An Initial Assessment of the Decline With Age for the 6-minute Walk Test (6MWT) in Chinese Older Adults With Chronic Obstructive Pulmonary Disease (COPD).

Objective: To establish an initial assessment of the decline with age for the 6-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD) in Chinese older adults. Design: It was an observational analytical study. Setting: The study was conducted in a local acute hospital. Participants: From January 2017 to January 2021, a total of 525 patients (431 men, 94 women; mean age 73.4±7.9; N=525) with COPD were studied. Main Outcome Measures: Information including sex, age, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, and 6-minute walk distance (6MWD) were collected. Results: The 6MWD was significantly decreased with increased age (P˂0.05). Mean 6MWD in the 61-65 years, 66-70 years, 71-75 years, 76-80 years, 81-85 years, and 86 years or above age groups were 301 m, 305 m, 274 m, 257 m, 260 m, and 215 m, respectively. The difference between the youngest and oldest age groups was 29%. The 6MWD was significantly lower in patients with more severe COPD (P˂0.05). The distance decreased from 317 m in GOLD 1, 306 m in GOLD 2, 259 m in GOLD 3 to 167 m in GOLD 4. The percentage dropped in 6MWD from GOLD 1 to GOLD 4 was 47%. Conclusion: An initial assessment of the decline with age for 6MWT in Chinese older adults with COPD has been established. 6MWD decreases as age (in groups 66-75, 81-85, and 86 or above) and COPD severity increases, primarily because of the increased severity of dyspnea, decline in exercise capacity, and muscle changes in aging. Health care professionals in Chinese community can use these values to evaluate these patients' functional capacity, assess treatment effect, and set treatment goals.

Improving mobility in the intensive care unit with a protocolized, early mobilization program: observations of a single center before-and-after the implementation of a multidisciplinary program.

BACKGROUND: Early intensive care unit (ICU) protocolized rehabilitative programs have been described previously, yet with differing starting time points and mostly on mechanically ventilated patients. We extended the concept to all admitted ICU patients and investigate the efficacy of early mobilization in improving mobility of the critically ill, address issues surrounding the timing and intensity of an early rehabilitative program. METHODS: Prospective cohorts of patients admitted consecutively before-and-after (control, n=92; intervention, n=90) the introduction of an early mobilization program in a single center, general hospital ICU. Improvement in mobility as assessed by ICU mobility score, on ICU admission and upon ICU discharge, was measured as a primary outcome. RESULTS: Those receiving early mobilization in the intensive care unit had higher ICU mobility score (2.63; 95% confidence interval, 0.65-4.61; P<0.001) upon discharge from the intensive care, with earlier out of bed mobilization on day 5 compared to the control group of day 21 (P<0.001). No differences were found in terms of mortality, intensive care hospitalization and subsequent hospitalization duration after discharge from ICU. CONCLUSIONS: Here, we report that improvement in mobility score earlier in the course of intensive care hospitalization with the introduction of a protocolized early rehabilitative program.

Chinese translation and validation of the Sport Concussion Assessment Tool 3 (SCAT3).

OBJECTIVE: The aim of this study was to translate, adapt and validate the Sport Concussion Assessment Tool 3rd edition (SCAT3), a test for assessing athletes for concussion, into the Chinese context. METHODS: Translation and adaptation were performed in several stages, which included forward translation by two independent teams, translation merging, backward translation, reviews by both native Cantonese-speaking and Mandarin-speaking multidisciplinary expert panels (n=49) for semantic and conceptual equivalence and reviews by pitch-side physiotherapists (n=18) as end-users of the SCAT3 and rugby players (n=11) for face validity. The Serial 3 s subtraction test was used as a substitute for the Months Backward Test (MBT) for measures of concentration in the Standardized Assessment of Concussion subscale. English-speaking and Chinese-speaking rugby players (n=52) were recruited to perform these tests to assess the level of difficulty, time for completion and accuracy. Inter-rater and test-retest reliability were assessed in 33 and 38 healthy young individuals, respectively. RESULTS: Despite the longer mean completion time (p<0.05) for the Serial 3 s test, no significant difference was found in the percentage accuracy between MBT and the Serial 3 s test. No significant difference was found in either the percentage accuracy or completion time between English-speaking and Cantonese-speaking rugby players. All subscales in the Chinese SCAT3 had excellent levels of inter-rater reliability for all items (ICC2,1 range: 0.96-0.99) but a low to moderate test-retest reliability (ICC3,2 range: 0.32-0.65). The mean completion time of the Chinese SCAT3 was 10.6±1.1 min. CONCLUSION: Chinese SCAT3 is a valid instrument for pitch-side assessment of concussed Chinese-speaking athletes.