom CPET and right heart catheterization (RHC) measurements were taken at rest and at anaerobic threshold (AT). We correlated CPET-determined O2·pulseAT/O2·pulserest with RHC-determined SVAT/SVrest. We evaluated the sensitivity and specificity of O2·pulseAT/O2·pulserest to detect SVAT/SVrest below the lower limit of normal (LLN). For comparison, we performed similar analyses comparing echocardiographically-measured peak tricuspid regurgitant velocity (TRVpeak) with SVAT/SVrest. RESULTS: From July 2018 through February 2023, 83 simultaneous RHC and CPET were performed. Thirty-six studies measured O2·pulse and SV at rest and at AT. O2·pulseAT/O2·pulserest correlated highly with SVAT/SVrest (r = 0.72, 95% CI 0.52, 0.85; p

The aim of this study is to examine the available scientific evidence on the reliability and criterion validity of 6-minute run walk field-based test when administered to children and adolescents. Systematic searches were performed in three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus) from their inception until February 2024, with an update on August 15, 2024. Studies were considered eligible if they provided information on the criterion-related validity and/or reliability of the 6-minute run walk test when conducted by children (aged 12 years and under) and/or adolescents (aged 13 to 17 years). To examine reliability and validity, two separate meta-analyses were implemented. In the meta-analysis focused on criterion-related validity, the five studies included indicated a fair validity (r = 0.56 [95% CI: 0.44–0.66]) and high homogeneity (I2 0%). In the meta-analysis focused on reliability, the pooled data from the five studies employing Pearson’s correlation coefficient (n = 585) revealed strong reliability values (r = 0.82 [95% CI: 0.75–0.87]), albeit with a moderate level of heterogeneity (I2 71% prediction interval 0.55–0.94). The evidence suggests that the 6-minute run walk field-based test demonstrated fair criterion-related validity and strong test-retest reliability when conducted with children and adolescent. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to measure the functional exercise capacity of patients with ankylosing spondylitis (AS) with the incremental shuttle walk test (ISWT), and to determine the factors associated with this test. Methods: This cross-sectional study included 54 patients with AS (29 males, 25 females). The ISWT was performed to determine functional exercise capacity. The number of completed shuttles was recorded, and the total incremental shuttle walk distance (ISWD) was calculated. Disease activity was assessed with the Bath AS Disease Activity Index (BASDAI), physical functioning was assessed with the Bath AS Functional Index (BASFI), and spinal mobility was assessed with the Bath AS Mobility Index (BASMI). Upper body and core endurance were assessed by sit-up and push-up tests. Tests were performed in a single session in the order listed. Results: The mean ISWD of the patients was 462.41 ± 97.96 m, and the subjects reached 50.48% of the predicted ISWD. The ISWD of male subjects was significantly higher than that of females (p <.05). At the end of the test, male subjects reached 60.87% of the age-predicted maximal heart rate, and female subjects reached 55.25%. There was a significant positive moderate correlation between ISWD and height (r = 0.535, p <.01), sit-up test (r = 0.617, p <.01), and push-up test (r = 0.495, p <.01), while there was a negative weak correlation between BASFI (r = -0.344, p =.011) and BASMI (r = -0.280, p =.040). Conclusion: The study showed that functional exercise capacity as assessed by the ISWT decreased in patients with AS. ISWT performance was associated with sex, height, functionality, spinal mobility, and muscular endurance. [ABSTRACT FROM AUTHOR]

Providing an overview of the clinimetric properties of the steep ramp test (SRT)—a short-term maximal exercise test—to assess cardiorespiratory fitness (CRF), describing its underlying physiological responses, and summarizing its applications in current clinical and research practice. MEDLINE (through PubMed), CINAHL Complete, Cochrane Library, EMBASE, and PsycINFO were searched for studies published up to July 2023, using keywords for SRT and CRF. Eligible studies involved the SRT as research subject or measurement instrument and were available as full text articles in English or Dutch. Two independent assessors performed data extraction. Data addressing clinimetric properties, physiological responses, and applications of the SRT were tabulated. In total, 370 studies were found, of which 39 were included in this study. In several healthy and patient populations, correlation coefficients between the work rate at peak exercise (WR peak) attained at the SRT and oxygen uptake at peak exercise during cardiopulmonary exercise testing (CPET) ranged from.771-.958 (criterion validity). Repeated measurements showed intraclass correlation coefficients ranging from.908-.996 for WR peak attained with the first and second SRT (test-retest reliability). Physiological parameters, like heart rate and minute ventilation at peak exercise, indicated that the SRT puts a lower burden on the cardiopulmonary system compared to CPET. The SRT is mostly used to assess CRF, among others as part of preoperative risk assessment, and to personalize interval training intensity. The SRT is a practical short-term maximal exercise test that is valid for CRF assessment and to monitor changes in CRF over time in various healthy and patient populations. Its clinimetric properties and potential applications make the SRT of interest for a widespread implementation of CRF assessment in clinical and research practice and for personalizing training intensity and monitoring longitudinal changes in CRF. [ABSTRACT FROM AUTHOR]

Pectus excavatum, the most frequent malformation of the chest wall, has been related to cardiac compression and exercise intolerance. Cardiac outcomes after minimally invasive repair of pectus excavatum with retrosternal implants, particularly after removal (> 2 years postoperative) are generally unknown. We evaluated stress echocardiography outcomes before repair and after bar removal. This study comprised a retrospective cohort of patients with diagnosis of isolated pectus excavatum who underwent stress echocardiography before minimally invasive repair with retrosternal implants, and after bar removal. The diastolic function was evaluated by means of the trans tricuspid flow and tissue doppler imaging. The compression of the atrioventricular groove was assessed using the trans tricuspid gradient and the tricuspid area. We included 43 patients, with a mean age of 15.7 ± 4.0 years (91% male). After bar removal, 83% of patients referred improvement of exercise capacity. Furthermore, we found a significant improvement in right ventricular filling patterns, including a better E/A ratio profile during exercise (p = 0.001), lower filling pressures both at rest (p < 0.0001) and during exercise (p = 0.031), and lower rates of resting paradoxical septal motion [70% vs. 20%, p = 0.0007]. The trans tricuspid mean gradient during exercise was significantly lower after bar removal (p < 0.0001). In this study involving patients with minimally invasive repair of pectus excavatum, we demonstrated a beneficial impact of such intervention after bar removal, with significant improvements related to the right ventricular function, as well as signs of relief of cardiac compression. [ABSTRACT FROM AUTHOR]

This study investigated the impact of six high-intensity interval training (HIIT) running sessions on 1% or 10% slopes on various physiological and performance parameters in 25 men. The participants underwent assessments of VO2max, time to exhaustion on 1% slope (TLim1%), and time to exhaustion on 10% slope (TLim10%) in the initial three visits. They were then randomly assigned to control (CON), HIIT on 1% slope (GT1%), or HIIT on 10% slope (GT10%) groups. Over three weeks, participants performed six HIIT sessions with equalized workload based on their individual maximal oxygen uptake (vVO2max). The sessions comprised 50% of TLim, with a 1:1 ratio of exercise to recovery at 50% vVO2max. The results indicated significant improvements in VO2max and peak velocity (VPeak) after HIIT on both slopes. Heart rate (HR) differed between sessions for GT1%, while no significant differences were observed for GT10%. Ratings of perceived exertion (RPE) were significantly reduced for GT1% after the third session, with a similar trend for GT10%. In summary, six HIIT sessions on a 1% or 10% slope effectively enhanced VO2max and VPeak, but there was no improvement in TLim performance, suggesting no adaptive transfer between training groups. [ABSTRACT FROM AUTHOR]

Background Material and Methods Results Conclusion Atrial fibrillation (AF) is usually triggered by frequent atrial premature complexes (APC) and atrial tachycardias originated in the pulmonary veins. The aim of the current study is to clarify the relationship between AF and APCs observed during treadmill exercise testing through long‐term patient follow‐up.Our study only examined the data of patients who did not have any obstructive coronary artery disease and had an exercise test. In total, 1559 patients were included in this research. The study data were divided into two groups according to the development of AF during follow‐up. The patients who developed any type of AF during the follow‐up period were classified as AF (+). Mean follow‐up time for AF (+) and (−) groups were 48 and 47 months, respectively.In the univariable analysis, age, LAAP, and the presence of APCs (HR: 3.906, 95% CI: 2.848–5.365, p < 0.001) during the treadmill exercise test were significantly associated with the development of AF. In the multivariable analysis, age (adjusted HR: 1.063, 95% CI: 1.043–1.083, p < 0.001) and the presence of APCs during the treadmill exercise test (adjusted HR: 2.504, 95% CI: 1.759–3.565, p < 0.001) emerged as independent risk factors for the development of AF. The AF‐free survival was significantly lower in the APCs (+) patients compared with the APCs (−) patients (log rank p < 0.001).Our study revealed that individuals without obstructive CAD who exhibited frequent APCs during treadmill exercise tests were more likely to develop AF. [ABSTRACT FROM AUTHOR]

Summary: Sleep‐disordered breathing is highly prevalent in individuals with high‐level spinal cord injury. In addition, chest mechanics are known to be altered, leading to paradoxical breathing. Here we investigated the interaction between paradoxical breathing and sleep quality in these patients, and its association with measurements of respiratory function, hypercapnic ventilatory response and peak exercise ventilation. Home‐based polysomnography was performed in 13 patients with spinal cord injury (C4 to T4) untreated for sleep‐disordered breathing. We defined paradoxical breathing as counterphase between thoracic and abdominal movements during slow‐wave and rapid eye movement sleep. Sleep quality, pulmonary function, hypercapnic ventilatory responses and peak exercise ventilation were compared between those with and without paradoxical breathing. Half of individuals presented with nocturnal paradoxical breathing. Despite similar age, body mass index, injury level, time since injury, and respiratory function, those with paradoxical breathing had higher apnea–hypopnea index (13 ± 8 versus 5 ± 3 events per hr) and average sleep heart rate (67 ± 12 versus 54 ± 4 bpm; p < 0.05). Moreover, paradoxical breathing was associated with lower hypercapnic ventilatory response (slope: 0.35 ± 0.17 versus 0.96 ± 0.38) and lower peak exercise ventilation (33 ± 4 versus 48 ± 12 L min−1; p < 0.05). Nocturnal respiratory muscle desynchronization could play a role in the pathophysiology of sleep apnea, and could relate to low ventilatory responses to both hypercapnia and exercise in high‐level spinal cord injury. Polysomnography may be an important diagnostic tool for these patients for whom therapeutic approaches should be considered to treat this abnormality. [ABSTRACT FROM AUTHOR]

Background and Objectives: Few comparative studies have evaluated wearable single-lead electrocardiogram (ECG) devices and standard multi-lead ECG devices during exercise testing. This study aimed to validate the accuracy of a wearable single-lead ECG monitor for recording heart rate (HR) metrics during graded exercise tests (GXTs). Methods: A cohort of 50 patients at a tertiary hospital underwent GXT while simultaneously being equipped with wearable single- and conventional multi-lead ECGs. The concordance between these modalities was quantified using the intraclass correlation coefficient and Bland–Altman plot analysis. Results: The minimum and average HR readings between the devices were generally consistent. Parameters such as ventricular ectopic beats and supraventricular ectopic beats showed strong agreement. However, the agreement for the Total QRS and Maximum RR was not sufficient. HR measurements across different stages of the exercise test showed sufficient agreement. Although not statistically significant, the standard multi-lead ECG devices exhibited higher noise levels compared to the wearable single-lead ECG devices. Conclusions: Wearable single-lead ECG devices can reliably monitor HR and detect abnormal beats across a spectrum of exercise intensities, offering a viable alternative to traditional multi-lead systems. [ABSTRACT FROM AUTHOR]

In pulmonary disease patients since oxygen desaturation during 6-min walk test (6MWT) affects walk distance (6MWD), some novel indices such as desaturation/distance ratio [DDR, oxygen desaturation area (DAO2)/6MWD] and distance-saturation product [DSP, 6MWD × minimum peripheral oxygen saturation (SpO2)] are evaluated. However, there has been no study examining these indices that consider exercise-induced desaturation (EID) in patients with cardiovascular disease. In 94 cardiovascular disease patients without pulmonary complications, 6MWT and echocardiography were performed at the entry of cardiac rehabilitation. SpO2 was measured during 6MWT using a continuously monitorable pulse oximeter, and DSP and DDR were calculated using minimum SpO2 and DAO2 [sum of (100-SpO2) per second during 6MWT], respectively. EID was defined as SpO2 decrease of ≥ 4% or minimum SpO2 of < 90% during 6MWT. DSP was slightly lower and DDR was markedly higher in patients with EID than in those without. When examining correlations of DSP and DDR with their components, DSP was correlated with 6MWD much closely than minimum SpO2, while DDR was correlated as closely with DAO2 as 6MWD. Furthermore, DAO2, but not minimum SpO2, had a direct correlation with 6MWD. As for associations with cardiac function, DSP was correlated with several cardiac parameters, but DDR was not correlated with any of these parameters. Our findings suggest that oxygen desaturation during 6MWT affects walking distance in cardiovascular disease patients even without pulmonary complications and that DDR is more appropriate than DSP as an index of walking performance that takes EID into consideration, independently of cardiac function. [ABSTRACT FROM AUTHOR]

The number of people who run to achieve competitive performance has increased, encouraging the scientific community to analyze the association of factors that can affect a runner performance. Is there association between running spatiotemporal and angular kinematics with the physiological markers of endurance performance during a cardiorespiratory exercise test? This was an observational cross-sectional study with 40 distance runners simultaneously submitted to a running biomechanical analysis and cardiorespiratory exercise test on a treadmill. Mixed models were developed to verify the association between angular kinematic data obtained by the Movement Deviation Profile and the running spatiotemporal data with oxygen consumption and ventilatory thresholds. Spatiotemporal variables [.e., step frequency Odds Ratio 0.09 [0.06–0.12 95 % Confidence Interval], center of mass vertical displacement Odds Ratio 0.10 [0.07–0.14 95 % Confidence Interval], and step length [Odds Ratio −0.01 [-0.01 to −0.00 95 % Confidence Interval]] were associated with VO 2. Also, step frequency Odds Ratio 1.03 [1.01–1.05 95 % Confidence Interval] was associated with the first ventilatory threshold, and angular running kinematics [Movement Deviation Profile analysis] Odds Ratio 1.47 [1.13–1.91 95 % Confidence Interval] was associated with peak of exercise during the cardiorespiratory exercise test. Our findings demonstrated that: both higher step frequency and center of mass vertical displacement are associated with the increase of oxygen demand; step frequency is associated with the first ventilatory threshold, due to the entrainment mechanism and angular kinematic parameters are associated with peak aerobic speed. Future studies could also compare the biomechanical and physiological characteristics of different groups of distance runners. This could help identify the factors that contribute to oxygen demands during running and performance across different ages, genders, and levels of competition. • Study examines running kinematics and endurance performance. • Spatiotemporal variables affect oxygen consumption and VT1. • Angular kinematics (MDP analysis) was associated with peak of exercise and speed. • Findings suggest ways to improve running economy and performance. [ABSTRACT FROM AUTHOR]

Purpose: In this study we evaluated the reliability of blood lactate levels (BLa), energy expenditure and substrate utilization during prolonged exercise at the intensity that elicits maximal fat oxidation (FATmax). Furthermore, we investigated the accuracy of a single graded exercise test (GXT) for predicting energy metabolism at FATmax. Methods: Seventeen young men with obesity (26 ± 6 years; 36.4 ± 7.2 %body fat) performed a GXT on a treadmill in a fasted state (10–12 h) for the assessment of FATmax and cardiorespiratory fitness. Afterward, each subject performed two additional prolonged FATmax trials (102 ± 11 beats·min−1; 60-min) separated by 7 days. Indirect calorimetry was used for the assessment of energy expenditure and substrate utilization kinetics whereas capillary blood samples were taken for the measurement of BLa. Results: The BLa (limits of agreement (LoA): −1.2 to 0.8 mmol∙L−1; p = 1.0), fat utilization (LoA: −8.0 to 13.4 g∙h−1; p = 0.06), and carbohydrate utilization (LoA: −27.6 to 22.4 g∙h−1; p = 0.41) showed a good agreement whereas a modest systematic bias was found for energy expenditure (LoA: −16811 to 33355 kJ∙h−1; p < 0.05). All the aforementioned parameters showed a moderate to good reliability (Intraclass correlation coefficient: 0.67–0.92). The GXT overestimated fat (~46%) and carbohydrate (~26%) utilization as well as energy expenditure (36%) during steady-state exercise at FATmax. Conversely the GXT underestimated BLa (~28%). Conclusion: a single GXT cannot be used for an accurate prediction of energy metabolism during prolonged exercise in men with obesity. Thus, an additional steady-state FATmax trial (40–60 min) should be performed for a tailored and precise exercise prescription. [ABSTRACT FROM AUTHOR]

Background: Age-related changes in body composition affect physical fitness in older adults. However, whether the autonomic response is associated with body fat percentage and its implication for physical fitness is not fully understood. Aim: To understand the association between physical fitness, body composition, and heart rate variability in older people and its mediating factors. Methods: A cross-sectional study with 81 older adults was conducted, assessing Short Physical Performance Battery (SPPB), Two-minute Step Test (TMST), body composition, and cardiac autonomic response. Correlation and mediation analyses were performed. Results: Body fat percentage negatively correlated with physical fitness (SPPB: r = − 0.273, p = 0.015; TMST: r = − 0.279, p = 0.013) and sympathetic activity (sympathetic nervous system (SNS) index: r = − 0.252, p = 0.030), yet positively correlated with parasympathetic tone (root mean square of successive differences (RMSSD): r = 0.253, p = 0.029; standard deviation of NN intervals (SDNN): r = 0.269, p = 0.020). Physical fitness associated with sympathetic nervous system index (SPPB: r = 0.313, p = 0.006; TMST: r = 0.265, p = 0.022) and parasympathetic nervous system index (TMST: r = − 0.344, p = 0.003). Muscle mass mediated body fat's impact on physical fitness, while physical fitness mediated body fat's impact on autonomic response. Conclusion: Body composition and cardiac autonomic response to exercise are associated with physical fitness in older people, highlighting a possible protective effect of muscle mass against the decline in physical fitness associated with increased body fat. [ABSTRACT FROM AUTHOR]

Objective: Prolactinoma can increase the risk of cardiovascular diseases (CVDs), such as arterial stiffness, atherosclerosis, dysrhythmia and heart failure. This study aimed to evaluate and compare muscle function, exercise capacity, physical activity (PA) level, CVD risk factor knowledge level, sleep quality, fatigue and quality of life between prolactinoma patients and healthy controls. Methods: Nineteen female patients with prolactinomas and 19 healthy women were included in this study. Quadriceps muscle strength (QMS) was measured using a hand dynamometer, and muscular endurance was evaluated via the squat test. The 6-minute walking test (6MWT) distance was also measured. CVD risk factor knowledge levels were evaluated with the Cardiovascular Diseases Risk Factors Knowledge Level Scale (CARRF-KL), PA levels were assessed with the International Physical Activity Questionnaire-short form (IPAQ), sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), fatigue was assessed with the Multidimensional Fatigue Rating Scale (MAF), and quality of life was assessed with the Short Form-36 questionnaire (SF-36). Results: Patients with prolactinomas had significantly lower 6MWT distances; CARRF-KL total scores; SF-36 general health and physical limitation scores; and higher IPAQ-sitting scores than did healthy controls (p < 0.05). Moreover, there were no significant differences between the groups in terms of QMS score; number of squats; severity of IPAQ score; severity, moderate, or total walking score; total PSQI score; or total MAF score (p > 0.05). Conclusions: Exercise capacity and quality of life are adversely affected, and sedentary behavior is observed in prolactinomas. Patients with prolactinomas have less knowledge about CVD risk factors than healthy individuals. CVD incidence and knowledge and functional capacity should be improved in patients with prolactinomas by the use of a multidisciplinary team for cardiac rehabilitation. Clinical trial registration: This study is part of a larger clinical trial registered on ClinicalTrials.gov prior to participant enrollment (NCT05236829). [ABSTRACT FROM AUTHOR]

The study aim was to compare physiological, physical, accumulated wellness and load markers within a European professional soccer team between starters and non-starters. Ten starters (age: 25.1 ± 2.2 years; experience: 7.3 ± 2.3 years) and eight non-starters (age: 26.1 ± 4.6; years’ experience: 8.3 ± 4.1 years) participated in the study. The study was conducted across 20 weeks where 75 training sessions and 15 matches occurred. Wellness (fatigue, quality of sleep, muscle soreness, stress and mood) and load (rating of perceived exertion (RPE), accelerations, decelerations, high-speed running and sprinting) measures were observed. Physiological evaluation consisted of a 1200 m maximum effort shuttle test while physical capacity assessment included isokinetic strength, jump ability and balance tests. Isokinetic tests were used to assess peak torque of both legs (extension and flexion at 60°/s and 180°/s), single squat jump and single hop jump were utilized to assess jump ability and Y-balance tests were employed to examine balance. Starters presented significantly higher values for peak torque extension of the non-dominant leg compared to non-starters (p = 0.038, effect size (ES) = 0.996), while non-starters showed higher values for both Y-balance postero-medial and postero-lateral (p = 0.009, ES = −1.309 and p = 0.021, ES = −1.133, respectively). Accumulated duration and RPE were lower for non-starters than starters (p ≤ 0.001, ES = 1.268, and p = 0.022, ES = 1.123, respectively). The physiological and physical tests conducted in this study do not seem to determine the starting status of players, considering that only one test revealed significantly higher values for starters. Despite the lower training and match duration for non-starters, this showed that it is possible to accumulate identical load while managing wellness regardless of starting status.

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Injury rates in competitive alpine skiing are high. With current methods, identifying people at risk is expensive and thus often not feasible at the youth level. The aims of this study were (1) to describe the jump performance and movement quality of youth competitive alpine skiers according to age and sex, (2) to compare the jump distance among skiers of different sexes and movement quality grades, and (3) to assess the inter-rater grading reliability of the qualitative visual movement quality classification of such jumps and the agreement between live and video-based post-exercise grading. Materials and Methods: This cross-sectional study is based on an anonymized dataset of 301 7- to 15-year-old competitive alpine skiers. The skiers performed two-legged forward triple jumps, whereby the jump distance was measured, and grades were assigned by experienced raters from the frontal and sagittal perspectives depending on the execution quality of the jumps. Furthermore, jumps were filmed and ultimately rated post-exercise. Differences in jump distance between various groups were assessed by multivariate analyses of variance (MANOVAs). Reliability was determined using Kendall's coefficient of concordance. Results: The jump distance was significantly greater in U16 skiers than in U11 skiers of both sexes and in skiers with good execution quality than in those with reduced or poor execution quality. Overall, jump distance in U16 skiers significantly differed between female (5.37m with 95% CI [5.21, 5.53]) and male skiers (5.90m with 95%CI [5.69, 6.10]). Slightly better inter-rater grading reliability was observed for video-based post-exercise (strong agreement) ratings than for live ratings (moderate agreement). Conclusion: In competitive alpine skiers aged 7 to 15 years, jump performance increases with age, and around puberty, sex differences start to manifest. Our results highlight the importance of evaluating both jump distance and movement quality in youth skiers. To improve test-retest reliability, however, a video-based post-exercise evaluation is recommended. [ABSTRACT FROM AUTHOR]

Abstract In pre-pubertal children the factors affecting maximal oxygen uptake have yet to be fully understood. Therefore, the purpose of this analysis is to present cardiorespiratory fitness in prepubertal boys and girls and to determine if there are any differences based on sex, exercise testing modality or if maximal or peak oxygen consumption metrics are used. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. For statistical analysis, multilevel models grounded in Bayesian principles were used. Selected studies obtained: maximal effort during the test, peak or maximal oxygen consumption (V̇O2) values, boys and girls (sex specific groups only) age under 11, cycle ergometry or treadmill, pre-intervention or no intervention data. In boys using cycle ergometry, 118 studies were included in the analysis, in boys using treadmill 115, in girls using cycle ergometry 83 and in girls using treadmill testing 95 study entries were included. As children get older, their cardiorespiratory fitness increases (P ≈ 100%). Studies with participants having smaller body mass have higher V̇O2 relative to body mass values (P ≈ 100%). Boys have higher V̇O2 values than girls (P ≈ 100%). Studies using treadmill reported higher values than those using cycle ergometer (P ≈ 100%). Regarding the influence of measurement method (max vs. peak) on V̇O2 values we did not find significant differences. In conclusion, we present reference values for cardiorespiratory fitness in prepubertal boys and girls using cycle ergometry or treadmill. Prepubertal boys have higher cardiorespiratory fitness than girls and using treadmill testing might be a preferred method to cycle ergometry, especially in older children. Maximal or peak oxygen consumption metrics might be used interchangeably in prepubertal children.

Abstract Background Brachycephalic obstructive airway syndrome (BOAS), observed in many flat-faced dog breeds, is one of the most urgent welfare problems in pedigree dogs. Various breeding schemes against BOAS have been implemented in many countries during recent years, but their impact on breed health remains unknown. The BOAS breeding test, used by the Finnish Kennel Club (FKC), includes an exercise component with a recovery assessment, BOAS grading by a veterinarian that evaluates upper respiratory signs before and after exercise, and a nostril stenosis assessment. The aim of our study was to evaluate BOAS breeding test results and estimate the heritability of the BOAS grade using parent–offspring regression from FKC data collected during 2017–2022. Results The majority (80%) of dogs (n = 957) participating in FKC BOAS testing were English Bulldogs, French Bulldogs, and Pugs. In 2022, 89–100% of the litters from these three breeds registered with the FKC had at least one parent tested for BOAS. The proportion of dogs failing the exercise test was highest in English Bulldogs (11%), followed by French Bulldogs (4%) and Pugs (3%). In these three breeds, moderate to severe BOAS signs were reported in 28%, 22% and 30% of dogs, respectively. The proportion of moderate to severe nostril stenosis was highest (71%) in Pugs, followed by French Bulldogs (55%), and English Bulldogs (40%). Estimates of heritability for BOAS grade were separately calculated for these three breeds and for all dogs, and the estimates were moderate to high, ranging from 0.39 to 0.58. Conclusions The exercise test alone did not sufficiently identify dogs with moderate to severe BOAS signs. To better consider the complex nature of BOAS and breed differences, exercise tolerance, the severity of upper respiratory signs (BOAS grade) and nostril stenosis should all be assessed together in breeding animals. The heritability estimates for veterinary-assessed BOAS grade indicated that BOAS grade could be used in selective breeding to obtain less-affected offspring.

ABSTRACT Importance 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). Objective This study aimed to assess the feasibility and reproducibility of performing the 3‐min step test with remote supervision. Methods 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. Results 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%). Interpretation Physiological responses between tests were similar, indicating it was feasible to perform the 3‐min step test with remote supervision in CF children.

In pre-pubertal children the factors affecting maximal oxygen uptake have yet to be fully understood. Therefore, the purpose of this analysis is to present cardiorespiratory fitness in prepubertal boys and girls and to determine if there are any differences based on sex, exercise testing modality or if maximal or peak oxygen consumption metrics are used. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. For statistical analysis, multilevel models grounded in Bayesian principles were used. Selected studies obtained: maximal effort during the test, peak or maximal oxygen consumption (V̇O2) values, boys and girls (sex specific groups only) age under 11, cycle ergometry or treadmill, pre-intervention or no intervention data. In boys using cycle ergometry, 118 studies were included in the analysis, in boys using treadmill 115, in girls using cycle ergometry 83 and in girls using treadmill testing 95 study entries were included. As children get older, their cardiorespiratory fitness increases (P ≈ 100%). Studies with participants having smaller body mass have higher V̇O2 relative to body mass values (P ≈ 100%). Boys have higher V̇O2 values than girls (P ≈ 100%). Studies using treadmill reported higher values than those using cycle ergometer (P ≈ 100%). Regarding the influence of measurement method (max vs. peak) on V̇O2 values we did not find significant differences. In conclusion, we present reference values for cardiorespiratory fitness in prepubertal boys and girls using cycle ergometry or treadmill. Prepubertal boys have higher cardiorespiratory fitness than girls and using treadmill testing might be a preferred method to cycle ergometry, especially in older children. Maximal or peak oxygen consumption metrics might be used interchangeably in prepubertal children. [ABSTRACT FROM AUTHOR]

Impaired quality of life (QoL) is prevalent among patients with chronic thromboembolic pulmonary hypertension (CTEPH) despite improved survival due to medical advances. We clarified the physical QoL of patients with CTEPH with mildly elevated pulmonary hemodynamics and evaluated its determinants using a database of patients with CTEPH evaluated for hemodynamics during exercise. The QoL was measured in 144 patients with CTEPH (age, 66 (58−73) years; men/women, 48/96) with mildly elevated mean pulmonary artery pressure (<30 mm Hg) at rest after treatment with balloon pulmonary angioplasty and/or pulmonary endarterectomy using the Short-Form 36 (SF-36) questionnaire. The enrolled patients were divided into 2 groups: physical component summary (PCS) scores in the SF-36 over 50 as PCS-good and those under 50 as PCS-poor. The median PCS in SF-36 score was 43.4 (IQR 32.4–49.5) points. The PCS-poor group (n = 110) was older and had lower exercise capacity and SaO 2 during exercise. PCS scores were correlated with 6-minute walk distance (rs = 0.40, p < 0.001), quadriceps strength (rs = 0.34, p < 0.001), peak VO 2 (rs = 0.31, p < 0.001), SaO 2 at rest (rs = 0.35, p < 0.001) and peak exercise (rs = 0.33, p < 0.001), home oxygen therapy usage (rs = −0.28, p = 0.001), and pulmonary vascular resistance at peak exercise (rs = −0.26, p = 0.002). The impairment of physical QoL was common in patients with CTEPH with improved hemodynamics; exercise capacity, hypoxemia, and hemodynamic status during exercise were related to the physical QoL. [ABSTRACT FROM AUTHOR]

Aim: Exercise test outdoors is widely used to diagnose asthma in children, but it is unclear how much outdoor air factors affect the results. Methods: We analysed 321 outdoor exercise challenge tests with spirometry in children 6–16 years conducted due to suspicion of asthma or for assessing the effect of medication on asthma. We studied the association of FEV1 decrease and incidence of exercise‐induced bronchoconstriction (EIB) with temperature, relative humidity (RH) and absolute humidity (AH). Results: Asthma was diagnosed in 57% of the subjects. AH ≥5 g/m3, but not RH or temperature, was associated with the EIB incidence (p = 0.035). In multivariable logistic regression, AH ≥5 g/m3 was negatively associated (OR = 0.51, 95% CI [0.28─0.92], p = 0.026) while obstruction before exercise (OR = 2.11, 95% CI [1.16─3.86], p = 0.015) and IgE‐mediated sensitisation were positively associated with EIB (OR = 2.24, 95% CI [1.11─4.51], p = 0.025). AH (r = −0.12, p = 0.028) and temperature (r = −0.13, p = 0.023) correlated with decrease in FEV1. In multivariable linear regression, only AH was associated with FEV1 decrease (coefficient = −0.044, 95% CI [−0.085 to −0.004], p = 0.033). Conclusion: AH of outdoor air associates with occurrence and severity of EIB in outdoor exercise tests in children. Care should be taken when interpreting negative outdoor exercise test results if AH of air is high. [ABSTRACT FROM AUTHOR]

BACKGROUND: The health-related quality of life (HRQOL) and cardiopulmonary exercise testing (CPET) performance of individuals with subclinical and early stage hypertrophic cardiomyopathy (HCM) have not been systematically studied. Improved understanding will inform the natural history of HCM and factors influencing well-being. METHODS: VANISH trial (Valsartan for Attenuating Disease Evolution in Early Sarcomeric HCM) participants with early stage sarcomeric HCM (primary analysis cohort) and subclinical HCM (sarcomere variant without left ventricular hypertrophy comprising the exploratory cohort) who completed baseline and year 2 HRQOL assessment via the pediatric quality of life inventory and CPET were studied. Metrics correlating with baseline HRQOL and CPET performance were identified. The impact of valsartan treatment on these measures was analyzed in the early stage cohort. RESULTS: Two hundred participants were included: 166 with early stage HCM (mean age, 23±10 years; 40% female; 97% White; and 92% New York Heart Association class I) and 34 subclinical sarcomere variant carriers (mean age, 16±5 years; 50% female; and 100% White). Baseline HRQOL was good in both cohorts, although slightly better in subclinical HCM (composite pediatric quality of life score 84.6±10.6 versus 90.2±9.8; P=0.005). Both cohorts demonstrated mildly reduced functional status (mean percent predicted peak oxygen uptake 73±16 versus 78±12 mL/kg per minute; P=0.18). Percent predicted peak oxygen uptake and peak oxygen pulse correlated with HRQOL. Valsartan improved physical HRQOL in early stage HCM (adjusted mean change in pediatric quality of life score +4.1 versus placebo; P=0.01) but did not significantly impact CPET performance. CONCLUSIONS: Functional capacity can be impaired in young, healthy people with early stage HCM, despite New York Heart Association class I status and good HRQOL. Peak oxygen uptake was similarly decreased in subclinical HCM despite normal left ventricular wall thickness and excellent HRQOL. Valsartan improved physical pediatric quality of life scores but did not significantly impact CPET performance. Further studies are needed for validation and to understand how to improve patient experience. [ABSTRACT FROM AUTHOR]

Background: Brachycephalic obstructive airway syndrome (BOAS), observed in many flat-faced dog breeds, is one of the most urgent welfare problems in pedigree dogs. Various breeding schemes against BOAS have been implemented in many countries during recent years, but their impact on breed health remains unknown. The BOAS breeding test, used by the Finnish Kennel Club (FKC), includes an exercise component with a recovery assessment, BOAS grading by a veterinarian that evaluates upper respiratory signs before and after exercise, and a nostril stenosis assessment. The aim of our study was to evaluate BOAS breeding test results and estimate the heritability of the BOAS grade using parent–offspring regression from FKC data collected during 2017–2022. Results: The majority (80%) of dogs (n = 957) participating in FKC BOAS testing were English Bulldogs, French Bulldogs, and Pugs. In 2022, 89–100% of the litters from these three breeds registered with the FKC had at least one parent tested for BOAS. The proportion of dogs failing the exercise test was highest in English Bulldogs (11%), followed by French Bulldogs (4%) and Pugs (3%). In these three breeds, moderate to severe BOAS signs were reported in 28%, 22% and 30% of dogs, respectively. The proportion of moderate to severe nostril stenosis was highest (71%) in Pugs, followed by French Bulldogs (55%), and English Bulldogs (40%). Estimates of heritability for BOAS grade were separately calculated for these three breeds and for all dogs, and the estimates were moderate to high, ranging from 0.39 to 0.58. Conclusions: The exercise test alone did not sufficiently identify dogs with moderate to severe BOAS signs. To better consider the complex nature of BOAS and breed differences, exercise tolerance, the severity of upper respiratory signs (BOAS grade) and nostril stenosis should all be assessed together in breeding animals. The heritability estimates for veterinary-assessed BOAS grade indicated that BOAS grade could be used in selective breeding to obtain less-affected offspring. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsTo evaluate cardiorespiratory fitness in patients with early to mid-stage Parkinson’s disease by cardiopulmonary exercise test (CPET) on a stationary cycle ergometer.To compare the differences in each index of the cardiopulmonary exercise test between the two groups of subjects; general data such as disease duration, medication use and exercise habits were also collected.(1) Finally, 36 Parkinson’s disease patients and 12 healthy controls successfully completed the cardiopulmonary exercise test without any adverse events. (2) The V’O2peak, Metspeak, RERpeak, MVVpeak, Wpeak, HRpeak, HRpeak/pre, percentage of HRR-1 min decay > 12 bpm, SBPpeak in the Parkinson’s disease group were lower than those in the control group (p < .05, each). Detailed data: V’O2peak (15.7 ± 4.5vs21.5 ± 3.6 ml/kg/min, p < .01), Metspeak (4.5 ± 1.3 vs 6.1 ± 1.0, p < .01), RERpeak (1.04 ± 0.10 vs 1.15 ± 0.10, p = .001), MVVpeak (37.22 ± 11.58 vs 53.00 ± 16.85L/min, p = .009), Wpeak (49.17 ± 29.72 vs 49.17 ± 29.72W, p < .01), HRpeak (111.08 ± 16.67 vs 111.08 ± 16.67bpm, p < .01), HRpeak/pre (71.19 ± 10.06 vs 96.00 ± 21.13, p = .002), percentage of HRR-1min decay > 12bpm (33.3% vs 100%, p < .01), systolic blood pressure (155.81 ± 31.83 vs 175.83 ± 17.84 mmHg, p = .01). (3) Divided Parkinson’s disease patients into high V’O2peak group (V’O2peak ≥ 15 mL/kg/min) and low V’O2peak group (V’O2peak < 15 mL/kg/min). The age of patients, Hoehn–Yahr grade and incidence of symptom fluctuation in high V’O2peak group were lower (p < .05, respectively), percentage of males and percentage of HRR-1 min decay > 12 bpm were higher (p < .05, respectively); p < .05 is considered a statistically significant difference. Detailed data: age of patients(61.05 ± 6.93 vs 68.57 ± 7.99 years, p = .005), Hoehn–Yahr grade(1.75 ± 0.48 vs 2.18 ± 0.64, p = .028), incidence of symptom fluctuation (59.1 vs 92.9%, p = .03), percentage of males (77.7 vs 42.9%, p = .041), percentage of HRR-1 min decay > 12 bpm (50 vs 7.1%, p = .008).Cardiopulmonary exercise test was safe to perform and the cardiorespiratory fitness is significantly reduced in patients with early and middle stage Parkinson’s disease. Patients with Parkinson’s disease presented blunted heart rate and systolic blood pressure responses to exercise test. Females, older age, fluctuating symptoms, high H-Y staging and higher activities of daily living may be associated with lower oxygen uptake. [ABSTRACT FROM AUTHOR]

Introduction: Left bundle branch block (LBBB) disrupts the electrical activation of the left ventricle, potentially impairing its systolic function, leading to LBBB-induced cardiomyopathy. This study examined cardiopulmonary exercise test (CPET) variables in patients with and without LBBB and assessed the longitudinal development of left ventricular ejection fraction (LVEF). Method: An observational, comparative clinical study was executed in two stages at a private hospital in Brazil. The sample consisted of 27 individuals: 11 with LBBB and 16 without LBBB, all with preserved LVEF (>50%) and without confirmed ischemia. CPET variables were assessed, and after 4 years, participants had a transthoracic echocardiogram for LVEF re-evaluation. Groups were compared using the t test or the χ2 test. Multivariate analysis of covariance determined effect magnitude. Results: Patients with LBBB demonstrated significant differences in CPET variables, particularly in predicted peak V ˙ O2, predicted peak PO2, V ˙ E/ V ˙ CO2 slope, and T ½ V ˙ O2. They also exhibited a more significant decline in LVEF over a 4-year span compared to the patients without LBBB. Although initial preservation of LVEF, changes in contractile patterns due to LBBB interfered with its systolic function, suggesting early ventricular dysfunction indicated by a reduction in LVEF and an increase in the V ˙ E/ V ˙ CO2 slope. Despite differences in cardiopulmonary function and changes in LVEF over time between patients with and without LBBB, the effect size was considered mild to moderate. Conclusions: LBBB patients with initially preserved LVEF displayed reduced exercise tolerance and a decrease in LVEF over time, emphasizing the need for vigilant monitoring and early intervention in these patients. [ABSTRACT FROM AUTHOR]

Exertional breathlessness is a cardinal symptom of cardiorespiratory disease. How does breathlessness abnormality, graded using normative reference equations during cardiopulmonary exercise testing (CPET), relate to self-reported and physiologic responses in people with chronic airflow limitation (CAL)? An analysis was done of people aged ≥ 40 years with CAL undergoing CPET in the Canadian Cohort Obstructive Lung Disease study. Breathlessness intensity ratings (Borg CR10 scale [0-10 category-ratio scale for breathlessness intensity rating]) were evaluated in relation to power output, rate of oxygen uptake, and minute ventilation at peak exercise, using normative reference equations as follows: (1) probability of breathlessness normality (probability of having an equal or greater Borg CR10 rating among healthy people; lower probability reflecting more severe breathlessness) and (2) presence of abnormal breathlessness (rating above the upper limit of normal). Associations with relevant participant-reported and physiologic outcomes were evaluated. We included 330 participants (44% women): mean ± SD age, 64 ± 10 years (range, 40–89 years); FEV 1 /FVC, 57.3% ± 8.2%; FEV 1 , 75.6% ± 17.9% predicted. Abnormally low exercise capacity (peak rate of oxygen uptake < lower limit of normal) was present in 26%. Relative to peak power output, rate of oxygen uptake, and minute ventilation, abnormally high breathlessness was present in 26%, 25%, and 18% of participants. For all equations, abnormally high exertional breathlessness was associated with worse lung function, exercise capacity, self-reported symptom burden, physical activity, and health-related quality of life; and greater physiologic abnormalities during CPET. Abnormal breathlessness graded using CPET normative reference equations was associated with worse clinical, physiological, and functional outcomes in people with CAL, supporting construct validity of abnormal exertional breathlessness. [ABSTRACT FROM AUTHOR]

Most studies that use the NIH Toolbox 2-Minute Walk Test with young children, modify the protocol, compromising the generalizability of outcomes. A standardizable protocol is needed. The purpose of this study was to compare the 2MWT performance of children ages 3–6 years on the standard NIH Toolbox protocol and on a modified protocol designed to support young children. Cross-over randomized controlled trial. Fifteen typically developing children ages 3–6 years were randomly assigned to the performance order of the NIH toolbox 2MWT protocol and the Modified Accessibility Path (MAP) 2MWT protocol. Outcome variables and statistical analyses included test completion (McNemar test), distance walked (Wilcoxon signed-rank test), and accuracy (general estimating equation model with Poisson distribution). All children completed 2 min of walking with the MAP protocol. Only 40% of children completed the NIH Toolbox protocol, with 83% of these NIH completers bolstered by previous exposure to the MAP protocol. Collapsed across the order, children also had significantly fewer errors per lap with the MAP protocol (p < 0.0001), despite walking a significantly greater distance (p = 0.006). These findings lend preliminary support for standardized application of a 2MWT with young children when the protocol is designed to be child-friendly. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nImplications for RehabilitationTo develop and assess the Bed Bridge Test’s (BBT) feasibility, safety, and clinimetric properties and evaluate functional capacity in hospitalised patients.This feasibility and measurement study examined four BBT versions, including the timed-limited at 30 and 60 s and repetition-limited at 5 and 10 times, in hospitalised patients in a university hospital in Brazil. Ninety-two functionally stable patients with respiratory, gastrointestinal, or post-surgical conditions participated. Participants completed the BBT versions in a random order. BBT concurrent criterion validity was evaluated using the Short Physical Performance Battery (SPPB), Sit-to-Stand (STS) test, and Functional Status Score (FSS).The participants were 51 ± 17 years old, 60% female, and 66% with clinical conditions. All participants completed the BBT versions without adverse events. Test–retest reliability was good–excellent (intraclass correlation coefficient >0.87) for all BBT versions, with acceptable agreement parameters and minimal detectable changes. The time-limited versions of the BBT might be affected by a ceiling effect. Floor effects were minimal for all BBT versions. BBT showed moderate associations with SPPB and STS and weak associations with FSS.The BBT is feasible and has promising measurement properties.The Bed Bridge Test (BBT) offers a valuable solution for healthcare professionals by addressing the limitations of existing functional tests, providing a straightforward assessment of functional capacity for both the patient and the assessor.The BBT has demonstrated excellent feasibility and safety, as all eligible participants completed its various versions without adverse events, indicating its potential utility across diverse patient populations.The BBT exhibits good to excellent reliability, indicating its reproducibility in clinical settings.The BBT has validated its effectiveness by exhibiting robust correlations with established functional tests such as the Short Physical Performance Battery (SPPB) and Sit-to-Stand (STS) test.The Bed Bridge Test (BBT) offers a valuable solution for healthcare professionals by addressing the limitations of existing functional tests, providing a straightforward assessment of functional capacity for both the patient and the assessor.The BBT has demonstrated excellent feasibility and safety, as all eligible participants completed its various versions without adverse events, indicating its potential utility across diverse patient populations.The BBT exhibits good to excellent reliability, indicating its reproducibility in clinical settings.The BBT has validated its effectiveness by exhibiting robust correlations with established functional tests such as the Short Physical Performance Battery (SPPB) and Sit-to-Stand (STS) test. [ABSTRACT FROM AUTHOR]

Objective: There is evidence that indicates that the Walked Distance (WD) in the 6-Minute Walk Test (6MWT) would be sensitive to the type of track and encouragement. The aim of study was compared the impact of track type and verbal encouragement provided in the 6MWT on WD, physiological cost, perceived exertion, and gait efficiency in healthy young adults unfamiliar with the test. Method: WD, heart rate, subjective sensation of dyspnea (SSD), and fatigue (SSF) were measured in four 6MWT protocols: i) 30 m linear track and protocolized encouragement (LT + PE), ii) 30mlinear track and constant encouragement (LT + CE), iii) 81m elliptical track and protocolized encouragement (ET + PE), and iv) 81m elliptical track and constant encouragement (ET + CE). In addition, the Gait Efficiency Index (GIE) associated with physiological cost, dyspnea and fatigue was calculated and compared between the different protocols. Results: TheWD was significantly higher in the ET + CE protocol. The percentage of the heart rate reserve used (%HRRu) at minute 6 was higher in the ET + CE protocol. The SSD and SSD had difference in startup time between the protocols. The GEI was higher in %HRRu, SSD, and SSF for the ET + CE protocol. Conclusion: The ET + CE protocol showed a significant increase inWDduring the 6MWT in healthy young adults. Although it obtained the highest physiological cost, it did not present perceptual differences when entering cardiopulmonary assessment windows relevant to a more efficient test for the participant. It is advisable to discuss, based on the findings, the fundamental objective of the 6MWT and national and international recommendations to achieve a result as close as possible to the real maximal effort. [ABSTRACT FROM AUTHOR]

Patients with idiopathic pulmonary fibrosis (IPF) often present with dyspnea, fatigue, and desaturation. These symptoms can be highly limiting, as they lead to a decrease in performing activities of daily living (ADL). Therefore, it is essential to evaluate the degree of functional limitation of these individuals. The present study aimed to evaluate the validity and reliability of the Glittre-ADL test (TGlittre) and its association with self-reported limitation in ADL and health-related quality of life (HRQoL) in patients with IPF. Twenty-seven individuals with IPF (60.5 ± 10.6 years), with forced vital capacity 2.26 ± 1.03 L (51.09 ± 20.62% of predicted) were assessed for the time spent in TGlittre, 6-minute walking distance (6MWD), limitation in ADL and HRQoL. TGlittre was reliable (intraclass correlation coefficient3,1 = 0.96; P <.001); however, a learning effect of 10.6% was observed between the first and second execution of TGlittre. The time spent in TGlittre correlated with 6MWD, limitation in ADL, and disease-specific HRQoL (P <.05). TGlittre is valid and reliable for assessing functional capacity in patients with IPF. Still, it presents a learning effect and should be performed twice when assessing functional capacity in clinical practice. [ABSTRACT FROM AUTHOR]

Cognitive responses are an important part of sports performance which may be affected by particular athletes' characteristics and exercise configuration. Here we investigated whether a single bout of high-intensity short-duration exercise performed by people with different chronotype characteristics differently affects cognitive responses in the acute phase post-exercise performed in the light and dark periods of the day. Twenty-six adult men visited the laboratory twice. One visit was in the morning between 7 am and 10 am, and the other in evening, between 6 pm and 9 pm, alterned and with 48 h apart. They performed cognitive tests before and after a high-intensity short-duration exercise including continuous jump landing exercise. During the exercise, we determine the jump height and power output. Individual responses to the morning-evening questionnaire estimated the individual chronotype. Data were compared between pre- and post-exercise and between the different times of the day. While both morning and evening individuals achieved better results in the evening, the evening chronotype positively correlated with performance in the evening. High-intensity short-duration exercise affects cognitive performance depending on daytime but not individual chronotype. We suggest that professionals in sports medicine could benefit from our results when designing protocols for performance assessment. [ABSTRACT FROM AUTHOR]

The use of cardiopulmonary exercise testing (CPET) in pediatrics provides critical insights into potential physiological causes of unexplained exercise-related complaints or symptoms, as well as specific pathophysiological patterns based on physiological responses or abnormalities. Furthermore, CPET helps evaluate exercise performance in children with chronic (lung/heart) diseases. For instance, it can ascertain any adverse reaction to exercise and estimate the effects of specific treatment measures. It affords a global assessment of the pathophysiological patterns, responses and abnormalities to exercise that is inadequately reflected by resting lung function and/or cardiac function assessment. Clinical interpretation of the results of a CPET in pediatrics requires specific knowledge regarding pathophysiological responses and interpretative strategies that can be adapted to address concerns specific to the child's medical condition or disability. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: Is direct measurement of peak oxygen uptake (VO2peak) a predictor of survival in octogenarians? Findings: The mortality rate was nearly three times higher in individuals with VO2peak below 80% of the predicted values. The data emphasize the prognostic value of VO2peak in older adults, comparable to its significance in younger individuals. Message: Oxygen uptake below 80% of age-specific reference values serves as a predictor of mortality in octogenarians. Purpose: Peak oxygen uptake (VO2peak) is a crucial health marker, extensively studied in adults for its prognostic value. However, its significance in the older persons, especially octogenarians, remains underexplored due to limited representation in research. This study aims to assess the predictive power of VO2peak for survival in individuals aged 80 and above. Methods: We included individuals aged 80 or older who underwent cardiopulmonary exercise tests at a single center. Mortality rates were compared based on VO2peak relative to 80% of predicted values (%VO2peak). We employed three multivariate Cox regression models: Model 1 (unadjusted), Model 2 (adjusted for age) and Model 3 (adjusted for age and stroke). Results: Among 188 participants (mean age 83.3 ± 3 years, 68.9% male), 22 (11.7%) passed away during a median follow-up of 494 days. Non-survivors tended to be older with lower VO2peak and %VO2peak. All models demonstrated associations between %VO2peak ≤ 80% and mortality: HR = 3.19 (95% CI: 1.30–7.86, p = 0.011) for M1; HR = 3.12 (95% CI: 1.26–7.74, p = 0.013) for M2 and HR = 2.80 (95% CI: 1.11–7.06, p = 0.028) for M3. Conclusion: In the context of an aging population, this study underscores the enduring significance of VO2peak as a survival predictor among the older person, including octogenarians. These findings carry profound implications for tailoring healthcare strategies to address the evolving demographic landscape. [ABSTRACT FROM AUTHOR]

Importance: 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). Objective: This study aimed to assess the feasibility and reproducibility of performing the 3‐min step test with remote supervision. Methods: 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. Results: 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%). Interpretation: Physiological responses between tests were similar, indicating it was feasible to perform the 3‐min step test with remote supervision in CF children. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

IntroductionSeveral studies report that pulmonary oxygen uptake (V̇O 2 ) at the respiratory compensation point (RCP) is equivalent to the V̇O 2 at critical power (CP), suggesting that the variables can be used interchangeably to demarcate the threshold between heavy and severe intensity domains. However, if RCP is a valid surrogate for CP, their values should correspond even when assessed in patients with chronic obstructive pulmonary disease (COPD) in whom the "normal" mechanisms linking CP and RCP are impeded. The aim of this study was to compare V̇O 2 at CP with V̇O 2 at RCP in patients with COPD.MethodsTwenty-two COPD patients (14 male/8 female; forced expiratory volume in 1 s, 46% ± 17% pred) performed ramp-incremental cycle ergometry to intolerance (5-10 W·min -1 ) for the determination of gas exchange threshold (GET) and RCP. CP was calculated from the asymptote of the hyperbolic power-duration relationship from 3-5 constant-power exercise tests to intolerance. CP was validated with a 20-min constant-power ride.ResultsGET was identified in 20 of 22 patients at a V̇O 2 of 0.93 ± 0.18 L·min -1 (75% ± 13% V̇O 2peak ), whereas RCP was identified in just 3 of 22 patients at a V̇O 2 of 1.40 ± 0.39 L·min -1 (85% ± 2% V̇O 2peak ). All patients completed constant-power trials with no difference in peak physiological responses relative to ramp-incremental exercise ( P > 0.05). CP was 46 ± 22 W, which elicited a V̇O 2 of 1.04 ± 0.29 L·min -1 (90% ± 9% V̇O 2peak ) during the validation ride. The difference in V̇O 2 at 15 and 20 min of the validation ride was 0.00 ± 0.04 L, which was not different from a hypothesized mean of 0 ( P = 0.856), thereby indicating a V̇O 2 steady state.ConclusionsIn COPD patients, who present with cardiopulmonary and/or respiratory-mechanical dysfunction, CP can be determined in the absence of RCP. Accordingly, CP and RCP are not equivalent in this group.

Background Age-related changes in body composition affect physical fitness in older adults. However, whether the autonomic response is associated with body fat percentage and its implication for physical fitness is not fully understood. Aim To understand the association between physical fitness, body composition, and heart rate variability in older people and its mediating factors. Methods A cross-sectional study with 81 older adults was conducted, assessing Short Physical Performance Battery (SPPB), Two-minute Step Test (TMST), body composition, and cardiac autonomic response. Correlation and mediation analyses were performed. Results Body fat percentage negatively correlated with physical fitness (SPPB: r = − 0.273, p = 0.015; TMST: r = − 0.279, p = 0.013) and sympathetic activity (sympathetic nervous system (SNS) index: r = − 0.252, p = 0.030), yet positively correlated with parasympathetic tone (root mean square of successive differences (RMSSD): r = 0.253, p = 0.029; standard deviation of NN intervals (SDNN): r = 0.269, p = 0.020). Physical fitness associated with sympathetic nervous system index (SPPB: r = 0.313, p = 0.006; TMST: r = 0.265, p = 0.022) and parasympathetic nervous system index (TMST: r = − 0.344, p = 0.003). Muscle mass mediated body fat’s impact on physical fitness, while physical fitness mediated body fat’s impact on autonomic response. Conclusion Body composition and cardiac autonomic response to exercise are associated with physical fitness in older people, highlighting a possible protective effect of muscle mass against the decline in physical fitness associated with increased body fat.

Abstract Background Pathological changes were observed in the diaphragm due to abnormal renal function in chronic kidney disease (CKD). Inspiratory muscle training (IMT) has been suggested for patients with CKD; however, the most appropriate intensity for IMT has not been determined. Therefore, this study aimed to investigate the effects of different IMT protocols on respiratory muscle strength, quadriceps femoris muscle strength (QMS), handgrip muscle strength (HGS), functional exercise capacity, quality of life (QoL), pulmonary function, dyspnoea, fatigue, balance, and physical activity (PA) levels in patients with CKD. Methods This randomized, controlled, single-blind study included 47 patients and they were divided into three groups: Group 1 (n = 15, IMT with 10% maximal inspiratory pressure (MIP)), Group 2 (n = 16, IMT with 30% MIP), and Group 3(n = 16; IMT with 60% MIP). MIP, maximal expiratory pressure (MEP), 6-min walking test (6-MWT), QMS, HGS, QoL, pulmonary function, dyspnoea, fatigue, balance, and PA levels were assessed before and after eight weeks of IMT. Results Increases in MIP, %MIP, 6-MWT distance, and %6-MWT were significantly higher in Groups 2 and 3 than in Group 1 after IMT (p

Objective: Adapt functional mobility and muscle strength tests for older people with dementia to be performed remotely in the home environment; determine intra-rater and inter-rater reliability of functional mobility and strength tests for older people with dementia; and correlate the performance on the physical tests executed remotely and the Timed Up and Go (TUG) test, which was validated remotely in healthy older people. Methods: We included 43 people with dementia. The Short Physical Performance Battery (SPPB), TUG, TUG Dual Task (TUG-DT), and 30-Second Sit-to-Stand Test (SST30s) were performed through videocalls. Test performance was documented to facilitate the subsequent determination of inter- and intra-rater reliability. The intra-rater reliability was determined at a 2-week interval from the real-time videocall to analysis of the recording. Results: Intra-rater reliability ranged from good to excellent for all tests performed (ICC 0.862–1.000). Inter-rater reliability values were fair for gait speed (ICC = 0.223), moderate for some of the SPPB items (ICC = 0.706–0.801), good for the SPPB two-foot balance (ICC = 0.860) and the SPPB total score (ICC = 0.831), and excellent for the rest of the tests. Conclusion: Functional mobility and muscle strength tests proved reliable and feasible for remote, at-home assessments of older people with dementia when assisted by their respective caregivers, providing an additional alternative for assessment of this patient population.

Context: Cardiogoniometry (CGM) is a noninvasive technique for quantitative three-dimensional vectorial analysis of myocardial depolarization and repolarization. We describe a method of surface electrophysiological cardiac assessment using CGM performed at rest to detect variables helpful in identifying coronary artery disease (CAD) and interplaying factors in patients who underwent coronary artery bypass graft (CABG). Materials and Methods: In this study, all patients with CAD undergoing CABG were enrolled. Echocardiography, CGM, and electrocardiography (ECG) were obtained before surgery and a month later. The ECG and CGM alterations were compared before and after CABG and the accuracy of those two methods was evaluated. Results: In this study, 50 patients were enrolled, of which 33 (66%) were male versus 17 (44%) female, with a mean age of 39.12 ± 60 years. The mean ejection fraction before and after surgery was 44.3 ± 7.9% (range: 20–55) and 40.9 ± 12.5% (20–50), respectively. Before surgery, all patients had sinus rhythm, five cases had left bundle-branch block (LBBB), and one case was with right bundle-branch block (RBBB). Subsequently, after surgery, five cases had LBBB, and two cases were found to have RBBB. The rate of postoperation bleeding was 20%. There was no significant change in echocardiographic characteristics before and after operation (P = 0.81); likewise, no significant change was seen in ECG criteria before and after operation (P = 0.96). A significant correlation was seen regarding CGM characteristics before and after CABG (P = 0.003). Conclusions: A significant association was seen regarding CGM characteristics before and after undergoing an operation. In addition, the specificity and sensitivity of the CGM and ECG before and after operation improved well.

Introduction. Although Chagas disease causes high levels of morbidity, the muscle function and tolerance to physical activity in Chagas disease patients are still not completely understood. Objective. To compare health-related fitness of patient groups with acute Chagas disease versus chronic Chagas disease. Materials and methods. We conducted a cross-sectional study involving 18 patients. The data were obtained from patient´s records, and functional capacity was measured with the sixminute walk test, the peripheral muscle strength with handgrip strength, and respiratory muscle strength using the maximum inspiratory pressure and the maximum expiratory pressure. Results. The 18 patients were divided in two groups: acute Chagas disease (n=9) and chronic Chagas disease (n=9). The distance walked in the six-minute walk test was lower than the predicted distance walked in both groups (p < 0.0001). The maximum expiratory pressure was lower than the predicted one (p = 0.005), and statistically significant for chronic Chagas disease patients (p = 0.02). Heart rate increased faster in the chronic Chagas disease group within the first two minutes of the six-minute walk test (p = 0.04). The sixminute walk test in the acute Chagas disease group presented a strong correlation with peripheral muscle strength (p = 0.012) and maximum inspiratory pressure (p = 0.0142), while in the chronic Chagas disease group, only peripheral muscle strength and maximum inspiratory pressure were correlated (p = 0.0259). Conclusion. The results suggest lowered functional capacity and reduced respiratory and peripheral muscle strength in patients with Chagas disease, although no differences were observed between groups. The early increase in heart rate during exercise in the chronic Chagas disease group implies a greater myocardial overload.

Introduction Injury rates in competitive alpine skiing are high. With current methods, identifying people at risk is expensive and thus often not feasible at the youth level. The aims of this study were (1) to describe the jump performance and movement quality of youth competitive alpine skiers according to age and sex, (2) to compare the jump distance among skiers of different sexes and movement quality grades, and (3) to assess the inter-rater grading reliability of the qualitative visual movement quality classification of such jumps and the agreement between live and video-based post-exercise grading.Materials and Methods This cross-sectional study is based on an anonymized dataset of 301 7- to 15-year-old competitive alpine skiers. The skiers performed two-legged forward triple jumps, whereby the jump distance was measured, and grades were assigned by experienced raters from the frontal and sagittal perspectives depending on the execution quality of the jumps. Furthermore, jumps were filmed and ultimately rated post-exercise. Differences in jump distance between various groups were assessed by multivariate analyses of variance (MANOVAs). Reliability was determined using Kendall’s coefficient of concordance.Results The jump distance was significantly greater in U16 skiers than in U11 skiers of both sexes and in skiers with good execution quality than in those with reduced or poor execution quality. Overall, jump distance in U16 skiers significantly differed between female (5.37 m with 95% CI [5.21, 5.53]) and male skiers (5.90 m with 95%CI [5.69, 6.10]). Slightly better inter-rater grading reliability was observed for video-based post-exercise (strong agreement) ratings than for live ratings (moderate agreement).Conclusion In competitive alpine skiers aged 7 to 15 years, jump performance increases with age, and around puberty, sex differences start to manifest. Our results highlight the importance of evaluating both jump distance and movement quality in youth skiers. To improve test-retest reliability, however, a video-based post-exercise evaluation is recommended.