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. © 2022 PTChP

Cognitive and motor performances in dual task in patients with chronic obstructive pulmonary disease: a comparative study

Background Patients with chronic obstructive pulmonary disease (COPD) may display a motor and/or cognitive disadvantage during dual tasking. However, studies investigating dual task are quite limited in patients with COPD. Aims To compare cognitive and motor performances (i.e., muscle force production and functional balance/mobility together with a cognitive task) in dual task between patients with COPD and healthy controls. Methods Thirty-five clinically stable patients with COPD and 27 age- and sex-matched healthy controls participated in this cross-sectional controlled study. The muscle force production (knee extension muscle strength assessed with an isokinetic strength dynamometer) and functional balance/mobility (Timed Up and Go (TUG) test) were performed with and without a cognitive task. Dual-task interference (DTI) was assessed. Additionally, the rate of correct responses per second (RCR) was calculated to evaluate cognitive performance. Results The decrease in RCR(muscle force production)values was greater in the COPD group compared with the control group (p= 0.045). Similarly, the cognitive DTI in muscle force production test was higher in the control group than in the COPD group (p 0.05). Conclusion The study results indicate that in individuals with COPD, cognitive performance deteriorations are more pronounced than motor performance defects during dual tasking. Further studies are needed to investigate the effects of dual task taking into account this disadvantage in patients with COPD rather than focusing solely on motor performance

CT taramalarında hastanın kilosuna göre alınan dozun değişimi

Tüm radyoterapi işlemi sırasında çekilen Bilgisayarlı Tomografi (BT) görüntüleri, tedavi portalı tasarımı, planlaması ve hasta pozisyonunun sağlanması için önemlidir. Ancak bu BT taramalarında hastanın aldığı doz, planlama doz hesaplamalarına dahil edilmez. Özellikle adaptif tedavilerde kritik organların limit dozlarının hesaplanmasında günlük BT taramalarından alınan doz çok önemli hale gelmektedir. Bu çalışmada, Monte Carlo tekniğinin kullanıldığı NCICT kodu ile hastaların bazı kritik organları olan kalp ve karaciğerin aldığı dozun hastanın ağırlığına göre değişimi araştırıldı.Computed Tomography (CT) images taken during whole radiotherapy procedure is important for treatment planning, portal design and providing patient position. However, the dose received by the patient in these CT scans are not included in the planning dose calculations. Especially in adaptive treatments, the dose received from daily CT scan becomes very important in calculation of the limit doses of critical organs. In this study, with the NCICT code, which use the Monte Carlo technique, the change of the dose absorbed by some critical organs of the patients, namely the heart and liver, according to the weight of the patient, was investigated

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: For-ty-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 vari-ance (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. © 2022 by The Korean Geriatrics Society

Role of spinal mobility on unsupported upper extremity exercise capacity in asymptomatic young adults: A crosssectional study

Purpose: Upper extremities are essential to perform activities of daily living. Along with many factors, the spinal region has an important effect on performing upper extremity movements. Our study's first aim was to examine the relationship between unsupported upper extremity exercise capacity (UUEEC) and spinal mobility. The second aim of the study was to determine whether spinal mobility is a predictor of the UUEEC. Methods: Forty asymptomatic and volunteer individuals (age=21.50±1.51 years, 52.5% of females) were included in the study. The 6-minute pegboard and ring test (6PBRT) was performed to assess the UUEEC. Spinal mobility was assessed to use a hand-held, computer-assisted electromechanical device (the Spinal Mouse System, Idiag, Fehraltorf, Switzerland). The spinal mobility analysis in the sagittal (SAP - maximal extension/flexion) and the coronal (CRP - maximal left/right lateral flexion) plane was measured. Results: The 6PBRT score had a moderate and positive correlation with the SAP spinal mobility (r=0.361, p=0.022) and the CRP spinal mobility (r=0.322, p=0.043). Stepwise multiple linear regression analysis demonstrated that the SAP spinal mobility was a significant and independent predictor of the 6PBRT score with 11% of the variance. Conclusions: The SAP spinal mobility was found as a predictor of the UUEEC in asymptomatic individuals. This study demonstrates that UUEEC could be improved by increasing spinal mobility. © 2021 Turkish Physiotherapy Association. All rights reserved

I-131 radyoizotop aktivitelerinin nükleer tıpta kullanılan organ dozu üzerine etkisi

Hayatta radyasyona maruz kalmanın birçok yolu vardır. Özellikle tıbbi uygulamalar, şiddetli maruziyetin en önemli sebebidir. Tıbbi uygulamalarda Bilgisayarlı Tomografi (BT) taramaları ilk sırada yer alırken, nükleer tıp ikinci sırada yer almaktadır. Tabii ki, maruz kalan doku ve dolayısıyla organlar tarafından emilen doz, sağlığa yönelik risklerle doğru orantılıdır. Nükleer tıpta tedavi amaçlı vücuda yerleştirilen radyoizotoplar nedeniyle sadece tümörün bulunduğu organ ve/veya dokulara değil, çevredeki diğer organ ve dokular az miktarda olsa da doz absorbe eder. Bu çalışmada erişkin fantomların (erkek ve dişi) tiroid bezine yerleştirilen iyot radyoizotop I-131'in aktivitelerine göre tiroid bezi, timüs ve lenf bezlerinin aldığı dozlardaki değişim Monte Carlo-tabanlı NCINM kodu ile araştırılmıştır.There are many ways to be exposed to radiation in life. Medical applications, in particular, are the most important form of severe exposure. In medical applications, Computed Tomography (CT) scans are in the first place, while nuclear medicine is in the second place. Of course, the dose absorbed by the exposed tissue and therefore the organs is directly proportional to the risks to health. In nuclear medicine, due to the radioisotopes placed in the body for therapeutic purposes, some doses are not given only to the organ and/or tissues where the tumor is placed, but also to other surrounding organ and tissues. In this study, the change in the doses received by the thyroid gland, thymus, and lymph nodes according to the activities of the iodine radioisotope I-131 placed in the thyroid gland of adult phantoms (both male and female) were investigated with the Monte Carlo-based code

Does Plantar Pressure Distribution Influence the Lumbar Multifidus Muscle Thickness in Asymptomatic Individuals? A Preliminary Study

Background: Atrophy can occur in the lumbar multifidus (LM) muscle quickly as a result of various musculoskeletal problems. Knowing factors influencing muscle thickness of the LM will provide important clues about lumbopelvic stability. Objectives: Although there are several studies in the literature investigating the adverse effects of foot–ankle postural disorders on the lumbopelvic region, to our knowledge there has been no investigation of plantar pressure distribution (PPD) as a factor influencing muscle thickness of the LM. The aim of this study was to determine whether PPD could affect LM muscle thickness. Methods: This observational study consisted of 25 asymptomatic individuals. Ultrasonographic imaging was used to determine the thickness of the LM. All participants were subjected to PPD analysis using the Digital Biometry Scanning System and Milletrix software in 9 different plantar pressure zones. The Pearson product-moment correlation coefficients were used to examine the correlations between the LM muscle thickness and other variables. Stepwise multiple linear regression analysis was used to determine the variables with the greatest influence on LM muscle thickness. Results: Peak pressures of medial and lateral zones of the heel were the significant and independent factors influencing static LM thickness, with 39.5% of the variance; moreover, the peak pressures of heel medial and fourth metatarsal bone were the significant and independent factors influencing dynamic LM thickness, with 38.7% of the variance. Conclusions: Plantar pressure distribution could be an important factor influencing LM thickness, although further research is required. Examining foot–ankle biomechanics may provide information about the stability of the LM. © 202

Test-retest reliability and validity of the timed up and go test and 30-second sit to stand test in patients with pulmonary hypertension

Background: Timed up and go (TUG) and sit to stand (STS) tests that required less space and easier to be performed in respiratory and cardiac diseases for assessing functionality. Aim was to test the reliability of TUG and 30-second STS (30STS) tests and determine the validity of TUG and 30STS tests in patients with Pulmonary Hypertension (PH). Methods: Thirty-eight patients with diagnosed PH were included. We collected TUG, 30STS, quadriceps muscle strength, physical activity level, and 6MWT. Intra-class correlation coefficient (ICC) was used to determine test-retest reliability and correlations with quadriceps muscle strength, physical activity level and 6MWT for validity of the TUG and 30STS tests. Results: The TUG and 30STS tests were associated with age, functional class, muscle strength, physical activity and functional exercise capacity in patients with PAH (p < 0.05). 6MWT was associated with age, functional class, muscle strength, physical activity and functional exercise capacity (p < 0.05). ICC (95%) for TUG test and 30STS were 0.96 (0.93-0.98) and 0.95 (0.90-0.97), respectively. Conclusions: The TUG and 30STS tests were reliable and valid tests for measuring physical performance in PH. This study supports using the TUG and 30STS tests as practical assessment tools in patients with PH. (C) 2020 Elsevier B.V. All rights reserved

Balance performance in patients with heart failure

Background: It has been suggested that patients with heart failure (HF) have an increased fall rate. Although balance is one of the most important risk factors for fall, there is not sufficient information about balance in HF. Objective: To compare static, dynamic and functional balance between patients with HF and healthy controls. Methods: Twenty-seven patients with HF and 22 healthy controls were recruited in this study. The Unilateral Stance (US) and Limits of Stability (LOS) tests were used to measure static and dynamic balance, respectively. Functional balance was assessed with Berg Balance Scale. Results: There was no significant difference in age, gender and body mass index between the groups (p > 0.05). There was a significant difference in US with open eyes between the groups (p < 0.05). Reaction time (backward and left), endpoint excursion (backward), maximum excursion (forward and backward) and directional control (forward and right) variables of LOS were significantly different between the groups (p < 0.05). Conclusions: Patients with HF have impaired static, dynamic and functional balance. Considering the balance impairment, a comprehensive balance assessment performed and balance training should be included in the management of HF as a part of the cardiac rehabilitation program. © 2020 Elsevier Inc

Is Peer Assessment Reliable in Objectively Structured Clinical Examination?

Objective:The study was designed to evaluate the reliability of the peer assessment in the objectively structured clinical examination (OSCE) for the summative assessment of 4th grade students at the end of general surgery clerkship.Method:The study was planned prospectively with the permission of the Dean of Medicine Faculty and approval of the ethics committee. The 6th grade students who were in the surgery rotation participated in the study as peer assessors (PA). Both peers and department of general surgery assessed the students. Pass/fail point was accepted as 60. The scores of OSCE and performance evaluation given by peers and faculty were compared statistically.Results:Twenty-three students completed general surgery clerkship. Ten students (43.5%) were female. According to performance scores given by the faculty, 15 (65.2%) of the 23 students were successful, while all students were considered successful (having a grade of 60 or more) based on the scores of peer evaluation. There was a significant difference between the faculty members and PA with regard to the performance evaluation (p=0.008). The faculty members found five students (27.8%) successful in the OSCE (having a grade of 60 or more). However, ten students (43.5%) received a score of at least six from peer evaluation. Although there was a difference, it was not significant (p=0.063). Gender did not affect scoring in performance evaluation and OSCE application.Conclusion:Although there was a difference between faculty members and peer evaluators in the performance evaluation, no difference was observed in OSCE. In conclusion, OSCE assessment by peer evaluators is reliable