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1.
Can J Surg ; 63(5): E409-E411, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009895

RESUMO

SUMMARY: There is currently no consensus on the appropriate sports and occupational restrictions for military service members with a joint replacement. Data from the United States show that 14% of military patients complete an operational deployment after the index surgery. No published data are available on arthroplasty in the militaries of other North Atlantic Treaty Organization countries. Research is needed to determine the appropriate medical employment limitations for Canadian Armed Forces members with a knee or hip replacement. Service members wanting to continue military service should be carefully screened to ensure that their duties do not compromise the longevity of the implant and that the risk of mission-threatening complications is minimal.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Medicina Militar/normas , Militares/estatística & dados numéricos , Falha de Prótese , Canadá , Consenso , Teste de Esforço/normas , Humanos , Medicina Militar/estatística & dados numéricos , Aptidão Física , Guias de Prática Clínica como Assunto , Estados Unidos , Avaliação da Capacidade de Trabalho
2.
Einstein (Sao Paulo) ; 18: eRW5232, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32725055

RESUMO

Objective To perform a systematic literature review and meta-analysis to investigate the reliability of The International Fitness Scale questionnaire for assessing overall physical fitness and related components. Methods PubMed®, BIREME, SciELO, EMBASE, SPORTDiscus, LILACS and Cochrane databases were searched using the following search terms: "The International Fitness Scale", "International Fitness Scale" and "IFIS". Article selection and data extraction were performed according to the following eligibility criteria: reliability and/or validity study of the measure tools of The International Fitness Scale; adoption of the The International Fitness Scale as a reference criterion (gold standard) and being an original article. Quality of the study was considered based on Assessment of Reliability Studies. Data analysis used Kappa coefficient of agreement, Cochran and the Higgins I2 test. Sensitivity analysis was conducted using the withdrawal model. Results A total of seven articles were included in the analysis. Test-retest reliability coefficients ranged from 0.40 to 0.99, with most studies achieving values ≥0.60, indicative of moderate to substantial reliability. Conclusion In spite of appropriate test-retest scores attributed to most reliability indicators, heterogeneity among the studies remained high. Therefore, further studies with low risk of bias are needed to support the reliability of the self-reported The International Fitness Scale.


Assuntos
Teste de Esforço/normas , Exercício Físico , Aptidão Física , Inquéritos e Questionários/normas , Humanos , Reprodutibilidade dos Testes
3.
Gerontology ; 66(4): 401-408, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32623430

RESUMO

BACKGROUND: Many studies have demonstrated an inverse relationship between gait performance and cognitive impairment. The main purposes of this study were: (1) to design and validate a complex gait test (CGT) in older people, (2) to analyze the effects of age and sex on CGT, and (3) to analyze the association between CGT performance and physical functioning and cognitive measures. METHODS: A total of 279 older people (60-97 years) were analyzed in 2019. Fitness tests, gait performance, and several cognitive measures such asthe Trail-Walking Test and Montreal Cognitive Assessment were used. RESULTS: The CGT reported adequate reliability and validity parameters. In the test-retest analysis, the intra-class correlation coefficient was 0.868 (p < 0.001). There was a significant correlation between the CGT and Trail-Walking Test (r = 0.592; p < 0.001). The linear regression analysis showed that the CGT was associated with the Montreal Cognitive Assessment (R2 = 0.357; p =0.001). The binary logistic regression analysis revealed that a high CGT score was a risk factor for mild cognitive impairment (odds ratio 1.201, 95% CI 1.081-1.334; p = 0.001). The ROC curve of the mild cognitive impairment was predicted by the CGT performance (area under the curve = 0.768, 95% CI 0.647-0.889; p < 0.001), reaching the cut-off point at 20.25 s. CONCLUSIONS: The CGT showed good reliability and validity and may serve as a potential biomarker in mild cognitive impairment prediction in older adults aged 60-97 years.


Assuntos
Cognição/fisiologia , Teste de Esforço/normas , Marcha/fisiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/fisiopatologia , Estudos de Coortes , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores Sexuais , Espanha , Caminhada/fisiologia
4.
Tunis Med ; 98(5): 378-395, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32548841

RESUMO

OBJECTIVE: The objective of this literature review is to gather all the LFT norms available for the Tunisian population, as well as QDV questionnaires specific to chronic respiratory patients that have been validated in Tunisia. METHODS: This review included a literature search using the PubMed and Sciencedirect databases. The reference lists of the retrieved English/French articles were searched for any additional reference. Specific research has been carried out for each stage of the natural evolution of chronic diseases. For LFT used in the exploration of deficiency, the key-words were ("respiratory function test" OR "spirometry" OR "plethysmography" OR "exhaled fraction of oxide nitric" OR "lung diffusion" OR "peak nasal inspiratory flow" OR "Lung age") AND ("Tunisia" OR "North Africa") AND ("reference equation" OR "reference value" OR "standard reference"). For LFT used in the exploration of incapacity, the key-words were ("exercise test" OR "maximal oxygen uptake" OR "cardiorespiratory test" OR "six minute walk distance" OR "six-minute walk distance" OR "6-minute walk distance" OR "six-min walk distance" OR "6-min walk distance" OR "six minute walking distance" OR "six-minute walking distance" OR "6MWD") AND ("Tunisia" OR "North Africa") AND ("reference equation" OR "reference value" OR "standard reference"). For the QOL questionnaires used in pneumology, the key-words were: ("quality of life" OR "QOL") AND ("respiratory" OR "pulmonology") AND ("Tunisia" OR "North Africa"). RESULTS: As part of deficiency exploration, 11 Tunisian norms are available. As part of incapacity exploration, three Tunisian norms are available for the 6-minute walk test. Only one QOL questionnaire specific to chronic respiratory patients has been validated in Tunisia. CONCLUSION: Despite its richness, the Tunisian "bank" of norms for LFT and QOL questionnaires has yet to be enriched.


Assuntos
Doença Pulmonar Obstrutiva Crônica/diagnóstico , Qualidade de Vida , Testes de Função Respiratória/normas , Insuficiência Respiratória/diagnóstico , Inquéritos e Questionários/normas , Doença Crônica , Pessoas com Deficiência , Progressão da Doença , Teste de Esforço/métodos , Teste de Esforço/normas , Humanos , Doença Pulmonar Obstrutiva Crônica/patologia , Valores de Referência , Testes de Função Respiratória/métodos , Insuficiência Respiratória/patologia , Índice de Gravidade de Doença , Tunísia , Estudos de Validação como Assunto
5.
Rev. int. med. cienc. act. fis. deporte ; 20(78): 369-380, jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194788

RESUMO

Se analiza la influencia que tienen las variables cineantropométricas y dinamométricas sobre el test Sit and Reach en deportistas amateur. Se tomaron veinte variables antropométricas, cuatro pruebas de dinamometría, el test Sit and Reach y la actividad física realizada. Encontramos diferencias significativas en los valores de flexibilidad entre hombres y mujeres. Las ecuaciones de predicción fueron diferentes en hombres y en mujeres (30.6% y 32.5%), en las mujeres apareció la talla como factor influyente. La ecuación general de predicción calculada se obtiene un 39,1% (moderada). Hombres y mujeres se diferencian significativamente en todas las variables antropométricas excepto en pliegue subescapular y suprailiaco. ¿Qué otros factores influirían sobre una posible predicción del resultado? Los valores de flexibilidad no se consideran influenciados por las variables antropométricas, dinamométricas y la tipología de actividad física realizada. El índice de fuerza no correlaciona con el valor del test Sit and Reach


Analyzes the influence of kinanthropometric and dynamometric variables on the Sit and Reach test in amateur athletes. We used twenty anthropometric variables, four dynamometry tests, the Sit and Reach test and the amount of physical activity practiced. Significant differences were found between men and women in terms of flexibility levels. The prediction equations were differed according to gender (30.6% men and 32.5% women), height being an influential factor in women. The general prediction equation calculated, the level is 39.1% (moderate). Men and women show significant differences in all anthropometric variables except subscapular and suprailiac skinfolds. What other factors influence the kind of results that can be expected? The results of the flexibility test are not influenced by the anthropometric and dynamometric variables, or by the type of physical activity performed. The strength index does not correlate with the Sit and Reach test value


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Antropometria , Dinamômetro de Força Muscular , Atividade Motora , Teste de Esforço/normas , Músculo Esquelético/fisiologia , Análise de Regressão , Teste de Esforço/métodos , Esportes/fisiologia
6.
Sports Health ; 12(6): 552-558, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32392085

RESUMO

BACKGROUND: Current anterior cruciate ligament reconstruction (ACLR) guidelines utilize single-leg hop tests (SLHTs) to assist in return-to-sport decision making. A limb symmetry index (LSI) of ≥90% is often required; however, after ACLR, most youth athletes cannot achieve this standard. Reporting the performance of age-matched normative controls will allow clinicians to compare post-ACLR performance with noninjured peers, improving the utility of SLHTs. The purpose of this study was to report hop test LSI within healthy youth athletes and determine whether athlete performance surpasses post-ACLR requirements. HYPOTHESIS: The LSI for the majority of healthy youth athletes will be ≥90%. STUDY DESIGN: Cross-sectional cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Each participant performed a single hop (SH), triple hop (TrH), crossover hop (CrH), and timed hop (TiH). A 3-trial mean was utilized to calculate an LSI (nondominant/dominant leg [self-reported kicking leg]) for each hop. The frequency of pass/fail at ≥90% LSI was calculated. Pearson correlation coefficients analyzed the relationship between the different hops, and a 2-way analysis of variance determined the effects of age and sex on LSI. RESULTS: A total of 340 participants (54% male; mean age, 10.9 ± 1.5 years; range, 8-14 years) were included. The mean LSI was >95% for each SLHT (SH, 97.9% [SD, 0.7]; TrH, 96.6% [SD, 0.6]; CrH, 96.8% [SD, 0.8]; TiH, 96.5% [SD, 0.6]). When analyzed as a test battery, only 45% of participants achieved this standard. Significantly weak to moderate correlations existed among hop tests (P < 0.01; r = 0.342-0.520). Age and sex had no effect on LSI (P < 0.05). CONCLUSION: While the mean LSI in our sample was >95% for each individual hop test, participant performance across all SLHT components varied, such that less than half of healthy athletes could achieve ≥90% LSI across all hops. CLINICAL RELEVANCE: Current guidelines require ≥90% LSI on SLHTs. The majority of healthy youth athletes could not achieve this standard, which questions the validity of this LSI threshold in youth athletes after ACLR.


Assuntos
Teste de Esforço/métodos , Extremidade Inferior/fisiologia , Esportes Juvenis/fisiologia , Fatores Etários , Lesões do Ligamento Cruzado Anterior/reabilitação , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Criança , Estudos Transversais , Teste de Esforço/normas , Feminino , Humanos , Masculino , Valores de Referência , Reprodutibilidade dos Testes , Volta ao Esporte , Fatores Sexuais , Esportes Juvenis/lesões
7.
J Sports Med Phys Fitness ; 60(5): 709-712, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32438786

RESUMO

BACKGROUND: The cardiorespiratory fitness (CRF) is one of the most important indicators of the health-related physical fitness components because it reflects the efficiency of the cardiovascular and respiratory systems. To indirectly assess CRF, the original protocol of the 20mSRT was adapted in a new version suitable for children called 20mSRT-PREFIT, providing performances comparable to the standards of the European area. In fact, CRF normative values are missing in the Italian context and therefore they would be meaningful to be assessed. We aimed to determine CRF from 20mSRT-PREFIT in a small sample of Italian pre-school children and to compare the outcomes with the available European references. METHODS: A convenience sample of 5-year-old pre-school children (N.=32, M/F ratio: 19/13) was freely recruited from a kindergarten of the northwest Italy. Children performed the 20mSRT-PREFIT and the number of full shuttles, exhaustion time, and maximum speed were collected to obtain CRF. RESULTS: Predicted VO2max was similar between Italian male and female groups. All other outcomes originating from the 20mSRT-PREFIT were consistent with those included in the available European databases. CONCLUSIONS: According to these preliminary indications, Italian pre-school children may have a CRF level equivalent to that one ascertained in other European countries. Thus, current rakings should be cautiously scrutinized, as they might inappropriately underrate Italian children's performances.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Teste de Esforço/métodos , Criança , Pré-Escolar , Conjuntos de Dados como Assunto , Exercício Físico , Teste de Esforço/normas , Feminino , Humanos , Itália , Masculino
8.
J Sports Med Phys Fitness ; 60(5): 720-732, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32438788

RESUMO

INTRODUCTION: This review aimed 1) to describe the most common tests used for assessing change of direction (COD) performance; 2) to detail the reliability of current COD tests; 3) to provide an overview of current intervention strategies used to improve COD performance in adolescent female soccer players. EVIDENCE ACQUISITION: A computerized search was conducted in the PubMed, Cochrane Plus and Web of Science (from 1995 to January 2020) for English and Spanish language and peer-reviewed investigations. EVIDENCE SYNTHESIS: A total of 221 studies were identified, with only 16 meeting the specific search criteria. The main findings were that eleven different tests have been used to assess COD performance with intraclass correlation coefficient and coefficient of variation values between 0.72-0.99 and 1-10.6%, respectively. The number of CODs performed during each test ranged from 1 to 9 within a range of 45º to 180º and with a duration <5 s, 5-9 s and >10 s. CONCLUSIONS: Findings indicate that the reliability of the COD tests seems to depend on: the equipment used, the surface tested on and the technical level of the soccer player. These results should be interpreted with caution as they may be influenced by the period of growth and maturation, the playing position of the player and the period of the soccer season. Finally, strength and power drills could be considered as appropriate to improve COD performance.


Assuntos
Teste de Esforço/normas , Corrida/fisiologia , Futebol/fisiologia , Adolescente , Feminino , Humanos , Reprodutibilidade dos Testes
9.
J Bras Pneumol ; 46(3): e20180422, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32321033

RESUMO

OBJECTIVE: To evaluate the construct validity and reproducibility of the six-minute step test (6MST) in individuals with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP). METHODS: We evaluated 48 volunteers diagnosed with OSA and treated with CPAP for at least two months. The volunteers underwent the six-minute walk test (6MWT) and the 6MST, in random order and on different days, with an interval of, at most, seven days between the two tests. RESULTS: A moderate positive correlation was found between the distance walked on the 6MWT and the number of steps climbed on the 6MST (r = 0.520; p < 0.001). There was no significant difference between the two 6MSTs in terms of the number of steps climbed (121.7 ± 27.1 vs. 123.6 ± 26.7). Reproducibility for performance on the 6MST and for cardiovascular variables was considered excellent (intraclass correlation coefficient > 0.8). Regarding cardiovascular responses, the 6MST produced higher values than did the 6MWT for HR at six minutes, percent predicted maximum HR, and leg fatigue at six minutes, as well as for systolic blood pressure at six minutes and at one minute of recovery. CONCLUSIONS: The 6MST is valid and reproducible, producing greater cardiovascular stress than does the 6MWT. However, the 6MST is also characterized as a submaximal test for the assessment of exercise tolerance in individuals with OSA treated with CPAP.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas/métodos , Teste de Esforço/normas , Tolerância ao Exercício/fisiologia , Apneia Obstrutiva do Sono/terapia , Teste de Esforço/métodos , Humanos , Reprodutibilidade dos Testes , Apneia Obstrutiva do Sono/fisiopatologia
10.
PLoS Med ; 17(4): e1003082, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32243458

RESUMO

BACKGROUND: The evaluation of the credibility of results from a meta-analysis has become an important part of the evidence synthesis process. We present a methodological framework to evaluate confidence in the results from network meta-analyses, Confidence in Network Meta-Analysis (CINeMA), when multiple interventions are compared. METHODOLOGY: CINeMA considers 6 domains: (i) within-study bias, (ii) reporting bias, (iii) indirectness, (iv) imprecision, (v) heterogeneity, and (vi) incoherence. Key to judgments about within-study bias and indirectness is the percentage contribution matrix, which shows how much information each study contributes to the results from network meta-analysis. The contribution matrix can easily be computed using a freely available web application. In evaluating imprecision, heterogeneity, and incoherence, we consider the impact of these components of variability in forming clinical decisions. CONCLUSIONS: Via 3 examples, we show that CINeMA improves transparency and avoids the selective use of evidence when forming judgments, thus limiting subjectivity in the process. CINeMA is easy to apply even in large and complicated networks.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Eletrocardiografia/normas , Teste de Esforço/normas , Imagem Cinética por Ressonância Magnética/normas , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Intervalos de Confiança , Doença da Artéria Coronariana/epidemiologia , Eletrocardiografia/métodos , Teste de Esforço/métodos , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
11.
PLoS One ; 15(4): e0227185, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271758

RESUMO

Standardized physical fitness monitoring provides a more accurate proxy for youth health when compared with physical activity. Little is known about the utilization of broad-scale individual-level youth physical fitness testing to explore health disparities. We examined longitudinal trends in population-level fitness for 4th-12th grade New York City youth during 2006/7-2016/17 (average n = 510,293 per year). Analyses were performed in 2019. The primary outcome was whether or not youth achieved sex-/age-specific performance levels (called the Healthy Fitness Zone) on the aerobic capacity, muscular strength and muscular endurance tests using the NYC FITNESSGRAM. The Cooper Institute's most recent Healthy Fitness Zone criteria were applied to all tests and years. Prevalence estimates were weighted, accounted for school clustering, adjusted for student-level sociodemographics, and run by sociodemographic subgroups and year. The overall prevalence for meeting 3 Healthy Fitness Zones increased from 15.5% (95%CI: 13.9%-17.0%) in 2006/7 to 23.3% (95%CI: 22.2%-24.4%) in 2016/17 for students in grades 4-12. Fitness for all student groups increased over time, although Hispanic and non-Hispanic black girls consistently had the lowest prevalence of meeting 3 Healthy Fitness Zones as compared to all other race/sex subgroups. Also, 9th-12th graders had a lower prevalence of meeting 3 Healthy Fitness Zones as compared to 4th-8th graders. Given forecasted sharp increases in cardiovascular disease prevalence, routine youth fitness surveillance using standardized, criterion referenced methods can identify important fitness disparities and inform interventions.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Disparidades nos Níveis de Saúde , Aptidão Física/fisiologia , Estudantes/estatística & dados numéricos , Adolescente , Fatores Etários , Doenças Cardiovasculares/fisiopatologia , Criança , Teste de Esforço/normas , Teste de Esforço/estatística & dados numéricos , Teste de Esforço/tendências , Feminino , Humanos , Estudos Longitudinais , Masculino , Cidade de Nova Iorque/epidemiologia , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Fatores Sexuais , Adulto Jovem
12.
Arq Bras Cardiol ; 114(2): 209-218, 2020 02.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32215486

RESUMO

BACKGROUND: Atrial fibrillation (AF) is associated with increased mortality in heart failure (HF) patients. OBJECTIVE: To evaluate whether the risk of AF patients can be precisely stratified by relation with cardiopulmonary exercise test (CPET) cut-offs for heart transplantation (HT) selection. METHODS: Prospective evaluation of 274 consecutive HF patients with left ventricular ejection fraction ≤ 40%. The primary endpoint was a composite of cardiac death or urgent HT in 1-year follow-up. The primary endpoint was analysed by several CPET parameters for the highest area under the curve and for positive (PPV) and negative predictive value (NPV) in AF and sinus rhythm (SR) patients to detect if the current cut-offs for HT selection can precisely stratify the AF group. Statistical differences with a p-value <0.05 were considered significant. RESULTS: There were 51 patients in the AF group and 223 in the SR group. The primary outcome was higher in the AF group (17.6% vs 8.1%, p = 0.038). The cut-off value of pVO2 for HT selection showed a PPV of 100% and an NPV of 95.5% for the primary outcome in the AF group, with a PPV of 38.5% and an NPV of 94.3% in the SR group. The cut-off value of VE/VCO2 slope showed lower values of PPV (33.3%) and similar NPV (92.3%) to pVO2 results in the AF group. CONCLUSION: Despite the fact that AF carries a worse prognosis for HF patients, the current cut-off of pVO2 for HT selection can precisely stratify this high-risk group.


Assuntos
Fibrilação Atrial/mortalidade , Fibrilação Atrial/fisiopatologia , Teste de Esforço/normas , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Medição de Risco/normas , Adulto , Idoso , Teste de Esforço/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Oxigênio/metabolismo , Consumo de Oxigênio/fisiologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Padrões de Referência , Fatores de Risco , Estatísticas não Paramétricas , Volume Sistólico/fisiologia , Fatores de Tempo
13.
J Bras Pneumol ; 46(1): e20180267, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32130343

RESUMO

OBJECTIVE: To establish reference values for the Unsupported Upper Limb EXercise (UULEX) test, which measures peak arm exercise capacity, in healthy adults in Brazil. METHODS: This was a cross-sectional study, involving presumably healthy individuals ≥ 30 years of age who completed questionnaires and underwent spirometry. All of the individuals underwent two UULEX tests 30-min apart. The outcome measure was the maximum time (in min) to completion of the test. RESULTS: We included 100 individuals between 30 and 80 years of age. The mean test completion time was 11.99 ± 1.90 min among the women and 12.89 ± 2.15 min among the men (p = 0.03). The test completion time showed statistically significant correlations with age (r = -0.48; p < 0.001), gender (r = 0.28; p = 0.004), body mass index (BMI, r = -0.20; p = 0.05), and height (r = 0.28; p = 0.005). Linear regression analysis showed that the predictors of UULEX completion time were age (p = 0.000), BMI (p = 0.003), and gender (p = 0.019), which collectively explained 30% of the total variability. The mean UULEX completion time was 6% lower for the women than for the men. CONCLUSIONS: The present study was able to establish reference values for the UULEX test in healthy adults in Brazil. The values were influenced by age, gender, and BMI.


Assuntos
Teste de Esforço/normas , Exercício Físico/fisiologia , Extremidade Superior/fisiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Brasil , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Padrões de Referência , Valores de Referência , Reprodutibilidade dos Testes , Fatores Sexuais , Estatísticas não Paramétricas
14.
Pneumologie ; 74(2): 88-102, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32050280

RESUMO

Cardiorespiratory fitness has been established as an independent overall predictor of morbidity and mortality. However, patients' symptoms or stated levels of exercise intolerance correlate only poorly with resting functional and imaging tests. Cardiopulmonary exercise testing (CPET) is the gold standard for the integrative assessment of the cardiocirculatory, pulmonary and metabolic response to exercise and can help identify the source of exercise limitation, monitor disease progression, evaluate treatment responsiveness and inform about prognosis. Though CPET offers more valuable and pertinent information with slightly more expenditure of time compared to other methods even at submaximal exercise levels, it remains underutilized for various reasons such as costs, reimbursement and expertise. CPET can be seen as a complex, but not necessarily difficult tool. The objective of this review was to provide a description of the underlying principles of physiology, and an easy-to-follow guidance to indications, methodology, and interpretative strategies of CPET.


Assuntos
Aptidão Cardiorrespiratória , Teste de Esforço/métodos , Teste de Esforço/normas , Guias de Prática Clínica como Assunto , Exercício Físico , Tolerância ao Exercício , Humanos , Consumo de Oxigênio
15.
J Electromyogr Kinesiol ; 51: 102401, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32087511

RESUMO

PURPOSE: The reliability of lower extremity muscle activation patterns has not been clearly studied in a dual-belt instrumented treadmill environment. The primary study objective was to quantify the day-to-day reliability of quadriceps, hamstrings, gastrocnemius and gluteus medius activation patterns in healthy young adult gait. Secondarily, the reliability of spatiotemporal, and knee/hip motion and moment-based gait outcomes was assessed. SCOPE: 20 young adults were recruited and tested on two separate days. Using standardized procedures, participants were prepared for surface electromyography and lower extremity motion capture. All individuals walked on a dual-belt instrumented treadmill while muscle activation, segment motions and ground reaction forces were recorded. Sagittal plane motion and net external sagittal and frontal plane moments were calculated. Discrete biomechanical and muscle activation measures were calculated, and non-negative matrix factorization extracted amplitude and temporal muscle activation features. Intraclass Correlation Coefficients, Standard Error of Measurement and Minimum Detectable Change were calculated. CONCLUSIONS: High to excellent Intraclass correlation coefficients were found between visits for most primary and secondary outcomes. The absolute and relative reliability, including Minimum Detectable Change values, provided in this study support the use of dual-belt instrumented treadmill walking as an acceptable medium to collect biomechanical and lower extremity EMG outcomes for future studies.


Assuntos
Variação Biológica Individual , Teste de Esforço/normas , Marcha , Fenômenos Biomecânicos , Feminino , Humanos , Articulação do Joelho/fisiologia , Perna (Membro)/fisiologia , Masculino , Músculo Esquelético/fisiologia , Reprodutibilidade dos Testes , Adulto Jovem
16.
Clin Physiol Funct Imaging ; 40(3): 173-182, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32056351

RESUMO

Monitoring physical fitness in young athletes is essential to improve physical performance, identify talents and develop injury prevention programs. The aim of this investigation was to analyse the reliability of the physical fitness tests from the FITescola® battery in young athletes with different sports backgrounds and competition levels. Participants comprised of 138 young athletes (boys n = 92) aged 9 and 18 years old. Eight physical fitness tests assessing six components of physical fitness were performed: cardiorespiratory fitness (PACER); upper body muscular fitness (push-up); flexibility (sit and reach); lower-body muscular fitness (horizontal and vertical jump); agility (4 × 10 shuttle run); and speed (sprint at 20 m and 40 m). Each test was performed twice, with a one-week interval (7 days) between duplicate tests. No differences between duplicate tests were found (p > .05), except for the speed at 20 m in boys (p < .001) and speed at 40 m in girls (p = .006). The battery of tests had good or excellent reliability and concordance of the ICC between the two trials (ICC ≥ 0.75) with exception for the 20 m speed run in girls that presented moderate reliability (ICC = 0.57). The Bland-Altman plots showed high reliability for all the fitness tests for both sexes. Hence, The FITescola® battery may be a novel tool to assess the physical fitness of large groups of young athletes from different sports backgrounds.


Assuntos
Atletas , Teste de Esforço/métodos , Teste de Esforço/normas , Aptidão Física/fisiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
17.
Int J Sports Med ; 41(8): 520-527, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32059246

RESUMO

Isometric strength tests are gaining popularity in recent years. However, no study has validated any isometric strength tests to assess upper body pulling ability. The aim of this study was to investigate the validity and reliability of isometric prone bench pull. Twenty-three resistance trained athletes (age: 26±4 years, height: 1.75±0.07 m, body mass: 78.6±11.5 kg) were required to perform prone bench pull 1 repetition maximum and isometric prone bench pull tests during the familiarization and actual testing sessions. Isometric prone bench pull was performed at 90° and 120° elbow angles. Peak force and rate of force development measures were highly reliable with intra-correlation coefficient between 0.881-0.987. Peak force obtained from isometric prone bench pull at both elbow angles showed large correlations to prone bench pull 1 repetition maximum (r=0.833-0.858, p<0.01). Linear regression equations to predict 1RM performance from isometric prone bench pull peak force produced an estimated 1RM with a standard error of only 3-6% of the average prone bench pull 1 repetition maximum. The current findings show that isometric prone bench pull is a reliable test and can be used to predict prone bench pull performance.


Assuntos
Teste de Esforço/métodos , Teste de Esforço/normas , Força Muscular/fisiologia , Adulto , Estudos Cross-Over , Eletromiografia , Humanos , Contração Isométrica , Masculino , Decúbito Ventral , Reprodutibilidade dos Testes , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-32102379

RESUMO

BACKGROUND: Reliability refers to the precision of an assessment, so it is a critical topic to take the right decisions related to health management. People usually perform several tasks at the same time in their daily life. The aim of this study was to examine the reliability of the 30-s chair stand test in people with type 2 Diabetes Mellitus (T2DM) with test-retest, with and without dual-task (motor + cognitive task). METHODS: Twenty-six subjects with T2DM and 30 subjects without T2DM performed the 30-s Chair Stand Test (30sCST) in which they must sit and stand as many times as possible in 30 s. They performed the test in the usual way (30sCST) and also with an additional cognitive task (30sCST-DT). A retest was conducted 7-14 days later. RESULTS: Relative reliability was excellent in both groups (intraclass correlation coefficient > 0.9). In 30sCST-DT, relative reliability was high in the T2DM group (intraclass correlation coefficient > 0.7) and excellent in subjects without T2DM (intraclass correlation coefficient > 0.9). CONCLUSIONS: The 30sCST and the 30sCST-DT tests are reliable tools for people with T2DM to measure changes after an intervention. The smallest real difference was 15% and 20% upper in the T2DM group in the 30sCST and 30sCST-DT tests, respectively.


Assuntos
Cognição , Diabetes Mellitus Tipo 2/fisiopatologia , Teste de Esforço/normas , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
19.
J Electromyogr Kinesiol ; 51: 102402, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32092642

RESUMO

Muscular activity in terms of surface electromyography (sEMG) is usually normalised to maximal voluntary isometric contractions (MVICs). This study aims to compare two different MVIC-modes in handcycling and examine the effect of moving average window-size. Twelve able-bodied male competitive triathletes performed ten MVICs against manual resistance and four sport-specific trials against fixed cranks. sEMG of ten muscles [M. trapezius (TD); M. pectoralis major (PM); M. deltoideus, Pars clavicularis (DA); M. deltoideus, Pars spinalis (DP); M. biceps brachii (BB); M. triceps brachii (TB); forearm flexors (FC); forearm extensors (EC); M. latissimus dorsi (LD) and M. rectus abdominis (RA)] was recorded and filtered using moving average window-sizes of 150, 200, 250 and 300 ms. Sport-specific MVICs were higher compared to manual resistance for TB, DA, DP and LD, whereas FC, TD, BB and RA demonstrated lower values. PM and EC demonstrated no significant difference between MVIC-modes. Moving average window-size had no effect on MVIC outcomes. MVIC-mode should be taken into account when normalised sEMG data are illustrated in handcycling. Sport-specific MVICs seem to be suitable for some muscles (TB, DA, DP and LD), but should be augmented by MVICs against manual/mechanical resistance for FC, TD, BB and RA.


Assuntos
Eletromiografia/métodos , Contração Isométrica , Músculo Esquelético/fisiologia , Extremidade Superior/fisiologia , Adulto , Braço/fisiologia , Calibragem , Eletromiografia/normas , Teste de Esforço/métodos , Teste de Esforço/normas , Humanos , Masculino
20.
Arq. bras. cardiol ; 114(2): 209-218, Feb. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1088870

RESUMO

Abstract Background: Atrial fibrillation (AF) is associated with increased mortality in heart failure (HF) patients. Objective: To evaluate whether the risk of AF patients can be precisely stratified by relation with cardiopulmonary exercise test (CPET) cut-offs for heart transplantation (HT) selection. Methods: Prospective evaluation of 274 consecutive HF patients with left ventricular ejection fraction ≤ 40%. The primary endpoint was a composite of cardiac death or urgent HT in 1-year follow-up. The primary endpoint was analysed by several CPET parameters for the highest area under the curve and for positive (PPV) and negative predictive value (NPV) in AF and sinus rhythm (SR) patients to detect if the current cut-offs for HT selection can precisely stratify the AF group. Statistical differences with a p-value <0.05 were considered significant. Results: There were 51 patients in the AF group and 223 in the SR group. The primary outcome was higher in the AF group (17.6% vs 8.1%, p = 0.038). The cut-off value of pVO2 for HT selection showed a PPV of 100% and an NPV of 95.5% for the primary outcome in the AF group, with a PPV of 38.5% and an NPV of 94.3% in the SR group. The cut-off value of VE/VCO2 slope showed lower values of PPV (33.3%) and similar NPV (92.3%) to pVO2 results in the AF group. Conclusion: Despite the fact that AF carries a worse prognosis for HF patients, the current cut-off of pVO2 for HT selection can precisely stratify this high-risk group.


Resumo Fundamento: A fibrilação atrial (FA) está associada ao aumento da mortalidade em pacientes com insuficiência cardíaca (IC). Objetivo: Avaliar se o risco de pacientes com FA pode ser estratificado com precisão em relação aos pontos de corte do teste de esforço cardiopulmonar (TECP) para seleção do transplante cardíaco (TC). Métodos: Avaliação prospectiva de 274 pacientes consecutivos com IC com fração de ejeção do ventrículo esquerdo ≤ 40%. O endpoint primário foi um composto de morte cardíaca ou TC urgente no seguimento de 1 ano. O endpoint primário foi analisado através de vários parâmetros do TECP para a maior área sob a curva e para o valor preditivo positivo (VPP) e negativo (VPN) em pacientes com FA e ritmo sinusal (RS) para detectar se os atuais pontos de corte para a seleção de TC podem estratificar com precisão o grupo com FA. Diferenças estatísticas com valor de p < 0,05 foram consideradas significativas. Resultados: Havia 51 pacientes no grupo de FA e 223 no grupo RS. O endpoint primário foi maior no grupo FA (17,6% vs. 8,1%, p = 0,038). O valor de corte de pVO2 para a seleção do TC mostrou um VPP de 100% e um VPN de 95,5% para o endpoint primário no grupo FA, com um VPP de 38,5% e um VPN de 94,3% no grupo RS. O valor de corte da inclinação VE/VCO2 apresentou valores mais baixos de VPP (33,3%) e valor semelhante de VPN (92,3%) aos resultados de pVO2 no grupo FA. Conclusões: Apesar do fato de a FA apresentar um pior prognóstico para os pacientes com IC, o atual ponto de corte de pVO2 para a seleção de TC pode estratificar com precisão esse grupo de alto risco.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/mortalidade , Medição de Risco/normas , Teste de Esforço/normas , Insuficiência Cardíaca/fisiopatologia , Oxigênio/metabolismo , Consumo de Oxigênio/fisiologia , Prognóstico , Padrões de Referência , Volume Sistólico/fisiologia , Fatores de Tempo , Modelos de Riscos Proporcionais , Análise Multivariada , Estudos Prospectivos , Fatores de Risco , Seguimentos , Estatísticas não Paramétricas , Teste de Esforço/métodos , Insuficiência Cardíaca/mortalidade
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