The 6-minute walk test and fall risk in patients with heart failure: A cross-sectional study.

BACKGROUND: Given the increased risk of falls in patients with heart failure (HF), there is limited information in the literature about the possible relationship between fall risk and functional capacity. OBJECTIVE: To investigate the relationship between functional capacity and fall risk in patients with HF and to determine whether there are differences in clinical parameters between patients with and without fall risk. METHODS: The study included 64 patients with HF. The Activity-Specific Balance Confidence Scale (ABC) determined the fall risk. Functional capacity was assessed with the 6-minute walk test (6MWT). The Berg Balance Scale (BBS), the timed up-and-go test (TUG), and the five times sit-to-stand (5-STS) test were used to evaluate functional balance and mobility. Comorbidities and dyspnea perception were assessed with the Charlson Comorbidity Index (CCI) and modified Medical Research Council (mMRC), respectively. RESULTS: The 6MWT was associated with fall risk in logistic regression with an odds ratio of 0.979 (0.970-0.989, p < 0.001). Furthermore, the 6MWT had a discriminative value for increased fall risk in patients with HF, with a cutoff value of 248 m. Patients with increased fall risk had lower 6MWT distance, BBS, and gait speed, and higher CCI and mMRC, number of falls, duration of TUG and 5STS compared to patients with no increased fall risk (p < 0.05). CONCLUSIONS: The study results demonstrated that 6MWT may be a clinically useful tool in quickly identifying potential balance problems and increased fall risk by providing insight into fall risk/balance confidence in addition to assessing functional capacity.

Energy expenditure and glucose-lowering effect of different exercise modalities in diabetes mellitus.

OBJECTIVES: Hypoglycaemia is a serious complication of exercise in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to test energy expenditure and the degree of the glucose-lowering effect of different exercise modalities. DESIGN: Cross-sectional study PARTICIPANTS: This study included 44 patients {35 women and nine men, mean age 51 [standard deviation (SD) 5] years} with T2DM [mean HbA1c 7% (SD 1%)]. MAIN OUTCOME MEASURES: Standardised exercise tests for walking, running and cycling were performed using the 6-minute walk test (6MWT), incremental shuttle walk test (ISWT), and symptom-limited maximal cycle exercise test, respectively. Energy expenditure was assessed with a multisensory accelerometer. Change in capillary glucose levels (∆glucose) was measured before and after each exercise modality. RESULTS: ∆Glucose was lower in the 6MWT {median 14 [interquartile range (IQR) 22] mg/dl} than in the ISWT [median 18 (IQR 23) mg/dl; median difference 7 mg/dl, 95% confidence interval (CI) of the difference 3-11] and the cycle test [median 18 (IQR 24) mg/dl; median difference 7 mg/dl, 95% CI 0-16]. Energy expenditure was lower during the 6MWT [median 41 (IQR 18) Kcal] compared with the ISWT [median 51 (IQR 23) Kcal; median difference 11 Kcal, 95% CI 6-16] and the cycle test [median 44 (IQR 25) Kcal; median difference 6 Kcal, 95% CI 0-13]. CONCLUSIONS: Energy expenditure and corresponding glucose-lowering effect during exercise in patients with T2DM can be predicted from the results of an exercise test. The type of exercise is related to the risk of hypoglycaemia. Walking is associated with the lowest energy expenditure and risk of hypoglycaemia, while cycling and running/jogging cause higher energy expenditure and greater reductions in glucose in patients with T2DM. CONTRIBUTION OF THE PAPER.

Exercise performance in children and adolescents with cystic fibrosis with and without abnormal glucose tolerance: a single center cross-sectional study.

BACKGROUND: Abnormal glucose tolerance (AGT) in cystic fibrosis (CF) affects lung function and clinical parameters, including aerobic fitness. However, its effects on physical activity level (PAL), anaerobic power (AP), and muscle strength (MS) in children and adolescents are unknown. PURPOSE: To investigate aerobic fitness, PAL, AP, and MS in pediatric patients with mild-to-moderate CF and AGT. METHODS: The study included children and adolescents with CF aged 10-18 years. Participants underwent a pulmonary function test, quadriceps, and handgrip MS measurement, vertical jump test to assess AP, and six-minute walk test (6MWT) to assess aerobic fitness. Bouchard's Three-Day Physical Activity record was used to determine PAL. RESULTS: Height z-score (p = .006), 6MWT (p = .024), handgrip (p = .028), quadriceps MS (p = .044), and AP (p = .036) were significantly lower in AGT (n = 21) than normal glucose tolerance (NGT) (n = 19). In the AGT group, glycosylated hemoglobin (HbA1c) was significantly associated with forced expiratory volume in one second (FEV1) (p = .046). 6MWT distance (6MWD) was associated with height (p = .008), FEV1 (p = .001), forced vital capacity (FVC) (p = .001), forced expiratory flow from 25% to 75% (FEF25-75%) (p = .030), handgrip MS (p = .012), and PAL (p = .034). After adjusting for height and FEV1, the groups had similar 6MWD, MS, and AP (p > .05); also, insulin was associated with MS and AP but not with 6MWT or quadriceps MS. CONCLUSION: Measures of aerobic fitness, MS, and AP are lower in AGT, but after adjusting for height and FEV1, aerobic fitness, MS, and AP do not show substantial differences. Insulin sensitivity and resistance are associated with MS and AP.

Daily living activities, exercise capacity, cognition, and balance in COPD patients with and without frailty.

BACKGROUND: Information on the interaction between frailty and chronic obstructive pulmonary disease (COPD) is limited. AIMS: This study aimed to compare activities of daily living (ADL), exercise capacity, balance, and cognition in COPD patients with and without frailty. METHODS: Twenty frail and 28 non-frail COPD patients aged 55 years and over were included. Frailty was determined according to Fried et al. Dyspnea was evaluated using the modified Medical Research Council (mMRC) dyspnea scale. Respiratory and peripheral muscle strength were measured. Functional capacity was assessed using a 6-min walk test (6MWT); ADL performance was evaluated using the Glittre ADL test. The balance was evaluated using the functional reach test (FRT). Cognitive function was assessed using the Montreal Cognitive Evaluation (MoCA) Test. Quality of life was measured using the COPD Assessment Test (CAT). RESULTS: The mMRC and CAT scores were higher in the frail patients as compared with the non-frail patients (p < 0.05). The maximal inspiratory pressure, handgrip strength, 6MWT distance, and FRT score were lower in the frail patients as compared with the non-frail patients (p < 0.05). The duration for the Glittre ADL test was longer in the frail patients than the non-frail patients (p < 0.05). There was no significant difference between MoCA scores between groups (p > 0.05). CONCLUSIONS: Frail COPD patients have increased dyspnea perception, impaired muscle strength, and functional capacity, ADL performance, balance, and quality of life. Whether pulmonary rehabilitation programs for patients with frail COPD need to be adapted with new rehabilitation strategies, including components of frailty, needs further investigation.

Validity and reliability of 6-minute pegboard and ring test in patients with asthma.

OBJECTIVE: The 6-minute pegboard and ring test (6PBRT) is a test of upper-extremity functional capacity designed for and validated in chronic obstructive pulmonary disease. The aim of this study was to evaluate the validity and reliability of the 6PBRT in asthma patients. METHODS: Thirty-four adults (30 women, 4 men) with well-controlled asthma were included. Unsupported upper-extremity exercise capacity was assessed using 6PBRT, maximal arm exercise capacity using an arm ergometer, handgrip strength using a hand dynamometer, activities of daily living with the London Chest Activities of Daily Living Scale (LCADL), Milliken ADL scale (MAS) and health-related quality of life using the Asthma Quality of Life Questionnaire (AQLQ) and Health Assessment Questionnaire Disability Index (HAQ-DI). RESULTS: The 6PBRT showed moderate to excellent test-retest reliability with an intraclass correlation coefficient (ICC) value of 0.872 [95% confidence interval (CI) 0.702-0.941]. The 6PBRT was reproducible according to Bland-Altman analysis, with upper and lower limits of agreement of 53.51 and -25.08 rings moved, respectively. The 6PBRT score was significantly correlated with maximum workload (r = 0.514, p = 0.002) achieved in the arm ergometer test, change in dyspnea during 6PBRT (r = -0.402, p = 0.020), LCADL-self-care (r = -0.364, p = 0.037), MAS total (r = 0.483, p = 0.005), AQLQ-symptom domain (r = 0.420, p = 0.026) and HAQ-DI total scores (r = -0.390, p = 0.025). CONCLUSIONS: The 6PBRT can be used as a valid and reliable test to evaluate functional arm exercise capacity in patients with well-controlled asthma.

Physical fitness and activities of daily living in primary ciliary dyskinesia: A retrospective study.

BACKGROUND: Primary ciliary dyskinesia (PCD) is a rare, hereditary, autosomal recessive disorder characterized by recurrent upper and lower respiratory tract infections. This study aimed to compare pulmonary function, respiratory muscle strength, exercise capacity, physical fitness, and activities of daily living (ADLs) retrospectively between patients with PCD and healthy controls. METHODS: Data from 20 patients with PCD and 20 matched, healthy counterparts recorded between July 2015 and January 2017 were analyzed. The data evaluated and recorded included pulmonary function using a portable spirometer, respiratory muscle strength (using a mouth pressure device, exercise capacity using the incremental shuttle walk test,), physical fitness (using the Munich Fitness Test), and ADLs (using the Glittre ADL test). RESULTS: Pulmonary function, respiratory muscle strength, incremental shuttle walk test scores (all parameters), and total Munich Fitness Test scores were lower in the PCD group relative to controls (P < 0.05). The duration to complete the Glittre ADL test was higher in PCD patients than in healthy subjects (P < 0.05). CONCLUSIONS: Pulmonary function, respiratory muscle strength, exercise capacity, physical fitness, and ADL were affected by PCD. Thus, pulmonary rehabilitation regimens should be tailored according to these impacts.

Health-Promoting Behaviors, Health Literacy, and Levels of Knowledge about Smoking-Related Diseases among Smokers and Non-smokers: A Cross-Sectional Study.

BACKGROUND: For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers. METHODS: The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ). RESULTS: The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%). CONCLUSION: Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals' awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.

Evaluation of exercise capacity using two field tests in patients with metabolic syndrome.

PURPOSE: Field tests are popular for assessing exercise capacity because they are practical and have established validity. The objective of this study was to compare physiological responses and exercise performance of patients with metabolic syndrome in two field tests of exercise capacity. MATERIAL AND METHODS: Forty-seven patients diagnosed with metabolic syndrome participated in this cross-sectional study. Exercise capacity was assessed using incremental shuttle walk test and six-minute walk test. Factors determining exercise capacity and agreement between the two tests were also investigated. RESULTS: Metabolic syndrome patients achieved a significantly greater percentage of predicted maximal heart rate, blood pressure, and longer distance in the incremental shuttle walk test than in the six-minute walk test (p < 0.001). Gender and body mass index explained 48.5% of the variance in six-minute walk test distance (R = 0.697, R2 = 0.485, F(2-46) = 20.737, p < 0.001). Body mass index and fat-free mass explained 55% of the variance in incremental shuttle walk test distance (R = 0.746, R2= 0.557, F(2-46) = 27.623, p < 0.001). CONCLUSIONS: Despite the agreement in the percentages of predicted maximal heart rate during these two field tests, the incremental shuttle walk test may be a better assessment tool than the six-minute walk test because it elicits more pronounced and definitive physiological responses to exercise tolerance in patients with metabolic syndrome.IMPLICATIONS FOR REHABILITATIONThe incremental shuttle walk test can be used to evaluate exercise capacity in metabolic syndrome.The incremental shuttle walk test elicits greater physiological responses than the six-minute walk test.The incremental shuttle walk test may be preferable over the six-minute walk test in investigating exercise capacity.Both tests can guide and assist in the evaluation of this patient population in clinical practice.Body mass index affected distance in both exercise tests.

Subclinical Inflammation Is Associated With Reductions in Muscle Oxygenation, Exercise Capacity and Quality of Life in Adults With Type 2 Diabetes.

OBJECTIVES: Exercise capacity is related to both morbidity and mortality in patients with type 2 diabetes (T2DM). The aim of this study was to investigate the relationship between subclinical inflammation level, exercise capacity, muscle oxygenation and quality of life in T2DM. METHODS: This study includes 28 patients with T2DM (mean age, 51.5±5.0 years; male-to-female ratio, 6:22). Exercise capacity was evaluated using an incremental symptom-limited maximal exercise test on a bicycle ergometer. Muscle oxygenation was investigated using a wearable lactate-measuring device. Diabetes-specific quality of life was assessed using the Diabetes Quality of Life Questionnaire (DQOL). Subclinical inflammation was assessed using C-reactive protein (CRP) levels. RESULTS: CRP level was negatively correlated with peak workload during the test (r=-0.588, p=0.002), muscle oxygenation (r=-0.465, p=0.019) and the psychological impact of treatment subscale of the DQOL (r=-0.540, p=0.017), and positively correlated with body mass index (r=0.519, p=0.008), waist circumference (r=0.426, p=0.038) and fat percentage (r=0.573, p=0.004). There was no correlation between CRP and fasting blood glucose or glycated hemoglobin level (p>0.05). Peak workload was inversely related to fat percentage (r=-0.467, p=0.016) and the DQOL worry about the future impact of diabetes subscale (r=-0.501, p=0.021). CONCLUSIONS: In our study, subclinical inflammation negatively affected muscle oxygenation, exercise capacity and quality of life independently of glycemic indicators. Our findings suggest that the degree of glycemic control is insufficient to explain lower exercise capacity. Further studies are needed to investigate subclinical inflammation-reducing interventions in T2DM.

Exercise Capacity and Activities of Daily Living are Related in Patients With Chronic Obstructive Pulmonary Disease / La capacidad de ejercicio y las actividades de la vida diaria están relacionada en pacientes con enfermedad pulmonar obstructiva crónica

INTRODUCTION: The knowledge of the relationship between exercise capacity and activities of daily living (ADLs) is important to minimize the negative outcomes in ADLs resulting from reduced exercise capacity in patients with chronic obstructive pulmonary disease (COPD). There is a limited study about the association between exercise capacity and ADLs in patients with COPD. This study aimed to investigate the relationship between maximal exercise capacity and ADLs in patients with GOLD stage II-III COPD. METHODS: Twenty-seven clinically stable GOLD stage II-III COPD patients were included (mean age = 58.59 ± 9.63 years and mean FEV1 = 50.6 ± 13.7%) in this cross-sectional study. Maximal and submaximal exercise capacity were evaluated using an incremental shuttle walk test (ISWT) and 6-min walk test (6 MWT), respectively. Activities of daily living were assessed using Glittre-ADL test. RESULTS: The ISWT distance was significantly correlated with Glittre-ADL test time (r = -0.517, p = 0.006). There was also a negative correlation between 6MWT distance and Glittre-ADL test time (r = -0.506, p = 0.007). CONCLUSION: A moderate relationship was found between maximal exercise capacity and general activities of daily living performance. The reduction in exercise capacity increases the negative influences in ADLs and strengthens our beliefs that exercise interventions in pulmonary rehabilitation could influence activities of daily living positively

INTRODUCCIÓN: Es importante conocer la relación entre la capacidad de ejercicio y las actividades de la vida diaria (ADL) para minimizar los resultados negativos de las ADL que resultan de una capacidad reducida de ejercicio en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Los estudios sobre la asociación entre la capacidad de ejercicio y las ADL en pacientes con EPOC son limitados. En este estudio se investigó la relación entre la capacidad máxima de ejercicio y las ADL en pacientes con EPOC de estadios GOLD grado II-III. MÉTODOS: Estudio transversal que incluyó a 27 pacientes clínicamente estables con EPOC de estadios GOLD grado II-III (edad media = 58.59 ± 9.63 años and FEV1 medio = 50.6 ± 13.7%). Las capacidades máxima y submáxima de ejercicio se evaluaron utilizando la prueba de lanzadera por tramos (ISWT) y la prueba de marcha de 6 minutos (6 MWT) respectivamente. Las actividades de la vida diaria se evaluaron mediante el test de Glittre-ADL. RESULTADOS: La distancia ISWT mostró una correlación significativa con el tiempo en el test Glittre-ADL (r = -0.517, p = 0.006). También se observó una correlación negativa entre la distancia en el 6MWT y el tiempo en la prueba de Glittre-ADL (r = -0.506, p = 0.007). CONCLUSIÓN: Se encontró una relación moderada entre la capacidad máxima de ejercicio y el desempeño general de las actividades de la vida diaria. La reducción en la capacidad de ejercicio aumenta las influencias negativas en las ADL y refuerza nuestras creencias de que las intervenciones con ejercicio tienen una influencia positiva en las actividades de la vida diaria en la rehabilitación pulmonar

Deviations of body functions and structure, activity limitations, and participation restrictions of the International Classification of Functioning, Disability, and Health model in children with cystic fibrosis and non-cystic fibrosis bronchiectasis.

BACKGROUND: To the best of our knowledge, there is no study in the literature investigating the extrapulmonary outcomes of children with non-cystic fibrosis (CF) bronchiectasis and CF under the framework of the International Classification of Functioning, Disability, and Health (ICF) model. The purpose of the present study is to evaluate the children with CF and non-CF bronchiectasis using the ICF model. MATERIALS AND METHODS: Children with CF, non-CF bronchiectasis, and healthy counterparts were evaluated (20 participants in each group) according to the ICF items in domain b (body functions), domain s (body structures), and domain d (activities and participation). The pulmonary functions, respiratory and peripheral muscle strength tests, and posture analysis were carried out for domain b. For domain d, however, the Glittre-activities of daily living test and Pediatric Outcome Data Collection were used. RESULTS: Muscle strength of shoulder abductors and hip extensors in children with CF was significantly lower than healthy children and adolescents (P < .05). The severity of lateral and posterior postural abnormalities in children with CF and non-CF bronchiectasis was higher than those of healthy children (P < .05). Among the patient groups, global function, sports/physical function, expectations, transfers/basic mobility, and pain/comfort were the most affected participation dimensions (P < .05). CONCLUSIONS: This study highlights the need for comprehensive up-to-date evaluation methods according to the ICF model for understanding rehabilitation requirements in CF and non-CF bronchiectasis in different age groups.

Physical activity of patients with bronchiectasis compared with healthy counterparts: A cross-sectional study.

BACKGROUND: A few studies have implied that patients with bronchiectasis have a more inactive lifestyle than healthy counterparts do. The main objective of this study was to compare physical activity (PA) levels subjectively and objectively between patients with bronchiectasis and healthy individuals using an accelerometer and a questionnaire. METHODS: The study included 41 patients with bronchiectasis aged 18-65 years and 35 healthy age- and sex-matched control subjects. The PA level was assessed objectively using a multisensorial PA monitor, the SenseWear Armband (SWA), and subjectively with the International Physical Activity Questionnaire (IPAQ). All participants performed the incremental shuttle walk test (ISWT) for the assessment of exercise capacity. Pulmonary function, dyspnea, severity of bronchiectasis, respiratory and peripheral muscle strength, and quality of life were assessed. RESULTS: The pulmonary function test parameters, respiratory and peripheral muscle strength, exercise capacity, step count, moderate- and vigorous-intensity PA duration were significantly lower in patients with bronchiectasis than in the healthy control group (p < 0.05). Sedentary, moderate, vigorous, and total PA duration measured using the SWA were higher than those obtained using the IPAQ (p < 0.05). CONCLUSIONS: Patients with bronchiectasis have a reduced PA level compared with healthy counterparts. The IPAQ (based on the subjective estimation of PA) outcomes differed from the SWA outcomes, reinforcing the necessity for a disease-specific PA questionnaire. IPAQ underestimates the physical activity level compared with objective measurements.

Exercise Capacity and Activities of Daily Living are Related in Patients With Chronic Obstructive Pulmonary Disease.

INTRODUCTION: The knowledge of the relationship between exercise capacity and activities of daily living (ADLs) is important to minimize the negative outcomes in ADLs resulting from reduced exercise capacity in patients with chronic obstructive pulmonary disease (COPD). There is a limited study about the association between exercise capacity and ADLs in patients with COPD. This study aimed to investigate the relationship between maximal exercise capacity and ADLs in patients with GOLD stage II-III COPD. METHODS: Twenty-seven clinically stable GOLD stage II-III COPD patients were included (mean age=58.59±9.63 years and mean FEV1=50.6±13.7%) in this cross-sectional study. Maximal and submaximal exercise capacity were evaluated using an incremental shuttle walk test (ISWT) and 6-min walk test (6MWT), respectively. Activities of daily living were assessed using Glittre-ADL test. RESULTS: The ISWT distance was significantly correlated with Glittre-ADL test time (r=-0.517, p=0.006). There was also a negative correlation between 6MWT distance and Glittre-ADL test time (r=-0.506, p=0.007). CONCLUSION: A moderate relationship was found between maximal exercise capacity and general activities of daily living performance. The reduction in exercise capacity increases the negative influences in ADLs and strengthens our beliefs that exercise interventions in pulmonary rehabilitation could influence activities of daily living positively.

Aerobic exercise training in Kartagener's syndrome: case report.

Kartagener's syndrome is a rare, autosomal recessive inherited disease, which is characterized by a triad of chronic sinusitis, bronchiectasis, and situs inversus. In this report, we aimed to represent the effect of aerobic exercise training in addition to chest physiotherapy in an outpatient with Kartagener's syndrome. An 18-year-old female diagnosed with Kartagener's syndrome applied with the complaints of productive cough and dyspnea with exertion and attended pulmonary rehabilitation program comprising exercise training in addition to standard treatment. Aerobic exercise training was performed three times weekly at 80% of the peak heart rate, for 8 weeks as supervised sessions. Respiratory physiotherapy and postural exercises were taught to the patient to be performed at home each day of the week. Before and after pulmonary rehabilitation program, incremental shuttle walk test (ISWT) was performed; dyspnea and fatigue were assessed using Borg Scale. Pulmonary function test was evaluated using spirometer. The patient wore activity monitor for 7 consecutive days before and after training. After pulmonary rehabilitation program, 90-m increase in ISWT was observed. We recommend exercise training in patients with Kartagener's syndrome to increase exercise capacity. Further randomized control trial is needed to clarify the effects.

Reduced anaerobic and aerobic performance in children with primary ciliary dyskinesia.

Primary ciliary dyskinesia (PCD) restricts lifestyle and increases morbidity. The aim of the study was to investigate anaerobic and aerobic performance in children with PCD and their healthy counterparts. Thirty-one children with PCD and 29 age- and sex-matched healthy subjects were studied. Pulmonary function, hand grip strength (HGS), quadriceps strength (QMS), physical activity, anaerobic capacity (muscle power sprint test), and aerobic performance (modified shuttle walk test (MSWT)) were determined. Pulmonary function, HGS, QMS, mean anaerobic power (MAP), and MSWT distance in PCD were significantly lower than those of healthy subjects (p < 0.05). In PCD, the MAP was significantly correlated with age, FEV1, and the mean kcal for 3 days (p < 0.05), and age was its independent predictor (p < 0.05). The MSWT distance was significantly related to gender and weight (p < 0.05), and gender was selected as its independent predictor (p < 0.05). In healthy controls, the MAP was significantly associated with age, gender, FVC, FEV1, HGS, QMS, and the mean kcal for three days (p < 0.05). The MSWT distance was significantly related to weight and body mass index in healthy group (p < 0.05). CONCLUSION: Anaerobic and aerobic performance is impaired in PCD from the early stages. Age determines anaerobic performance. Gender is the determinant of aerobic performance. Whether skeletal muscle characteristics and sex-related changes in body composition affect anaerobic and aerobic capacity in PCD children warrants further study. What is Known: • Exercise performance is determined by anaerobic and aerobic power. • Few studies have shown that PCD patients have lower aerobic performance which is associated with impaired lung function. What is New: • The present research indicated that both anaerobic and aerobic exercise capacity determined using field testing is impaired in PCD from the early stages. • Anaerobic capacity was found to be independently associated with age in PCD. Higher aerobic performance is independently associated with male gender.

Listening to motivational music while walking elicits more positive affective response in patients with cystic fibrosis.

OBJECTIVE: The purpose of this study was to investigate the effects of motivational and relaxation music on affective responses during exercise in patients with cystic fibrosis (CF). METHODS: Thirty-seven patients with CF performed the 6-min walk test (6MWT) under three experimental conditions: listening to no music, relaxation music, and motivational music. 6-min distance × body weight product (6MWORK) was calculated for each trial. Patients' affective responses during exercise was evaluated with Feeling Scale (FS). The motivational qualities of music were evaluated with the Brunel Music Rating Inventory-2 (BMRI-2). RESULTS: 6MWORK was significantly lower while listening to relaxation music compared to 6MWORK without music (p < 0.05). FS and BMRI-2 scores were significantly higher during 6MWT with motivational music than 6MWT with relaxation music (p < 0.05). CONCLUSIONS: Carefully selected motivational music can lead to positive affective response during exercise and increase the enjoyment of patients from exercises in CF.