Predictors of shuttle walking test performance in patients with cardiovascular disease

Objective: The incremental shuttle walking test (ISWT) is used to estimate cardiorespiratory fitness, but data from healthy individuals suggest that demographic and anthropometric measures account for much of the variance in test performance. The aim of this study was to determine whether anthropometric, demographic and selected gait measures also predict ISWT performance (i.e. distance walked) in patients with cardiovascular disease. Design: Observational study. Setting: A community-based cardiac rehabilitation centre (Cohort 1) and a hospital outpatient cardiac rehabilitation programme (Cohort 2). Participants: Sixteen patients with clinically stable cardiovascular disease (Cohort 1) and 113 patients undergoing cardiac rehabilitation (Cohort 2). Interventions: Patients in Cohort 1 performed the ISWT on two occasions. Anthropometric data and walking and turning variables were collected. Linear regression analyses were used to identify the predictors of test performance. The authors subsequently attempted to validate the equation created by comparing predicted and actual ISWT values in a larger (n= 113) validation sample (Cohort 2). Main outcome measures: Distance walked during ISWT, step length and height. Results: No gait or turning measures were significantly associated with ISWT performance. Distance walked correlated most strongly with step length (r= 0.83, P< 0.05) and height (r= 0.74, P< 0.05). Given the similarity of these correlations and the rarity of step length assessment in clinical practice, ISWT performance was predicted using patient's height; this explained 55% of the variance in ISWT performance. Height was also the best predictor in Cohort 2, explaining 17% of test variance (P< 0.01). Body mass index explained an additional 3% of variance (P< 0.05) in ISWT performance. Conclusions: Routine clinical measures, particularly patient's height, are predictive of ISWT performance. The findings of the present study are in partial agreement with similar studies performed in healthy individuals, and it remains unclear whether the ISWT performance of patients with cardiovascular disease is influenced by the same factors as the ISWT performance of healthy individuals. © 2013

Characteristics of the nuclear (18S, 5.8S, 28S and 5S) and mitochondrial (12S and 16S) rRNA genes of Apis mellifera (Insecta: Hymenoptera): structure, organization, and retrotransposable elements

As an accompanying manuscript to the release of the honey bee genome, we report the entire sequence of the nuclear (18S, 5.8S, 28S and 5S) and mitochondrial (12S and 16S) ribosomal RNA (rRNA)-encoding gene sequences (rDNA) and related internally and externally transcribed spacer regions of Apis mellifera (Insecta: Hymenoptera: Apocrita). Additionally, we predict secondary structures for the mature rRNA molecules based on comparative sequence analyses with other arthropod taxa and reference to recently published crystal structures of the ribosome. In general, the structures of honey bee rRNAs are in agreement with previously predicted rRNA models from other arthropods in core regions of the rRNA, with little additional expansion in non-conserved regions. Our multiple sequence alignments are made available on several public databases and provide a preliminary establishment of a global structural model of all rRNAs from the insects. Additionally, we provide conserved stretches of sequences flanking the rDNA cistrons that comprise the externally transcribed spacer regions (ETS) and part of the intergenic spacer region (IGS), including several repetitive motifs. Finally, we report the occurrence of retrotransposition in the nuclear large subunit rDNA, as R2 elements are present in the usual insertion points found in other arthropods. Interestingly, functional R1 elements usually present in the genomes of insects were not detected in the honey bee rRNA genes. The reverse transcriptase products of the R2 elements are deduced from their putative open reading frames and structurally aligned with those from another hymenopteran insect, the jewel wasp Nasonia (Pteromalidae). Stretches of conserved amino acids shared between Apis and Nasonia are illustrated and serve as potential sites for primer design, as target amplicons within these R2 elements may serve as novel phylogenetic markers for Hymenoptera. Given the impending completion of the sequencing of the Nasonia genome, we expect our report eventually to shed light on the evolution of the hymenopteran genome within higher insects, particularly regarding the relative maintenance of conserved rDNA genes, related variable spacer regions and retrotransposable elements

Incremental shuttle walking test to assess functional capacity in cardiac rehabilitation: a narrative review

Background/Aims Low functional capacity has been recognised to be the most important predictor of overall mortality compared to all other cardiovascular risk factors in patients with cardiovascular disease. Walk tests, such as the incremental shuttle walking test and the 6-Minute Walk Test, are used to assess functional capacity in patients, the effectiveness of a cardiac rehabilitation programme and the prognosis of cardiovascular diseases. The aim of this review was to provide a narrative review of the literature and identify the key features of the incremental shuttle walking test as a measure of functional capacity testing in cardiac rehabilitation patients. Methods The PubMed, MEDLINE, Elsevier and Google Scholar databases were searched for relevant scientific articles published up to March 2021 with no restriction on start day. The key words defined by researchers were ‘incremental shuttle walking test’, ‘exercise test’, ‘functional capacity’, ‘cardiovascular disease’, ‘cardiac rehabilitation’, ‘reliability’ ‘prediction; ‘walk tests’. A final set of 31 articles was included in this narrative review. Results Evidence-based findings suggest that the incremental shuttle walking test is a valid, reliable, sensitive, useful tool for detecting and predict cardiorespiratory capacity. Conclusions Clinicians can be confident that they can use the incremental shuttle walking test to monitor changes in functional capacity in patients with cardiovascular disease. © 2022 MA Healthcare Ltd

Does Turning Affect Shuttle Walking Test Performance in Cardiovascular Disease Patients? A Narrative Review

Objective: To critically present and discuss the influences of turning on incremental shuttle walking test (ISWT) performance in clinically stable patients with cardiovascular disease (CVD). Methods: We searched the literature in the most widely used health care electronic databases, including PubMed, MEDLINE, Elsevier, and Google Scholar, published up to March 2021 with no restriction on start day, by using the terms incremental shuttle walking test, exercise test, functional exercise capacity, cardiovascular disease, biomechanics, and turning strategy. Papers that were not in English and were not peer-reviewed were excluded. Results: A total of 70 articles were included in the final set of the literature. Turning influences walking performance by requiring increasing time and effort from the participant to complete a turning task in patients with mobility disabilities, but not in stable patients with CVD. Conclusions: It can be suggested that turning parameters are not related to ISWT performance in stable patients with CVD. There is no need to take into consideration gait parameters when the shuttle walking test is performed in clinical practice. Turning may be more important in less-able patients with reduced mobility and greater orthopedic limitations. With larger, multicentered studies, such results can be validated and improve patient performance in clinical practice. © 2021 by Begell House,

Comparison of heart rate response and heart rate recovery after step test among smoker and non-smoker athletes

Background: Exercise performance depend on the ability of the cardiovascular system to respond to a wide range of met-abolic demands and physical exertion. Objectives: To investigate the habitual smoking effects in heart rate response and heart rate recovery after step test in ath-letes. Methods: Seventy-eight physically healthy active athletes (45 non-smokers and 33 smokers) aging 27±8years old, participat-ed in this study. All participants completed the International Physical Activity Questionnaire and performed the six-minute step test. Cardiovascular parameters such (resting heart rate, peak heart rate, heart rate at 1 min after testing, heart rate re-covery, recovery time, blood pressure at rest, and post-testing blood pressure) were recorded. Results: Smoker-athletes had higher resting heart rate (76 ± 9bpm vs. 72 ± 10bpm, p<0.05), maximum heart rate (154 ± 18bpm vs. 147 ± 17bpm, p<0.05) and recovery time (7min 25sec ± 6min 31sec vs. 4min 21sec ± 4min 30sec, p<0.05) than non-smoker athletes. Scores from the IPAQ were approximately the same (Μ=7927 ± 10303, Μ= 6380 ± 4539, p<0.05). Conclusion: Smoking was found to affect athletes' cardiovascular fitness. The change of the athletes’ heart rate recovery and recovery time contributes to the adaptation of cardiovascular function in training requirements. © 2021 Pepera G et al. Licensee African Health Sciences

A pilot study to investigate the safety of exercise training and testing in cardiac rehabilitation patients

We conducted a pilot study to evaluate the safety of the shuttle walking test (SWT) and exercise training for cardiac patients in community-based cardiac rehabilitation settings. Overall, 33 cardiac patients were tested (19 males and 14 females, 67 ± 8 years). Eleven cardiac patients (testing group) and 22 cardiac patients (training group) underwent ambulatory electrocardiogram (ECG) monitoring during the SWT and exercise training during a long-term cardiac rehabilitation programme. Frequency of ECG events was reported for the two groups. Chi-square test was performed to determine associations between the incidence of cardiovascular events and poor functional capacity (SWT <450 m). The findings showed only minor events provoked during the SWT or exercise training, and no event-related hospitalisation, syncope episodes or fatality. The most important cardiac event was silent, myocardial ischaemia (testing group: 27.3%; training group: 18%). Poor functional capacity was not associated with the risk of a cardiac event during exercise (testing group: X 2=0, p=0.99, phi=0.24; training group: X2=2.1, p=0.15, phi=-0.42). In conclusion, supervised exercise testing and training are accompanied only by minor cardiovascular events and they can be carried out safely in community-based cardiac rehabilitation settings

Cardiac rehabilitation and innovative therapeutic approaches after mitral valve surgery

Valvular heart disease (VHD) is a major cause of mortality and morbidity, and its prevalence increases with age. VHD is mainly degenerative in origin, and it is widespread in the developed countries, following rheumatic heart disease. In most cases of mitral valve (MV) disease, surgery is needed to either repair or replace the MV. Cardiac rehabilitation (CR), with exercise as the main component, contributes significantly to the quality of the life (QoL) in patients who have undergone MV surgery, and decreases morbidity and mortality. The role of the physiotherapist, as part of the scientific CR team, is to evaluate and prescribe individualized rehabilitation programs for patients following MV surgery. Cardiorespiratory physiotherapy is an evidence-based essential rehabilitation procedure for these patients. Innovative therapeutic approaches, such as e-Ηealth applications, telerehabilitation, home-based exercise, aquatic exercise training, and neuromuscular electrical stimulation (NMES) training, all appear to be beneficial alternative CR techniques. © Athens Medical Society

Cardiac telerehabilitation improves lipid profile in the long term: Insights and implications

[No abstract available