Search Results (74)

Background and Objectives: Functional capacity assessment is essential in bariatric surgery candidates, but the Six-Minute Walk Test (6MWT) may be limited by fatigue, joint pain, and spatial constraints in individuals with severe obesity. Shorter tests such as the Two-Minute Walk Test (2MWT), Three-Minute Walk Test (3MWT), and One-Minute Sit-to-Stand Test (1MSTS) have been proposed as alternatives, yet comparative data in this population remain scarce. We aimed to evaluate the validity, reliability, and clinical utility of the 2MWT, 3MWT, and 1MSTS as substitutes for the 6MWT in patients preparing for bariatric surgery. Materials and Methods: In this cross-sectional study, 142 obese adults (BMI ≥ 30 kg/m²) underwent standardized 2MWT, 3MWT, 6MWT, and 1MSTS protocols. Correlation, linear regression, test–retest reliability (ICC), and ROC analyses were used to determine each test’s correlation and discriminative accuracy for impaired exercise tolerance (6MWT < 450 m). Results: The 3MWT showed the strongest correlation with the 6MWT (r = 0.930) and the highest explained variance (R² = 0.865), especially in individuals with BMI > 50. It also exhibited excellent reliability (ICC > 0.9) and a strong ROC profile (AUC = 0.931; 212 m cut-off). The 2MWT demonstrated acceptable concurrent validity but slightly lower agreement. The 1MSTS showed weak and inconsistent associations with 6MWT performance, suggesting limited value in assessing aerobic capacity in this population. Conclusions: The 3MWT appears to be a valid, reliable, and clinically practical alternative to the 6MWT in individuals with severe obesity. The 2MWT may be used when time or patient tolerance is limited. The 1MSTS, while safe and simple, may reflect strength and coordination more than aerobic capacity, limiting its utility in this context. Full article

Background: Falls are a major public health issue among older adults, often related to postural or orthostatic hypotension (OH). The optimal timing and methods for measuring blood pressure (BP) to assess OH and its relationship with falls are uncertain. Methods: We analyzed data from two older cohorts: the PROHEALTH study (n = 30, aged ≥ 65 years) and the NILVAD-CBF trial (n = 58, aged ≥ 50 years). Continuous beat-to-beat BP was measured during active stand tests. We assessed orthostatic BP responses during sit-to-stand and supine-to-stand maneuvers and calculated the associations between orthostatic BP response variables and falls. Results: In the PROHEALTH cohort, participants with a history of falls exhibited a significantly lower baseline BP (115 ± 13/68 ± 10 vs. 142 ± 21/79 ± 11 mmHg; p = 0.004/0.018) and lower systolic BP (SBP) nadir (90 ± 22 vs. 112 ± 25 mmHg; p = 0.043) than non-fallers. SBP recovery within three minutes post-stand was delayed in fallers but rapid in non-fallers. A lower resting BP was associated with fall risk, and a lower BP nadir within 10 s after standing showed a trend toward a higher fall risk. No significant associations were found in the NILVAD-CBF cohort (prospective falls). Conclusions: Our findings demonstrate that a lower resting SBP and diastolic BP (DBP) are associated with an increased fall risk in older adults, with a lower SBP and DBP nadir after standing also showing a potential association. Persistent OH or delayed BP recovery is identified as a potentially relevant fall risk factor. The supine-to-stand test was more sensitive in detecting OH than the sit-to-stand test. Continuous BP monitoring provides the advantage of detecting pathophysiologic orthostatic BP responses for fall risk assessment in older adults. Further research with larger cohorts is warranted to validate our findings. Full article

Background/Objectives: In recent years, scientific literature has illustrated the growing interest in telerehabilitation after ACL reconstruction. The aim of this study is to compare the effectiveness of remotely supervised rehabilitation with traditional supervised rehabilitation after ACLR, focusing on objective postoperative functional assessment outcomes. Methods: A retrospective analysis of prospectively collected data was carried out, selecting patients that underwent arthroscopic ACLR by a single surgeon. Functional assessments of the patients were carried out at 1 and 2 weeks and 1, 2 and 3 months after surgery, including range of motion (ROM), maximal voluntary isometric contractions (MVICs) of extensor and flexor muscles, the sit-to-stand test and the countermovement jump. Intergroup statistics were carried out using a non-inferiority hypothesis. Results: A total of 251 patients were included in this study (supervised rehabilitation n = 165; remotely supervised rehabilitation n = 86). Functional assessment improved over time in both groups. The extension ROM deficit decreased to 0 difference 30 days after surgery. The median flexion ROM ILD at 60 days was significantly different among the groups, with a residual 10° ILD in the Group R compared with 0° ILD in group S (p = 0.01). All other assessments did not achieve statistical significance. Conclusions: The results support the integration of a digital rehabilitation tool in post-ACLR recovery programs. The results suggest that remotely supervised rehabilitation can be a viable alternative to traditional supervised rehabilitation for early-stage recovery. However, more research is needed to optimize protocols and to identify patients who may benefit most from this approach. Full article

Background: Interventions involving Olympic combat sports, such as Taekwondo (TKD) and Boxing (BOX), represent innovative approaches for promoting health in older people. Elastic bands training (EBT), by contrast, is a safe and cost-effective method that has demonstrated positive effects on functional physical parameters in this population. This study aimed to compare the effects of TKD and BOX interventions, relative to EBT, on body composition and physical function in Chilean older women. Methods: This randomized controlled trial comprised three parallel groups: TKD (n = 10), BOX (n = 10), and EBT (n = 10). Participants in each group underwent pre- and post-intervention assessments following two 60 min sessions per week over an eight-week period. Results: Multiple comparisons revealed significant advantages for EBT over TKD and BOX in maximal isometric handgrip strength for both the dominant (p < 0.001; d = 0.967, large effect) and non-dominant (p < 0.001; d = 0.641, moderate effect) hands. Conversely, significant improvements in Timed Up-and-Go performance were observed in the TKD and BOX groups compared to EBT (p < 0.001; d = 2.071, large effect). All groups showed significant within-group improvements in the 30 s chair stand test (p < 0.001; d = 0.095, large effect). No significant changes were found in body fat percentage, fat-free mass, back scratch test, sit-and-reach test, or 2 min step test across groups. Conclusions: Although no substantial differences were observed between groups for most variables, TKD and BOX interventions significantly reduced Timed Up-and-Go times, whereas EBT enhanced maximal isometric handgrip strength in both hands. These findings highlight the distinct functional benefits of each intervention modality for older Chilean women. Full article

Objectives: This study aimed to evaluate the validity and reliability of the self-administered Timed Up and Go (TUG) test—a gold standard for fall risk screening—by comparing it to the traditional face-to-face assessment conducted by a physiotherapist. Methods: A total of 37 community-dwelling adults—mean age 61.78 ± 6.88, 73% female—who took part in fall risk screening actions in the central region of Portugal were assessed. The protocol included sociodemographic and history of falls questions, the Self-Efficacy for Exercise questionnaire, the Activities and Participation Profile Related to Mobility (PAPM), and three functional tests, namely the 10-Metre Walking Speed (10-MWS), TUG, and 30 Seconds Sit to Stand (30 s STS) tests. Within an interval of 18–24 h after the face-to-face moment, the participants were instructed to self-administer the TUG test at home. The validity and reliability of self-administered TUG test were examined using the limits of agreement, clinically acceptable limit, intra-class correlation coefficients (ICCs), paired t-tests, and Pearson’s coefficient correlation (r). Results: The limits of agreement for self-administered assessment were within the clinically acceptable limits. The average result of the face-to-face TUG test and the self-administered TUG test was 7.47 ± 2.45 and 7.57 ± 3.10 s, respectively. When comparing the two evaluations, they were strongly associated (r = 0.716, p < 0.001), with an excellent ICC of 0.82 (0.65–0.91), for a 95% confidence interval and significance level of 0.05 (p ≤ 0.05). Conclusions: The use of the self-administered TUG test for the screening of risk of fall, using low-cost technology, appears to be valid and reliable in community-dwelling adults aged 50 and above. Enabling older adults to perform the TUG test at home can empower them to take an active role in managing their health and ageing process, while also offering physiotherapists regular feedback for fall prevention. Full article

Background and Objectives: There is evidence of decreasing knee pain in patients with knee osteoarthritis when knee mechanical traction is performed surgically. Our aim was to measure the effects of standard physiotherapy with the addition of knee mechanical traction on pain, physical activity and quality of life in patients with knee osteoarthritis. Materials and Methods: A clinical observational study with intervention and without a control group was conducted at three outpatient health clinics on a primary level of the health care system. Twenty-three patients with knee osteoarthritis voluntarily participated in the study. Standard physiotherapy included education, therapeutic and aerobic exercise, conventional TENS, low-intensity laser and manual soft tissue techniques. Mechanical traction of 150 N continuous force for 15 min with the knee joint at 25° flexion was added to standard physiotherapy. The following outcome measures were used: VAS, Knee Injury and Osteoarthritis Outcome Score and a 30 s sit-to-stand test. Results: The pain measured for the VAS at rest (p < 0.001) and during movement (p < 0.001) as well as for the Knee Injury and Osteoarthritis Outcome Score pain part decreased (p < 0.05). The quality of life did not improve (p > 0.05), but the physical activity of the patients did (p < 0.05). A decrease in pain correlated with body mass (p < 0.05). Conclusions: Standard physiotherapy with the addition of mechanical traction had an effect on reducing pain and improving physical activity. Full article

Background/Objectives: Reported patient results after total hip arthroplasty (THA) have been described as a function of surgical approach. Such results have commonly been subjective. Though self-reported outcomes are of value and often utilized, inclusion of functional performance measures represents an objective measure to compare THA techniques. Methods: Patients that underwent primary THA surgery at our institution were grouped by surgical approach (Direct Anterior vs Posterior). Patient data were collected pre-operatively, as well as post-operatively at three and twelve months. Hip Dysfunction and Osteoarthritis Outcome Score (HOOS JR) was utilized, and function was assessed with the timed up and go test (TUGT), 4-m walk test (4MWT), and 30 s sit-to-stand (30STS) test. Unpaired T tests were used to compare mean results and differences between the groups. Results: Functional outcome scores were improved to a similar degree for both surgical approach groups at all the time points post-operatively. At 3 months, the TUGT was improved by 2.33 s for the posterior group, the 30STS was increased by 2.71 repetitions, and the 4MWT was increased by 1.23 s; the anterior group had 2.66 s, 2.49 repetition, and 1.18 s improvements in the three functional tests, respectively. At 12 months, the posterior group had improvements of 2.86 s, 3.99 repetition, and 1.19 s, while the anterior group had improvements of 3.15 s, 3.83 repetition, and 1.23 s, respectively. No clinical and statistical significant differences in surgical approach were noted in these measures. In contrast, the anterior group showed a statistically significant but not clinically significant improvement in self-reported HOOS JR scores compared to the posterior group at the 3-month post-operative mark (p = 0.045). Conclusions: This study suggests both anterior and posterior surgical approaches to total hip arthroplasty yield equivalent functional results at 3 months and one year post-operatively, while the anterior approach demonstrates more improved patient satisfaction than the posterior approach at the 3-month post-operative assessment. Full article

Peripheral magnetic stimulation (PMS) is commonly used for neurological conditions, but its effectiveness in enhancing functional mobility and morphology in children with spastic diplegia remains underexplored. This study assessed the impact of PMS with physical therapy (PT) versus PT alone on mobility and morphology in spastic diplegia. Forty-five children with spastic diplegia (mean age 12.7 ± 3.8 years) were randomly assigned to one of three intervention groups: PMS + PT, PT, or control, with fifteen children in each group. The training was conducted thrice weekly for eight weeks, included muscle morphology assessments, the 30 s sit-to-stand test (30sSTS), functional reach test (FRT), 10 m walk test (10MWT), and 6 min walk test (6MWT). The study revealed increased left quadricep and calf muscle thickness following PMS + PT (d = 0.19, 0.39, respectively; all p < 0.05). Improvement in 30sSTS was observed after both PMS + PT (d = 0.56) and PT (d = 1.43). FRT demonstrated increases following both PMS + PT and PT interventions (d = 1.52, 0.93, respectively). Furthermore, improvements were observed in 10MWT following PMS + PT and PT interventions (d = 1.20, 0.78), while PT increased the 6MWT (d = 0.82). The control group showed declines in 10MWT and 6MWT. The treatment significantly impacted FRT, 10MWT, and 6MWT in spastic diplegia. While PMS may not enhance physical capacities beyond PT alone, it may improve FRT and 10MWT outcomes. Full article

Background/Objectives: This study aimed to examine differences in motor competence and muscular fitness between children engaged in combat sports and their peers who do not participate in structured physical activity. Methods: The sample consisted of 120 healthy eight-year-old children, evenly divided into two groups: 60 children practicing combat sports (karate, judo, and wrestling) for at least one year and 60 children without structured sports involvement. Motor competence was assessed using the Test of Gross Motor Development-2 (TGMD-2), while muscular fitness was evaluated through standing broad jump, grip strength, 30 s sit-ups, bent arm hang, medicine ball throw, and push-ups. For differences between groups, the independent samples t-test was performed. Results: Results indicated that children practicing combat sports demonstrated significantly higher locomotor and manipulative skills (p < 0.01, ES = 0.76–1.25) and superior muscular fitness across all tests (p < 0.01, ES = 0.53–1.09) compared to their peers. Conclusions: These findings highlight the positive impact of combat sports on overall physical development, particularly in enhancing motor competence, muscle strength, and endurance. Given the critical role of motor competence and physical fitness at this age, integrating combat sports into daily routines can support long-term athletic development, encourage physical activity, and enhance overall health. Future research should explore the influence of specific combat sports on distinct physical attributes and consider additional factors such as total physical activity levels. Full article

Background: Alberta Cancer Exercise (ACE) is a hybrid effectiveness–implementation study evaluating a cancer-specific community-based exercise program across urban sites in Alberta, Canada. The purpose of this paper is to describe the baseline characteristics of participants. Methods: Adults with any type and stage of cancer, who were undergoing cancer treatment or up to three years post treatment completion, were eligible. ACE was delivered in person at 18 sites across 7 cities in Alberta, with video conferencing introduced during the COVID-19 pandemic. Participants took part in 60 min of mild-to-moderate intensity exercise twice weekly for a 12-week period and were encouraged to increase overall physical activity. Results: From January 2017 to February 2023, 2570 individuals enrolled. Participants were a mean age of 57.8 years, 71.3% were female, 45.4% had breast cancer, and 49.4% were undergoing cancer treatment. At baseline, only 22.4% of participants self-reported meeting recommended physical activity levels, 66.0% were overweight/obese, and 71.4% reported one or more comorbidities. Most participants were below normative levels for the six-minute walk and 30 s sit-to-stand tests, and 75.9% reported fatigue. Conclusion: Participants were largely inactive, unfit, and symptomatic. ACE attracted more females and individuals with breast cancer but was otherwise representative of the Alberta cancer population. Full article

Background: Ageing and sedentary lifestyles affect physical and cognitive function and markers of frailty, increasing the risk of falls in older adults and affecting their quality of life. The aim of this study was to evaluate the effects of a Square Step Exercise programme on physical and cognitive function and plasma SMP30 levels for the prevention of falls in older adults. Methods: A randomised controlled trial was designed with 44 participants assigned to an experimental group (SSE group) and a control group. The SSE group performed SSE sessions twice a week for three months, with a follow-up in the fourth month. The assessments of physical function included tests such as the Four-Square Step Test, Brisk Walking and its dual-task variant, Time Up and Go and its imagined and dual-task variants, 30 s Sit-to-Stand and its dual-task and imagined variants and a 6 min walking test. Questionnaires were also used to assess the risk and fear of falling. Resting EEG activity was also recorded to assess electrocortical brain activity. SMP30 levels were measured by Western blotting. Results: The SSE group showed significant improvements compared to the control group in the Four-Square Step Test (p < 0.001), Brisk Walking (p < 0.05) and reduction in the fear of falling (p < 0.001) after the training programme, but these adaptations were not maintained one month after the programme ended (p < 0.05). No significant changes were observed in the remaining variables of physical function, cognitive function, fall risk questionnaire, EEG activity or plasma levels of SMP30 compared to the control group (p > 0.05). Conclusions: The SSE programme showed efficacy in improving balance, gait speed and reducing fear of falling in older adults but did not show improvement over the control group in other areas of physical or cognitive function or plasma SMP30 levels for fall prevention. Full article

Background: Incidence of cardiometabolic disease among U.S. Hispanics/Latinos is higher than in non-Hispanic Whites. Prolonged sitting duration is prevalent in older adults, and compounded with menopause, greatly increases cardiometabolic risk in postmenopausal women. Metabolomic analyses of interventions to reduce sitting are lacking and mechanistic understanding of health-promoting behavior change in postmenopausal Latinas is needed. Methods: To address this knowledge gap, an exploratory analysis investigated the plasma metabolome impact of a 12-week increased standing intervention among sedentary postmenopausal Latinas with overweight or obesity. From a parent-randomized controlled trial, a subset of Best Responders (n = 43) was selected using parameters of highest mean change in sitting bout duration and total sitting time; baseline variable-Matched Controls (n = 43) were selected using random forest modeling. Targeted LC-MS/MS analysis of archived baseline and 12-week plasma samples was conducted. Metabolite change was determined using a covariate-controlled general linear model and multivariate testing was performed. A false discovery rate correction was applied to all analyses. Results: Best Responders significantly changed time sitting (−110.0 ± 11.0 min; −21%), standing (104.6 ± 10.1 min; 40%), and sitting in bouts >30 min (−102.3 ± 13.9 min; −35%) compared to Matched Controls (7.1 ± 9.8 min, −7.8 ± 9.0 min, and −4.6 ± 12.7 min, respectively; all p < 0.001). Twelve-week metabolite change was significantly different between the two groups for 24 metabolites (FDR < 0.05). These were primarily related to amino acid metabolism, improved blood flow, and ATP production. Enzyme enrichment analysis predicted significant changes regulating glutamate, histidine, phenylalanine, and mitochondrial short-chain fatty acid catabolism. Pathway analysis showed significant intervention effects on glutamate metabolism and phenylalanine, tyrosine, and tryptophan biosynthesis, potentially indicating reduced cardiometabolic disease risk. Conclusions: Replacing nearly two hours of daily sitting time with standing and reduced prolonged sitting bouts significantly improved metabolomic profiles associated with cardiometabolic risk among postmenopausal Latinas. Full article

Background/Objectives: This study aimed to assess and compare the effects of an adapted taekwondo (TKD) program, multicomponent training (MCT), walking exercise (WE), and inactive control group (CG) on blood pressure, morphological variables, frequency of food consumption, cognitive status, health-related quality of life (HRQoL), physical fitness tests, and postural balance in independent older females. Methods: A randomized controlled trial study was conducted with the following groups: TKD (n = 13), MCT (n = 12), WE (n = 12), and CG (n = 14), considering three/weekly 60-min/sessions for 16-weeks. A two-factor mixed analysis of the variance model with repeated measures was performed. Results: TKD improved significantly more in phonetic fluency (p = 0.021; ES = 1.89) than WE and in general health (p = 0.033; ES = 1.11) than CG. Both TKD and MCT improved significantly more than CG in the 30 s chair stand, arm curl, chair sit-and-reach, timed up-and-go, maximal isometric handgrip strength, and postural balance for the eyes closed condition in the area and anteroposterior velocity (p < 0.05). Conclusions: Only TKD improved the area (p = 0.008; ES = 1.00) and mediolateral velocity (p = 0.019; ES = 0.79) for the eyes open condition, and mediolateral velocity (p = 0.021; ES = 1.57) for the eyes closed condition. Blood pressure, morphological variables, and food consumption frequency showed no significant intragroup or intergroup interactions. TKD equivalently improved HRQoL and physical fitness to MCT, with better postural balance in older females. Full article

(1) Background: Long-term health effects after SARS-CoV-2 infections can manifest in a plethora of symptoms, significantly impacting the quality of life of affected individuals. (2) Aim: The present paper aimed to assess the effects of an individualized and controlled exercise intervention on fatigue and exercise capacity among Long-COVID (LC) patients in an ambulatory setting. (3) Methods: Forty-one (n = 41) LC patients performed an exercise protocol with an individualized control of the patients’ training intensity during the study period based on the individual’s ability to achieve the target criteria. The program was carried out two to three times a week, each session lasted 30 min, and the study parameters were recorded at the beginning of the program, as well as after 6 and 12 weeks, respectively. These included both patient-reported (PCFS questionnaire, FACIT–Fatigue questionnaire) and objective (one-minute sit-to-stand test (1MSTST), workload) outcomes. (4) Results: The exercise training intervention resulted in significant improvements in the FACIT–Fatigue (F(2, 80) = 18.08, p < 0.001), 1MSTST (${\chi }^2$(2) = 19.35, p < 0.001) and workload scores (${\chi }^2$(2) = 62.27, p < 0.001), while the PCFS scores remained unchanged. Changes in the workload scores were dependent on the frequency of the completed exercise sessions and were higher in the LC patients with a moderate Post COVID Syndrome Score (PCS) compared to a severe PCS. (5) Conclusions: The individualized and controlled training approach demonstrated efficacy in reducing fatigue and enhancing exercise capacity among outpatient LC patients. However, for complete regeneration, a longer, possibly indefinite, treatment is required, which in practice would be feasible within the framework of legislation. Full article

Background: Lung cancer carries a high burden of systemic symptoms, including in survivors, leading to a reduced quality of life (QoL). We assessed whether a 12-week multicomponent supervised exercise programme, including muscular strength and aerobic training, was beneficial in patients who had undergone surgery for early non-small cell lung cancer (NSCLC) in terms of physical performance, QoL, and metabolic and nutritional analytical parameters. Methods: Physical performance was measured by gait speed, handgrip strength, 30 s sit-to-stand (30s-STS) test repetitions, distance covered in the 6 min walk test (6MWT), and the Short Physical Performance Battery (SPPB) score. QoL was assessed with the EORTC-QLQ-C30 questionnaire. Blood glucose, cholesterol, triglycerides, total proteins, albumin, pre-albumin, creatinine, c-reactive protein, insulin-growth factor 1 (IGF-1), and the haemoglobin and hematocrit percentages were measured before and after the intervention in order to observe any beneficial effects related to metabolic markers. Results: After the intervention, the mean scores for the 6MWT (p < 0.001), STS (p < 0.001), 6MWT (p < 0.01), and SPPB (p < 0.01) had significantly improved. However, handgrip strength and nutritional analytical were unchanged. The EORTC-QLQ-C30 functions and symptoms significantly improved after the intervention (p < 0.05 and p < 0.01, respectively). A significant decrease in cholesterol, triglycerides, and IGF-1 and a significant increase in pre-albumin in blood was also observed post-intervention (p < 0.05). Conclusions: This supervised, community-based 12-week multicomponent was feasible (adherence rate 70.35%) and provided benefits not only to physical performance but also to the quality of life of patients with NSCLC. Full article