Optimal Cut-Off Points of 4-meter Gait Speed to Discriminate Functional Exercise Capacity and Health Status in Older patients with Chronic Obstructive Pulmonary Disease.

BACKGROUND: Gait speed, a vital sign of health and functional capacity, is commonly used to measure mobility. Although studies have assessed gait speed in older adults and individuals with chronic obstructive pulmonary disease (COPD) separately, few have evaluated gait speed in older adults with COPD. Therefore, the primary objective of our study was to determine the threshold point for the 4-meter gait speed test (4MGS) to better discriminate between functional exercise capacity and health status in older patients with COPD. The second objective was to determine possible predictors of gait speed. METHODS: In this cross-sectional study, we assessed participants' pulmonary function, dyspnea, health status (COPD Assessment Test [CAT]), gait speed (4MGS), functional exercise capacity (6-minute walk test [6MWT]), and physical activity. RESULTS: Forty-five older patients with COPD participated in this study. The predicted 6MWT and CAT scores were independent and significant determinants of the 4MGS score, explaining 54% of the variance (p<0.001). We identified gait speeds of 0.96 m/s and 1.04 m/s as thresholds to predict abnormal functional exercise capacity (sensitivity 85% and specificity 56%) and impaired health status (sensitivity 90% and specificity 69%), respectively (p<0.05). CONCLUSION: Our findings demonstrated that gait speed can discriminate between abnormal functional exercise capacity and impaired health status in older patients with COPD. Moreover, functional exercise capacity and health status are predictors of gait speed.

Gait speed predictors and gait-speed cut-off score to discriminate asthma control status and physical activity in patients with asthma.

INTRODUCTION: As a "vital sign" of health and functional capacity, gait speed is commonly used. However, there is insufficient evidence for possible determinants of gait speed in patients with asthma. The primary objective of the present study was to determine predictors of gait speed in patients with asthma. The second objective was to determine the cut-off point for the 4-minute Gait Speed (4MGS) to better discriminate asthma control status and physical activity in asthma. MATERIAL AND METHODS: Fifty-seven patients with asthma were included in this cross-sectional study. Demographic and clinic characteristics, pulmonary function, asthma control status (ACT, Asthma Control Test), dyspnea, gait speed (4MGS), physical activity [International Physical Activity Questionnaire-Short Form (IPAQ-SF)] and activities of daily living were evaluated. Stepwise multiple linear regression analysis was used to investigate the possible predictors of gait speed. Receiver operating characteristic (ROC) curve analysis was used to determine whether usual gait speed had a discriminative value. RESULTS: The stepwise multiple regression analysis revealed that the ACT score and the IPAQ-SF score were significant and independent predictors of the 4MGS in patients with asthma explaining 40% of the variance in 4MGS (p < 0.001). The ROC curve showed a cut-off point of 1.06 m/s for the 4MGS for poorly controlled asthma and physical inactivity (p < 0.05). CONCLUSIONS: Our findings indicate that asthma control status and physical activity can be independent predictors of gait speed in patients with asthma. In addition, gait speed may be discriminative to determine poorly controlled asthma and physical inactivity in patients with asthma.

Choroidal vascularity index in obstructive sleep apnea syndrome.

BACKGROUND: There is growing evidence supporting an association between obstructive sleep apnea syndrome (OSAS) and systemic vascular disorders. However, the data on choroidal microvasculature are limited. In recent years, choroidal thickness (CT) and choroidal vascularity index (CVI) have been of considerable interest as objective markers of choroidal vascularity. We hypothesized that the imbalance of vascular regulation in OSAS may adversely affect the CT and CVI and may help to assess the vascular risk in these patients. PURPOSE: This study aimed to evaluate the choroidal morphology in patients with OSAS. MATERIALS AND METHODS: Patients with moderate OSAS were included to this study. The subfoveal, nasal, and temporal CT were calculated. The choroidal area (CA) was binarized to the luminal area (LA) and stromal area (SA) using ImageJ software. The CVI was calculated as the proportion of the LA to the total CA. RESULTS: Of 40 eyes of 40 patients, the mean subfoveal CT was significantly decreased in the OSAS group in comparison to the controls (p = 0.032). The mean CA, LA, and SA were decreased in the OSAS group compared with the controls, but the differences did not reach a statistical significance (p = 0.132, p = 0.104, and p = 0.184, respectively). The CVI was not significantly changed in patients with OSAS (p = 1.000). CONCLUSION: Unlike CT, there were no significant differences in choroidal structural parameters and CVI in patients with OSAS.