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introduction: This study aimed to study the potential effects of oxaliplatin-based chemotherapy on cardiorespiratory fitness, handgrip strength (HGS), body composition, and quality of life (QoL) of stages III–IV colorectal cancer (CRC) patients before the first cycle (T0) and after the last cycle of systemic adjuvant/neoadjuvant chemotherapy (T1). Methods: Cardiorespiratory fitness, HGS, body composition, and QoL were evaluated with the six-minute walk test (6MWT), hydraulic hand dynamometer, body composition analyzer, and Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire in both T0 and T1, respectively. Results: Twenty-eight CRC patients were included in this study. The total walked distance (TWD) was found to be decreased from T0 to T1 (499.72 m vs. 488.56 m); however, this change was not significant (z = -.706, p = 0.48). Type of chemotherapy whether adjuvant or neoadjuvant also showed no significant effect on TWD (z = -.1.372, p =.17 vs z = -1.180, p =.238, respectively). The QoL was significantly decreased (T0 = 118.35 vs T1 = 110.77, t = 2.176,p = 0.05). The TWD was significantly correlated with the physical well-being (PWB) subscale of FACT-C (r =.64, p = 0.001) as well as with HGS (r =.46, p =.018) in T0. After controlling for age, type of chemotherapy, and type of regimen, the HGS did not show a significant difference from T0 to T1 (F(1,23) = 1.557, p =.22, ηp2 =.06). However, the effect of time x gender showed significant difference from T0 to T1 (F(1,23) = 4.906, p =.037, ηp2 =.17). Conclusion: This study showed the decreased QoL and physical well-being of CRC patients who underwent oxaliplatin-based treatment. In addition, the gender effect of decreased HGS should be considered further when planning an oncological rehabilitation program. [ABSTRACT FROM AUTHOR]

Background: Cardiac resynchronization therapy is an essential treatment for heart failure patients. Candidates typically have cardiomyopathy accompanied by delayed electrical activation in the left ventricular lateral wall, causing uncoordinated contractions and worsening heart failure. Heart failure severity can be assessed with functional tests: the cardiopulmonary test, which is a maximal exercise test, remains the gold standard, but the 6 min walk test has emerged as an easier, faster, and more comfortable alternative to be used by clinicians to adjust treatment protocols for cardiovascular and pulmonary conditions. Methods: This is a prospective observational study that included 69 patients from a single healthcare facility, and the purpose was to determine if the 6 min walk test results could be associated with changes in various electrocardiographic, clinical, functional, and demographic parameters. All the parameters and the 6 min walk distance were recorded at four key time moments: before the procedure and after 6, 9, and 12 months. The electrocardiographic parameters were obtained from the patients' electrocardiograms recorded in the four key moments and included variables such as QRS area, duration, percentage of biventricular pacing, and many others, while the functional variables included the monitored intraprocedural systolic blood pressure and the end-systolic left ventricular volume. We also aimed to check if clinical conditions such as diabetes and chronic kidney disease and demographic variables such as age or sex have any impact. Results and Conclusions: All this research was performed in order to identify which parameters hold a predictive value and can serve as future criteria for better patient selection and for defining a proper resynchronization outcome. The study shows that parameters such as diabetes and QRS duration have an impact over the 6 min walk distance. Also, newer variables such as the QRS area and the R/S ratio may represent a direction worth studying in order to predict the outcomes of cardiac resynchronization therapy. [ABSTRACT FROM AUTHOR]

Background: The available evidence suggests that people with epilepsy have reduced cardio-respiratory fitness and muscle strength endurance, and impaired balance and mobility. The 6-minute walk test (6MWT), Timed Up and Go (TUG), and 30-second chair stand test (30CST) are physical performance tests frequently used in clinical practice. Objective: To establish the test-retest reliability and minimal detectable change of the 6MWT, TUG, and 30CST in people with epilepsy. Methods: The study was designed as an observational study. Forty-one people with epilepsy (23 females, 18 males; mean age 34.7 ± 10.4 years) participated. The 6MWT, TUG, and 30CST were tested by a trained physiotherapist during two sessions, which were conducted 7–14 days apart. The test-retest reliability of measures was assessed using the intra-class correlation coefficients (ICC) using two-way random effects and absolute agreement methods. The 95% limits of agreement, standard error of measurement (SEM), and minimal detectable change (MDC₉₅) were calculated. Results: The 6MWT (ICC = 0.92, SEM = 15.8, MDC₉₅ = 43.8), TUG (ICC = 0.95, SEM = 3.2, MDC₉₅ = 0.5) and 30CST (ICC = 0.92, SEM = 1.0, MDC₉₅ = 2.8) performance measurements demonstrated excellent test-retest reliability. The 95% limits of agreement was calculated, as illustrated in a Bland-Altman plot. Conclusion: The 6MWT, TUG, and 30CST are reliable for measuring physical performance. The findings of this study can support researchers and clinicians to decide if a change score of a person with epilepsy is likely to be measurement error or true change. [ABSTRACT FROM AUTHOR]

Introduction: Nusinersen clinical trials have limited data on adolescents and adults with 5q-associated spinal muscular atrophy (SMA). We conducted a systematic literature review (SLR) and meta-analysis to assess effectiveness of nusinersen in adolescents and adults with SMA in clinical practice. Methods: Our search included papers published 12/23/2016 through 07/01/2022 with ≥ 5 individuals ≥ 13 years of age and with ≥ 6 months' data on ≥ 1 selected motor function outcomes [Hammersmith Functional Motor Scale–Expanded (HFMSE), Revised Upper Limb Module (RULM), and Six-Minute Walk Test (6MWT)]. For meta-analysis, effect sizes were pooled using random-effects models. To understand treatment effects by disease severity, subgroup meta-analysis by SMA type and ambulatory status was conducted. Results: Fourteen publications including 539 patients followed up to 24 months met inclusion criteria for the SLR. Patients were age 13–72 years and most (99%) had SMA Type II or III. Modest improvement or stability in motor function was consistently observed at the group level. Significant mean increases from baseline were observed in HFMSE [2.3 points (95% CI 1.3–3.3)] with 32.1% (21.7–44.6) of patients demonstrating a clinically meaningful increase (≥ 3 points) at 18 months. Significant increases in RULM were consistently found, with a mean increase of 1.1 points (0.7–1.4) and 38.3% (30.3–47.1) showing a clinically meaningful improvement (≥ 2 points) at 14 months. Among ambulatory patients, there was a significant increase in mean 6MWT distance of 25.0 m (8.9–41.2) with 50.9% (33.4–68.2) demonstrating a clinically meaningful improvement (≥ 30 m) at 14 months. The increases in HFMSE were greater for less severely affected patients, whereas more severely affected patients showed greater improvement in RULM. Conclusions: Findings provide consolidated evidence that nusinersen is effective in improving or stabilizing motor function in many adolescents and adults with a broad spectrum of SMA. Plain Language Summary: Motor neurons are specialized cells in the brain and spinal cord that control the function of muscles. People with spinal muscular atrophy (SMA) do not make enough survival motor neuron (SMN) protein, which motor neurons need to function. As a result, people with SMA experience decreased muscle function that gets worse over time. Nusinersen is a drug that increases the amount of SMN protein made in the brain and spinal cord. However, most clinical trials of nusinersen have been in infants and children with SMA. Less is known about the effects of nusinersen in teenagers and adults with SMA who may have less severe but still progressive forms of the disease. In this manuscript, we first conducted a thorough review and analysis of research published by investigators who treated teenagers and adults with nusinersen for up to 24 months. We then used an additional analysis, called a meta-analysis, that allowed us to combine the information from several articles, so that we could better understand whether nusinersen helped these patients. We looked at 3 tests that investigators used to see how nusinersen affected patients' motor function. The Hammersmith Functional Motor Scale–Expanded (HFMSE) assesses upper and lower limb motor function; the Revised Upper Limb Module (RULM) evaluates upper limb function; and the Six-Minute Walk Test (6MWT) measures the maximum distance a person can walk in 6 minutes. Our study showed that nusinersen can improve motor function or prevent motor function from getting worse in many teenagers and adults with SMA. [ABSTRACT FROM AUTHOR]

The heterogeneity of Parkinson’s disease (PD) presents considerable challenges for accurate diagnosis, particularly during early-stage disease, when the symptoms may be extremely subtle. This study aimed to assess the accuracy of a convolutional neural network (CNN) technique based on the 6-min walk test (6MWT) measured using wearable sensors to distinguish patients with early-stage PD (n = 78) from healthy controls (n = 50). The participants wore six sensors, and performed the 6MWT. The time-series data were converted into new images. The results revealed that the gyroscopic vertical component of the lumbar spine displayed the highest classification accuracy of 83.5%, followed by those of the thoracic spine (83.1%) and right thigh (79.5%) segment. These findings suggest that the 6MWT and CNN models may facilitate earlier diagnosis and monitoring of PD symptoms, enabling clinicians to provide timely treatment during the critical transition from normal to pathologic gait patterns. [ABSTRACT FROM AUTHOR]

Abstract The heterogeneity of Parkinson’s disease (PD) presents considerable challenges for accurate diagnosis, particularly during early-stage disease, when the symptoms may be extremely subtle. This study aimed to assess the accuracy of a convolutional neural network (CNN) technique based on the 6-min walk test (6MWT) measured using wearable sensors to distinguish patients with early-stage PD (n = 78) from healthy controls (n = 50). The participants wore six sensors, and performed the 6MWT. The time-series data were converted into new images. The results revealed that the gyroscopic vertical component of the lumbar spine displayed the highest classification accuracy of 83.5%, followed by those of the thoracic spine (83.1%) and right thigh (79.5%) segment. These findings suggest that the 6MWT and CNN models may facilitate earlier diagnosis and monitoring of PD symptoms, enabling clinicians to provide timely treatment during the critical transition from normal to pathologic gait patterns.

Introduction/Aims: Persons with spinal muscular atrophy (pwSMA) report progressive muscle weakness but also reduced endurance when performing repetitive tasks in daily life, referred to as "performance fatigability" (PF). Data regarding the effects of the new disease‐modifying drugs on PF are scarce. Thus, our main objective was to examine PF in adult ambulatory pwSMA treated long‐term with nusinersen. Methods: Six‐minute walk test (6MWT) data from 14 adult pwSMA treated with nusinersen for up to 70 months were retrospectively analyzed to determine PF. Performance fatigability was defined as the percentage change in the distance covered between the last and first minute of the 6MWT. In addition, relationships between PF and other clinical features were assessed. Results: Performance fatigability was found in 12/14 pwSMA (85.7%) prior to treatment. The mean distance walked in the sixth minute (71.1 m) was shorter than the distance covered in the first minute (81.8 m), corresponding to a mean PF of 13.1% (95% confidence interval (CI): 6.5–19.6, p =.0007). During treatment with nusinersen, there was a mean reduction in PF of 5.6% (95% CI: −10.0 to −1.3, p =.0148). We found no relationship between PF and fatigue as measured by the Fatigue Severity Scale. Discussion: This study demonstrates the presence of PF as an independent component of motor impairment and as a potential therapeutic target in our cohort of adult ambulatory pwSMA. Furthermore, the observations in our cohort suggest that nusinersen may have a beneficial effect on PF. [ABSTRACT FROM AUTHOR]

Introduction: Fibrosing interstitial lung diseases (ILDs) often progress despite treatment and become life-threatening, with lung transplant (LTx) remaining the only curative option. Six-minute walk distance (6MWD) is increasingly recognized as reliable predictor of clinical course, especially when longitudinally considered. The use of reference equations to express 6MWD as percent predicted (6MWD%) has not been previously studied in fibrosing ILDs. We sought to investigate whether the prognostic power of 6MWD% is superior to that of 6MWD expressed in meters (6MWD-m). Methods: A retrospective, multicenter cohort analysis was conducted on both idiopathic pulmonary (IPF) and non-IPF fibrosing ILD patients. Patients were divided into a discovery (n = 211) and a validation (n = 260) cohort. Longitudinal changes of 6MWD% and lung function parameters were simultaneously considered. LTx-free survival at 3 years from baseline was the endpoint. Competing risks of death and LTx were considered. Results: Baseline 6MWD% and its longitudinal changes were significant predictors of LTx-free survival and independent from lung function variables. In both cohorts, on multivariate cox proportional hazard regression analysis, receiver operating characteristics analysis and Kaplan–Meier estimates, 6MWD% was consistently, but only slightly superior to 6MWD-m as a predictor of LTx-free survival. Conclusion: 6MWD% has only a slight, yet detectable advantage over 6MWD-m as a predictor of survival in fibrosing ILDs. Utilizing 6MWD% may aid in risk stratification, treatment monitoring, and LTx timing optimization. However, available reference equations do have predicting limitations. Refined predictive equations and standardizing reporting practices are therefore needed to further enhance the clinical utility of 6MWD% in fibrosing ILDs. [ABSTRACT FROM AUTHOR]

Abstract Aims Frailty is an obstacle to performing cardiopulmonary exercise test (CPET) in patients with chronic heart failure (CHF). We evaluated the usefulness of oxygen uptake efficiency slope (OUES) using a 6 min walk test (6MWT) with portable gas analysis compared with CPET‐derived parameters in patients with CHF. Methods and results Patients with CHF who underwent both the 6MWT with portable gas analysis and CPET between December 2016 and May 2020 were retrospectively investigated. The 6MWT‐derived and echocardiographic parameters were compared with the OUES and peak oxygen consumption (VO2) from the CPET. Forty patients were analysed; 50% were male with a mean age of 55.45 ± 14.70 years. Twenty‐six patients (65%) had New York Heart Association Functional Classification II or III dyspnoea. Twenty‐five patients (62.5%) had heart failure (HF) with preserved ejection fraction (EF) (left ventricular EF > 50%), and nine patients (22.5%) had HF with reduced EF (EF

Abstract Knowledge about a patient’s physical fitness can aid in medical decision-making, but objective assessment can be challenging and time-consuming. We aimed to investigate the concordance of self-reported health status and physical functioning with the 6 minute walking distance (6MWD) as objective measure of physical performance. The prospective characteristics and course of heart failure stages A/B and determinants of progression (STAAB) cohort study iteratively follows a representative sample of residents of the city of Würzburg, Germany, aged 30–79 years, without a history of heart failure (HF). The 6MWD was measured in 2752 individuals (aged 58 ± 11 years, 51% women) from a population-based cohort under strictly standardized conditions. Self-reported health status and physical functioning were assessed from items of the short form 36 (SF-36). After the respective classification of self-reported health status and physical functioning into ‘good’, ‘moderate’, and ‘poor’, we determined the association of these categories with 6MWD by applying a generalized linear model adjusted for age and sex. Prevalence of self-reported good/moderate/poor general health and physical functioning was 41/52/7% and 45/48/7%, respectively. Mean 6MWD in the respective categories was 574 ± 70/534 ± 76/510 ± 87 m, and 574 ± 72/534 ± 73/490 ± 82 m, with significant sex-specific differences between all categories (all p

Introduction: Pulmonary Tuberculosis (PTB) treatment can improve health, but patients may experience sequelae of cardiopulmonary complications. PTB can contribute to complications in the cardiovascular system, including abnormal Electrocardiogram (ECG) readings, and the pulmonary system can be damaged, leading to reduced lung capacity and difficulty in breathing. It may cause a combined impact on Quality of Life (QoL). Understanding this is crucial for optimising patient care and identifying potential complications early. Aim: To assess cardiopulmonary functions and QoL in patients undergoing PTB treatment. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital in Pune, Maharashtra, India from August 2019 to October 2019. Total of 32 patients (20-50 years old) receiving PTB treatment for six months were included. Haematological tests and Chest X-ray (CXR) were conducted, and QoL was measured using the St. George’s Respiratory Questionnaire (SGRQ). Exercise capacity was evaluated by measuring Oxygen Saturation (SpO2) before and after the 6-Minute Walk Test (6MWT). Results: In this study, anaemia was prevalent in 24 patients (75%). ECG abnormalities were detected in 20 (62.5%) patients, and Echocardiography (ECHO) revealed Pulmonary Arterial Hypertension (PAH) in 2 (6.25%) patients. Exercise capacity, measured by a 6MWT, decreased SpO2 in most patients 27 (84.37%), with a greater decline in females and older individuals. All patients reported significant QoL impairment, with worse activity scores in males. Conclusion: PTB treatment may impact cardiovascular function and QoL. Regular screening for complications and potentially tailored treatment plans are warranted for PTB patients.

Background: A six-minute walk test (6MWT) is a reproducible, easily performed test, and is widely used to determine functional exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). However, there is currently a paucity of data on the clinical significance of baseline and serial 6-minute walk tests in patients with IPF, especially in Asian patients. Objectives: We aimed to investigate the clinical significance of serial 6MWT in patients with IPF, especially in Asian patients. Design: This is a single-center retrospective cohort study. Methods: Clinical data of patients diagnosed with IPF at a tertiary center in Korea were retrospectively analyzed. IPF diagnosis was defined according to the clinical guidelines of the American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society/Latin American Thoracic Association. Results: There were 216 patients diagnosed with IPF from December 2012 to January 2022, of whom 198 had a baseline of 6MWT data. The mean age of the cohort was 66.9 ± 8.6, and 89% were male. The non-survivors showed significantly lower six-minute walk distance (6MWD), minimum saturation of peripheral oxygen (SpO2) during 6MWT, forced vital capacity, and diffusing capacity of the lung for carbon monoxide than survivors at baseline. A multivariate Cox analysis demonstrated that lower minimum SpO2 was independently associated with increased mortality rates (Hazard ratio (HR): 1.081, 95% confidence interval (CI): 1.024–1.142, p = 0.005). Higher mortality rates were also associated with echocardiographic-determined pulmonary hypertension (HR: 2.466, 95% CI: 1.149–5.296, p = 0.021) at diagnosis. Among 144 patients with 6MWT results at 12 months, patients with a decline of 50 m or more in the 6MWD showed poorer overall survival than others (median survival: 45.0 months vs 58.0 months, p < 0.001). Conclusions: Baseline lower minimum SpO2 during 6MWT was an independent prognostic factor in patients with IPF, and a decline in 6MWD in serial follow-up was also associated with a poorer prognosis. These findings suggest that both baseline 6MWT and follow-up data are important in the prognostication of patients with IPF. [ABSTRACT FROM AUTHOR]

Aims: Frailty is an obstacle to performing cardiopulmonary exercise test (CPET) in patients with chronic heart failure (CHF). We evaluated the usefulness of oxygen uptake efficiency slope (OUES) using a 6 min walk test (6MWT) with portable gas analysis compared with CPET‐derived parameters in patients with CHF. Methods and results: Patients with CHF who underwent both the 6MWT with portable gas analysis and CPET between December 2016 and May 2020 were retrospectively investigated. The 6MWT‐derived and echocardiographic parameters were compared with the OUES and peak oxygen consumption (VO2) from the CPET. Forty patients were analysed; 50% were male with a mean age of 55.45 ± 14.70 years. Twenty‐six patients (65%) had New York Heart Association Functional Classification II or III dyspnoea. Twenty‐five patients (62.5%) had heart failure (HF) with preserved ejection fraction (EF) (left ventricular EF > 50%), and nine patients (22.5%) had HF with reduced EF (EF < 40%). During the 6MWT, the peak VO2 was 14.97 ± 3.80 mL/kg/min, which was only 74% of the peak VO2 in the CPET, 20.18 ± 5.64 mL/kg/min. The OUES in the 6MWT was lower than that in the CPET (1528.87 ± 579.01 in the 6MWT vs. 1638.69 ± 601.31 in the CPET). The 6 min walk distance (6MWD) and OUES in the 6MWT were positively correlated with the OUES in the CPET (6MWD, r = 0.434, P = 0.005; OUES, r = 0.729, P < 0.001). The OUES in the 6MWT showed the strongest correlation with the OUES in the CPET. When we divided patients into two groups according to peak VO2 in the CPET, the correlation between OUES values of the 6MWT and that of the CPET was consistently confirmed (peak VO2 ≥ 20 mL/kg/min group, r = 0.661, P = 0.001; peak VO2 < 20 mL/kg/min group, r = 0.526, P = 0.021). In addition, the 6MWD, OUES, and peak VO2 in the 6MWT were associated with peak VO2 in the CPET (6MWD, r = 0.627, P < 0.001; OUES, r = 0.452, P = 0.003; and peak VO2, r = 0.492, P = 0.001). Conclusions: In frail patients with CHF who have difficulty performing maximal exercises, the OUES through the 6MWT may be applied instead of the OUES and peak VO2 from the CPET. [ABSTRACT FROM AUTHOR]

Instrumenting the six-minute walk test (6MWT) adds information about gait quality and insight into fall risk. Being physically active and preserving multi-directional stepping abilities are also important for fall risk reduction. This analysis investigated the relationship of gait quality during the 6MWT with physical functioning and physical activity. Twenty-one veterans (62.2 ± 6.4 years) completed the four square step test (FSST) multi-directional stepping assessment, a gait speed assessment, health questionnaires, and the accelerometer-instrumented 6MWT. An activity monitor worn at home captured free-living physical activity. Gait measures were not significantly different between minutes of the 6MWT. However, participants with greater increases in stride time (ρ = −0.594, p < 0.01) and stance time (ρ = −0.679, p < 0.01) during the 6MWT reported lower physical functioning. Neither physical activity nor sedentary time were related to 6MWT gait quality. Participants exploring a larger range in stride time variability (ρ = 0.614, p < 0.01) and stance time variability (ρ = 0.498, p < 0.05) during the 6MWT required more time to complete the FSST. Participants needing at least 15 s to complete the FSST meaningfully differed from those completing the FSST more quickly on all gait measures studied. Instrumenting the 6MWT helps detect ranges of gait performance and provides insight into functional limitations missed with uninstrumented administration. Established FSST cut points identify aging adults with poorer gait quality. [ABSTRACT FROM AUTHOR]

Knowledge about a patient's physical fitness can aid in medical decision-making, but objective assessment can be challenging and time-consuming. We aimed to investigate the concordance of self-reported health status and physical functioning with the 6 minute walking distance (6MWD) as objective measure of physical performance. The prospective characteristics and course of heart failure stages A/B and determinants of progression (STAAB) cohort study iteratively follows a representative sample of residents of the city of Würzburg, Germany, aged 30–79 years, without a history of heart failure (HF). The 6MWD was measured in 2752 individuals (aged 58 ± 11 years, 51% women) from a population-based cohort under strictly standardized conditions. Self-reported health status and physical functioning were assessed from items of the short form 36 (SF-36). After the respective classification of self-reported health status and physical functioning into 'good', 'moderate', and 'poor', we determined the association of these categories with 6MWD by applying a generalized linear model adjusted for age and sex. Prevalence of self-reported good/moderate/poor general health and physical functioning was 41/52/7% and 45/48/7%, respectively. Mean 6MWD in the respective categories was 574 ± 70/534 ± 76/510 ± 87 m, and 574 ± 72/534 ± 73/490 ± 82 m, with significant sex-specific differences between all categories (all p < 0.001) as well as significant differences between the respective groups except for the categories 'moderate' and 'poor' health status in men. This cross-sectional analysis revealed a strong association between self-reported health status and physical functioning with the objective assessment of 6MWD, suggesting that physicians can rely on their patients' respective answers. Nevertheless, sex-specific perception and attribution of general health and physical functioning deserve further in-depth investigation. Decision-making based on self-reported health requires prospective evaluation in population-based cohorts as well as adult inpatients. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary Tuberculosis (PTB) treatment can improve health, but patients may experience sequelae of cardiopulmonary complications. PTB can contribute to complications in the cardiovascular system, including abnormal Electrocardiogram (ECG) readings, and the pulmonary system can be damaged, leading to reduced lung capacity and difficulty in breathing. It may cause a combined impact on Quality of Life (QoL). Understanding this is crucial for optimising patient care and identifying potential complications early. Aim: To assess cardiopulmonary functions and QoL in patients undergoing PTB treatment. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital in Pune, Maharashtra, India from August 2019 to October 2019. Total of 32 patients (20-50 years old) receiving PTB treatment for six months were included. Haematological tests and Chest X-ray (CXR) were conducted, and QoL was measured using the St. George’s Respiratory Questionnaire (SGRQ). Exercise capacity was evaluated by measuring Oxygen Saturation (SpO2 ) before and after the 6-Minute Walk Test (6MWT). Results: In this study, anaemia was prevalent in 24 patients (75%). ECG abnormalities were detected in 20 (62.5%) patients, and Echocardiography (ECHO) revealed Pulmonary Arterial Hypertension (PAH) in 2 (6.25%) patients. Exercise capacity, measured by a 6MWT, decreased SpO2 in most patients 27 (84.37%), with a greater decline in females and older individuals. All patients reported significant QoL impairment, with worse activity scores in males. Conclusion: PTB treatment may impact cardiovascular function and QoL. Regular screening for complications and potentially tailored treatment plans are warranted for PTB patients. [ABSTRACT FROM AUTHOR]

Purpose: Guidelines advocate the use of pulmonary rehabilitation (PR) in individuals with COVID-19. However, there is a lack of concrete information on inpatient PR. Therefore, we synthesized literature on the efficacy of inpatient PR on pulmonary outcomes in individuals with COVID-19. Methods: Using PubMed, Web of Science, Cochrane Library and Embase, three researchers screened 474 articles for eligibility with the search terms: (covid-19 or coronavirus or 2019-ncov or sars-cov-2 or cov-19 *) AND (respiratory or pulmonary) AND (physical therapy or physiotherapy or rehabilitation). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. Nine articles were finalized using the inclusion criteria: diagnosis of COVID-19, age >18 years and inpatient PR. Reviewers extracted relevant information and appraised using the Robins-I tool and the Newcastle Ottawa Scale. Results: The pooled sample consisted of 718 participants (F = 35.2%, age = 36-71 y). Study quality for non-randomized trial was moderate, while cohort studies had a mean score of 7/9. The pooled estimate showed that inpatient PR could improve the exercise capacity with clinical importance for individuals with COVID-19. Within group changes were noted in FEV1 and FVC values (n54) and HR-QoL (n = 3). Inpatient PR was reported to be safe (n = 4). Conclusions: Current review suggests that inpatient PR was safe, feasible and induced large improvements in exercise capacity in individuals with COVID-19. Given the high heterogeneity, sample sizes and quality of designs of the included studies, findings should be interpreted with caution. Our study provides valuable evidence that inpatient PR is safe and may accelerate improvement in exercise capacity in individuals with COVID-19. [ABSTRACT FROM AUTHOR]

Background: Poor cardiorespiratory fitness poses the highest risk of mortality. Long-COVID-19 survivors exhibit a reduced cardiorespiratory fitness (CRF). While exercise rehabilitation, such as cardiopulmonary exercise, is used for long-COVID-19 survivors, the effects of exercise on CRF in this population remain inconclusive. In this study, we aim to systematically summarise and synthesise whether exercise rehabilitation improves CRF among long-COVID-19 survivors. Methods: A comprehensive search was performed through PubMed, CINAHL, Embase, Scopus, and the Cochrane Library (since their inception to November 2023) and study reference lists. Studies presenting the effects of exercise rehabilitation on CRF (peak oxygen consumption (VO2peak) and six-minute walk distance (6MWD)) in long-COVID-19 survivors were identified. The standardised mean difference (SMD), mean difference (MD), and 95% confidence interval (CI) were used for analyses. The certainty of evidence was measured using a Grading of Recommendation Assessment, Development and Evaluation approach. Results: Twelve eligible studies (five RCTs and seven non-RCTs) with 682 participants were analysed. The meta-analysis showed significantly improved 6MWDs (MD 76.47, 95% CI 59.19–93.71, low certainty) and significantly greater 6MWDs (SMD 0.85, 95% CI 0.11–1.59, very low certainty) in the exercise rehabilitation group compared to the control group. A significantly improved 6MWD was found in subgroups of young to middle-aged adults and subgroups of patients who undertook aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. Conclusions: Exercise rehabilitation is effective for improving CRF, as measured by the 6MWD in long-COVID-19 survivors. Improvements are likely to be more pronounced in specific subgroups of young to middle-aged adults and patients undertaking aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. However, recommendations for clinical practice are limited due to the very low evidence certainty. [ABSTRACT FROM AUTHOR]

Study Design. A retrospective observational study. Objective. To assess whether the six-minute walk test (6MWT) can predict cardiopulmonary function in children with idiopathic scoliosis (IS) as an alternative to the cardiopulmonary exercise test (CPET). Summary of Background Data. Cardiopulmonary functional impairment in the setting of IS is a common health problem. A simple and convenient assessment method is needed. Materials and Methods. We recruited 65 children (eight male, 57 female) aged 10.70 to 14.84 years old with IS. Radiographic characteristics of the cohort were measured, including Risser's sign and Cobb angle. We measured cardiopulmonary exercise tolerance using both the 6MWT and CPET and their corresponding indicators, including six-minute walking distance (6MWD) and peak oxygen uptake (peak VO2), respectively. Pearson correlation analysis was used to determine the relationship between 6MWT indicators and IS parameters. Linear regression models were used to explore the relationship between 6MWT and CPET response indicators. Results. Over a third of the cohort (35.4%) had a Risser's sign grade of 0, with 21.5% in grade 2 and 3, respectively. The cohort's mean Cobb angle was 26.02°. 6MWD was significantly positively correlated with Risser's sign (R= 0.258; P=0.038) and change in respiratory rate positively correlated with vertebral rotation (R=0.264; P= 0.034). 6MWD positively correlated with peak VO2, peak VO2/heart rate (HR), and metabolic equivalents, and negatively correlated with the ventilation equivalent of the carbon dioxide slope (VE/VCO2 slope) (P< 0.05). These four CPET indicators were found to be predicted from 6MWD in the linear regression model (P< 0.05). Conclusions. CPET response indicators, especially peak VO2, can be predicted using 6MWD, among other factors. The 6MWT can therefore be used to rapidly and efficiently predict the cardiorespiratory tolerance of children with IS. [ABSTRACT FROM AUTHOR]

The six-minute walk test (6MWT) is considered reliable and valid for assessing walking capacity in people with neurologic conditions. However, the consistency in the test length and configuration used is unclear. To determine how the 6MWT was configured by licensed physical therapists working with patients with neurologic conditions in clinical practice, identify their knowledge of the American Thoracic Society (ATS) and Academy of Neurologic Physical Therapy (ANPT) guidelines for the 6MWT and assess relationships between therapist demographic characteristics and knowledge of the 6MWT guidelines. One hundred forty-six therapists completed a survey related to the configuration they used for the 6MWT. Configuration of the 6MWT varied widely. Space limitation was the most frequently selected reason for reported configurations. Over half had available the standardized 100-feet straight walkway but fewer than one-third used this configuration of the ATS guidelines. Fewer than half knew of the ATS guidelines and nearly three-fourths knew of the ANPT guidelines. American Physical Therapy Association membership and having a higher percentage of neurologic patients were associated with knowledge of both guidelines. The 6MWT must be completed within the constraints of the working environment, and this requirement is clinically relevant when comparing patient results to normative values and measurements across clinics. Our results suggest a need for updated norms that are more congruent with space constraints in current practice settings. [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]

Silicosis is associated with preventable but irreversible lung damage. Early quantifiable assessment of silicosis workers would promote early interventional steps to reduce health deterioration. The objectives of this study were to correlate spirometry findings and post-six-minute walk test oxygen desaturation (post-6MWT OD) in chronic simple silicosis with age, duration of silica exposure (DSE), smoking pack years (SPY), occupation, and mean pulmonary artery pressure. Based on occupational exposure to silica and radiologic confirmation of chronic simple silicosis, 104 patients (all males) were enrolled and grouped based on SPY (nil, 1-10, 11-20, and >20) and occupation (drillers and dressers). They were further investigated with spirometry, post-6MWT OD, and transthoracic echocardiography (TTE), and findings were statistically analyzed. Abnormal spirometry findings were seen in 62.5% of total cases (65/104), with the highest percentage in the >20 SPY group (84%; 21/25) and drillers (68.3%; 28/41). The post-6MWT OD was seen in 50.96% of cases (53/104) with the highest percentage in the >20 SPY group (56%; 14/25) and drillers (63.4%; 26/41). Normal and restrictive patterns were predominant among 20 SPY group. Normal, obstructive, and restrictive patterns were predominant among dressers, while mixed patterns were in drillers. Mean age and mean DSE were higher for >20 SPY group and dressers; obstructive and mixed patterns; and patients with post-6MWT OD. Pulmonary hypertension was significantly associated with the presence of abnormal spirometry patterns (69.3%; 45/65) and post-6MWT OD (79.3%; 42/53). Mean forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) was significantly lower for the >20 SPY group. Mean FEV1 had an inverse relation with SPY, and mean FVC was lower for drillers than dressers. Spirometry, post-6MWT OD, and TTE assessment give a complete overview of the cardiopulmonary exercise capacity of chronic silicosis patients and facilitate early interventions with special consideration for workers involved in machine-based mining activity.

Introduction: Survivors of severe Coronavirus Disease-2019 (COVID-19) pneumonia may experience Exercise-Induced Desaturation (EID), which can remain undiagnosed at discharge, as most exhibit normal resting Arterial Blood Gases (ABGs). This undiagnosed condition may lead to unexpected hospital readmissions, causing additional burden to the health system. However, the prevalence of EID among this population, especially in developing countries, is not well documented. Aim: To estimate the prevalence of EID among survivors of severe COVID-19 pneumonia and to explore the predictive role of Lung Ultrasound Scan (LUS) in detecting EID. Materials and Methods: This hospital-based, observational, cross-sectional study was conducted at the Institute of Chest Diseases in Kozhikode, Kerala, India from October 2021 to September 2022. It involved 153 COVID-19 patients aged 18 years and above who had recovered from severe pneumonia, were otherwise fit for hospital discharge, and had normal resting ABGs. The study examined the prevalence of EID using the 6-Minute Walk Test (6MWT). Additionally, it investigated the predictive ability of a LUS for EID. A LUS was performed on all patients and scoring was conducted according to the established protocol. Results: The mean age of the study subjects was 53.50±14.13 years, with 119 (77.8%) being male. During the 6MWT, 96 patients (62.7%) showed significant desaturation. A total of 83 (95.4%) subjects in the desaturated group required Non-Invasive Ventilation (NIV) compared to 4 (4.6%) in the non-desaturated group (p

Purpose: Exercise has been demonstrated to alleviate symptoms of restless legs syndrome (RLS) in individuals with RLS, but there are few studies on physical health in primary RLS. This case series aims to describe the outcome of supervised aerobic exercise training in individuals with RLS. Case Report: Five individuals with RLS were given supervised aerobic exercise training 2 days a week for 12 weeks. The International Restless Legs Syndrome Study Group Rating Scale (IRLS) was used to detect the severity of RLS. The Turkish version of the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The functional effect of fatigue was assessed using the Fatigue Impact Scale (FIS). The Six-Minute Walk test (6MWT) was used to determine the functional exercise capacity. All assessments were taken at baseline and post-intervention. Conclusion: Following aerobic exercise, clinically meaningful changes in RLS severity, PSQI, and 6MWT were reported in all individuals with severe RLS. Four out of 5 patients improved their FIS at postintervention. These results suggest that 24-session supervised aerobic exercise training might help to improve RLS severity, sleep quality, fatigue, and exercise capacity in an individual with RLS. [ABSTRACT FROM AUTHOR]

BackgroundPurposeMethodsResultsConclusionMaximal treadmill cardiopulmonary exercise testing is the gold standard for assessing functional capacity in patients with idiopathic pulmonary fibrosis (IPF).Primarily to investigate the concurrent validity between three field tests and cardiopulmonary exercise testing in these patients.Patients performed the cardiopulmonary exercise testing, a six-minute walk test, an incremental shuttle walk test, and, the Glittre–ADL test. For cardiopulmonary exercise testing, the ten seconds with the higher average of the peak oxygen uptake obtained within the last 30 seconds were considered; for six-minute walk test and incremental shuttle walk test, the longer distance; and for the Glittre-ADL test, the shorter time spent. Concurrent validity was assessed using different regression models based on the best adjustment of the data.Twenty-two patients with IPF were assessed, aged: 68 ± 8.1 years, 13 male. Patients presented a peak oxygen uptake of 16.5 ± 3.6 mL.kg−1.min1, achieving a distance of 512.6 ± 102.8 meters in the six-minute walk test and 415.7 ± 125.1 meters in incremental shuttle walk test. The walking distance in the six-minute walk test and the incremental shuttle walk test explained, respectively, 64% and 56% peak oxygen uptake variance observed in the cardiopulmonary exercise testing (R2 = 0.64,p < .001; R2 = 0.56,p < .001). The time spent in the Glittre-ADL test was 233.4 ± 88.7 seconds and explained 47% of the peak oxygen uptake variance observed in cardiopulmonary exercise testing (R2 = 0.47,p = .001).The six-minute walk test, incremental shuttle walk test, and Glittre-ADL test were considered valid tests to explain the peak oxygen uptake variance obtained by the cardiopulmonary exercise testing in patients with IPF. [ABSTRACT FROM AUTHOR]

Simple Summary: Symptom management in the cancer setting focuses on the improvement of the overall quality of life and physical function, particularly for patients with muscle and weight loss, a syndrome known as cachexia, who suffer from low functional ability. Yet, there are no guidelines for measuring or defining low functional ability or standards for identifying meaningful changes in functional ability in response to disease and/or treatment. This unmet need is a major obstacle to developing new/improved therapies for cancer cachexia. This review presents the available evidence for identifying low functional ability and meaningful changes in functional ability in patients with cancer cachexia. Patients with cachexia may display a meaningful reduction in hand grip strength, which may be improved by interventions aiming to increase muscle mass. Future studies should confirm these observations in addition to identifying low functional ability and meaningful changes for other functional outcomes. Managing clinical manifestations of cancer/treatment burden on functional status and quality of life remains paramount across the cancer trajectory, particularly for patients with cachexia who display reduced functional capacity. However, clinically relevant criteria for classifying functional impairment at a single point in time or for classifying meaningful functional changes subsequent to disease and/or treatment progression are lacking. This unmet clinical need remains a major obstacle to the development of therapies for cancer cachexia. This review aims to describe current literature-based evidence for clinically meaningful criteria for (1) functional impairment at a single timepoint between cancer patients with or without cachexia and (2) changes in physical function over time across interventional studies conducted in patients with cancer cachexia. The most common functional assessment in cross-sectional and interventional studies was hand grip strength (HGS). We observed suggestive evidence that an HGS deficit between 3 and 6 kg in cancer cachexia may display clinical relevance. In interventional studies, we observed that long-duration multimodal therapies with a focus on skeletal muscle may benefit HGS in patients with considerable weight loss. Future studies should derive cohort-specific clinically relevant criteria to confirm these observations in addition to other functional outcomes and investigate appropriate patient-reported anchors. [ABSTRACT FROM AUTHOR]

Introduction: Survivors of severe Coronavirus Disease-2019 (COVID-19) pneumonia may experience Exercise-Induced Desaturation (EID), which can remain undiagnosed at discharge, as most exhibit normal resting Arterial Blood Gases (ABGs). This undiagnosed condition may lead to unexpected hospital readmissions, causing additional burden to the health system. However, the prevalence of EID among this population, especially in developing countries, is not well documented. Aim: To estimate the prevalence of EID among survivors of severe COVID-19 pneumonia and to explore the predictive role of Lung Ultrasound Scan (LUS) in detecting EID. Materials and Methods: This hospital-based, observational, cross-sectional study was conducted at the Institute of Chest Diseases in Kozhikode, Kerala, India from October 2021 to September 2022. It involved 153 COVID-19 patients aged 18 years and above who had recovered from severe pneumonia, were otherwise fit for hospital discharge, and had normal resting ABGs. The study examined the prevalence of EID using the 6-Minute Walk Test (6MWT). Additionally, it investigated the predictive ability of a LUS for EID. A LUS was performed on all patients and scoring was conducted according to the established protocol. Results: The mean age of the study subjects was 53.50±14.13 years, with 119 (77.8%) being male. During the 6MWT, 96 patients (62.7%) showed significant desaturation. A total of 83 (95.4%) subjects in the desaturated group required Non-Invasive Ventilation (NIV) compared to 4 (4.6%) in the non-desaturated group (p<0.001). All 24 (100%) subjects in the desaturated group required Invasive Mechanical Ventilation (IMV), while none in the non-desaturated group did. The mean Length Of Stay (LOS) in the hospital was 35.50±13.35 days for the desaturated group, compared to 23.32±16.25 days for the non-desaturated group (p<0.001). The LUS score was significantly higher in the desaturated group (16.61±5.92) than in the non-desaturated group (5.54±4.62). The Receiver Operating Characteristic (ROC) curve for the LUS score indicated a cut-off value of 8.5 for identifying significant EID. Conclusion: Survivors of COVID-19 who recovered from Acute Respiratory Failure (ARF) and have normal resting ABGs may still have significant EID. A protocol-based LUS score can potentially identify individuals at risk for EID. [ABSTRACT FROM AUTHOR]

Objective This study aimed to investigate the effect of stageⅠcomprehensive cardiac rehabilitation in patients with acute ST elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention(PCI). Methods A total of 72 patients with acute ST-segment elevation myocardial infarction combined with PCI admitted to the Department of Cardiovascular Medicine of Beijing Electric Power Hospital of State Grid Corporation from June 2021 to June 2022, which were selected as the research objectsand divided into control group and observation group randomly (36 cases in each group). The control group was treated with routine nursing and health education, and the observation group with stageⅠcomprehensive cardiac rehabilitation, including initial assessment (cardiovascular comprehensive assessment), exercise training (exercise training and breathing training), daily activity suggestions and health education, discharge assessment (six-minute walking test and Barthel index assessment). The score of Barthel index (BI) at discharge, the 6-minute walking test distance (6MWD) at discharge, the incidence of major adverse cardiovascular event (MACE) during hospitalization and within one month of discharge, and the length of stay were compared between the two groups. Results After intervention, the six-minute walking test distance(6MWD)and Barthel index(BI)score in the observation group were better than those in the control group, the difference was statistically significant (P < 0.05). The incidence of major adverse cardiovascular events (MACE) during hospitalization and one month after discharge was lower in the observation group than in the control group, and the difference was statistically significant (P < 0.05). The length of hospitalization in observation group was lower than that in control groupbut there was no statistical difference (P > 0.05). Conclusion The application of phaseⅠcomprehensive cardiac rehabilitation training in patients with acute STsegment elevation myocardial infarction combined with emergency PCI could improve the patients' exercise ability, improve their ability of daily activity, reduce the incidence of major adverse cardiovascular events (MACE) in the early stage of the disease, facilitate the patients to return to their families and society as soon as possible, and improve their quality of life. It has high clinical application value. [ABSTRACT FROM AUTHOR]

Objective -- To investigate the effect of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy on physical condition in children with cystic fibrosis (CF) during a 12month period. Materials and Methods -- This is a retrospective cohort study including children aged ≥5 years treated with Elexacaftor/Tezacaftor/Ivacaftor (ELX/TEZ/IVA) or Lumacaftor/ Ivacaftor (LUM/IVA). A six-minute walk test (6MWT) was performed at baseline and at the 3-month follow-ups. Changes in spirometry and sweat chlorides, and body mass index (BMI) were also observed. Collected data were analysed for changes in 6MWT results in correlation with other parameters. The 6MWT results were compared to those predicted for healthy peers. Missing values were replaced using imputation. Results -- Study includes 34 patients (median age 14 years); 28 received ELX/TEZ/ IVA, and 6 LUM/IVA. The average 6MWT walking distance (6MWD) increased from 519.3±107.7 m at baseline to 620.0±99.5 m after 12 months (P<0.0001). The 12 month 6MWD values matched those expected for healthy peers. The increase in BMI z-score (P=0.019) and ppFEV1 (P<0.0001) visible at the 3-month followup was sustained throughout the rest of the year. Sweat chloride concentration decreased (P< 0.0001); after 12 months 13/34 subjects had values below 60 mmol/L. No correlation between 6MWD and other parameters was observed. Conclusion -- Significant improvement in 6MWT results was already visible at three months following the initiation of CFTR modulator treatment. After 12 months patients performed 6MWT at a level indistinguishable from that expected of healthy peers. [ABSTRACT FROM AUTHOR]

Aim: The six-minute walk test (6MWT) is a common measure of functional capacity in patients with heart failure (HF). Primary clinical study end points in cardiomyopathy (CM) trials, including transthyretin-mediated amyloidosis with CM (ATTR-CM), are often limited to hospitalization and mortality. Objective: To investigate the relationship between the 6MWT and hospitalization or mortality in CM, including ATTR-CM. Method: A PRISMA-guided systematic literature review was conducted using search terms for CM, 6MWT, hospitalization and mortality. Results: Forty-one studies were identified that reported 6MWT data and hospitalization or mortality data for patients with CM. The data suggest that a greater 6MWT distance is associated with a reduced risk of hospitalization or mortality in CM. Conclusion: The 6MWT is an accepted alternative end point in CM trials, including ATTR-CM.

Abstract Background Respiratory complications in breast cancer (BC) patients after chemotherapy (CT) and radiotherapy (RT) have been well acquainted and these complications should be investigated to prevent secondary problems and/or improve BC patients’ clinical outcomes. Therefore, this study aimed to assess the potential acute effect of systemic chemotherapy and radiotherapy on respiratory function and functional status of patients with breast cancer. Methods A total of 25 BC patients who were candidates for systemic chemotherapy and radiotherapy were recruited after oncological examination and included in this study. Respiratory function and functional status were assessed with the Pulmonary Function Test (PFT) and the Six-Minute Walk Test (6MWT), respectively. Patients were assessed before CT (c0), after CT (c1), and after RT (r1). Results 25 BC patients were assessed in c0 and c1 while only 15 out of 25 patients (60%) were assessed in r1. The actual values of Forced vital capacity (FVC) (t = 2.338, p =.028), Forced expiratory volume in 1s (FEV1 (t = 2.708, p =.012), and the forced expiratory flow of between 25% and 75% of vital capacity (FEF25-75%) (t = 2.200, p =.038) were found significantly different after systemic CT. Inspiratory (MIP) and expiratory (MEP) muscle strength also did not show a significant change from c0 to c1. A significant effect of the type of surgery was found (Wilks’ lambda, F [1, 19] = 6.561, p =.019, ηp2 = 0.25) between c0 and c1 in actual FVC value. The main effect of time was found significant in FVC (F [2, 28] = 4.840, p =.016, ηp2 = 0.25) from c0 to r1. Pairwise comparisons with Bonferroni correction showed that there was a significant difference between c0 and r1 (p =.037). Discussion The present study showed decreased FVC and FEV1 actual values and percent predicted rates from baseline to the completion of treatment. Since the interactional effect of the type of surgery was significant, we suggest that clinical and demographic factors such as age should be considered when interpreting the early changes in PFT. In addition, the significant linear trend of decreasing in some specific outcomes in respiratory function also highlighted the need for continuous monitoring of potential respiratory problems in patients with BC from baseline to the completion of chemotherapy and radiotherapy.

Abstract Background The assessment of cardiorespiratory fitness is important because it allows the identification of subgroups with poor health status and the targeting of effective intervention strategies to improve health. Objective To compare the cardiorespiratory capacity of children and adolescents living in a moderate altitude region of Peru with international studies and to develop reference values for the 6-min walk test (6MWT) according to age and sex. Methodology A descriptive cross-sectional study of schoolchildren from a region of moderate altitude in Peru was carried out. A total of 704 schoolchildren (400 males and 304 females) with an age range of 6 to 17 years were studied. Weight, standing height, waist circumference (WC), body mass index (BMI) and tri-ponderal mass index (TMI) were evaluated. The 6MWT was assessed in a straight line over a distance of 30 m. Percentiles were created through the LMS method [L (skewness: lambda), M (median: mu) and S (coefficient of variation: Mu)]. Results There were discrepancies in cardiorespiratory fitness performance with international studies by age and sex. The schoolchildren in the study reached stability and the highest number of meters in the last two age ranges (14 to 15 years: 698.1 m and 16 to 17 years 686.3 m in males). While females (14 to 15 years: 698.1 m and 16 to 17 years: 686.3 m). The proposed percentile values show ascending values as age advances. The cut-off points adopted are: low cardiorespiratory fitness 75. Conclusion We verified that the cardiorespiratory fitness evaluated by means of the 6MWT is ascending with the course of age. Even the performance with other countries is heterogeneous at early and middle ages, stabilizing during adolescence. The proposed reference values can be used to evaluate and monitor cardiorespiratory fitness during physical education classes.

Background: The assessment of cardiorespiratory fitness is important because it allows the identification of subgroups with poor health status and the targeting of effective intervention strategies to improve health. Objective: To compare the cardiorespiratory capacity of children and adolescents living in a moderate altitude region of Peru with international studies and to develop reference values for the 6-min walk test (6MWT) according to age and sex. Methodology: A descriptive cross-sectional study of schoolchildren from a region of moderate altitude in Peru was carried out. A total of 704 schoolchildren (400 males and 304 females) with an age range of 6 to 17 years were studied. Weight, standing height, waist circumference (WC), body mass index (BMI) and tri-ponderal mass index (TMI) were evaluated. The 6MWT was assessed in a straight line over a distance of 30 m. Percentiles were created through the LMS method [L (skewness: lambda), M (median: mu) and S (coefficient of variation: Mu)]. Results: There were discrepancies in cardiorespiratory fitness performance with international studies by age and sex. The schoolchildren in the study reached stability and the highest number of meters in the last two age ranges (14 to 15 years: 698.1 m and 16 to 17 years 686.3 m in males). While females (14 to 15 years: 698.1 m and 16 to 17 years: 686.3 m). The proposed percentile values show ascending values as age advances. The cut-off points adopted are: low cardiorespiratory fitness < p25, moderate p25 to p75 and high cardiorespiratory fitness p > 75. Conclusion: We verified that the cardiorespiratory fitness evaluated by means of the 6MWT is ascending with the course of age. Even the performance with other countries is heterogeneous at early and middle ages, stabilizing during adolescence. The proposed reference values can be used to evaluate and monitor cardiorespiratory fitness during physical education classes. [ABSTRACT FROM AUTHOR]

Background: Respiratory complications in breast cancer (BC) patients after chemotherapy (CT) and radiotherapy (RT) have been well acquainted and these complications should be investigated to prevent secondary problems and/or improve BC patients' clinical outcomes. Therefore, this study aimed to assess the potential acute effect of systemic chemotherapy and radiotherapy on respiratory function and functional status of patients with breast cancer. Methods: A total of 25 BC patients who were candidates for systemic chemotherapy and radiotherapy were recruited after oncological examination and included in this study. Respiratory function and functional status were assessed with the Pulmonary Function Test (PFT) and the Six-Minute Walk Test (6MWT), respectively. Patients were assessed before CT (c0), after CT (c1), and after RT (r1). Results: 25 BC patients were assessed in c0 and c1 while only 15 out of 25 patients (60%) were assessed in r1. The actual values of Forced vital capacity (FVC) (t = 2.338, p =.028), Forced expiratory volume in 1s (FEV1 (t = 2.708, p =.012), and the forced expiratory flow of between 25% and 75% of vital capacity (FEF25-75%) (t = 2.200, p =.038) were found significantly different after systemic CT. Inspiratory (MIP) and expiratory (MEP) muscle strength also did not show a significant change from c0 to c1. A significant effect of the type of surgery was found (Wilks' lambda, F [1, 19] = 6.561, p =.019, ηp2 = 0.25) between c0 and c1 in actual FVC value. The main effect of time was found significant in FVC (F [2, 28] = 4.840, p =.016, ηp2 = 0.25) from c0 to r1. Pairwise comparisons with Bonferroni correction showed that there was a significant difference between c0 and r1 (p =.037). Discussion: The present study showed decreased FVC and FEV1 actual values and percent predicted rates from baseline to the completion of treatment. Since the interactional effect of the type of surgery was significant, we suggest that clinical and demographic factors such as age should be considered when interpreting the early changes in PFT. In addition, the significant linear trend of decreasing in some specific outcomes in respiratory function also highlighted the need for continuous monitoring of potential respiratory problems in patients with BC from baseline to the completion of chemotherapy and radiotherapy. [ABSTRACT FROM AUTHOR]

Physical activity plays a pivotal role in preventing obesity and cardiovascular risks. The six-minute walk test (6MWT) is a tool to assess functional capacity and predict cardiovascular events. The aim of this cross-sectional study was to compare the performance and haemodynamic parameters before and after a 6MWT between obese/overweight vs. normal-weight children (average age 8.7 ± 0.7 years) participating in a project involving four primary schools in South Verona (Italy). Validated questionnaires for physical activity and diet, as well as blood drops, were collected. Overweight or obese children (OW&OB; n = 100) covered a shorter 6MWT distance compared to normal-weight children (NW, n = 194). At the test's conclusion, the OW&OB group exhibited a higher Rate Pulse Product (RPP = Systolic Blood Pressure × Heart Rate) as compared to the NW. Body Mass Index, waist-to-height ratio, fat mass by electrical impedance, and trans fatty acids showed direct correlations with pre and post-test haemodynamic parameters, such as RPP, and inverse correlations with oxygen saturation. OW&OB children demonstrated lower performance in this low-intensity exercise test, along with an elevated haemodynamic response. Excess fat in childhood can be considered a risk factor for haemodynamic stress, with potential deleterious consequences later in life. Efforts should be initiated early to break this cycle. [ABSTRACT FROM AUTHOR]

Background: Major abdominal surgery is associated with a high rate of post‐operative complications with increased risk of adverse surgical outcomes due to the presence of frailty. This study aims to evaluate the effectiveness of the multimodal Recovery of Surgery in the Elderly (ROSE) prehabilitation program with supervised exercise in mitigating postoperative functional decline when compared to standard care. Method: The ROSE program enrolled ambulant patients who were 65 years and above, had a Clinical Frailty Scale score of 4 or more and were planned for major abdominal surgery. Participation in supervised exercise sessions before surgery were compared with standard physiotherapy advice. The primary outcome was 6‐min walk test (6MWT) distance assessed at baseline, after prehabilitation and 30 days follow‐up after surgery. Secondary outcomes included physical performance, length of hospital stay and postoperative morbidity. Results: Data from 74 eligible patients, 37 in each group, were included. Median age was 78 years old. Forty‐two patients (22 in Prehab group and 20 in control group) with complete 6MWT follow‐up data at 30 days follow‐up were analysed for outcomes. Most patients underwent laparoscopic surgery (63.5%) and almost all of the surgeries were for abdominal malignancies (97.3%). The Prehab group had an increase in 6MWT distance at the 30‐day follow up, from a baseline mean (SD) of 277.4 (125) m to 287.6 (143.5) m (p = 0.415). The 6MWT distance in the control group decreased from a baseline mean (SD) of 281.7 (100.5) m to 260.1 (78.6) m at the 30‐day follow up (p = 0.086). After adjusting for baseline 6MWT distance and frailty score, the Prehab group had significantly higher 6MWT distance at 30‐day follow‐up than control (difference in adjusted means 41.7 m, 95% confidence interval 8.7–74.8 m, p = 0.015). There were no significant between‐group differences in the secondary outcomes. Conclusion: A multimodal prehabilitation program with supervised exercise within a short time frame can improve preoperative functional capacity and maintain baseline functional capacity in frail older adults undergoing major abdominal surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: Pneumoconiosis can impair lung functions and the exercise capacities of patients. The six-minute walk test (6MWT) is a submaximal cardiopulmonary exercise test. In cases of pneumoconiosis, it may serve as a reliable functional tool for medical, social, and legal assessments. Considering this, we aimed to investigate the value of the 6MWT in pneumoconiosis patients experiencing dyspnea despite normal pulmonary function tests (PFTs). METHODS: This cross-sectional study, conducted from September to December 2015, investigated 85 inpatients with pneumoconiosis who showed symptoms of dyspnea despite having normal results in PFTs. Data on sociodemographic features, occupational history, functional and radiological assessments, and 6MWT results were evaluated. Radiological assessment were performed according to International Labour Organization (ILO) categorization. RESULTS: All patients were male. The mean age of the patients were 41.65±10.8. The majority had q opacity (51.8%) and were in category 1 (67%). 11 (13.0%) patients had a large opacity, and 6 of these were classified as having A opacity in ILO classification. The mean distance in the 6MWT was 488.54±87.54 meters, with 18 (21.1%) patients developing desaturation of more than 4%. A moderate negative correlation was observed between chest X-ray profusion and walking distance (p=0.001, r=-0.365). Walking distance was significantly lower in patients with a profusion of 2/1 or higher (452.29±94.36 m vs. 506.35±78.8 m; p=0.021). Receiver operating curve analysis indicated a cut-off value of 414 meters for category 2 or worse radiology. CONCLUSIONS: This study evaluated pneumoconiosis patients with dyspnea and normal PFT results, showing that the 6MWT is moderately correlated with radiological findings. More extensive disease was associated with a lower walking distance. These results suggest the potential role of the 6MWT in the routine evaluation of pneumoconiosis patients. The 6MWT may be a valuable tool in occupational health for monitoring pneumoconiosis patients. [ABSTRACT FROM AUTHOR]

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Background: Myocardial work is an innovative echocardiographic tool to assess left ventricular performance. Emerging data have shown the added value of this method for evaluating cardiac function compared to traditional echocardiographic parameters and global longitudinal strain. However, few studies are present in the literature about the role of myocardial work during cardiac rehabilitation. Our aim was to assess the impact of a rehabilitation program on myocardial work indices in patients with preserved left ventricular ejection fraction and after coronary artery bypass grafting. In addition, we assessed the correlation between baseline myocardial work indices and their change after cardiac rehabilitation, establishing an optimal cut-off value to predict the improvement. Methods: An observational, single-center, and prospective study was conducted. We enrolled patients referred to cardiac rehabilitation after coronary artery bypass grafting and with preserved left ventricular ejection fraction. Before and after the cardiac rehabilitation program, a comprehensive patient assessment was performed, including traditional transthoracic echocardiography, myocardial work analysis, and a six-minute walk test. Results: Eighty-four patients were enrolled; the mean age was 67.96 (±7.42) years and 78.6% were male. The left ventricular ejection fraction was preserved in all patients, and the global longitudinal strain was −16.18 ± 2.55%, the global work index was 1588.56 ± 345 mmHg%, the global constructive work was 1771.27 ± 366.36 mmHg%, the global wasted work was 105.8 ± 72.02 mmHg%, and the global work efficiency was 92.63 ± 3.9% at baseline. After the cardiac rehabilitation program, the global work index, the global constructive work, and the six-minute walk test improved significantly (1588.56 ± 345 vs. 1960.2 ± 377.03 mmHg%, p-value < 0.001; 1771.27 ± 366.36 vs. 2172.01 ± 418.73 mmHg%, p-value < 0.001; 70.71 ± 40.2 vs. 437.5 ± 108.70 m, p-value < 0.001, respectively). Conclusions: Myocardial work indices, specifically global work index and global constructive work, improve after cardiac rehabilitation program in patients undergoing coronary artery bypass grafting with preserved left ventricular ejection fraction. [ABSTRACT FROM AUTHOR]

Postoperative pulmonary complications (PPCs) are unexpected disorders that occur up to 30 days after surgery, affecting the patient’s clinical status and requiring therapeutic intervention. Therefore, it becomes important to assess the patient preoperatively, as many of these complications can be minimized with proper perioperative strategies following a thorough preoperative checkup. Herein, we describe the PPCs and risk factors associated with developing PPCs in patients undergoing upper abdominal surgery. Additionally, we compared the accuracy of the American Society of Anaesthesiologists (ASA) score, the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, the 6-Minute Walk Test (6MWT), and spirometry in predicting PPCs. Consenting patients (>18 years) undergoing elective upper abdominal surgery were recruited from November 2021 to April 2023. Clinical history was noted. Spirometry and 6MWT were both performed. Pre-operative ASA and ARISCAT scores were recorded. Postoperative follow-up was conducted to assess respiratory symptoms and the occurrence of PPC. PPC was defined as per EPCO guidelines. A total of 133 patients were recruited, predominantly male. A total of 27 (20.3%) patients developed PPCs. A total of 14 (10.5%) patients had more than one PPC. The most common PPCs developed were pleural effusion (11.3%), respiratory failure (7.5%), and pneumonia (4.5%). We obtained ten statistically significant associated variables on univariable analysis, viz obstructive airway disease (p=0.002), airflow limitation (p=0.043), chest radiography (p

Abstract Background The six-minute walk test (6MWT) is widely used to assess functional capacity in patients with various diseases. Use of wearable devices can make this test more accurate and easier to administer, and may even enhance it by providing additional information. The purpose of this study was to evaluate the validity of FeetMe® insoles for assessing the total six-minute walking distance (6MWD) by comparing the FeetMe® estimates and those obtained by a rater to the ground truth measured with a surveyor’s wheel. Results Data were analyzed from healthy volunteers who performed the 6MWT on 10-m and 30-m tracks while wearing FeetMe® insoles (n = 32), and being simultaneously assessed by a rater (n = 33) and followed by an investigator with a surveyor’s wheel. The mean average error (MAE) of the estimates was below 13 m on both tracks for FeetMe®, whereas it ranged from 16.24 m to 38.88 m on the 30-m and 10-m tracks for the rater. Conclusion The FeetMe® insoles provided a more accurate estimate and showed greater agreement with the ground truth than the rater, and the accuracy of the FeetMe® estimates did not vary according to the track length. We conclude that the FeetMe insoles are a valid solution for measuring the 6MWD.

Instrumenting the six-minute walk test (6MWT) adds information about gait quality and insight into fall risk. Being physically active and preserving multi-directional stepping abilities are also important for fall risk reduction. This analysis investigated the relationship of gait quality during the 6MWT with physical functioning and physical activity. Twenty-one veterans (62.2 ± 6.4 years) completed the four square step test (FSST) multi-directional stepping assessment, a gait speed assessment, health questionnaires, and the accelerometer-instrumented 6MWT. An activity monitor worn at home captured free-living physical activity. Gait measures were not significantly different between minutes of the 6MWT. However, participants with greater increases in stride time (ρ = −0.594, p < 0.01) and stance time (ρ = −0.679, p < 0.01) during the 6MWT reported lower physical functioning. Neither physical activity nor sedentary time were related to 6MWT gait quality. Participants exploring a larger range in stride time variability (ρ = 0.614, p < 0.01) and stance time variability (ρ = 0.498, p < 0.05) during the 6MWT required more time to complete the FSST. Participants needing at least 15 s to complete the FSST meaningfully differed from those completing the FSST more quickly on all gait measures studied. Instrumenting the 6MWT helps detect ranges of gait performance and provides insight into functional limitations missed with uninstrumented administration. Established FSST cut points identify aging adults with poorer gait quality.

In patients with systemic sclerosis (SSc), interstitial lung disease (ILD) is a factor in the decline of functional capacity up to disability and is also the leading cause of death. Therefore, one of the most important tasks in the treatment of this group of patients is not only to detect involvement of respiratory system, but also to predict the likelihood of its development.Objective: to study the possibility of predicting the development of ILD and advanced ILD in patients with SSc.Material and methods. The study included 79 patients with SSc (mean age 64.4±11.5 years; 94.9% women) from the Registry of myositis, SSc and Mixed Connective Tissue Diseases (РЕМИССиС) who underwent high-resolution computed tomography (HRCT) of the lungs. Classification trees (CTr) were constructed to predict the development of widespread ILD using the CHAID algorithm (exhaustive). All patients were tested for antibodies against Scl-70 (anti-Scl-70), CENP-B (anti-CENP-B), and PmScl (anti-PmScl).Results and discussion. ILD signs according to HRCT were detected in 53 patients. Fibrotic (34.2%) and cellular (15.2%) types of nonspecific interstitial pneumonia were the most common, and common interstitial pneumonia was less frequent (11.4%).The presence of ILD and advanced ILD (involvement of more than 20% of the lung parenchyma) were significantly associated with the detection of any autoantibodies, except anti-centromere antibodies, an increase in pulmonary artery systolic pressure, a decrease in forced vital capacity, diffusing capacity of the lungs, blood oxygen saturation at rest, and all parameters of six-minute walk test (6MWT), and complaints of shortness of breath. In addition, the presence of extensive ILD was also significantly associated with diffuse SSc and with SSc without skin manifestations.In establishing the CTr, it was found that the development of widespread ILD was unlikely in individuals who were able to walk more than 440 m in 6MWT and had neither anti-Scl-70 nor anti-PmScl.Significant associations were also found between the radiological pattern of ILD and the types of disease-specific antibodies.Conclusion. The 6MWT data in conjunction with the results of testing for SSc-specific autoantibodies provide a very accurate prediction of the presence and extent of ILD. It is advisable to include these indicators in the algorithm for screening and monitoring patients with SSc.

Abstract Background Physical activity is an effective management strategy for heart failure with reduced ejection fraction, but patients’ compliance is challenging. Walking is a suitable form of physical activity due to its convenience and sustainability, and it can potentially improve functional capacity in heart failure patients. Objectives The WATCHFUL trial aims to determine whether a pedometer-based walking intervention combined with face-to-face sessions and regular telephone contact improves functional capacity in heart failure patients. Methods The WATCHFUL trial is a 6-month multicenter, parallel-group, randomized, controlled, superiority trial with a 6-month follow-up. A total of 202 patients were recruited for the trial. The primary analysis will evaluate the change in distance walked during the 6-min walk test from baseline to 6 months based on the intention-to-treat population; the analysis will be performed using a linear mixed-effect model adjusted for baseline values. Missing data will be imputed using multiple imputations, and the impact of missing data will be assessed using a sensitivity analysis. Adverse events are monitored and recorded throughout the trial period. Discussion The trial has been designed as a pragmatic trial with a scalable intervention that could be easily translated into routine clinical care. The trial has been affected by the COVID-19 pandemic, which slowed patients’ recruitment and impacted their physical activity patterns. Conclusions The present publication provides details of the planned statistical analyses for the WATCHFUL trial to reduce the risks of reporting bias and erroneous data-driven results. Trial registration ClinicalTrials.gov (identifier: NCT03041610, registered: 3/2/2017).

Abstract Background The long-term exercise tolerance changes in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) are of great interest because of its chronic course. This study aimed to characterize the associations between changes over time in six-minute walking test (6MWT) parameters and clinical parameters in patients with NTM-PD. Methods Overall, 188 patients with NTM-PD, visiting outpatient clinics at Keio University Hospital from April 2012 to March 2020 were included in the study. Data were collected using the St. George’s Respiratory Questionnaire (SGRQ), pulmonary function test (PFT), blood tests, and the 6MWT at registration and at least once after that. The association of the anchors and clinical indicators with the 6MWT parameters was assessed. Results The median age [interquartile range] of the patients was 67 [63–74] years. The median baseline six-minute walk distance (6MWD) and final Borg scale (FBS) were 413 [361–470] m and 1 [0–2], respectively. In the correlation analysis, ΔSGRQ total/year (yr), Δforced vital capacity (FVC, % predicted)/yr, Δforced expiratory volume in 1 s (FEV1, % predicted)/yr, and Δdiffusing capacity for carbon monoxide (DLCO, % predicted)/yr correlated with both Δ6MWD/yr and ΔFBS/yr in the longitudinal analysis (|Rho| > 0.20). When stratified into three quantiles of changes in each anchor, the 6MWT parameters worsened over time in the bottom 25% group by mixed-effects model. Specifically, Δ6MWD was affected by SGRQ activity, SGRQ impacts, PFT (FVC, FEV1, and DLCO), and C-reactive protein (CRP). ΔFBS was affected by all SGRQ components, total score, and PFT. Anchor scores and variables at baseline that worsened Δ6MWD were higher SGRQ scores, lower FVC (% predicted), lower DLCO (% predicted), higher Krebs von den Lungen-6, old age, and undergoing treatment at registration. Similarly, these clinical parameters and elevated CRP, excluding undergoing treatment at registration, worsened ΔFBS. Conclusions The decreased walking distance and exacerbation of dyspnea on exertion over time in patients with NTM-PD may reflect a deterioration of health-related quality of life and pulmonary function. Thus, the change in 6MWT over time can be used as an indicator to accurately assess the patient’s condition and tailor their healthcare environment.

Abstract Objective To investigated the dynamic ventilatory responses and their influence on functional exercise capacity in patients with long-COVID-19 syndrome (LCS). Results Sixteen LCS patients were subjected to resting lung function (spirometry and respiratory oscillometry-RO) and cardiopulmonary performance to exercise (Spiropalm®-equipped six-minute walk test-6MWT and cardiopulmonary exercise test-CPX). At rest, spirometry showed a normal, restrictive and obstructive pattern in 87.5%, 6.25% and 6.25% of participants, respectively. At rest, RO showed increased resonance frequency, increased integrated low-frequency reactance and increased difference between resistance at 4–20 Hz (R4-R20) in 43.7%, 50%, and 31.2% of participants, respectively. The median of six-minute walking distance (DTC6) was 434 (386–478) m, which corresponds to a value of 83% (78–97%) of predicted. Dynamic hyperinflation (DH) and reduced breathing reserve (BR) were detected in 62.5% and 12.5% of participants, respectively. At CPX, the median peak oxygen uptake (VO2peak) was 19 (14–37) ml/kg/min. There was a significant correlation of 6MWD with both R4-R20 (rs=-0.499, P = 0.039) and VO2peak (rs=0.628, P = 0.009). Our results indicate that DH and low BR are contributors to poor exercise performance, which is associated with peripheral airway disease. These are promising results considering that they were achieved with simple, portable ventilatory and metabolic systems.

Physical inactivity and a decline in cardiorespiratory fitness (CRF) are well-known risk factors for cardiovascular disease. Furthermore, evidence suggests a correlation between obesity and diminished CRF level. However, the influence of physical activity (PA) on the CRF level of obese young adults remains unclear. The aim of this study is to compare the performance of the six-minute walk test (6MWT) in physically active and inactive obese young adults aged 18-25 years. Fifty-six participants were included and classified into two groups based on their level of PA, assessed using the Global Physical Activity Questionnaire (GPAQ). These groups consisted of physically active obese participants (PAO; n = 28) and physically inactive obese participants (PIO; n = 28). All participants underwent a 6MWT, during which baseline demographic, anthropometric, dyspnea, and clinical data were recorded. Following the 6MWT, clinical data and the 6-min walking distance (6MWD) were evaluated, and the estimated maximal oxygen consumption (VO2max) was subsequently calculated. The findings indicated that following the 6MWT, there were no statistically significant differences between the groups in terms of heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation and dyspnea (all p > 0.05). Nevertheless, the PAO group exhibited a greater 6MWD and VO2max compared to the PIO group (p < 0.05). The results suggest that physically active obese young adults have a greater 6MWD and VO2max compared to their inactive counterparts. This implies that consistent PA could provide cardiovascular fitness benefits for obese individuals.

Peripheral artery disease (PAD) patients with claudication symptoms exhibit impaired functional capacity, which has been associated with disease severity, worse quality of life and higher risk of cardiovascular events. Different tests have been used to assess functional capacity in PAD patients. Therefore, understanding the characteristics, strengths and limitations of these tests are important to support the choice of tests to be used in clinical practice. This review summarizes the main methods to assess functional capacity in PAD patients, discussing their psychometric properties, applications, and limitations. Robust evidence supports the use of treadmill and six-minute walk tests in PAD patients, as their results are associated with clinically meaningful outcomes, adequate psychometric properties and are sensitive to effects of interventions. On the other hand, other functional tests (Shuttle-walk test, outdoor walking capacity test, timed-up and go, four-meter walk test, heel-rise test, short physical performance battery and modified physical performance battery) are related to activities of daily living and do not require sophisticated equipment and can be easily used in clinical practice. However, these other tests still need evidence regarding their clinical relevance, reliability, and ability to detect long-term intervention changes, providing further investigation directions. [ABSTRACT FROM AUTHOR]

Background: Electronic cigarettes or e-cigarettes have gained significant popularity as an alternative to traditional combustible tobacco smoking particularly among the youth. Although there is a growing prevalence of e-cigarette usage, the effects on cardiovascular function and physical capacity have not been adequately studied. The toxic products in combustible tobacco cigarettes negatively impact functional exercise capacity. However, the available data regarding the effect of e-cigarette use on functional exercise capacity are scarce. Thus, in the current study, we aimed to evaluate the functional aerobic exercise capacity among chronic e-cigarette users compared to combustible cigarette smokers and non-smokers. Results: This comparative, cross-sectional study was conducted on 105 healthy volunteers. Participants were assigned into three study groups each consisting of 35 participants: chronic e-cigarette users, combustible cigarette smokers, and a non-smoker control group. Basal demographic and clinical data were similar in all groups. Mean heart rates and respiratory rates were significantly higher among e-cigarette smokers and combustible cigarette smokers compared to non-smoker controls (p < 0.001). Chronic e-cigarette users and combustible cigarette smokers had shorter 6-MWT distances compared to non-smokers (508.3, 488, and 616.6 m, respectively, p < 0.001). Borg scale scores after performing the six-minute walking test were significantly higher in chronic e-cigarette users and combustible cigarette smokers groups compared to non-smokers, where perceived exertion (4.9, 5.5, 2.1, respectively, p < 0.001), dyspnea (5.7, 6.5, 0.1, respectively, p < 0.001) and leg fatigue (4.2, 5.4, 1.4, respectively, p < 0.001). Conclusion: In this cross-sectional study, significant evidence demonstrates that e-cigarette use is not harmless. This was particularly presented in apparently healthy e-cigarette users in comparison to the healthy non-smoker control group. Chronic e-cigarette use is associated with reduced functional capacity compared to non-smoker controls. This was signified by decreased 6MWT walking distances, higher Borg scale scores, and lower oxygen saturation percentages among the chronic electronic cigarette users as compared to non-smoker controls after performing the six-minute walking test. All the evaluated parameters in the current study were similarly reduced among both the e-cigarette users group and the combustible cigarette smokers group compared to non-smokers with no statistically significant differences between both smoker groups. [ABSTRACT FROM AUTHOR]