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Duchenne muscular dystrophy (DMD) results in a progressive loss of functional skeletal muscle mass (MM) and replacement with fibrofatty tissue. Accurate evaluation of MM in DMD patients has not previously been available. Our objective was to measure MM using the D3creatine (D3Cr) dilution method and determine its relationship with strength and functional capacity in patients with DMD over a wide range of ages. Subjects were recruited for participation in a 12 month, longitudinal, observational study. Here, we report the baseline data. A 20 mg dose of D3Cr dissolved in water was ingested by 92 patients with DMD (ages 4-25 years) followed later with a fasting urine sample. Enrichment of D3creatinine was determined by liquid chromatography-mass spectrometry analysis. The North Star Ambulatory Assessment (NSAA) total score was determined for ambulatory participants, and the Performance of Upper Limb (PUL 2.0) total score and grip strength for all participants. We observed a significant age-associated increase in body weight along with a substantial decrease in MM/body weight (%MM). MM and %MM were associated with PUL score (r = 0.517, P

• Upper extremity functional capacity is decreased in patients with HF. • HF patients required more time to perform their ADL compared with healthy controls with similar physical and demographic characteristics. • Exercise capacity and peripheral muscle strength are decreased in patients with HF. • Post-test dyspnea was observed to be higher in patients following the 6PBRT and Londrina ADL protocols. Considering the limitations in activities of daily living (ADL) and the impact of improvements in patients with heart failure (HF), appropriate assessment of upper extremity functional capacity and ADL is important. To evaluate upper extremity functional capacity and ADL in patients with HF and compare them with healthy controls. This study included 30 HF patients and healthy controls. Upper extremity functional capacity was assessed with the 6-Minute Pegboard Ring Test (6PBRT), ADL by the Londrina protocol, exercise capacity by 6-Minute Walk Test (6MWT), peripheral muscle strength by hand dynamometer, and dyspnea by Modified Medical Research Council Scale (MMRC). For performance tests, pre-test (resting) and post-test (after performance) values ​​were also measured. Patients with HF with ejection fraction ≤50 % and controls were similar in terms of age (52.63±6.2 and 50.03±6.5 years, respectively) and gender (25 females for each group) (p > 0.05). Patients showed a statistically significant increase in total test time in the Londrina protocol and fewer rings moved in 6PBRT (p < 0.0001). The post-test dyspnea (p = 0.03) and pre-test arm fatigue (p < 0.0001) were observed to be higher in patients in the Londrina protocol. There was a statistically significant group by time interaction in the patients' pre- and post-test lower heart rate (F = 4.80, p = 0.03), post-test dyspnea (p < 0.0001), and post-test arm fatigue (p = 0.005) were observed to be higher in patients in 6PBRT. The evidence showed a decrease in upper extremity functional capacity in patients with HF. Patients required more time to perform their ADLs compared with healthy controls. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThe study aimed to assess frailty in adults with congenital heart disease (ACHD) and to compare muscle strength, functional capacity, activities of daily living (ADL), and cognition between frail and non-frail ACHD patients.A cross-sectional study design was used. Sixty people with ACHD aged between 18 and 45 years were included. Frailty was determined according to the Fried criteria. Peripheral muscle strength was assessed with a digital dynamometer, functional capacity with the 6-min walk test (6MWT), ADL with the Glittre ADL test, and cognition with the Montreal Cognitive Assessment (MoCA) test.Frailty was seen in 38.33% (frail = 23 and non-frail = 37) of the participants. In the frail patients, dominant knee extensor strength (p = 0.002), shoulder abductor strength (p = 0.005), 6MWT distance (p = 0.021), and MoCA score (p = 0.005) were significantly lower than those in the non-frail patients. Glittre ADL test (p = 0.002) was significantly higher in the frail patients.Muscle strength, functional capacity, ADL, functional mobility, and cognition were lower in the frail participants with ACHD. Early assessment of frailty in ACHD and planning individualized exercise training programs for frail individuals may be a strategy to reduce the impact of frailty on adverse clinical outcomes.We found that muscle strength, functional capacity, ADL, functional mobility, physical activity, and cognition were lower in the frail ACHD patients than in the non-frail ones.Early assessment of frailty in individuals with ACHD is important for determining health status.Planning individualized exercise training programs for individuals with ACHD may be a strategy to reduce the impact of frailty on adverse clinical outcomes.We found that muscle strength, functional capacity, ADL, functional mobility, physical activity, and cognition were lower in the frail ACHD patients than in the non-frail ones.Early assessment of frailty in individuals with ACHD is important for determining health status.Planning individualized exercise training programs for individuals with ACHD may be a strategy to reduce the impact of frailty on adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

Background Exercise referral schemes (ERS) are an effective strategy for increasing physical activity (PA) in older adults. Behavioural self-management strategies (SMS) may augment the maintenance of PA and associated benefits in this population, resulting in preservation of the functional capacity and prevention of disability over the long-term. Aim The primary aim was to investigate the long-term (22-months) effects of ERS enhanced with SMS on functional capacity assessed by the Short Physical Performance Battery (SPPB) compared to ERS (primary comparison) and a control condition (CTRL). Secondarily, between-group effects after 4 and 16 months on the SPPB and self-reported disability outcomes were investigated. Methods 1360 physically inactive community-dwelling older adults ≥65 years from four European countries were randomized into (i) 16 weeks ERS enhanced with SMS (ERS-SMS), (ii) ERS alone and (iii) CTRL. In addition to SPPB, self-reported function and disability were assessed by the short-form late life function and disability index and with a six-item activity of daily living questionnaire. Results No long-term effects were found for the SPPB-score in ERS-SMS vs ERS (0.21 point, 95% CI [−0.04, 0.46]). Significant group × time effects were observed for the SPPB-score after 4 months in favour of ERS-SMS over CTRL (0.51 point, 95% CI [0.29, 0.73]) and ERS (0.46 point, 95% CI [0.24, 0.68]). Conclusion The study did demonstrate differences, in favour of ERS + SMS, but on SPPB these were small, and not sustained over time. The additional effect of SMS was inconsistent and uncertain. [ABSTRACT FROM AUTHOR]

Duchenne muscular dystrophy (DMD) results in a progressive loss of functional skeletal muscle mass (MM) and replacement with fibrofatty tissue. Accurate evaluation of MM in DMD patients has not previously been available. Our objective was to measure MM using the D3creatine (D3Cr) dilution method and determine its relationship with strength and functional capacity in patients with DMD over a wide range of ages. Subjects were recruited for participation in a 12 month, longitudinal, observational study. Here, we report the baseline data. A 20 mg dose of D3Cr dissolved in water was ingested by 92 patients with DMD (ages 4–25 years) followed later with a fasting urine sample. Enrichment of D3creatinine was determined by liquid chromatography‐mass spectrometry analysis. The North Star Ambulatory Assessment (NSAA) total score was determined for ambulatory participants, and the Performance of Upper Limb (PUL 2.0) total score and grip strength for all participants. We observed a significant age‐associated increase in body weight along with a substantial decrease in MM/body weight (%MM). MM and %MM were associated with PUL score (r = 0.517, P < 0.0001 and r = 0.764, P < 0.0001 respectively). The age‐associated decrease in MM and %MM was strongly associated with ambulatory status. We observed very little overlap in %MM between ambulant and non‐ambulant subjects, suggesting a threshold of 18–22% associated with loss of ambulation. MM is substantially diminished with advancing age and is highly related to clinically meaningful functional status. The D3Cr dilution method may provide a biomarker of disease progression and therapeutic efficacy in patients with DMD or other neuromuscular disorders. Key points: The non‐invasive D3creatine dilution method provides novel data on whole body functional muscle mass (MM) in a wide range of ages in patients with DMD and reveals profoundly low functional MM in older non‐ambulant patients.The difference in %MM between ambulant and non‐ambulant subjects suggests a threshold for loss of ambulatory ability between 18 and 22% MM.The data suggest that as functional MM declines with age, maintaining a lower body weight may help to conserve ambulatory ability. [ABSTRACT FROM AUTHOR]

Introduction: Access to interstitial lung disease programs may not be available in rural settings. Home-based pulmonary rehabilitation (PR) programs have been proposed as an alternative to hospital-based programs. Method: Forty participants with ILD underwent a structured unsupervised home-based pulmonary rehabilitation program from September 2020 to September 2022. Quality of life was assessed using St. George Respiratory Questionnaire (SGRQ) and functional capacity using 6-minute walk test (6MWT). The outcome measures were assessed at baseline and 4 weeks post-unsupervised home-based PR program. Result: We recruited 40 participants with ILD. There was statistically significant improvement in the 6-minute walk distance (353.8 m and 368 m, effect size – 0.5, p ≤.001) and quality of life using SGRQ total score (38.6 and 42.35, effect size – 2.5, p ≤.001) between before and after receiving home-based PR among all 40 participants with ILD. Conclusion: Four weeks of home-based PR program, using minimal resources, deliver short-term improvements in functional exercise capacity and quality of life among ILD participants. Our home-based PR program resulted in a quarter percentage improvement in functional capacity, and we believe that if consistency is maintained, it will result in similar changes corresponding to the already established Minimal Clinically Important Difference (MCID) of 35 m. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMaterial and MethodsResultsConclusionsOur aim was to explore the predictive value of Return-to-Work-Readiness Questionnaire (RTW-RQ) among patients with mental disability.The cohort consists of 129 patients undergoing psychiatric assessment for work ability. RTW-RQ was used to assess self-perceived functional capacity concerning return-to-work. The questionnaire comprises an equal appearing interval scale (0–10) and qualitative questions related to facilitating and hindering factors towards return-to-work. Work status was measured at one-year.At one-year follow-up, 31 patients (24%) had returned to competitive employment (CE) and 81 (63%) were considered able to work. The mean score for RTW-RQ was 4.8 (SD 3.9) for patients having returned to CE, and 1.9 (2.7) for those having not returned. Medium and high RTW-RQ scores predicted return to CE compared to those with a low score (scores 2–4: OR 3.1, 95% 0.8–12.4; scores 5–10: OR 52.8, 95% 6.0–461.7). Health and work-related facilitating factors were positively associated with RTW-RQ and seemed to predict return to CE (OR 2.4, 95% CI 0.6–9.4, and OR 2.2, 95% CI 0.6–9.0, respectively). On the other hand, health-related hindering factors were negatively associated with RTW-RQ and seemed to predict return to CE (OR 0.6, 95% CI 0.1–3.3). Results were similar regarding work ability.RTW-RQ seem to predict return to competitive employment and work ability within one year among patients with mental disability. It also seems crucial to recognize facilitating and hindering factors in order to succeed in rehabilitation. [ABSTRACT FROM AUTHOR]

Abstract: The sit-to-stand test provides insight into age-related functional capacity; however, there are various variants of sit-to-stand, and we do not know which of these better discriminates against age-related functional capacity. Our study aimed to compare the age-related functional capacity in older people by evaluating sit-to-stand power variants, using young individuals as a reference. A cross-sectional study was conducted in 102 adults (57 women) aged 60–80 and 105 adults (54 women) aged 20–30. Participants performed five times sit-to-stand (5 sit-to-stand), 30-second sit-to-stand, and 1-min sit-to-stand. Z scores were obtained for each sit-to-stand variant using power (W), relative (W/kg), and allometric (W/m2 ) normalization methods. A mixed repeated-measures analysis of variance assessed the interactions among the sit-to-stand variants, normalization methods, sex, physical activity, and tobacco history. A significant interaction between sit-to-stand variants, normalization methods, and sex (P = 0.002) was found. The mean effect of sit-to-stand variants revealed that the 1-min sit-to-stand had the lowest Z score (P < 0.05). Significant variations were observed between sit-to-stand variants in all normalization methods for women (P < 0.001). However, in men, only the difference between 5 sit-to stand and 1-min sit-to-stand remained consistent across normalization methods (P < 0.05). Our findings highlight the efficacy of 1-min sit to-stand in distinguishing age-related functional capacity over the other sit-to-stand tests, especially in women. [ABSTRACT FROM AUTHOR]

Background/Objectives: The adverse effects of cancer and the long-term sequelae of associated treatments result in reduced quality of life and increased mortality for patients. Supporting patients with cancer to mitigate adverse outcomes is an important aspect of oncology care and the primary purpose of cancer rehabilitation. A retrospective service evaluation was conducted to evaluate the effectiveness of the core iCan patient-centred cancer rehabilitation service. Methods: At the beginning and end of a five-week programme, a series of questionnaires evaluating changes in mental health and wellbeing, and physical activity performance/attitudes, and functional capacity were administered to participants. Results: Following iCan, we found that functional capacity was improved (30 s sit-to-stand: +6.3 repetition; d = −1.00, p < 0.001) and that self-reported physical activity was increased (~1173 MET-mins/wk; d = −0.76, p < 0.001); participants also perceived greater capability, opportunity, and motivation to be active. Mental wellbeing was also improved (SWEMWBS: d = −0.69, p < 0.001), whilst fatigue was reduced (FACIT: d = −0.77, p < 0.001). Conclusion: It appears that iCan has beneficial effects upon the physical/functional and psychological health of its participants. Where data are available, there appear to be clinically significant improvements across the range of measured functional, wellbeing, and activity/sedentariness outcomes, which suggest that participation in iCan is instrumental in adding value to the health and wellbeing of patients. [ABSTRACT FROM AUTHOR]

Background: 2′-Fucosyllactose (2′-FL) is an oligosaccharide contained in human milk and possesses prebiotic and anti-inflammatory effects, which may alleviate skeletal muscle atrophy under caloric restriction. This study evaluated the impacts of 12 weeks of 2′-FL supplementation in conjunction with exercise (10,000 steps/day, 5 days/week) and energy-reduced (−300 kcals/day) dietary interventions on changes in body composition and health-related biomarkers. Methods: A total of 41 overweight and sedentary female and male participants (38.0 ± 13 years, 90.1 ± 15 kg, 31.6 ± 6.6 kg/m2, 36.9 ± 7% fat) took part in a randomized, double-blind, and placebo-controlled study. The participants underwent baseline assessments and were then assigned to ingest 3 g/day of a placebo (PLA) or Momstamin 2′-F while initiating the exercise and weight-loss program. Follow-up tests were performed after 6 and 12 weeks. Data were analyzed using general linear model statistics with repeated measures and mean changes from baseline values with 95% confidence intervals (CIs). Results: No group × time × sex interaction effects were observed, so group × time effects are reported. Participants in both groups saw comparable reductions in weight. However, those with 2′-FL demonstrated a significantly greater reduction in the percentage of body fat and less loss of the fat-free mass. Additionally, there was evidence that 2′-FL supplementation promoted more favorable changes in resting fat oxidation, peak aerobic capacity, IL-4, and platelet aggregation, with some minimal effects on the fermentation of short-chain fatty acids and monosaccharides in fecal samples. Moreover, participants' perceptions regarding some aspects of the functional capacity and ratings of the quality of life were improved, and the supplementation protocol was well tolerated, although a small, but significant, decrease in BMC was observed. Conclusions: The results support contentions that dietary supplementation of 2′-FL (3 g/d) can promote fat loss and improve exercise- and diet-related markers of health and fitness in overweight sedentary individuals initiating an exercise and weight-loss program. Further research is needed to explore the potential health benefits of 2′-FL supplementation in both healthy and elderly individuals (Registered clinical trial #NCT06547801). [ABSTRACT FROM AUTHOR]

Background: Intensive care unit (ICU) protein benchmarks are based on mortality and morbidity; whether these targets also support functional recovery is unknown. We assessed whether different protein doses influenced patients' functional capacity, measured by the Chelsea Physical Assessment score (CPAx). Methods: Single‐center retrospective cohort study on ICU survivors with length of stay ≥7 days admitted between October 2014 and September 2020. Eligible patients were divided according to protein intake (g/kg/day): low (<0.8), medium (0.8–1.19), high (1.2–1.5), and very high (>1.5). Protein dose effect on CPAx was assessed at ICU discharge with analysis of covariance adjusting for age, illness severity, hospital length of stay before ICU admission, time to start nutrition support, and mechanical ventilation duration. We also investigated effect modification by energy intake and nutrition status. Results: Enrolled patients (n = 531) were similar for age, nutrition status, and illness severity across groups. CPAxs were nonlinearly associated with protein doses and similar among low, medium, and very high groups. The CPAx for the high group was statistically different (P = 0.014), indicating that the data of three groups could be pooled. Mean CPAx difference remained statistically significant after adjusting for confounding variables (3.9 ± 1.8, P = 0.029 in the four‐group model, and 2.7 ± 0.9, P = 0.003 in the pooled two‐group model). Energy intake was equivalent between groups and did not modify CPAx. The high group had superior CPAx in both well‐nourished and malnourished patients, indicating nutrition status was not an effect modifier. Conclusion: Protein dose 1.2–1.5 g/kg/day was associated with superior functional capacity at ICU discharge compared with other doses. Neither energy intake nor nutrition status modified functional capacity across groups; therefore, the results appear to be influenced by 1.2–1.5 g/kg/day. [ABSTRACT FROM AUTHOR]

The six‐minute walking test (6MWT) is commonly used to measure functional capacity in field settings, primarily through the distance covered. This study aims to establish reference curves for the six‐minute walking distance (6MWD) and peak heart rate (PHR) and develop a predictive equation for cardiovascular capacity in Tunisian children and adolescents. A total of 1501 participants (706 boys and 795 girls), aged 10–18 years, were recruited from schools in Tunisia. The Lambda (L), Mu (M), and Sigma (S) methods (LMS method) were employed to develop smoothed percentile curves for 6MWD and PHR. Multivariate linear regression was utilized to formulate a prediction equation for 6MWD. Smoothed percentiles (3rd, 10th, 25th, 50th, 75th, 90th, and 97th) for 6MWD and PHR were presented with age. All variables showed a strong positive correlation (p < 0.001) with a six‐minute walking distance (r ranged from 0.227 to 0.558 for girls and from 0.309 to 0.610 for boys), except resting heart rate, which showed a strong negative correlation (girls: r = −0.136; boys: r = −0.201; p < 0.001). Additionally, PHR showed a weak correlation (p > 0.05). The prediction equations, based on age as the primary variable, were established for both genders. For boys: 6MWD = 66.181 + 38.142 × Age (years) (R2 = 0.372; Standard Error of Estimate (SEE) = 122.13), and for girls: 6MWD = 105.535 + 28.390 × Age (years) (R2 = 0.312; SEE = 103.66). The study provides normative values and predictive equations for 6MWD and PHR in Tunisian children and adolescents. These findings offer essential tools for identifying, monitoring, and interpreting cardiovascular functional deficits in clinical and research settings. Highlights: Established reference curves for six‐minute walking distance (6MWD) and peak heart rate (PHR) from the data of 1501 children and adolescents aged 10–18 years were recruited from multicenter schools in Tunisia.Developed predictive equations for 6MWD based on age using multivariate linear regression.Provides normative values and predictive equations for 6MWD and PHR, offering valuable tools for identifying and monitoring cardiovascular functional deficits in clinical and research settings. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a neurological disorder commonly associated with motor deficits. However, cognitive impairment is also common in patients with PD. Cognitive concerns in PD may affect multiple domains of neurocognition and vary across different stages of the disease. Extant research has focused mainly on cognitive deficits in middle to late stages of PD, whereas few studies have examined the unique cognitive profiles of patients with early-stage PD. This study addressed this gap in the published literature and examined neurocognitive functioning and functional capacity of patients with de novo PD, focusing on the unique pattern of cognitive deficits specific to the early stage of the disease. Results indicated that the pattern of cognitive deficits in patients with PD (n = 55; mean age = 72.93) was significantly different from healthy controls (n = 59; mean age = 71.88). Specifically, tasks related to executive functioning, attention, and verbal memory demonstrated the most pronounced deficits in patients with early-stage PD. Clinical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Introduction The U.S. Military Veterans aged 65 and older comprise an estimated 43% of the 22 million living Veterans in the United States. Veterans have high rates of physical, psychiatric, and social challenges, but it is not known whether Veteran status confers additional risk for cognitive or functional impairments in later life. Thus, this investigation specifically compared older Veterans with their non-Veteran peers in cognitive functioning and performance-based functional capacity. Materials and Methods Participants (N  = 110; 29 Veterans and 81 non-Veterans) were part of a larger longitudinal study on biopsychosocial functioning in independently living older adult residents of a Continuing Care Senior Housing Community. The University of California San Diego Institutional Review Board approved the study and all participants provided written informed consent. Participants provided demographic and mental health information and were administered a comprehensive neuropsychological battery. Functional capacity was assessed using the UCSD Performance-Based Skills Assessment-Brief (UPSA-B), which uses financial and communication role-plays to assess everyday functioning skills. Neuropsychological scores were appropriately normed prior to analysis. Multivariate Analyses of Variances with post hoc t -tests and an Analysis of Covariance were used to examine neuropsychological and functional capacity differences, respectively, between Veterans and non-Veterans. Results Veterans did not differ from non-Veterans in educational attainment (16.4 years versus 15.5 years, P  = 0.110), but they were significantly older (mean age 86.9 years ± 5.7, versus 81.74 years ± 6.53; P  < 0.001) and were more likely to be male (X 2 [1, N  = 110] = 62.39, P  < 0.001). Thus, though neuropsychological norms already accounted for demographic differences in our participants, age and sex were controlled in the Analysis of Covariance predicting UPSA-B score from Veteran status. Results suggested that, compared to non-Veterans, Veterans had significantly worse performance in the list learning portion of a test of verbal memory (Hopkins Verbal Learning Test-Revised, Total Recall; t = 2.56, P  = 0.012, d  = 0.56). Veterans and non-Veterans did not significantly differ in performance on the delayed recall portion of the verbal learning test and did not differ on a cognitive screening test (Montreal Cognitive Assessment) or on measures of premorbid intellectual functioning (Wide Range Achievement Test-4 Reading), language (Boston Naming Test, Verbal Fluency), visual memory (Brief Visuospatial Memory Test-Revised), attention/working memory (WAIS-IV Digit Span), processing speed (WAIS-IV Digit Symbol Coding), executive function (Delis-Kaplan Executive Function System Trails and Color-Word Test), or functional capacity (UPSA-B). Because our examination of multiple outcomes might have inflated Type I error, we performed a post hoc adjustment of P values using Benjamini-Hochberg procedures and the group difference in verbal learning remained significant. Conclusions Despite largely similar function in most domains, Veterans performed significantly more poorly in verbal list learning than their non-Veteran peers. Additional attention should be given to the understanding, assessment, and possible treatment of learning and memory differences in older Veterans, as this may be an area in which Veteran status confers additional risk or vulnerability to decline. This is the first study to compare objective neuropsychological and functional performance between older (age 65+) US Veterans and non-Veterans. [ABSTRACT FROM AUTHOR]

Objective: To establish the effect of high-intensity and progressive volume resistance training (HIRT), on general health, functional, mental status, and quality of life (QOL) indicators in people with spinal cord injury (SCI). Methods: The sample consisted of five people with SCI of both sexes, aged 46.2 ± 13.9 years, submitted to 12 weeks of HIRT, twice a week. We analyzed before and after the 12 weeks of intervention: body composition, muscle strength, functional status, perception of mental status, and QOL, using the following tests: dual-energy X-ray densitometry, 1RM, isometry of biceps, elbow flexion, Wingate, zigzag, medicine ball pitch, Beck inventory (anxiety, depression, and mental disorder) and SF-36. Results: The results pointed to an increase in the training load, the total bone mineral content (p = 0.043), the muscle power at 80% of 1RM (p = 0.043), the functional state (anaerobic power [MD = 6.81%; p = 0.043] and explosive strength [mean difference (MD) = 30.57%; p = 0.043] of the shoulder girdle muscles), the mental state (MD = 71.46%; p = 0.006) and finally, improvement in QOL, especially in the functional (MD = 60.87%; p = 0.006) and social aspects (MD = 44.44%; p = 0.006). Conclusions: HIRT can improve or maintain body composition, developing muscle power, anaerobic power, and explosive strength of the upper limbs that will impact functional capacity, promoting greater autonomy, with consequent reflex in improving mental state and of the QOL of the person with SCI. [ABSTRACT FROM AUTHOR]

To explore how plyometric-based hydro-kinesiotherapy (Plyo-HKT) would affect pain, muscle strength, postural stability, and functional performance in a convenience sample of children with hemophilic knee arthropathy (HKA). Forty-eight children with HKA (age: 8–16 years) were randomly allocated to the Plyo-HKT group (n = 24; underwent the Plyo-HKT for 45 min, twice/week over 12 wk in succession) or the comparison group (n = 24; performed the standard exercise rehabilitation at an equivalent frequency and duration). Pain, peak concentric torque of quadriceps and hamstring (produced at two angular velocities: 120 and 180 o/sec), dynamic limits of postural stability (DLPS), and functional performance [Functional Independence Score in Hemophilia (FISH) and 6-Minute Walk Test (6-MWT)] were assessed pre- and post-intervention. In contrast with the comparison group, the Plyo-HKT group achieved more favorable pre-to-post changes in pain (p =.028, η2p = 0.10), peak torque of quadriceps [120°/sec (p =.007, η2P = 0.15); 180°/sec (p =.011, η2P = 0.13)] and hamstring [120°/sec (p =.024, η2P = 0.11); 180°/sec (p =.036, η2P = 0.09)], DLPSdirectional [forward (p =.007, η2P = 0.15); backward (p =.013, η2P = 0.12); affected side (p =.008, η2P = 0.14); non-affected side (p =.002, η2P = 0.20)], DLPSoverall (p <.001, η2P = 0.32), and functional performance [FISH (p <.001, η2p = 0.26); 6-MWT (p =.002, η2p = 0.19)]. Plyo-HKT is likely helpful for reducing pain, improving strength, enhancing postural stability, and boosting functional capabilities in children with HKA. Physical rehabilitation practitioners should, therefore, consider this intervention strategy. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors often experience autonomic nervous system (ANS) dysfunction. While Transcranial Direct Current Stimulation (tDCS) has been shown to modulate the ANS when applied to the left hemisphere, its effects on the right hemisphere remain unexplored. Objective: We aimed to compare the effects of tDCS applied to both the injured and the contralateral hemispheres on heart rate variability (HRV) and functional capacity in individuals post-stroke. Methods: Twenty individuals with cerebral hemisphere lesions (ten with right-hemisphere lesions and ten with left-hemisphere lesions) were randomized into four groups: anodal and sham tDCS on the left temporal cortex (T3) and anodal and sham tDCS on the right temporal cortex (T4). HRV was assessed before the intervention, after the six-minute walk test (6MWT), and following tDCS. HRV data were categorized into frequency ranges: low frequency (LF), high frequency (HF), and sympathovagal balance. The 6MWT (meters) was conducted both pre- and post-tDCS. Results: In individuals with right-hemisphere lesions, a higher global LF value was observed (right side: 71.4 ± 16.8 nu vs. left side: 65.7 ± 17.3 nu; p = 0.008), as well as lower values of the HF component (right side: 29.5 ± 18.9 nu vs. left side: 34.0 ± 17.4 nu; p = 0.047), consequently exhibiting higher global values of the low/high-frequency ratio (right side: 3.9 ± 2.8 vs. left side: 2.9 ± 2.4). Regarding the stimulation site, tDCS over T3 led to a lower overall value of the low/high-frequency ratio (left hemisphere: 3.0 ± 2.2 vs. right hemisphere: 3.7 ± 2.9; p = 0.040) regardless of the lesion location. A significant increase in the distance covered in the 6MWT was observed for individuals with lesions in both hemispheres after tDCS at T3. Conclusions: Participants with right-hemisphere lesions exhibited superior global sympathetic autonomic nervous system activity. When the tDCS was applied on the left hemisphere, it maintained lower sympathovagal balance values and improved functional capacity regardless of the hemisphere affected by the stroke. [ABSTRACT FROM AUTHOR]

Background: Patients living with and beyond breast cancer frequently exhibit several side effects that can impact quality of life and physical functioning way beyond diagnosis and cancer therapies. Traditional on-land exercise has shown to be effective in reducing several symptoms of BC but little is known about the role of water-based exercise in improving physical and psychological well-being. Objectives: To compare land- vs. water-based exercise training for BC survivors to improve Health-Related Quality of Life (HRQoL), cancer-related fatigue (CRF), physical functioning, body composition and physical activity in patients with BC. Methods: A randomised, parallel group (1:1) controlled trial was conducted between 2020 and 2022. Patients were randomly allocated to complete a similar exercise training twice weekly during 12 weeks either on land (LG) using traditional gym equipment or in a swimming pool (WG) using body-weight exercises and water-suitable accessories. Both groups were supervised and monitored by an experienced physiotherapist. Main outcome was HRQoL (EORTC QLQ C30 and B23 module) and CRF measured with the Piper Scale. Secondary variables included functional capacity with the 6 Minutes Walking Test (6MWT), upper and lower body strength (handgrip strength and 30″ Sit-to-Stand (STS) test), body composition and objectively measured physical activity. Results: 28 patients were assessed and randomised during the study period. One patient did not receive the allocated intervention due to skin issues and one patient was dropped out during the intervention. A significant effect of time was found for both symptom severity (F(2,52) = 6.46, p = 0.003) and overall functioning (F1.67,43.45 = 5.215, p =0.013) but no interaction was found between group and time. No effects were reported for CRF. Similar findings were reported for functional capacity (time effect F1.231,32.019 = 16.818, p < 0.001) and lower body strength (time effect F2,52 = 15.120, p < 0.001) as well as fat mass (time effect F2,52 = 4.38, p = 0.017). Notably, a significant time per group interaction was reported for physical activity (F2,52 = 6.349, p =0.003) with patients in the WG significantly improving PA levels over time while patients in the LG exhibited a marked decreased. Conclusions: Exercise training either in water or on land can decrease symptom severity and improve functionality and body composition. Water-based training seems more effecting than land-based exercise to improve physical activity patterns over time. [ABSTRACT FROM AUTHOR]

Background The sequelae of post-coronavirus disease 2019 (COVID-19) pneumonia on lung function, exercise capacity, and quality of life were observed in both short-term and long-term. However, the study about the respiratory and locomotor muscle strength in severe and critically ill COVID-19 survivors are still limited. Therefore, we aimed to examine long-term pulmonary function, functional capacities, and respiratory and locomotor body muscle strength in severe to critically ill post-COVID-19 survivors. Methods A prospective observational study was conducted in 22 post-COVID-19 pneumonia and healthy adults. Clinical characteristics during admission, pulmonary function, functional capacity, respiratory muscles, and locomotor muscles strength were examined at 1, 3, and 6 months after discharge from the hospital. Results The generalized linear mixed model showed that percent predicted of forced expiratory volume in the 1 second (%FEV1), percent predicted of forced vital capacity (%FVC), maximum inspiratory pressure (MIP), handgrip strength, 6-minute walk distance, and five times sit to stand (5TSTS) were significantly lower in post-COVID-19 pneumonia patients than in healthy subjects during the follow-up period. The percent predicted of maximal voluntary ventilation (%MVV), and locomotor muscle strength were not different between the two groups throughout the follow-up period. Among post-COVID-19 pneumonia patients, %FEV1, %FVC, %MVV, 5TSTS, locomotor muscle strength significantly improved at three months compared to baseline at 1 month. Conclusion Pulmonary function, functional capacity, respiratory, and locomotor muscle strength of survivors from COVID-19 were impaired and recovery was observed after three to six months. These emphasized the need to evaluate the long-term consequences of COVID-19.

Abstract Background Heart failure complicated with iron deficiency is associated with impaired functional capacity, poor quality of life, increased hospitalization, and mortality. This systematic review and meta-analysis were conducted to assess the effect of oral and intravenous iron therapy on functional capacity, hospitalization risk, and mortality risk in patients with chronic heart failure and iron-deficiency anemia. Methods Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on Cochrane Library, PubMed Central, and Medline databases published in the last 20 years. Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results Based on the meta-analysis of included studies, the analytical results of intravenous iron therapy in patient with chronic heart failure and iron-deficiency anemia showed there is 30.82 (MD = 30.82: 95% CI 18.23–43.40) meter change in patient 6MWT, there is likelihood of 0.55 times (55%) (RR = 0.45: 95% CI 0.30–0.68) lower risk of hospitalization and lower risk of mortality (RR = 0.18: 95% CI 0.04–0.78), because heart failure worsening both with statistically significant overall effect compared with placebo. Conclusions There is statistically significant effect of intravenous iron therapy to improve patient functional capacity and reduce likelihood of hospitalization risk of 0.55 times (55%) in patient with chronic heart failure and iron-deficiency anemia.

Abstract Background There is lack of evidence regarding safety, effectiveness and applicability of prehabilitation on cardiac surgery population, particularly in patients candidates to cardiac valve replacement. The aim of the study is to assess and compare the effect of a multimodal prehabilitation program on functional capacity in patients with severe aortic stenosis (AoS) and severe mitral regurgitation (MR) proposed for valve replacement surgery. Methods Secondary analysis from a randomised controlled trial whose main objective was to analyze the efficacy of a 4–6 weeks multimodal prehabilitation program in cardiac surgery on reducing postoperative complications. For this secondary analysis, only candidates for valve replacement surgery were selected. The primary outcome was the change in endurance time (ET) from baseline to preoperative assessment measured by a cycling constant work-rate cardiopulmonary exercise test. Results 68 patients were included in this secondary analysis, 34 (20 AoS and 14 MR) were allocated to the prehabilitation group and 34 (20 AoS and 14 MR) to control group. At baseline, patients with AoS had better left systolic ventricular function and lower prevalence of atrial fibrillation compared to MR (p = 0.022 and p = 0.035 respectively). After prehabilitation program, patients with MR showed greater improvement in ET than AoS patients (101% vs. 66% increase from baseline). No adverse events related to the prehabilitation program were observed. Conclusions A 4–6 week exercise training program is safe and overall improves functional capacity in patients with severe AoS and MR. However, exercise response is different according to the cardiac valve type disfunction, and further studies are needed to know the factors that predispose some patients to have better training response. Trial registration The study has been registered on the Registry of National Institutes of Health ClinicalTrials.gov (NCT03466606) (05/03/2018).

Abstract The aim of the study was to determine the role of isometric strength and range of motion in predicting Functional Movement Screen (FMS) scores of adults. A total of 120 participants (age = 34.62 ± 11.82 years; height = 170.56 ± 9.63 cm; weight = 73.62 ± 15.39 kg) volunteered to participate in the study. Anthropometric measurements were performed, including height, body weight, muscle mass, and body fat. Following this, the ranges of motion of the shoulder, hip, knee, and ankle joints were measured sequentially. Isometric strength and FMS tests were then performed. Hip extension isometric strength explained 23% of the variation in FMStotal. The common effect of knee flexion, shoulder flexion, and dorsiflexion joint range of motion explained 34% of the change in FMStotal (F (3−116) = 20.375, p

Background Individuals with Parkinson’s Disease (PD), particularly those with the rigid-akinetic with postural instability (RA) subtype, often experience motor symptoms that impair functionality and postural control. Physiotherapy interventions, including both dry land and aquatic therapies, can help manage PD treatment. This study aimed to develop and assess the effects of two exercise protocols emphasizing the extensor musculature of the vertebral column (dry land and shallow water) on functional capacity in individuals with and without RA-type PD. Methods The study utilized a protocol study followed by a randomized clinical trial, with the registry number NCT04863118, involving ten RA-type PD (intervention group) and ten individuals without PD (reference group). Participants underwent exercise protocols of varying intensity levels, and their pre and post-intervention functional capacity were evaluated using standardized tests. The applicability and safety of these protocols were assessed through a self-perception questionnaire. Results Significant improvements were observed in functional capacity parameters following both dry land and aquatic physiotherapy interventions among PD individuals, including increased repetitions in the Sit-to-Stand test and reduced completion time in the Timed Up and Go test. Similar positive outcomes were observed in individuals without PD, indicating the efficacy of these interventions irrespective of PD status. Conclusion A single session of physiotherapy, whether on dry land or in shallow water, focusing on the extensor musculature of the vertebral column, enhances functional capacity in PD and non-PD individuals alike. Furthermore, the protocols demonstrated safety, comfort, and acceptability, promoting treatment adherence and future recommendations. These findings support the implementation of these protocols in clinical practice, aiding therapists in enhancing rehabilitation outcomes while ensuring individual safety. Registration Name of registry: Acute Effects of Strength Training and High Intensity Training on Functional and Biochemical Measurements of Individuals With Parkinson’s Disease in Different Environments and Depths Registry number: NCT04863118 Registration date:, 09/02/2024 URL: https://clinicaltrials.gov/study/NCT04863118.

Background: Heart failure complicated with iron deficiency is associated with impaired functional capacity, poor quality of life, increased hospitalization, and mortality. This systematic review and meta-analysis were conducted to assess the effect of oral and intravenous iron therapy on functional capacity, hospitalization risk, and mortality risk in patients with chronic heart failure and iron-deficiency anemia. Methods: Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on Cochrane Library, PubMed Central, and Medline databases published in the last 20 years. Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results: Based on the meta-analysis of included studies, the analytical results of intravenous iron therapy in patient with chronic heart failure and iron-deficiency anemia showed there is 30.82 (MD = 30.82: 95% CI 18.23–43.40) meter change in patient 6MWT, there is likelihood of 0.55 times (55%) (RR = 0.45: 95% CI 0.30–0.68) lower risk of hospitalization and lower risk of mortality (RR = 0.18: 95% CI 0.04–0.78), because heart failure worsening both with statistically significant overall effect compared with placebo. Conclusions: There is statistically significant effect of intravenous iron therapy to improve patient functional capacity and reduce likelihood of hospitalization risk of 0.55 times (55%) in patient with chronic heart failure and iron-deficiency anemia. [ABSTRACT FROM AUTHOR]

Introduction: Exercise-based cardiac rehabilitation programs (CRPs) represent a multidisciplinary therapeutic approach tailored to improve cardiorespiratory fitness and overall health-related quality of life, while reducing cardiovascular hospitalizations and mortality. Our aim was to determine changes in exercise capacity and cardiac events according to the left ventricular ejection fraction (LVEF) following a CRP. Methods: This single-center cohort study included 131 patients who completed a center-based CRP from 2015 to 2022. Cardiopulmonary exercise testing (CPET), transthoracic echocardiography, and laboratory analysis were performed before and after program completion. Results: Of 232 enrolled patients, 131 were included in our cohort analysis, with 36.6% having a reduced LVEF. These patients exhibited higher rates of atrial fibrillation (p = 0.019) and NT-proBNP values (p < 0.001). Patients with reduced LVEF had lower peak VO2 (pVO2) (p = 0.046), percentage of predicted oxygen consumption (ppVO2) (p < 0.001), and VO2 at anaerobic threshold (p = 0.015) during baseline CPET. Completion of the CRP led to comparable improvements in exercise performance between groups, assessed through Δ pVO2 (p = 0.990), Δ ppVO2 (p = 0.610), and Δ VE/VCO2 slope (p = 0.200). In the study population, male gender and hypertension independently predicted variation in VE/VCO2 slope (p = 0.017) and oxygen uptake efficiency slope (p = 0.048), respectively, post-CRP. During follow-up, 9.2% of all patients had hospital admissions for cardiac events, and 3.8% died, with no significant differences between groups. Conclusion: Patients with reduced LVEF admitted to our CRP showed lower functional status based on specific CPET parameters. After CRP, both reduced and preserved LVEF groups experienced similar functional improvements. Therefore, strategies to increase participation of patients with reduced LVEF in such programs are warranted. [ABSTRACT FROM AUTHOR]

Alterations in the body's nutritional status or composition may be observed as the kidney disease advances, which could influence the kidney's functional capacity and, consequently, could increase the risk of mortality. The aim of the study is to determine the influence of functional capacity on mortality assessed by different functional tests in patients with advanced chronic kidney disease (ACKD). A prospective observational study was designed, which included 225 patients followed for 8 years in a CKD clinic. The study assessed functional capacity by using a range of tests, which included the Short Physical Performance Battery, the 6 minutes walking gait test, the timed up and go, and the four versions of the sit-to-stand test. Additionally, body composition and nutritional conditions were considered, taking into consideration various biochemical indicators such as albumin, prealbumin, c-reactive protein (CRP), lymphocytes, and transferrin, muscle strength, comorbidity, and frailty. The relationship between functionality and all-cause mortality was investigated using a Cox proportional hazard model. A total of fifty patients died during the duration of the study. Patients who performed worse on the function and muscle strength tests showed a worse body composition and nutritional status, and exhibited a reduced life expectancy. Inflammation (CRP) was associated with an increased risk of mortality (model 1: hazard ratio (HR) = 1.246; 95% confidence interval (95% CI = 1.014–1.531; model 2: HR = 1.333; 95% CI = 1.104–1.610). Good functional capacity as determined by the SPPB test decreased the risk of mortality (model 1: HR = 0.764; 95% CI = 0.683–0.855; model 2 HR = 0.778; 95% CI = 0.695–0.872). Cut-off points of maximum sensitivity and specificity for mortality were obtained with different tests. The study demonstrated that functional capacity influences mortality in patients with ACKD, being higher in those patients with impaired functionality regardless of the test used, although the SPPB allows a larger number of patients to be assessed. Therefore, it is essential to incorporate the assessment of functionality into the comprehensive care of patients with CKD. [ABSTRACT FROM AUTHOR]

Background: There is lack of evidence regarding safety, effectiveness and applicability of prehabilitation on cardiac surgery population, particularly in patients candidates to cardiac valve replacement. The aim of the study is to assess and compare the effect of a multimodal prehabilitation program on functional capacity in patients with severe aortic stenosis (AoS) and severe mitral regurgitation (MR) proposed for valve replacement surgery. Methods: Secondary analysis from a randomised controlled trial whose main objective was to analyze the efficacy of a 4–6 weeks multimodal prehabilitation program in cardiac surgery on reducing postoperative complications. For this secondary analysis, only candidates for valve replacement surgery were selected. The primary outcome was the change in endurance time (ET) from baseline to preoperative assessment measured by a cycling constant work-rate cardiopulmonary exercise test. Results: 68 patients were included in this secondary analysis, 34 (20 AoS and 14 MR) were allocated to the prehabilitation group and 34 (20 AoS and 14 MR) to control group. At baseline, patients with AoS had better left systolic ventricular function and lower prevalence of atrial fibrillation compared to MR (p = 0.022 and p = 0.035 respectively). After prehabilitation program, patients with MR showed greater improvement in ET than AoS patients (101% vs. 66% increase from baseline). No adverse events related to the prehabilitation program were observed. Conclusions: A 4–6 week exercise training program is safe and overall improves functional capacity in patients with severe AoS and MR. However, exercise response is different according to the cardiac valve type disfunction, and further studies are needed to know the factors that predispose some patients to have better training response. Trial registration: The study has been registered on the Registry of National Institutes of Health ClinicalTrials.gov (NCT03466606) (05/03/2018). [ABSTRACT FROM AUTHOR]

Introduction: Participation in daily life activities with both the personal and community meaning is an important component of health and well-being. Even though there are mounting reports on the challenges in various aspects of daily-life functioning among individuals with post-traumatic stress disorder (PTSD), to date little research has been conducted on their comprehensive patterns of participation. The study aimed to describe objective and subjective participation dimensions in PTSD compared to healthy controls and investigate the association between personal and environmental factors and participation. Methods: Sixty-one individuals were enrolled in two groups: PTSD (N=31; age: M=34.3; women:77.4%) and healthy controls matched by age and gender. The PTSD group completed standard assessments for symptom severity, general cognition, executive function (EF), sensory processing, self-efficacy, functional capacity, and environmental properties. Both groups completed a participation questionnaire. Results: Individuals with PTSD participated with low intensity and diversity, more occupations were abandoned (-4.73

Patients with schizophrenia suffer from physical health conditions, culminating in reduced physical functioning with enormous costs for patients and society. Although aerobic endurance and skeletal muscle strength, typically reduced in this population, relate to cognition and function, no study has explored their respective contributions to performance of functional skills and everyday tasks. In a cross-sectional study, 48 outpatients (28/20 men/women; 35 ± 11(SD) years) with schizophrenia spectrum disorders (ICD-10; F20–25) were administered the UCSD Performance-based Skills Assessment-Brief (UPSA-B; functional skills), Specific Level of Functioning (SLOF; functional performance) and the Positive and Negative Syndrome (PANSS) scale. Peak oxygen uptake (V̇O 2peak) was assessed along with leg press maximal muscle strength (1RM) and mechanical power. UPSA-B performance was associated with V̇O 2peak (r = 0.28, p < 0.05), accounting for 8 % (p < 0.05) of shared variance, but was unrelated to 1RM and mechanical power. The SLOF physical functioning domain was associated with V̇O 2peak (r = 0.30, p < 0.05) and 1RM (r = 0.24,p < 0.05), while SLOF personal care (r = 0.27,p < 0.05) and activities (r = 0.30,p < 0.05) were related only to V̇O 2peak. Hierarchical regression analyses revealed that while V̇O 2peak and age combined to account for 20 % (p < 0.05) of the variance in physical functioning, the contribution of 1RM was eliminated after adjusting for age. V̇O 2peak and negative symptoms combined predicted 24 % and 35 % of the variance in personal care and activities, respectively. UPSA-B scores did not add to the prediction of SLOF scores. Although V̇O 2peak and 1RM both relate to functional outcomes, the combination of V̇O 2peak , age, and negative symptoms exert the greatest detrimental influence on functional performance beyond skills deficits. [Display omitted] [ABSTRACT FROM AUTHOR]

[Display omitted] • Healthy athletes often have borderline LV systolic function. • Differentiating between physiological remodelling and subtle pathological systolic dysfunction of the LV can be difficult. • Athletes have a lower GLS value (< 17.5%) than healthy controls. • The lower GLS value in athletes is unrelated to a specific LV remodelling pattern. • The lower GLS value in athletes has no impact on exercise capacity. • The athlete's heart is characterized by a specific myocardial deformation pattern. • This pattern shows a more pronounced epicardial layer strain impairment. • The impairment induces a higher endocardial/epicardial GLS ratio. Assessment of the athlete's heart is challenging because of a phenotypic overlap between reactive physiological adaptation and pathological remodelling. The potential value of myocardial deformation remains controversial in identifying early cardiomyopathy. To identify the echocardiographic phenotype of athletes using advanced two-dimensional speckle tracking imaging, and to define predictive factors of subtle left ventricular systolic dysfunction. In total, 191 healthy male athletes who underwent a preparticipation medical evaluation at Nancy University Hospital between 2013 and 2020 were included. Clinical and echocardiographic data were compared with 161 healthy male subjects from the STANISLAS cohort. Borderline global longitudinal strain value was defined as < 17.5%. Athletes demonstrated lower left ventricular ejection fraction (57.9 ± 5.3% vs. 62.6 ± 6.4%; P < 0.01) and lower global longitudinal strain (17.5 ± 2.2% vs. 21.1 ± 2.1%; P < 0.01). No significant differences were found between athletes with and without a borderline global longitudinal strain value regarding clinical characteristics, structural echocardiographic features and exercise capacity. A borderline global longitudinal strain value was associated with a lower endocardial global longitudinal strain (18.8 ± 1.2% vs. 22.7 ± 1.9%; P = 0.02), a lower epicardial global longitudinal strain (14.0 ± 1.1% vs. 16.6 ± 1.2%; P < 0.01) and a higher endocardial/epicardial global longitudinal strain ratio (1.36 ± 0.07 vs. 1.32 ± 0.06; P < 0.01). No significant difference was found regarding mechanical dispersion (P = 0.46). Borderline global longitudinal strain value in athletes does not appear to be related to structural remodelling, mechanical dispersion or exercise capacity. The athlete's heart is characterized by a specific myocardial deformation pattern with a more pronounced epicardial layer strain impairment. [ABSTRACT FROM AUTHOR]

A team comprising nursing, medical staff, and administrative leaders at an urban academic orthopedic hospital in the northeastern United States sought to revise a preoperative laboratory testing protocol based on evidence and practice guidelines. The goal was to decrease unnecessary tests by 20% without negatively affecting patient outcomes. After adding the revised protocol to the electronic health record, audits revealed that the target goal was not met and additional strategies were implemented, including educational webinars for surgeon office personnel who ordered tests, additional webinars for advanced practice professionals, and the creation of scorecards to track surgeons' progress. Overall, a downward trend in the ordering of unnecessary laboratory tests for patients without identified risks was observed, but a 20% reduction was not achieved. Surgical complications during the project were not associated with laboratory tests. Clinicians continue to use the revised preoperative laboratory testing protocol at the facility. [ABSTRACT FROM AUTHOR]

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Background: We explored whether the maximum predicted walking distance, assessed with six-minute walk test (6MWT) and reflecting submaximal functional exercise capacity, is decreased among patients with pectus excavatum (PEX). Methods: This study comprised a retrospective analysis of patients with PEX who underwent a 6MWT for the assessment of functional capacity. The maximum distance walked was recorded and compared to reference values established for different populations, including a young and healthy South American population. Results: We included 43 patients with PEX who underwent 6MWT. The mean age was 17.8 ± 6.7 years. The mean maximum distance walked was significantly lower than the predicted distance (600.8 ± 67.6 metres vs. 729.8 ± 67.5 metres, p < 0.0001). Using the Enright reference equation including an older reference population, the mean negative difference was higher (PEX patients walked 190.4 ± 78.4 metres less than predicted, p < 0.0001). We also applied the Li et al. reference equation accounting for sex among other variables, detecting a decreased walked distance compared to the gender-adjusted predicted distance (PEX patients walked a mean 222.4 ± 87.4 metres less than predicted, p < 0.0001). Using the Ulrich et al. equation, PEX patients walked a mean 114.2 ± 85.1 metres less than predicted (p < 0.0001). Although of uncertain clinical relevance, there was a significant decrease in the mean oxygen saturation after exercise (baseline 97.4 ± 1.2%, vs. final 96.4 ± 2.1%, p = 0.006). Conclusions: In this study, we identified a significant reduction in the maximum walked distance among patients with PEX compared to the predicted distance, thus potentially emerging as an unsophisticated means to evaluate and quantify functional exercise capacity. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that aerobic training with blood flow restriction is beneficial for treating fibromyalgia. This study evaluated the feasibility, safety, and effects of an aerobic training program with blood flow restriction for women with fibromyalgia. Methods: Thirty-seven women with fibromyalgia were included, and thirteen with an average age of 59 ± 3, a BMI of 26 ± 3, and who were polymedicated started the intervention period. The intervention group performed aerobic exercise with blood flow restriction using occlusive bands placed in the upper part of the rectus femoris, with a total duration of 14 min of restriction divided into two periods of 7 min with a rest period of 3 min and a total session duration of 17 min. Pressure intensity was measured using the visual pain scale (VAS), scoring 7 out of 10 (n = 7). The non-intervention group performed aerobic exercise without restriction of blood flow for the same periods, rest periods, and total duration of the session (n = 6). The intervention included 2 weekly sessions with 72 h between aerobic walking for 9 weeks. Walking was measured individually using the rating of perceived exertion scale (RPE) with an intensity between 6 and 7 out of 10. Visual and verbal support for the VAS and RPE scale was always provided throughout the sessions supervised by the investigator. Functional capacity was assessed using tests (six-minute walk test, incremental shuttle walk test, knee extension and handgrip test by dynamometer, 30 s chair stand test, and timed up-and-go test). Symptomatology was assessed using questionnaires (Widespread Pain Index, Symptom Severity Score, Fibromyalgia Impact Questionnaire, and Multidimensional Fatigue Inventory), and blood samples were collected. Results: There were no adverse effects, and only one participant in the intervention group withdrew. Between-group and intragroup differences showed that the intervention group obtained improvements in the functional tests; CST p = 0.005; 6MWT p = 0.011; Handgrip p = 0.002; TUGT p = 0.002 with reduced impact of the disease according to the questionnaires; FIQ Stiffness p = 0.027 compared with the nonintervention group. Biochemical results remained within normal ranges in both groups. Conclusions: Blood flow-restricted aerobic training may be feasible, safe, and more effective than unrestricted aerobic training as a physical exercise prescription tool to improve cardiorespiratory fitness, strength, balance, and stiffness in women with fibromyalgia. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic nephropathy is a growing public health challenge with implications on health. Renal function decline impacts the functional ability and overall health and well-being of individuals with diabetic nephropathy due to development of several renal manifestations. The objective of the study was to determine the effect of an exercise-based rehabilitation program on functional capacity and renal function among individuals with type 2 diabetic nephropathy. Methods: A total of 283 individuals were screened and 60 eligible participants aged 45–70 years with diabetic nephropathy were randomly allocated (n = 30 each) to the intervention group (IG) and control group (CG), respectively. The study outcome measures comprised of functional capacity (6-min walk test) and renal function assessed at baseline, 12th week and 24th week. Participants allocated to IG received 12 weeks of exercise based rehabilitation (comprising of supervised + home-based exercises) along with standard care and followed-up till 24th week. Results: The repeated measures ANOVA with Greenhouse–Geisser correction indicated significant timepoint*group interaction effect for 6-min walk distance F (1.71, 90.59) = 619, p < 0.001, serum creatinine F (1.23, 65.14) = 174.8, p < 0.001, estimated glomerular filtration rate F(1.15, 60.88) = 105.2, p < 0.001, serum urea F(1.48, 78.45) = 261.4, p < 0.001 and urine protein F (1.13, 59.82) = 4.58, p < 0.328. Conclusion: The study found that exercise based rehabilitation improved both functional capacity and renal function among individuals with type 2 diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Background: Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy subjects. The secondary aim was to investigate the potential determinants of balance in patients with COPD. Methods: This comparative study recruited 23 patients with COPD and 23 age- and comorbidity-matched healthy subjects. Participants were assessed regarding demographic and clinical data, "Postural Stability Test" (PST), "Limits of Stability Test" (LOST), "Clinical Test of Sensory Integration of Balance" (CTSIB), pulmonary function, respiratory and peripheral muscle strength, functional capacity, and cognitive function. Results: There were significant differences in all outcome measures assessing balance, pulmonary function, respiratory muscle strength, peripheral muscle strength, and functional capacity, but not cognitive function, in the COPD group compared to the healthy group (p < 0.05). The PST had a significant and strong correlation with maximal inspiratory pressure (MIP) (r = −0.630, p = 0.001) and a significant and moderate correlation with m. quadriceps strength and 6 min walk test (6MWT) distance (r = −0.472, p = 0.023; r = −0.496, p = 0.016; respectively). MIP, m. quadriceps strength, and 6MWT distance were independent predictors to explain the PST with an R2 = 0.336 (p = 0.004). Conclusions: The present study revealed that balance is impaired in adults with COPD, even if compared with age- and comorbidity-matched healthy subjects. Assessing and improving balance and its determinants, inspiratory and peripheral muscle strength, and functional capacity may be important for fall prevention and disease management in patients with COPD. [ABSTRACT FROM AUTHOR]

Background/aim: Symptoms of COVID-19 may persist for months. One of the persistent symptoms of COVID-19 is fatigue, which reduces functional status. The relationship between fatigue, functional status, and various other factors has received little attention, which this study aims to address.. Materials and methods: Patients with COVID-19 infection were included in this multicenter cross-sectional study. Age, sex, body mass index (BMI), marital status, smoking status, presence and duration of chronic disease, comorbidity index, regular exercise habits, time since COVID-19 diagnosis, hospitalization status, length of hospital stay, intubation status, home oxygen therapy after discharge, participation in a pulmonary rehabilitation program, presence of dyspnea, presence of cough, presence of sputum, and modified Medical Research Council, Post-COVID Functional Status (PCFS), Fatigue Severity Scale (FSS), and EQ-5D-5L Questionnaire scores were recorded. Results: We enrolled 1095 patients, including 603 (55%) men and 492 (45%) women with a mean age of 50 ± 14 years. The most common chronic lung disease was COPD (11%) and 266 (29%) patients had nonpulmonary disease. The median time elapsed since COVID-19 diagnosis was 5 months; the hospitalization rate was 47%. The median PCFS grade was 1 (0-4) and the median FSS score was 4.4 (1-7). The PCFS and FSS were positively correlated (r = 0.49, p < 0.01; OR: 1.88, 95% CI: 1.68-2.10). Both functional status and fatigue were associated with quality of life, which was lower in older patients, those with higher BMI, those with systemic disease, those not exercising regularly, and those with more severe COVID-19 infection (defined by dyspnea, pneumonia as indicated by computed tomography, hospitalization, length of stay, ICU admission, intubation, and the need for home oxygen after discharge). Conclusion: Fatigue may cause poorer functional status regardless of the time since COVID-19 diagnosis. In this study, patients with FSS scores of >4.78 showed moderate to severe functional limitations. It is important to address modifiable patient risk factors and reduce the severity of COVID-19 infection. [ABSTRACT FROM AUTHOR]

Physical inactivity among older adults remains a global burden, leading to a variety of health challenges and even mortality. This study evaluated the impact of a novel virtual humanoid coach-driven physical exercise program among older adults. A non-randomized (quasi) experimental research was conducted in two community senior centers. The recruited participants (n = 130) were primarily female older adults with a mean age of 66.40 and agreed to be purposively assigned either experimental or control groups. Trained healthcare providers performed health assessments in three time points using valid and reliable tools. Descriptive statistics, t-tests, and RM-ANOVA were used to quantitatively analyze the data using SPSS version 22. There are significant mean differences between the groups across all functional capacity assessments and Time 2-3 assessment of sleep quality. RM-ANOVA revealed significant differences in physical assessment over time between the two groups. The analyses of time and group interaction revealed significant improvement in health assessments among the members of the mixed reality group compared to the traditional groups. The impact of virtual coaches in community-based enhancing physical activity programs is comparable to the traditional mode and introduces a novel approach to promoting physical activity among older adults. [ABSTRACT FROM AUTHOR]

Aim. In the naval pentathlon, an increase in current sports performances up to close to the physiological limits of the human body requires a change in activity at the level of the main structural elements, namely training and competition. Methods. From this perspective, with the help of the means and methods applied at the naval pentathlon team level, we obtained an exponential development in functional capacity, which was reflected in the final results of the athletes engaged in the seamanship event. Results. In the study conducted, the application of the tests, which investigates the functional capacity, demonstrated that from a statistical point of view, for the experimental group, the mean values became significant at the final test for vital capacity (at n-1; p=0.05) and respiratory frequency. This significant difference for the experimental group was the result of implementing the content of the training program of the structures of specific means, optimally dosed, specific to the seafaring skills test. Conclusions. Thus, through the program developed and applied at the level of the sportsmen of the naval pentathlon team, significantly increased results were obtained at the level of the indices of the respiratory system: respiratory rate; apnea time; vital capacity; and of the cardiovascular system: the heart rate, a fact that determined a global increase in their performance at every single moment of the seamanship race. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the role of isometric strength and range of motion in predicting Functional Movement Screen (FMS) scores of adults. A total of 120 participants (age = 34.62 ± 11.82 years; height = 170.56 ± 9.63 cm; weight = 73.62 ± 15.39 kg) volunteered to participate in the study. Anthropometric measurements were performed, including height, body weight, muscle mass, and body fat. Following this, the ranges of motion of the shoulder, hip, knee, and ankle joints were measured sequentially. Isometric strength and FMS tests were then performed. Hip extension isometric strength explained 23% of the variation in FMStotal. The common effect of knee flexion, shoulder flexion, and dorsiflexion joint range of motion explained 34% of the change in FMStotal (F (3−116) = 20.375, p < 0.001). A significant relationship (R = 0.658, R2 = 0.413) was found between hip extension isometric strength, knee flexion, shoulder flexion, and dorsiflexion range of motion and FMStotal (F (4−115) = 21.952, p < 0.001). The common effect of all these variables explains 43% of the change in FMStotal. The results indicate that the FMS test scores, which are utilized to evaluate the risk of injury in sedentary adults, can be significantly predicted by the effect of hip extension isometric strength and parameters related to knee flexion, shoulder flexion, and dorsiflexion joint range of motion. At this time, it is advised that range of motion and isometric strength be taken into account when determining a person's functional movement capacity. [ABSTRACT FROM AUTHOR]

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an acquired disease with significant morbidity that affects both children and adults. Post-exertional malaise is a cardinal symptom of ME/CFS and impacts a patient's functional capacity (FC). The absence of effective tools to assess FC has significant consequences for timely diagnosis, clinical follow-up, assessments for patient disability benefits, and research studies. In interventional studies, the inability to assess FC can result in an incomplete assessment of the potential benefit of the intervention, leading to beneficial treatment outcomes being missed. Methods: Using extensive, repeated patient feedback, we have developed a new questionnaire, FUNCAP, to accurately assess FC in ME/CFS patients. The questionnaire consists of eight domains divided by activity types: A. personal hygiene/basic functions, B. walking/movement, C. being upright, D. activities in the home, E. communication, F. activities outside the home, G. reactions to light and sound, and H. concentration. Results: Through five rounds of anonymous web-based surveys and a further test–retest validation round, two versions of the questionnaire were developed: a longer version comprising 55 questions (FUNCAP55), developed for improved diagnostic and disability benefit/insurance FC assessments; and a shorter version (FUNCAP27) for clinical patient follow-up and potential use in research. Good reliability and validity and negligible floor and ceiling effects were found, with comparable findings in all aspects in both a large Norwegian (n = 1263) and a separate English-language international sample (n = 1387) demonstrating the validity and reliability of FUNCAP. Conclusions: Our findings support the utility of FUNCAP as an effective, reliable and valid tool for assessing FC in ME/CFS patients. [ABSTRACT FROM AUTHOR]

Introduction In head and neck cancer (HNC) patients, fatigue is present throughout the course of treatment and during follow-up. Cancer-related fatigue (CRF) is a significant treatment-related side effect experienced by oral cancer patients during and after treatment. CRF, when coupled with other side effects of oral cavity cancer, patients who undergo definitive treatment have some of the most dramatic acute side effects, and reduced overall quality of life (QoL). Although there are upcoming intervention strategies to manage CRF, the effect of exercise intervention is explored in this study. The rationale for considering exercise to manage CRF is that it may alleviate the combined effect of toxic treatment and decreased levels of activity during the treatment that reduces the capacity for physical performance. Objective This study was conducted to investigate the effectiveness of exercise intervention on CRF, and its influence on functional capacity and QoL among patients with oral cavity cancer during and after their primary cancer treatment. Materials and Methods Oral cavity cancer patients (n = 223), planned for only chemoradiotherapy with curative intent were screened for CRF. Based on the inclusion criteria, 69 patients were grouped randomly into experimental (n = 35) and control (n = 34) groups. Patients in the experimental group were provided structured exercise intervention, while the control group was offered standard and routine care. Structured exercise in this present study comprised moderate-intensity walking and resistance exercises using TheraBand every day for three to five times a week. CRF was assessed using symbolic assessment of fatigue extent and the functional capacity was assessed by 6-minute walk test (6MWT), maximal oxygen uptake (VO 2max), and hand dynamometer. QoL was assessed using the European Organization for Research and Treatment for Cancer-QoL (EORTC QLQ-C30) and the Head and Neck Cancer module (HN35), while distress was assessed by the National Comprehensive Cancer Network (NCCN) Distress Thermometer. Randomized patients were assessed at four points. Result The size effects in fatigue extent (η p2 = 0.40) and fatigue impact (η p2 = 0.41) were found to be moderate, and a positive correlation between 6MWT, fatigue extent, and fatigue impact was observed. Conclusion This study suggests that exercise intervention has a significant positive impact on CRF, most aspects of QoL, and the functional capacity of the patients. [ABSTRACT FROM AUTHOR]

Recreational team sports have received great acceptance lately, in different populations, indicating encouraging results in health-related quality of life. This study examined the efficacy of a 3-month basketball exercise program on selected indices of health (body mass—BM, body fat—BF, blood pressure—BP), functional capacity (flexibility of lower and upper limbs, balance), and physical fitness (maximum strength of lower limbs, trunk and handgrip, aerobic capacity) in middle-aged individuals. Forty middle-aged individuals (males and females; 40–55 years old) were randomly divided into (a) exercise (EG; n = 20) and (b) control groups (CG; n = 20). The EG followed a 3-month modified basketball exercise program (2 times/week; 24 training units), including different basketball drills with and without the ball (dribbling, passing, pivot, stops, etc.), to improve participants' health and physical fitness. Repeated measures ANOVA showed that the EG significantly increased their flexibility (17.23–74.88%; p < 0.001), static balance (44.76–54.69%; p < 0.001), and strength of lower limbs and trunk (11.67–13.13%; p < 0.001), while reducing BP (7.31–12%; p < 0.001), heart rate and RPE (5.30–34.37%; p < 0.001), and time during time-up-and-go test (−10.91%; p < 0.001). Handgrip strength, BM, and BF did not change following the program in the EG (p > 0.05). In the CG, the above variables remained stable. In conclusion, this program may be used to eliminate the detrimental effects of aging on health, functional capacity, and physical fitness parameters. [ABSTRACT FROM AUTHOR]

• Six-minute walk test (6MWT) is used to quantify morbidity. • Normalization of 6MWT by body weight (DW) brings a more precise assessment. • In PAD, absolute 6MWT and DW correlated with functional capacity. • DW showed a stronger relationship than the absolute value of 6MWT. • In PAD, absolute 6MWT and DW did not correlated with cardiovascular health. The six-minute walk test (6MWT) is extensively employed to evaluate gait impairment in patients with symptomatic peripheral artery disease (PAD) and has been associated with different health outcomes. However, various approaches exist for calculating and interpreting the six-minute test in order to address the needs of patients more effectively. Therefore, we investigated how these different approaches correlate with functional capacity and cardiovascular health in patients with symptomatic PAD. In total, 227 PAD patients [65.2% men and 67 (13) y.o.] were included in this cross-sectional study. The 6MWT was performed along a 30-meter corridor and the distance was expressed in three ways: absolute (described as the meters walked during the test), relativized (based on the results of the 6MWT in healthy individuals), and DW (multiplying the body weight in kilograms by the absolute distance in the 6MWT). A functional capacity z-score was calculated using the results of the handgrip strength test, 4-meter walking test, and sit-and-stand test. A cardiovascular parameter z-score was calculated with data on brachial and central blood pressure, the low-frequency component/high-frequency component ratio, and carotid-femoral pulse wave velocity. The absolute (b = 0.30, 95%CI: 18-0.43, R² = 0.11, p < 0.001) and DW (b = 0.40, 95%CI: 27-0.53, R² = 0.17, p < 0.001) measures were related to functional capacity, independently of sex, age, and the ankle-arm index of the patients. Neither absolute nor DW were related to cardiovascular health. The relativized measure was not associated with either functional capacity or cardiovascular health. In patients with symptomatic PAD, absolute and DW measures are related to functional capacity, but not cardiovascular function. [ABSTRACT FROM AUTHOR]

The purpose of the study was to identify the durations of maintaining apnea, in different static positions, with and without the use of a nose clip, in girls aged between 7 and 14 years,. The study included a total number of 92 girls, grouped by age into four groups of 2-year spans (7–8, 9–10, 11–12, 13–14 years), and depending on the experience of practicing synchronized swimming (6–42 months). In the study we applied five physical tests where apnea maintenance times were recorded in different static positions: Apnea Test of Facial floatation with and without nose clip, Apnea Test of Front tuck with and without nose clip and Apnea Test of Front layout with support to scull. The statistical analysis was performed with SPSS-24. During the study, a program of specific exercises to learn/consolidate the apneic breathing specific to artistic swimming was implemented, for a time interval of 3 months. The results were recorded at the beginning of the study (TI) and at the end of the study (TF). Analyzing the results of the study, we found positive and statistically significant improvements, related to age and experience. The most significant progress, taking into account the averages between the final and initial tests, was recorded in relation to Facial Flotation for 1.301 s for the 7–8-year-old group and 1.110 s for the 9–10-year-old group; the 11–12-year-old group recorded the most positive effect in the Facial Flotation test with a nose clip, with a result of 0.853 s, and in the 13–14-year-old group in the front tuck with nose clip test, a result of 0.807 s was reached. In all tests of the study, the Cohen's values in all groups fell between 0.184 and 0.478, the size of the effect being small and medium. The ANOVA analysis of variance showed that the differences were statistically significant for p < 0.05 between the arithmetic means of the four groups according to age and sport experiences. For all groups, the value of Wilks' Lambda was 0.009 (p < 0.01) for age and 0 (p < 0.01) for sports experience, highlighting large differences between groups. We conclude that the development of the ability to maintain apnea specific to synchronized swimming shows an upward trajectory, being conditioned by the training methodology, the age of the subjects and the sports experience. The small and medium values of the effect size highlight the fact that the improvement in apnea maintenance time is dependent on the duration and frequency of the apnea exercises performed in technical conditions specific to synchronized swimming. The training methodology must be adapted to the particularities of age, sports experience and the characteristics of synchronized swimming. [ABSTRACT FROM AUTHOR]

Considerable and convincing global data from cohorts across the health spectrum (i.e. apparently healthy to known disease) indicate that cardiorespiratory fitness (CRF) is a major predictor of overall and cardiovascular disease (CVD)-survival, seemingly with greater prognostic resolution compared to other traditional CVD risk factors. Therefore, the assessment of CRF in research and clinical settings is of major importance. In this manuscript, we review the technology of measuring CRF assessed by the 'gold standard,' cardiopulmonary exercise testing (CPET), as well as with various other methods (e.g. estimated metabolic equivalents, 6-minute walk tests, shuttle tests, and non-exercise equations that estimate CRF), all of which provide significant prognostic information for CVD- and all-cause survival. The literature through May 2024 has been cited. The promotion of physical activity in efforts to improve levels of CRF is needed throughout the world to improve lifespan and, more importantly, healthspan. The routine assessment of CRF should be considered a vital sign that is routinely assessed in clinical practice. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is one of the most prevalent diseases in the world and is characterized as a complex clinical syndrome. It is a disease that affects both the peripheral muscles and the respiratory muscles, causing damage such as reduced strength and endurance. One of the main symptoms is fatigue and exercise intolerance. The aim of this review article is to assess whether the use of inspiratory muscle training (IMT) associated with conventional training enhances inspiratory muscle strength (PImax) and inspiratory muscle endurance (SPImax) and functional capacity in patients with HF. Methods: A literature review was carried out on the use of IMT in patients, including 6 randomized clinical trials, searched in the PubMed, PEDro and Lilacs databases. Results: There is evidence showing an increase in PImax and SPImax with the addition of IMT to training; in addition, an improvement in VO2 peak, circulatory power and ventilatory efficiency. Conclusion: The use of IMT associated with conventional training is an interesting strategy for boosting gains in strength and inspiratory muscle endurance, increasing exercise tolerance and consequently improving patients' quality of life. However, more studies are needed in order to more clearly define the selection criteria and methodology for applying IMT. [ABSTRACT FROM AUTHOR]

The aim of the of the current investigation was to investigate the possible differences concerning males and females in anthropometry, body composition, functional capacity, strength and quality of life variables. After obtaining signed informed consent, 37 participants (18 males; 19 females), with mean age of 39.08 and standard deviation of 11.66 years, voluntarily participated in this study. Anthropometry, body composition, functional capacity, strength, and quality of life were assessed using validated and reliable instruments and tests for this population. The males and females were compared using a Mann–Whitney U signed rank test. Significant differences were detected among the following variables, height (p = 0.028), body mass index (p = 0.033), fat mass (p = 0.002), muscle mass (p ≤ 0.001), phase angle (p = 0.005), medicine ball throwing strength (p = 0.010), and peak toque left knee (p = 0.028), with males showing better results in all the variables. The sample in this study showed differences in the anthropometric, composition, and strength variables. Studying this population can help ensure that everyone has equal access to services and adequate support for their personal needs, improving their quality of life. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the quality of life (QoL) and physical functioning of patients with diabetic foot (DF) and their associated factors. Methods: 120 participants with DF were recruited in 5 diabetic foot clinics in Dominican Republic. QoL and physical function were measured with the SF-36 and FAAM questionnaires respectively. Multiple linear regression models were used to determine the factors associated with each of the SF-36 and FAAM dimensions. Results: The median scores for the SF-36's dimensions were: physical functioning 30 (Interquartile range [IQR]: 40), role limitations due to physical health 0 (IQR: 25), role limitations due to emotional problems 100 (IQR: 100), vitality 55 (IQR: 30), mental health 55 (IQR: 24), social functioning 50 (IQR: 50), bodily pain 45 (IQR: 47.5), general health 50 (IQR: 30). Median scores for the FAAM's activities of daily living and sports dimensions were 39.3 (IQR: 25.7) and 28.6 (IQR: 28.6) respectively. After multiple linear regression analysis, factors associated with lower SF-36 scores were advanced Wagner grade, smoking, unemployment, female sex, time to treatment, comorbidities and microvascular complications. Factors associated to lower FAAM scores were Wagner grade and living alone. Conclusion: Patients with DF have poor QoL and physical function, with Wagner grade being the main associated factor. Attention should be given to prevention and opportune treatment. Studies that evaluate the impact of preventive and chronic disease management programs for DF are needed.

Introduction & Purpose Although resistance training (RT) is essential to preserve musculoskeletal fitness and maintain a healthy, independent life into old age, only 10-30% of adults perform the recommended number of 2 RT per week, with women participating in even less RT (Bennie et al., 2016, 2018). As women have less skeletal muscle mass, experience an earlier strength loss, and a greater decline in muscle quality, RT appears especially beneficial for them (Doherty, 2001; Janssen et al., 2000). A novel approach to deal with common participation barriers (lack of time, limited access to equipment/facilities) are resistance exercise snacks (RES; Fyfe et al., 2022). Therefore, it was investigated whether RES is an efficient concept for the workplace health promotion (WHP) to facilitate RT in women and improve musculoskeletal fitness. Methods This pilot-study followed a prospective, controlled intervention design. Female employees with sedentary occupations doing RT on less than 2 days/week before study participation were included. Participants self-selected for intervention group (IG) or control group (CG). While the IG (N = 15, mean age 42.1 ± 11.1 years) completed 10 min of RES each working day for 12 weeks supervised by a trainer, the CG (N = 15, mean age 49.9 ± 9.7 years) maintained their habitual physical activity. Primary outcome was change in muscle mass (bioelectrical impedance analysis, SECA® mBCA515 scale). Secondary outcome was change in maximum isometric strength (Dr. WOLFF BackCheck® 617). Balance (Y-balance composite-score, Y-Balance test kit), cardiovascular fitness, (6-minute walking test), perceived health (minimum European health module), and general life satisfaction (general life satisfaction short scale) were assessed for exploratory purpose. Measurements were taken before and after the intervention. The difference in change between groups for muscle mass, strength, balance, and cardiovascular fitness was analyzed via mixed model ANOVA. For perceived health and general life satisfaction Wilcoxon test was applied to analyze within group changes. Results 12 participants of IG and 14 of CG completed the study. Muscle mass improved significantly more in the IG (+.42 kg ± .54) compared to the CG (-.16 kg ± .51) (p = .01, ⴄ²p = .24). Strength did not change significantly between groups. Nevertheless, there was a trend for greater improvements in the IG compared to the CG for trunk extension, trunk flexion, and upper body push but not upper body pull. Regarding exploratory endpoints, no significant changes were found. Discussion Findings of the present study support the notion that training with light loads (< 30% of 1RM) effectively stimulate muscle protein synthesis if the intensity of effort is high. Higher training loads might be required to maximally recruit muscle fibers and induce optimal strength gains. For improvements in balance and cardiovascular fitness more specific training programs are required. Future studies should investigate what training stimuli are needed within RES (e.g., volume, load, frequency) to optimize improvements in musculoskeletal fitness and motivate participants in the long-term applying randomized controlled intervention designs. Conclusion RES is an efficient approach for the WHP to improve muscle mass in inactive women with sedentary occupations. References Bennie, J. A., Lee, D.-C., Khan, A., Wiesner, G. H., Bauman, A. E., Stamatakis, E., & Biddle, S. J. H. (2018). Muscle-strengthening exercise among 397,423 U.S. adults: Prevalence, correlates, and associations with health conditions. American Journal of Preventive Medicine, 55(6), 864–874. https://doi.org/10.1016/j.amepre.2018.07.022 Bennie, J. A., Pedisic, Z., van Uffelen, J. G. Z., Charity, M. J., Harvey, J. T., Banting, L. K., Vergeer, I., Biddle, S. J. H., & Eime, R. M. (2016). Pumping iron in Australia: Prevalence, trends and sociodemographic correlates of muscle strengthening activity participation from a national sample of 195,926 adults. PLoS ONE, 11(4), Article e0153225. https://doi.org/10.1371/journal.pone.0153225 Doherty, T. J. (2001). The influence of aging and sex on skeletal muscle mass and strength. Current Opinion in Clinical Nutrition & Metabolic Care, 4(6), 503–508. Fyfe, J. J., Hamilton, D. L., & Daly, R. M. (2022). Minimal-dose resistance training for improving muscle mass, strength, and function: A narrative review of current evidence and practical considerations. Sports Medicine, 52(3), 463–479. https://doi.org/10.1007/s40279-021-01605-8 Janssen, I., Heymsfield, S. B., Wang, Z., & Ross, R. (2000). Skeletal muscle mass and distribution in 468 men and women aged 18–88 yr. Journal of Applied Physiology, 89(1), 81–88. https://doi.org/10.1152/jappl.2000.89.1.81