Health-related physical fitness, physical activity and its correlates among school going adolescents in hilly state in north India: a cross sectional survey.

INTRODUCTION: Health-related physical fitness, which includes body composition, cardiorespiratory fitness, muscular endurance, flexibility, power, and strength are associated with risks of chronic diseases and promote good health and wellness. There have been reports of increasing levels of physical inactivity among children and adolescents, leading to increasing rates of obesity and decreased physical fitness. The present study was conducted among school going adolescents to estimate the levels and correlates of PF for timely intervention. METHODOLOGY: School based cross-sectional study was done among students of class 8-11th in Government schools of Garhwal division of Uttarakhand. Multistage stratified random sampling was applied for recruitment of study participants. We recruited a final sample size of 634 students. Validated questionnaires and standard methods for assessment of physical fitness, physical activity levels and other variables such as waist circumference, hip circumference, BMI and hemoglobin estimation were done. RESULTS: Average and above average cardiorespiratory fitness score as per Harvard step test among boys (54.3%) was significantly higher as compared to girls (21.3%) (χ2 = 88.93, p < 0.001). There was a significant association between gender and dominant handgrip strength (χ2 = 8.02, p = 0.01) as well as between gender and Shoulder stretch test (SST) of dominant (χ2 = 17.5, p < 0.05) as well as nondominant arm (χ2 = 13.5, p < 0.05). Sit and reach test results also showed a significant association with gender (χ2 = 27.17, p < 0.001). Gender, hemoglobin level, BMI and PAL scores significantly predicted cardiorespiratory fitness scores (R2 = 0.188, F value of the model = 37.69, p =< 0.001)). CONCLUSION: Physical fitness of school going adolescents in Garhwal division of Uttarakhand was better than other parts of India, with significant gender differences. Physical activity levels (PAL) were poor and are also a significant predictor of physical fitness. More emphasis needs to be paid on the health and fitness of girl students. School based policies to increase PAL among students through innovation and rewards may go a long way in improving the long-term health of the students.

Physical Functioning, Physical Activity, and Variability in Gait Performance during the Six-Minute Walk Test.

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.

Genetic Background of Acute Heart Rate Response to Exercise.

The acute heart rate response (AHRR) to physical activity, which refers to the change in heart rate during and after exercise, has been associated with cardiovascular and all-cause mortality. Previous studies have shown that AHRR is significantly determined by genetics in addition to environmental and lifestyle factors. The aim of this study was to investigate the genetic background of AHRR by analysing ten single nucleotide polymorphisms (SNPs) associated with leisure-time physical activity (LTPA) in 620 samples from the Hungarian population. The AHRR can be characterised as the difference between post-exercise and resting heart rate, i.e., the delta heart rate (ΔHR) defined by the YMCA 3 min step test, with a lower value indicating better cardiovascular fitness. The association of SNPs with ΔHR was analysed both separately and in combination using an optimised polygenic score (oPGS). The results showed that five SNPs (rs10252228, rs459465, rs6022999, rs8097348, and rs12405556) had at least nominally significant (p < 0.05) individual associations with ΔHR. After optimizing the PGS, a cumulative effect was observed for eight SNPs (rs6022999, rs12405556, rs459465, rs10252228, rs8097348, rs10887741, rs12612420, and rs7023003) that had a strong and statistically significant association with ΔHR (B = -2.51, 95% CI: -3.46--1.76; p = 2.99 × 10-9). Of the four main domains of physical activity, the oPGS showed a significant positive association only with LTPA (B = 84.60; 95%CI: 25.23-143.98; p = 0.005). In conclusion, our results suggest that the SNPs we investigated influence individual leisure-time physical activity, mediated by their effects on the acute heart rate response.

Correlation of body mass index, with cardiometabolic and cardiorespiratory fitness in health care professionals of Multan.

The current study was conducted at Ali-Ul-Murtaza Department of Rehabilitation Sciences, Muhammad Institute of Medical and Allied Sciences, Multan, Pakistan, from October to December 2022 to explore the correlation of body mass index with cardiometabolic and cardiorespiratory parameters in 393 male and female healthcare professionals, including physiotherapists, pharmacists and medical laboratory technicians, aged 22- 40 years. The evaluation was on the basis of the Physical Activity Readiness Questionnaire, body mass index, lipid profile, body fat and correlation of blood pressure, temperature, oxygen saturation, respiration rate and heart rate with cardiorespiratory fitness assessed through shuttle-run test, step test and treadmill test. Data was analysed using SPSS 25. Of the 393 subjects, 140(35.62) were underweight, 140(35.62) were overweight and 113(28.75) were obese. Of the total, 153(38.93) were pleased with their general health, while 240(61.06) had a history of cardiovascular and metabolic conditions. There was a highly significant correlation between lipid profiles and the subjects' quality of life (p<0.05).

Associations between lower extremity muscle fat fraction and motor performance in myotonic dystrophy type 2: A pilot study.

INTRODUCTION/AIMS: Although muscle structure measures from magnetic resonance imaging (MRI) have been used to assess disease severity in muscular dystrophies, little is known about how these measures are affected in myotonic dystrophy type 2 (DM2). We aim to characterize lower extremity muscle fat fraction (MFF) as a potential biomarker of disease severity, and evaluate its relationship with motor performance in DM2. METHODS: 3-Tesla MRIs were obtained from nine patients with DM2 and six controls using a T1W-Dixon protocol. To calculate MFF, muscle volumes were segmented from proximal, middle, and distal regions of the thigh and calf. Associations between MFF and motor performance were calculated using Spearman's correlations (ρ). RESULTS: Mean age of DM2 participants was 62 ± 11 y (89% female), and mean symptom duration was 20 ± 12 y. Compared to controls, the DM2 group had significantly higher MFF in the thigh and the calf segments (p-value = .002). The highest MFF at the thigh in DM2 was located in the posterior compartment (39.7 ± 12.9%) and at the calf was the lateral compartment (31.5 ± 8.7%). In the DM2 group, we found a strong correlation between the posterior thigh MFF and the 6-min walk test (ρ = -.90, p-value = .001). The lateral calf MFF was also strongly correlated with the step test (ρ = -0.82, p-value = .006). DISCUSSION: Our pilot data suggest a potential correlation between lower extremity MFF and some motor performance tests in DM2. Longitudinal studies with larger sample sizes are required to validate MFF as a marker of disease severity in DM2.

Estimation methods to detect changes in cardiorespiratory fitness due to exercise training and subsequent detraining.

PURPOSE: To determine whether estimated maximal oxygen consumption ([Formula: see text]) can detect cardiorespiratory fitness (CRF) changes by behavioral modifications. This study compared changes in measured [Formula: see text]O2max (m[Formula: see text]O2max) through exercise intervention with e[Formula: see text]O2max using a multiple regression model (MRM) and linear extrapolation method (LEM). METHODS: A cross-sectional analysis involving 173 adults was conducted to establish an MRM by including age, sex, body mass index, questionnaire score, heart rate (HR) from step test, and m[Formula: see text]O2max. Subsequently, 15 men participated in an intervention experiment comprising an 8-week, high-intensity interval training, followed by 8-week detraining, and completed anthropometric measurements, questionnaires, step tests, and m[Formula: see text]O2max tests. m[Formula: see text]O2max changes throughout the intervention were compared to e[Formula: see text]O2max changes calculated using the MRM and LEM. The LEM used the HR during the step test with constant values (predetermined [Formula: see text]O2), such as the Chester step test. RESULTS: Inclusion of the step test HR in a questionnaire-based MRM improved the estimation power, although the MRM underestimated higher m[Formula: see text]O2max values. In the intervention, m[Formula: see text]O2max increased by 20.0 ± 14.1% (P < 0.01) and subsequently decreased by 9.5 ± 6.6% (P < 0.01) after exercise training and detraining, respectively. Significant method × time interactions were observed between m[Formula: see text]O2max and e[Formula: see text]O2max in the MRM but not in the LEM, i.e., an apparent systematic error (underestimation of high values) of the MRM was absent in the LEM, although the correlation between m[Formula: see text]O2max and e[Formula: see text]O2max using the LEM was moderate. CONCLUSION: e[Formula: see text]O2max, particularly using the MRM with HR as an explanatory factor, is not an appropriate method for detecting CRF changes along with behavioral modifications. CLINICAL TRIAL REGISTRATION: Registered number, UMIN000041031; Registered date, 2020/07/08; URL, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046855.

Cardiovascular fitness is associated with child adiposity at 5 years of age: findings from the ROLO longitudinal birth cohort study.

BACKGROUND: Cardiovascular fitness is strongly linked with metabolic risk; however, research is limited in preschool children. Although there is currently no simple validated measure of fitness in preschool children, heart rate recovery has been highlighted as an easily accessible and non-invasive predictor of cardiovascular risk in school-aged children and adolescents. We aimed to investigate whether heart rate recovery was associated with adiposity and blood pressure in 5-year-olds. STUDY DESIGN: This is a secondary analysis of 272 5-year-olds from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet in pregnancy to prevent recurrence of macrosomia) Kids study. Three-minute step tests were completed by 272 participants to determine heart rate recovery duration. Body mass index (BMI), circumferences, skinfold thickness, heart rate, and blood pressure were collected. Independent t-tests, Mann-Whitney U, and Chi-square tests were used to compare participants. Linear regression models examined associations between heart rate recovery and child adiposity. Confounders included child sex, age at study visit, breastfeeding, and perceived effort in the step test. RESULTS: The median (IQR) age at the study visit was 5.13 (0.16) years. 16.2% (n = 44) had overweight and 4.4% (n = 12) had obesity based on their BMI centile. Boys had a quicker mean (SD) heart rate recovery after the step test than girls (112.5 (47.7) seconds vs. 128.8 (62.5) seconds, p = 0.02). Participants with a slower recovery time (> 105 s) had higher median (IQR) sum of skinfolds (35.5 (11.8) mm vs. 34.0 (10.0) mm, p = 0.02) and median (IQR) sum of subscapular and triceps skinfold (15.6 (4.4) mm vs. 14.4 (4.0) mm, p = 0.02) compared to participants with a quicker recovery time. After adjusting for confounders (child sex, age at study visit, breastfeeding, effort in the step test), linear regression analyses revealed heart rate recovery time after stepping was positively associated with sum of skinfolds (B = 0.034, 95% CI: 0.01, 0.06, p = 0.007). CONCLUSION: Child adiposity was positively associated with heart rate recovery time after the step test. A simple stepping test could be used as a non-invasive and inexpensive fitness tool in 5-year-olds. Additional research is needed to validate the ROLO Kids step test in preschool children.

Validity of the four-square step test in persons with haemophilia.

INTRODUCTION: Recurrent bleeds into joints causes arthropathy leading to pain and reduced joint movement. This may cause a reduction in postural balance and increase the falls risk in patients with haemophilia (PWH). With an ageing PWH population the need to assess functional balance in clinic will be essential to monitor function and implement interventions to help maintain balance and prevent falls. AIM: To assess the utility of the Four-Square Step Test (FSST) in PWH. METHODS: 80 PWH of all severity types were recruited and underwent a battery of outcome measures: FSST, Timed up & go (TUG), Short performance physical battery (SPPB), Haemophilia Activity List (HAL), ABC confidence questionnaire, and Haemophilia Joint Health score (HJHS). Demographics were collected, together with self-reported falls/trips history. RESULTS: All 80 participants were able to complete all test measures. Median age 44.5 years. Number of participants reporting falls ranged from 23% in severe to 3% in mild. Recent trips 53% severe to 17% mild. Excellent Inter and intra-reliability, ICC of .981 (CI .953-.992), P < .001 and ICC .989 (.983-.993) P < .001, respectively. Strong correlations between FSST and TUG/ SPPB .753 and -.728, moderate correlation between FSST and ABC/HAL -.484, -.464 P < .01. CONCLUSION: FSST is a valid and safe measure to use in PWH. It correlates strongly with other functional measures, has excellent inter and intra rater reliability. FSST correlates with age rather than severity type and provides information to the clinician on the speed/ability to change direction and clear an obstacle. ABC questionnaire was able to differentiate between severities and offers insight into patient confidence to move. SPPB had a ceiling effect with 52/80 scoring 12 and may not be suitable for PWH.

Primary cervical decompression surgery may improve lumbar symptoms in patients with tandem spinal stenosis.

PURPOSE: Tandem spinal stenosis (TSS) refers to coexisting lumbar and cervical canal stenosis. Evidence regarding whether cervical decompression improves lumbar symptoms in TSS is insufficient. Therefore, we determined the effectiveness of cervical decompression surgery for patients with lumbar spinal stenosis (LSS) and cervical spinal stenosis. METHODS: The records of 64 patients with TSS experiencing lumbar symptoms who underwent cervical decompression surgery between April 2013 and July 2017 at a single institution were retrospectively reviewed. We categorized patients into the Non-improved (n = 20), Relapsed (n = 30), and Maintained-improvement (n = 14) groups according to the presence or absence of improvement and relapse in lower limb symptoms in TSS following cervical decompression surgeries. RESULTS: Of 64 patients, 44 (69%) showed improved lower limb or low back symptoms, with 14 (22%) patients maintaining improvement. The preoperative cervical myelopathy-Japanese Orthopedic Association score and the preoperative number of steps determined using the 10-s step test were significantly lower in the Non-improved group than in the Maintained-improvement group. Receiver operating characteristic curve of preoperative 10-s step test results revealed 12 steps as a predictor for maintained improvement. CONCLUSION: The improvement of LSS symptoms following cervical decompression surgeries may be associated with the severity of cervical myelopathy as determined in clinical findings rather than in imaging findings. Patients with TSS having a 10-s step test result of < 12 steps were more likely to experience a relapse of lower limb symptoms following cervical decompression surgeries.

Improvement of locomotive syndrome after total hip arthroplasty: A two-year longitudinal cohort study.

OBJECTIVES: Patients requiring total hip arthroplasty (THA) may possibly have locomotive syndrome (LS). Therefore, we investigated changes of LS in patients undergoing THA and clarified key factors that affected LS stage. METHODS: A prospective cohort study was conducted with 88 patients undergoing THA (74 females, 14 males, mean age: 67.6 years). Data collected using LS stage, stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale results were evaluated before THA, and 6 months, 1 year, and 2 years after THA. Key factors were determined using multivariate analysis and receiver operating characteristic (ROC) curve analysis. RESULTS: Before THA, all patients had fallen LS (stage1: 3.4% and stage2: 96.6%). Overall, 56.8% patients improved their LS stage, and 17.0% of patients overcame LS at 2 years after THA. The key factors that affected LS stage were preoperative two-step test and age. ROC analyses showed a preoperative two-step test score of 0.988 and an age of 67.5 years as a cut-off value for the change of LS stage. CONCLUSIONS: Patients experiencing LS due to hip disorders have the potential to recover after THA. Additional postoperative training may be beneficial for patients with low preoperative two-step test scores to improve their LS stage.

[The medical social importance of functional disorders under chronic obstructive disease of lungs].

The chronic obstructive disease of lungs is considered as important problem of modern public health system. The disease is increasingly keenly reflected in agenda of our society, economic and social sphere of the state. The steadily progressing course of disease, disability and increasing economic costs assigns task of finding and improving diagnostic methods in real clinical practice. The purpose of the study is to assess the medical social significance of new approaches to studying functional status of patients with chronic obstructive disease of lungs in routine clinical practice. The sampling of 105 males were examined: 64 patients with chronic obstructive disease of lungs and 41 volunteers from control group without any diseases of respiratory system. All examined patients underwent spirometry, sixth minute step test, analysis of heart rate variability and test with external peripheral vascular occlusion. The study results established high level of importance of complex assessment of functional status of patients in routine clinical practice. The patients with chronic obstructive disease of lungs with respiratory failure demonstrated persistent hyperactivity of ergoreflex during test with external peripheral vascular occlusion. Therefore, method of assessing ergoreflex according to heart rate variability indices is applicable in clinic and has perspectives of implementation as mode of additional diagnostics of functional disorders.

Test-retest agreement and reliability of the Six Spot Step Test in persons with multiple sclerosis.

BACKGROUND: The Six Spot Step Test (SSST) extends traditional walking outcomes in persons with multiple sclerosis (PwMS) by further challenging components of coordination and balance. Nonetheless, the test-retest agreement of the SSST has not been investigated. OBJECTIVE: To determine the within-day, day-to-day, and inter-rater agreement and reliability of the SSST in PwMS. A secondary aim was to investigate the validity of handheld timing. METHODS: A total of 38 PwMS with an Expanded Disability Status Scale (EDSS) <6.5 completed two SSSTs with a 5-minute break in-between. After 2 days, this procedure was repeated. Bland-Altman analysis was performed to determine the 95% Limits of Agreement (LOA) and Intraclass Correlation Coefficient (ICC) was calculated. In a subgroup of 18 PwMS, the SSSTs were video-recorded and timed by a second investigator. RESULTS: The relative LOA within and between days were ±15% and ±19%, while ICC were 0.987 and 0.983, respectively. A minor learning effect was found over four tests. The handheld timing error was ±0.5 seconds when compared to video-based timing. CONCLUSION: The SSST has an acceptable within- and between-day agreement and reliability. For interventional purposes, a change of >19% can be regarded as a real change. Valid timing can be performed by a handheld stopwatch.

Early Motor-Behavioral Outcome of Ischemic Stroke with Ketogenic Diet Preconditioning: Interventional Animal Study.

BACKGROUND: Cerebral stroke, with ischemic stroke being its most common type, is the leading cause of chronic disability. The ketogenic diet has been used for treating seizures for centuries and has been considered to be a treatment for other neurologic diseases in recent years. The goal of this study is to evaluate the effects of ketogenic diet preconditioning on the early motor-behavior outcome of rats with induced cerebral ischemic stroke. METHODS: Twenty-four rats were surveyed in 3 groups of Main, Control, and Sham. The Main group received a ketogenic diet plus medium chain triglyceride oil starting 3 days prior to stroke induction, while the other 2 groups took a normal diet. Subsequently, Endothelin-1 was injected stereotactically near the middle cerebral artery to induce an ischemic stroke in the Main and Control group. Normal saline was injected to the members of the Sham group with the same technique. The motor-behavior functions of the rats were compared between 3 groups using adjusting step, beam, and cylinder tests. RESULTS: After stroke induction, rats on ketogenic diet were able to adjust their steps more efficiently, moved faster on the beam, and used their hands more symmetrically in the transparent cylinder in relation to the rats in the Control group. CONCLUSION: It seems that ketogenic diet preconditioning improves the early motor-behavioral outcome of ischemic stroke.

Blunted Nighttime Sympathetic Nervous System Response to Stress Among Thai Men with Positive Family History of Sudden Unexplained Nocturnal Death Syndrome.

Sudden unexplained nocturnal death syndrome (SUNDS) is prominent among northeast Thai men. This study tests the hypothesis that Thai men with positive family history of SUNDS display abnormal diurnal, autonomic nervous system responses to stress. Healthy northeast Thai men (20-49 years old) lived in the same rural area were divided into two groups based on their positive (PF) or negative family (NF1) history of SUNDS. A second control included Thai men with an NF history of SUNDS from a non-endemic area (NF2). All data were collected at 4:00-6:00 AM (nighttime) and 4:00-6:00 PM (daytime). All three groups displayed nighttime decreases in mean arterial pressure, heart rate, and blood glucose. Furthermore, all subjects displayed similar glucose tolerance and electrolyte balance. The tachycardic responses to a four-minute step test were similar among groups in the daytime, but the nighttime responses were significantly blunted in the PF group compared to either control group (about 20 bpm less). Tachycardic responses to a cold pressor test tended to decrease more during the nighttime in the PF compared to NF1 and NF2 groups, but the difference was not significant. Arterial pressure responses to the exercise were similar among the three groups during the nighttime, whereas in the NF2, daytime mean arterial pressures increased more than those in the other groups. The present data suggest that Thai men with a PF history of SUNDS display blunted sympathetic nervous system responses to stress during the nighttime, a potential factor that may trigger cardiac arrhythmias and contribute to SUNDS.

Stand-up test overestimates the decline of locomotor function in taller people: a cross-sectional analysis of data from the Kameda Health Study.

[Purpose] The purpose of this study was to identify which physical attribute could influence each outcome in the Stand-up test and the Two-step test and the degree of their involvement. [Participants and Methods] The participants were 2,476 people (1,674 males and 802 females), who underwent a two-day health checkup and were requested to take the Locomotive Syndrome Risk Test (Locomo Test). Participants were divided into groups under the Locomo level based on the result of Locomo Test by gender. Furthermore, the relationship between each physical attributes (quartile) based on the result of Locomo Test and the Locomo level was evaluated. [Results] According to the relationship between each physical attributes and Locomo level 1 in the Stand-up test, height showed a positive relationship and the multivariable adjusted odds ratio significantly increased with taller height in both genders. Body weight and BMI showed a negative relationship, although rather weak positive relationship, it was identified in waist circumference. On the other hand, there was no clear correlation between each physical attribute and Locomo level 1 in the Two-step test. [Conclusion] The findings indicate The Stand-up test would overestimate the decline of locomotor function in taller people and would underestimate it in shorter individuals.

Evaluation of motor function using the two-step test in type C day care service.

[Purpose] Evaluation of motor function in preventive care services using a convenient method is necessary. The two-step test is clinically useful in evaluating motor function. Thus, we aimed to assess motor function using the two-step test in day care service type C. [Participants and Methods] The two-step test value and motor function used in day care service type C were evaluated in 23 elderly females (mean age: 77.4 ± 6.7 years). [Results] Timed Up and Go test and two-step test results were highly correlated. [Conclusion] The results suggest that the factors constituting the two-step test showed a dynamic balance. Intervention for step or dynamic balance is important to improve the gait ability of elderly females in type C day care service.

A comparison of a step-initiation task in women with and without urinary incontinence. A case-control study.

AIMS: The aim of the study was to objectively determine differences in postural response by women with and without urinary incontinence during a step-initiation task depending on the degree of bladder filling. METHODS: The study comprised 22 women with stress urinary incontinence and 20 women without urinary incontinence. All women participated in four trials: unperturbed and perturbed (obstacle crossing) transition between platforms, step-up and step-down trials. Velocities of center of pressure displacement, double-support period, time from exit from steady standing until the lead foot resting on the other platform and time from raising the foot from the first platform until gaining quiet standing on the other platform were measured and compared. RESULTS: No significant differences were noted between the performance of a step-initiation task by incontinent women with full/empty bladder whereas continent women performed differently during unperturbed transition with full/empty bladder. The step-up trial revealed significant intergroup differences. The antero-posterior mean velocity of center of pressure during the empty bladder test was significantly higher in women with stress urinary incontinence (effect size = 1.02). During the same bladder condition the women with stress urinary incontinence performed significantly more slowly in unperturbed (effect size = 1.09) and perturbed (effect size = 0.84) transition compared to control group. CONCLUSIONS: Our results indicate that women with incontinence performed the step initiation task slowly on the empty bladder tests compare to continent women.

Exercise Capacity and Respiratory Profile in Patients after Orthopedic Liver Transplantation: a Follow-up Study.

INTRODUCTION: We sought to describe: 1) The influence of orthotopic liver transplantation (OLT) on exercise capacity, pulmonary function and respiratory muscle strength after surgery, 2) The relationship between exercise capacity and symptoms of anxiety and depression. MATERIAL AND METHODS: This is a prospective follow up study conducted with patients submitted to OLT. All patients were assessed before and 1 month after surgery through measurements: six minute walk test (6MWT), 6 min step test (6MST) and HADS (Hospital Anxiety and Depression Scale). FEV1% (forced expiratory volume), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured in the pre-operative and on 1st, 3rd, 5th day and 1 month after surgery. RESULTS: In 77 patients , 6MWD improved 20.2 m (95%CI 8.1-32.3) and 6MST improved 7.8 steps after surgery (95%CI 3.9-11.6). Change in 6 MWD and 6 MST did not correlated with change HADS. The FEV1% at each time point were 88.8 ± 21.3 before surgery, 32.9 ± 9.9 on 1st day, 39.6 ± 11.5 on 3rd day, 46 ± 12.1 on 5th day and 86.6 ± 21.1 one month after surgery. MIP and MEP values at each time point were -67.4 ± 23.2 and 79.7 ± 26 before surgery, -30.8 ± 12.3 and 36.4 ± 15.4 on 1st day, -38.6 ± 14.1 and 43.8 ± 17 on 3rd day, -45.8 ± 15.9 and 49.7 ± 18.7 on 5th day and -67.1 ± 29.4 and 80.9 ± 23.9 one month after surgery. CONCLUSION: Exercise capacity was modestly increased after OLT without any correlation with symptoms of anxiety and depression. Pulmonary function and respiratory muscle strength decreased immediately after liver transplantation, and progressively recovered, returning to baseline values after 1 month.

Association between the gait pattern characteristics of older people and their two-step test scores.

BACKGROUND: The Two-Step test is one of three official tests authorized by the Japanese Orthopedic Association to evaluate the risk of locomotive syndrome (a condition of reduced mobility caused by an impairment of the locomotive organs). It has been reported that the Two-Step test score has a good correlation with one's walking ability; however, its association with the gait pattern of older people during normal walking is still unknown. Therefore, this study aims to clarify the associations between the gait patterns of older people observed during normal walking and their Two-Step test scores. METHODS: We analyzed the whole waveforms obtained from the lower-extremity joint angles and joint moments of 26 older people in various stages of locomotive syndrome using principal component analysis (PCA). The PCA was conducted using a 260 × 2424 input matrix constructed from the participants' time-normalized pelvic and right-lower-limb-joint angles along three axes (ten trials of 26 participants, 101 time points, 4 angles, 3 axes, and 2 variable types per trial). RESULTS: The Pearson product-moment correlation coefficient between the scores of the principal component vectors (PCVs) and the scores of the Two-Step test revealed that only one PCV (PCV 2) among the 61 obtained relevant PCVs is significantly related to the score of the Two-Step test. CONCLUSIONS: We therefore concluded that the joint angles and joint moments related to PCV 2-ankle plantar-flexion, ankle plantar-flexor moments during the late stance phase, ranges of motion and moments on the hip, knee, and ankle joints in the sagittal plane during the entire stance phase-are the motions associated with the Two-Step test.

Decrease in musculoskeletal pain after 4 and 12 months of an aerobic exercise intervention: a worksite RCT among cleaners.

BACKGROUND: Prevalence of musculoskeletal pain is high in jobs with high physical work demands. An aerobic exercise intervention targeting cardiovascular health was evaluated for its long term side effects on musculoskeletal pain. OBJECTIVE: The objective was to investigate if aerobic exercise affects level of musculoskeletal pain from baseline to 4- and 12-months follow-up. METHODS: One-hundred-and-sixteen cleaners aged 18-65 years were cluster-randomized. The aerobic exercise group ( n = 57) received worksite aerobic exercise (30 min twice a week) and the reference group ( n = 59) lectures in health promotion. Strata were formed according to closest manager (total 11 strata); clusters were set within strata (total 40 clusters, 20 in each group). Musculoskeletal pain data from eight body regions was collected at baseline and after 4- and 12-months follow-up. The participants stated highest pain in the last month on a scale from 0, stating no pain, up to 10, stating worst possible pain. A repeated-measure 2 × 2 multi-adjusted mixed-models design was applied to compare the between-groups differences in an intention to treat analysis. Participants were entered as a random effect nested in clusters to account for the cluster-based randomization. RESULTS: Clinically significant reductions (>30%, f 2 > 0.25) in the aerobic exercise group, compared to the reference group, in pain intensity in neck, shoulders, arms/wrists were found at 12-months follow-up, and a tendency ( p = 0.07, f 2 = 0.18) to an increase for the knees. At 4-months follow-up the only significant between-group change was an increase in hip pain. CONCLUSIONS: This study indicates that aerobic exercise reduces musculoskeletal pain in the upper extremities, but as an unintended side effect may increase pain in the lower extremities. Aerobic exercise interventions among workers standing or walking in the majority of the working hours should tailor exercise to only maintain the positive effect on musculoskeletal pain.