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Objectives: To compare the physical performance and responses obtained in the six-minute walking test (6MWT) and the six-minute step test (6MST) between asthmatic and healthy adolescents; and to investigate the relationship between the responses obtained in the tests and the body mass index (BMI), physical activity level and spirometric variables. Methods: Nineteen asthmatic adolescents (AG) and 19 healthy adolescents (HG) of both sexes, aged between 11 and 15 years, were assessed by means of spirometry, the 6MWT and the 6MST, and their physical activity levels were quantified using the International Physical Activity Questionnaire (IPAQ). Results: The AG had poorer physical performance, lower heart rate (HR) and greater lower-limb (LL) fatigue in the 6MST. In the 6MWT, the AG had positive correlations between walked distance (WD) and duration of intense activity, and between HR and BMI, whereas the HG had positive correlations between WD and HR and between WD and respiratory rate (RR). In the 6MST, the AG showed positive correlations between RR and maximum voluntary ventilation (MVV) and between duration of moderate activity and physical performance. The AG also showed negative correlations between physical performance in the 6MST and BMI, and between sensation of dyspnea and duration of walking. Also in the 6MST, the HG showed positive correlations between RR and MVV, and between BMI and LL fatigue (p≤0.05). Conclusion: The 6MST demonstrated differences in exercise capacity between the asthmatic and healthy individuals. Furthermore, the physical performance and responses obtained in the tests were correlated with the MW BMI and physical activity level. [ABSTRACT FROM AUTHOR]

The increase in the prevalence of asthma, particularly in urban communities, has encouraged investigations into preventive strategies. The hygiene theory proposes that early exposure to infections and unhygienic conditions during childhood influences immune system development, potentially protecting against allergic diseases. The mechanisms involved are related to alterations in the intestinal microbiota, such as with probiotics. This study aimed to evaluate the preventive effect of Lacticaseibacillus rhamnosus, Lacticaseibacillus paracasei, and Bifidobacterium animalis ssp. lactis, administered isolated or in combination, at various concentrations, on asthma in an animal model. Mice received two concentrations (1 × 10 9 and 1 × 10 10  CFU/ml) of three probiotics, isolated and in combination, over 26 consecutive days, initiating 10 days before sensitizing and challenging with ovalbumin. In vivo bronchial hyperresponsiveness and airway and lung inflammation were assessed. The administration of L. paracasei, L. rhamnosus, and B. animalis spp. lactis in different concentrations, isolated or in combination, did not reduce hyperresponsiveness and airway and lung inflammation. As probiotic effects are strain and dose-dependents, specific studies are necessary to assess the effect of different probiotic strains, doses, and regimes., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Occupational skin diseases are a frequently self-reported condition in industrialized countries. However, there are few developed and standardized self-report instruments to screen the population at risk for occupational dermatological diseases., Objectives: Translation and cross-cultural adaptation of the long and short versions of The Nordic Occupational Skin Symptoms Questionnaire into Brazilian Portuguese., Methods: The process of translation and cross-cultural adaptation of the questionnaire was developed following the good practice recommendations of the International Society for Pharmacoeconomics and Outcomes Research., Results: After translation into Brazilian Portuguese, the first reconciled version of the questionnaire was evaluated in a first round of interviews with 28 individuals, including patients with dermatological disease and healthy people. In the first meeting of the study review group, changes were made to 43 questions (75.4%) (e.g., inclusion of definition of terms, reformulation of instructions, and changes to alternative words or synonyms). In the second meeting of the study review group, there were modifications in three questions, creation of the second consensus version in Brazilian Portuguese, and then the back-translation of this version. After the second round of cognitive interviews, which took place with 10 patients, we had the third review group meeting (no modification was made) and definition of the final version of the questionnaire., Conclusions: The short and long versions of the Nordic Occupational Skin Symptoms Questionnaire questionnaire are available in Brazilian Portuguese., Competing Interests: Conflicts of interest: None

Objective: To determine the accuracy of incremental Shuttle Walking Test (ISWT) in detecting exercise-induced bronchospasm (EIB) in adults with asthma and to verify whether there is an association of the drop in FEV 1 between ISWT and cardiopulmonary exercise testing with constant-load CPET-CL., Methods: In this cross-sectional study 32 individuals with asthma performed two ISWTs, an incremental cardiopulmonary exercise test (CPET-I) and a constant-load cardiopulmonary exercise test (CPET-CL) with na interval of 48 h between tests. Spirometric measurements were obtained 5, 10, 15, 20 and 30 min after exercise; an FEV1 decline > 10% was considered EIB., Results: Fifteen individuals had EIB in both tests [χ2 = 9.41; κ = 0.46 p  < 0.002 (95% CI: 0.201-0.708)], with moderate agreement. There was a significant correlation between the greatest variation in the drop in FEV 1 between the ISWT and the CPET-CL ( r  = 0.48; p  < 0.01). There was a significant difference for ventilation maintenance time above 40% of Maximum Voluntary Ventilation between the groups of positive EIB ( p  = 0.001) and negative EIB ( p  = 0.001) and for ventilatory demand (positive EIB group) ( p  = 0.008) between ISWT vs CPET-CL. Moreover, assuming CPET-CL as the criterion test, ISWT presented a sensitivity of 62.5% and specificity was 100%., Conclusion: ISWT showed moderate accuracy in detecting EIB in adults with asthma and was able to show similar metabolic and ventilatory demand presented in CPET-CL.

Background: The incremental shuttle walk test (ISWT) has been widely used to assess exercise capacity of subjects with COPD. However, to date, no studies have assessed its reliability in the asthmatic population. This study aimed to assess the test-retest reliability of ISWT for the distance walked (ISWD) and cardiorespiratory and metabolic responses in adult subjects with asthma., Methods: This was a cross-sectional observational study. Thirty-four subjects of both genders, 18-45 y old, with a diagnosis of controlled asthma, were recruited from March 2012 to December 2015. The subjects performed 3 ISWTs on different days, with a minimum interval of 48 h and a maximum of 1 week between the second and third ISWT. For the reliability analysis, the values of the second and third ISWTs were used, eliminating the influence of any learning effect from the first test., Results: The intraclass correlation coefficients were > 0.75 ( P < .001) for ISWD (m), speed (km/h),oxygen uptake (V̇ O 2 ), ventilatory equivalent carbon dioxide (V̇ E /V̇ CO 2 ), and minute ventilation (V̇ E ) at the ISWT peak. The Bland-Altman plot presented a mean error close to zero, and measurement distribution was within acceptable limits of variation., Conclusion: The ISWT presented excellent reliability for the ISWD and metabolic responses. The cardiorespiratory responses in the ISWTs presented good reliability. We concluded that the ISWT was reliable for young adult subjects with controlled asthma., (Copyright © 2019 by Daedalus Enterprises.)

Background: Assessing the strength and endurance of respiratory muscles is fundamental for characterizing respiratory muscle dysfunction. Although a variety of tests are used to evaluate respiratory muscle endurance, not all of them are applicable in clinical practice. Assessments can be made using a practical device called PowerBreathe®, but its reproducibility has not been tested in chronic obstructive pulmonary disease (COPD) patients., Aim: To verify the reproducibility of the inspiratory muscle endurance test using a manometer and PowerBreathe® in COPD patients., Methods: A cross-sectional study was used. In total, 19 moderate-severe COPD patients, male and female, aged 50 to 80 years took part in the research. This evaluation consisted of 2 tests: an incremental test and a constant one held on the same day and repeated after 48 hr. The incremental test started with 10-cm H 2 O, adding 10-cm H 2 O every 2 min and taking 1 min of rest before increasing the load. The highest load that could be sustained for at least 1 min was considered the sustained maximum inspiratory pressure (SMIP) value. The constant test was performed at an intensity of 80% of the SMIP and the maximum time limit was 30 min., Results: In the incremental test, there was a significant increase in the SMIP compared to the test-retest (61 ± 24/64.7 ± 23.8; p = .015); the value of the relative reproducibility was 0.96, the standard error of the absolute measurement was 4.7 (95% confidence interval 9.2), and the minimum detectable difference was 10.9. In the Bland-Altman analysis, the mean error was 4.2 (confidence interval -7.6 to 16.1). The constant test was not reproducible., Conclusion: It was observed that the incremental test was reproducible to evaluate inspiratory muscle endurance in COPD patients. Furthermore, 2 tests needed to be carried out due to the learning effect., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: The 6-min walk test (6MWT) is an important tool in the assessment of functional capacity and prognosis in patients with COPD. However, especially in long-term follow-up in clinical settings, this test may be executed by a different assessor, and it is not well known whether 6MWT has an acceptable inter-rater reliability. The aim of this study is to analyze the intra- and inter-rater reliability of the performance in 6MWT, its cardiorespiratory changes, and effort perception in subjects with COPD., Methods: Thirty-two subjects with a diagnosis of COPD participated in the study, but 3 subjects did not appear on the second day of evaluation and therefore were included only in the intra-rater analysis; the first and second tests were executed by the same assessor with a 30-min interval between them, and the last was executed by a different assessor a week later. The intra-rater reliability was verified comparing the first and second 6MWT performance, and the inter-rater reliability was verified comparing the third test with the best performance of the first and second tests., Results: The intraclass correlation coefficient values were >0.75 (P < .001) for the walked distance on the 6MWT; however, the limits of agreement, SE of measurement, and minimal detectable difference were higher than the minimum clinically important differences already mentioned in the literature (∼25, 26, and 54 m), and the coefficient of variation was small in both intra- and inter-rater comparisons., Conclusions: The 6MWT showed excellent reliability for distance and perceived exertion and moderate to excellent for HR and SD as assessed by intra- and inter-rater analysis. Thus, based on the main study outcomes, we concluded that the 6MWT can be compared when conducted by 2 different evaluators., (Copyright © 2016 by Daedalus Enterprises.)

Objective: To determine the 6-minute step test's (6MST) reliability and validity and to establish reference performance values of this test., Design: Prospective observational cross-sectional study., Setting: Spirometry and Respiratory Physiotherapy Laboratory, Federal University of São Carlos (institutional)., Participants: Ninety-one individuals [42 men and 49 women, mean age = 39 years (SD, 17 years)] without any diagnosed diseases and with normal exercise capacity [6-minute walk test (6MWT) >75% of the predicted normal]., Independent Variables: Participants underwent two 6MST on 1 day and two 6MWT on another day in randomized order. Furthermore, age, gender, height, weight, lower limbs length, abdominal circumference, percentage of body fat, and fat-free mass were obtained., Main Outcome Measures: Test-retest reliability was assessed by comparing the findings of the two 6MST using the intraclass correlation coefficient (ICC) and Bland-Altman plot. Validity was assessed by comparing outcomes of the 6MST to outcomes of 6MWT using the Pearson correlation coefficient. A multiple regression analysis was conducted using the stepwise method to develop an equation to predict reference values., Results: The performance (mean steps ± SD) in the first and second test was 149 ± 34 and 149 ± 36 steps, respectively, which was correlated to distance (in meters) in 6MWT (r = 0.72; P < 0.05). Six-minute step test performance was reliable (ICC = 0.9; 95% confidence interval: 0.85-0.93). The equation to predict reference values for the first 6MST was significant (P < 0.001 and R = 0.48): Performance(steps) = 174 to 1.05 × Age(years) to women and Performance(steps) = 209 to 1.05 × Age(years) to men., Conclusions: Six-minute step test is a reliable and valid test. Moreover, the number of steps may be predicted by demographic and anthropometric variables with moderate strength of prediction., Clinical Relevance: Six-minute step test is an exercise test that is easy to be conducted, more tolerable than a graded exercise test, requires fewer equipments and space, and permits better monitoring of the participants. The assessment of the reliability, validity, and reference values will provide a better interpretability for clinicians to use it, especially in primary care.

Background: Patients with COPD may experience respiratory muscle weakness. Two therapeutic approaches to the respiratory muscles are inspiratory muscle training and calisthenics-and-breathing exercises. The aims of the study are to compare the effects of inspiratory muscle training and calisthenics-and-breathing exercises associated with physical training in subjects with COPD as an additional benefit of strength and endurance of the inspiratory muscles, thoracoabdominal mobility, physical exercise capacity, and reduction in dyspnea on exertion. In addition, these gains were compared between subjects with and without respiratory muscle weakness., Methods: 25 subjects completed the study: 13 composed the inspiratory muscle training group, and 12 composed the calisthenics-and-breathing exercises group. Subjects were assessed before and after training by spirometry, measurements of respiratory muscle strength and test of inspiratory muscle endurance, thoracoabdominal excursion measurements, and the 6-min walk test. Moreover, scores for the Modified Medical Research Council dyspnea scale were reported., Results: After intervention, there was a significant improvement in both groups of respiratory muscle strength and endurance, thoracoabdominal mobility, and walking distance in the 6-min walk test. Additionally, there was a decrease of dyspnea in the 6-min walk test peak. A difference was found between groups, with higher values of respiratory muscle strength and thoracoabdominal mobility and lower values of dyspnea in the 6-min walk test peak and the Modified Medical Research Council dyspnea scale in the inspiratory muscle training group. In the inspiratory muscle training group, subjects with respiratory muscle weakness had greater gains in inspiratory muscle strength and endurance., Conclusions: Both interventions increased exercise capacity and decreased dyspnea during physical effort. However, inspiratory muscle training was more effective in increasing inspiratory muscle strength and endurance, which could result in a decreased sensation of dyspnea. In addition, subjects with respiratory muscle weakness that performed inspiratory muscle training had higher gains in inspiratory muscle strength and endurance but not of dyspnea and submaximal exercise capacity. (ClinicalTrials.gov registration NCT01510041.)., (Copyright © 2016 by Daedalus Enterprises.)

Objective: To compare the autonomic modulation of heart rate (HR) in asthmatic and healthy volunteers to correlate it with the forced expiratory volume in the first second (FEV1)., Methods: Ten healthy and 14 asthmatic volunteers were included in this cross-sectional study. The volunteers underwent a cardiopulmonary exercise test, spirometry and a register of both resting heart rate variability (HRV) in the supine and seated positions along with HRV during the respiratory sinus arrhythmia maneuver (M-RSA)., Results: At rest in supine, asthmatic volunteers presented a higher HR (77.1 ± 9.9 vs. 68.7 ± 8.7 bpm), shorter interval between two R waves (R-Ri) (807.5 ± 107.2 vs. 887.5 ± 112.7 ms) when compared with the healthy volunteers, respectively. Moreover, in the frequency domain of HRV, there was increased low frequency (LF) index (50.4 ± 17.1 vs. 29.2 ± 11.1 n.u.) and decreased high frequency (HF) index (49.4 ± 17.1 vs. 70.7 ± 11.1 n.u.). During the M-RSA, the asthmatic presented higher HR (82.6 ± 10.0 vs. 72.4 ± 7.6 bpm) and lower values of R-Ri (746.4 ± 92.1 vs. 846.4 ± 81.4 ms) and approximate entropy (ApEn) (0.7 ± 0.0 vs. 0.8 ± 0.1). FEV1 was strongly correlated with the change of the continuous beat-to-beat variability of HR (SD2) index from the seated to the supine position (r = 0.78)., Conclusion: Controlled asthma in adults appears to induce an increased sympathetic modulation and attenuated response to the postural changes and the M-RSA. Furthermore, there is a correlation between the airways' obstruction and HRV, especially during postural changes.

Objectives: to evaluate the concurrent validity of the six-minute step test (6MST) in assessing exercise capacity of COPD patients using the six-minute walk test (6MWT) as a gold-standard. The predictive validity of the 6MST was assessed to determine a cut-off point for identification of low exercise capacity., Method: thirty-two COPD patients (50-87 years old) with mild to very severe obstruction performed the 6MST and 6MWT twice., Results: Concurrent validity: a strong positive correlation (Pearson) between the number of ascents on the first (T1), second (T2) and the best of both (T1 or T2) tests during the 6MWT was observed. Although a moderate negative correlation with BODE index and FEV1 was found, it was considered insufficient to test the validity, therefore ROC curves were not applied. The predictive validity (ROC) of the 6MST to identify low physical capacity (compared with the 6MWT) using the performance of T1 or T2, or solely T1 was considered accurate, and the area under the curve was 0.8 (IC95% 0.62-0.98) and 0.85 (IC95% 0.70-0.99), respectively. To classify patients, the cut-off points of 86 and 78 steps were chosen, with both values showing 90% of sensitivity and specificity of 64% and 68% for T1 or T2, or solely T1, respectively., Conclusion: The number of steps on the 6MST was valid to verify exercise capacity in COPD patients and the cut-off point of 78 steps was able to identify patients with poor exercise tolerance. Values under this cut-off point are considered to identify patients with a poorer prognosis.

Objective: To determine whether the quality of life of adolescents with asthma correlates with parameters obtained prior to and after the six-minute step test (6MST); spirometric results after the 6MST; and level of physical activity., Methods: Nineteen adolescents with asthma, ranging from 11-15 years of age, were assessed with spirometry, 6MST, the International Physical Activity Questionnaire (IPAQ), the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and the 10-point Borg category-ratio (CR10) scale., Results: Sensation of dyspnea correlated negatively with the total PAQLQ score (r = -0.54) and with the scores of its activity limitation (AL) and symptoms domains (r = -0.64 and r = -0.63, respectively), leg fatigue also correlating negatively with those same domains (r = -0.49 and r = -0.56, respectively). The total IPAQ score correlated with total PAQLQ score (r = 0.47) and with the PAQLQ AL domain (r = 0.51); IPAQ time spent walking correlated with the PAQLQ symptoms domain (r = 0.45); and IPAQ time spent in vigorous activity correlated with the AL domain (r = 0.50). In the regression analysis, only sensation of dyspnea remained significantly correlated with the total PAQLQ score and its AL domain; leg fatigue remained significantly correlated with the symptoms domain., Conclusions: Higher levels of physical activity indicate better quality of life, as do lower perception of dyspnea and less leg fatigue. The 6MST proved to be a viable option for evaluating exercise capacity in adolescents with asthma, because it reflects the discomfort that asthma causes during activities of daily living.