Search Results (251)

This study aims to evaluate the reliability and minimal detectable change (MDC) of the 2 min marching test (2MMT) for cardiovascular response, as well as to compare its outcomes with those of the 6 min walk test (6MWT), in youth recovering from post-COVID-19 condition. Forty-four youth with post-COVID-19 condition underwent two assessment sessions, separated by five days, utilizing both the 6MWT and 2MMT to measure cardiorespiratory response parameters. Test–retest reliability was found to be excellent for the 6MWT (ICC = 0.83; MDC₉₅ = 8.06%) and good for the 2MMT (ICC = 0.78; MDC₉₅ = 15.61%) between initial and follow-up measurements. The 2MMT demonstrates good reliability and validity for assessing cardiovascular response in youth with post-COVID-19 condition. The reported MDC values provide clinically meaningful thresholds that enable clinicians to distinguish true changes in performance from measurement error. These findings support the use of the 2MMT as a practical tool for clinical assessment, providing preliminary guidance for interpreting changes in performance. However, longitudinal monitoring of patient progress was not directly assessed in this study. Full article

Integrating physical activity into daily routines through walking and cycling supports health while promoting sustainable mobility. This assumption aligns with SDGs 3, 5 and 11. This study assessed the feasibility and health impacts of cycling within a university setting. As part of the UCicletas program at Coimbra University, sixteen participants (8 males, 8 females) used conventional or pedal-assist bicycles for eight weeks. Descriptive analyses, t-tests, and Spearman correlations were applied to anthropometric and cardiorespiratory measurements collected before and after the intervention. Weekly cycling distance was obtained through self-reported odometer values. After eight weeks, notable health improvements were observed. Body fat decreased by 1.8% overall, with a significant reduction in females (p < 0.05). VO_2max increased by 13.79% in males (p = 0.02) and 12.21% in females (p = 0.03). The Ruffier Index decreased by 18.87% in males (p < 0.05) and 14.73% in females (p = 0.03). Gender differences were evident in correlations: male BMI showed a strong negative association with respiratory recovery (ρ = −0.867, p = 0.005), whereas the female association was weak (ρ = 0.371). Correlations between cycling distance and health outcomes were weak and non-significant. Overall, the findings confirm that modest daily cycling improves health outcomes. Full article

(1) Background: The Sustainable Development Goals highlight the importance of ensuring healthy lives and promoting well-being for all. Within this framework, it is essential to improve health outcomes for people with disabilities and to continue generating scientific evidence in this field. This study aimed to (I) analyze differences in anthropometric characteristics and cardiorespiratory fitness among adults with disabilities, and (II) analyze the association between anthropometric characteristics and cardiorespiratory fitness in the total sample and by sex. (2) Methods: Fifty-three adults over 50 years of age with disabilities participated in this study. Anthropometric measurements and the 6 min walk test (6MWT) were conducted, recording physical-physiological and mechanical variables (using heart rate monitors and Stryd devices). (3) Results: Significant differences were observed between men and women with disabilities in height (p < 0.001, ES = −1.10), hip-to-chest ratio (p < 0.05, ES = 0.75), mean heart rate (p < 0.05, ES = 0.67), and absolute minimum power (p < 0.05, ES = 0.64) achieved during the 6MWT. A significant correlation was found between anthropometric characteristics and 6MWT performance across the entire sample (r = −0.29 to −0.67, p < 0.05). Among women, these characteristics were associated with distance covered (r = −0.35 to −0.42, p < 0.05), whereas in men, they were associated with relative power (r = −0.60 to −0.83, p < 0.05). (4) Conclusions: The findings suggest that, in this sample, anthropometric characteristics are associated with specific 6MWT performance variables, with patterns differing by sex. Full article

Background/Objectives: Patient preoperative cardiorespiratory physical fitness measured by maximal oxygen consumption (VO2max) is highly relevant to postoperative outcomes, with low VO2max associated with a greater symptom burden and a greater prevalence of long-term treatment-related cardiovascular disease risk factors in patients undergoing surgery. A network meta-analysis (NMA) was conducted to determine the effects of different components of prehabilitation, including exercise, nutrition, psychological intervention, and different combinations of the aforementioned interventions, on oxygen consumption in people undergoing major abdominal or cardiothoracic surgery. Methods: A literature search was conducted from inception to December 2025. Randomized controlled trials on the effectiveness of prehabilitation programmes on pre-surgery VO2max were included. The risk of bias was assessed via the Cochrane risk of bias (RoB 2.0) tool, and the quality of evidence was assessed via the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Pairwise meta-analyses and NMAs were conducted for direct and indirect evidence. Results: Fourteen studies were included in this NMA. The highest effect (ES) for VO2max scores was for the exercise group versus the control group (ES: 0.44; 95% CI: 0.11, 0.78). When exercise was categorized according to intensity, the highest effect was for high-intensity interval training (HIIT) versus the control (ES: 0.51; 95% CI: 0.04, 0.97). Conclusions: Exercise HIIT should be considered the most effective strategy for improving exercise capacity in patients undergoing major abdominal or cardiothoracic surgery. Given the importance of VO2 as a predictor of morbidity, mortality, and the potential occurrence of adverse events after the procedure in surgical patients, it is essential to include its measurement in future studies to estimate both the risk of procedures and the effect of prehabilitation programmes. Full article

Background: Childhood obesity continues to pose a major global health challenge, and schools offer a structured and scalable setting for implementing physical activity programs. However, the effectiveness of these interventions remains inconsistent. This systematic review synthesizes evidence from school-based physical activity interventions and evaluates their impact on obesity-related parameters, physical activity levels, physical fitness, and cardiorespiratory fitness among children. Methods: A comprehensive search of PubMed, Scopus, and the Cochrane Library identified randomized controlled trials published between January 2015 and March 2025. Eligible studies included children aged 5–18 years and assessed school-based physical activity interventions. Outcomes included BMI, body fat percentage, physical activity levels (including MVPA), physical fitness, and cardiorespiratory fitness. Due to methodological heterogeneity, a narrative synthesis was conducted. Results: A total of 28 studies met inclusion criteria. Among the 16 studies reporting obesity-related outcomes, 7 demonstrated statistically significant improvements in BMI or BMI z-scores, while 6 of 16 (37.5%) showed no measurable effect. Reductions in body fat percentage were more consistently observed (5 of 6 studies). Both short-term (<6 months) and long-term (>12 months) interventions showed comparable proportions of studies with statistically significant BMI improvements (~50%). For physical activity outcomes, 5 of 11 studies reported increased MVPA, whereas others showed no significant change. Sedentary behavior outcomes were mixed, with only 2 of 6 studies demonstrating significant reductions. Improvements in physical fitness were reported in two-thirds of studies, while cardiorespiratory fitness improvements were inconsistent, with significant gains observed primarily in higher-intensity or well-structured programs. Across outcomes, several findings were statistically significant but modest in clinical magnitude. Conclusions: School-based physical activity interventions have the potential to improve select obesity-related parameters, particularly body fat percentage and BMI in a subset of studies. However, effects on MVPA, sedentary time, overall activity levels, and cardiorespiratory fitness remain variable. The effectiveness of these programs appears influenced by intervention structure, intensity, and adherence rather than duration alone. Future interventions should incorporate tailored, multi-component approaches to enhance both clinical relevance and long-term sustainability. While several effects were statistically significant, most were modest in magnitude. However, even modest improvements in BMI z-score, body fat percentage, and fitness can be meaningful at a population level, particularly when delivered through universal, scalable school platforms that reach large numbers of children. Full article

Cystic fibrosis (CF) is a genetic disorder caused by mutations in the CFTR gene, leading to multi-system impairment. Sleep respiratory disorders (SRDs) are frequent in individuals with CF—even in those with normal or mildly impaired lung function—and may adversely affect overall health. The triple combination of elexacaftor, tezacaftor, and ivacaftor (ETI) has markedly improved clinical outcomes in CF; however, its long-term impact on SRDs remains unclear. This study aimed to assess the effects of ETI on nocturnal cardiorespiratory parameters in individuals with CF over a two-year period. Thirty-five clinically stable patients aged ≥13 years, eligible for ETI therapy, were enrolled. Nocturnal cardiorespiratory polygraphy and spirometry were performed at baseline (T0), one year (T1), and two years (T2) after ETI initiation. After one year, significant improvements were observed in mean oxygen saturation (mSpO₂), time with SpO₂ ≤ 90% (t ≤ 90%), and respiratory rate. Spirometric indices (FEV₁, FVC, FEF) also significantly increased (p < 0.05). Correlation analysis revealed positive associations between mSpO₂ and FEV₁ (ρ = 0.515, p = 0.002) and between FEV₁ and FVC (ρ = 0.894, p < 0.001), while t ≤ 90% negatively correlated with FEV₁ (ρ = −0.404, p = 0.016). No additional significant changes were found at T2. ETI therapy resulted in sustained improvements in nocturnal oxygenation and lung function, supporting the importance of nocturnal respiratory monitoring during follow-up. Full article

Background/Objectives: Early-stage breast cancer treatments adversely affect components of health-related fitness (HRF) important for treatment tolerability, recovery, and long-term outcomes. Few studies have examined cancer treatment modality-specific effects on HRF. We examined associations of breast cancer treatment modalities, regimens, and combinations with one-year changes in HRF. Methods: Newly diagnosed early-stage breast cancer patients were recruited between 2012 and 2019 for the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. HRF assessments were completed within 90 days of diagnosis and at one year, including cardiorespiratory fitness, muscle strength and endurance, and body composition. Analysis of covariance was used to test whether HRF changes differed between treatment modalities, regimens, and combinations. All tests were 2-sided. Results: A total of 1350 participants (mean [SD] age, 55.6 [10.7] years) were included. Women who received chemotherapy (n = 797; 59%) experienced statistically significant smaller increases in upper body strength (−1.7 kg, 95% confidence interval [CI]: −3.0 to −0.5), greater declines in lower body endurance (−118.0 kg, 95%CI: −216.6 to −19.3), and greater declines in total lean mass (−0.7 kg, 95%CI: −1.1 to −0.3), bone mineral density (−0.01 g/cm², 95%CI: −0.02 to 0.00), and bone mineral content (0.04 kg, 95%CI: −0.06 to −0.02). Other treatment modalities were modestly and inconsistently associated with HRF changes. Treatment combinations that included chemotherapy had the most negative impact on cardiorespiratory fitness and body composition. Conclusions: Chemotherapy—either alone or in combination with other treatments—had the largest and broadest negative impact on HRF recovery in early-stage breast cancer at one-year follow-up. Full article

Objectives: To assess risk factors for post-extubation stridor in children and its impact on clinical outcomes. Methods: Prospective cohort study with children aged from 0 to 13 years who were intubated or underwent orotracheal intubation in the pediatric intensive care units (PICU) of two tertiary public hospitals. The outcome of interest was the occurrence of post-extubation stridor. The information collected included patient characteristics, comorbidities, history of airway manipulation, and factors related to orotracheal intubation. A logistic regression was used to identify potential risk factors for post-extubation stridor; data were analyzed until hospital discharge, death, or referral to another facility. Results: A total of 239 children were included, with a median age of 1.3 years and a duration of intubation of three days. Post-extubation stridor was observed in 57.3% of children. A multivariate analysis included prehospital or non-specialized hospital intubation, trauma or complications during intubation, and orotracheal intubation longer than seven days as risk factors for stridor. Children with stridor had a longer PICU length of stay, longer duration of invasive mechanical ventilation, and were often managed with non-invasive ventilation (p < 0.05). Most children with extubation failure (p = 0.001) and cardiorespiratory arrest (p = 0.03) presented with stridor. Conclusions: Risk factors for post-extubation stridor included intubation performed in prehospital or non-specialized hospitals, orotracheal intubation longer than seven days, and trauma or complications during intubation. Children with stridor had a worse prognosis, with longer stays in the PICU and on mechanical ventilation and higher rates of extubation failure. Full article

Background/Objectives: This systematic review aimed to evaluate the effectiveness and feasibility of “exercise snacks,” brief, intermittent bouts of physical activity designed to interrupt prolonged sedentary behavior. The review synthesized findings across metabolic, cardiovascular, cognitive, and functional health domains to identify consistent patterns of benefit and determine their practical applicability across populations. Methods: A total of 26 studies met inclusion criteria, encompassing diverse populations such as healthy adults, older adults, and individuals with obesity, type 2 diabetes, or PCOS. Following the PRISMA 2020 guidelines, comprehensive searches were conducted across PubMed, Scopus, Web of Science, and CINAHL databases for studies published between 2012 and 2025. Eligible studies included randomized controlled trials, crossover trials, and feasibility studies assessing health outcomes following exercise snack interventions in adults. Data were extracted using standardized protocols, and methodological quality was evaluated using the Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale. Narrative synthesis was prioritized due to intervention heterogeneity. Results: Exercise snacks consistently improved postprandial glucose, insulin, and triglyceride responses, reduced blood pressure, preserved endothelial and cerebral blood flow, and enhanced cardiorespiratory fitness. Older adults demonstrated significant gains in lower-limb strength and mobility. Emerging evidence also indicated improvements in mood, fatigue, and cognitive performance. Feasibility trials confirmed high acceptability and adherence across settings and age groups. Conclusions: Exercise snacking represents a time-efficient, feasible, and evidence-based strategy to mitigate the health risks of sedentary behavior. By incorporating brief, frequent activity bouts into daily routines, individuals can achieve meaningful benefits in metabolic regulation, cardiovascular health, physical function, and cognitive well-being. Future research should refine optimal protocols and explore long-term sustainability across varied populations. Full article

This study examined the relationship between academic performance in pre-clinical assessments and clinical placement outcomes among entry-level physiotherapy students in cardiorespiratory physiotherapy. It also compared academic and clinical performance across genders and investigated the correlations between these two areas within the context of cardiorespiratory physiotherapy. The results from two cohorts of physiotherapy students in a single educational institution underwent retrospective analysis. The study compared academic performance data from pre-clinical assessments with clinical placement outcomes, further examined gender differences and investigated correlations between academic and clinical performance. Consistent academic performance was demonstrated across written assessments, but it correlated weakly with clinical placement outcomes. The findings highlight the importance of professional attributes, such as learning and work integration, professionalism, communication, problem-solving, adaptability, and teamwork, which were not assessed in pre-clinical assessments. No significant gender differences were found in academic or clinical performance, except in practical exams. The study suggests that clinical success, in addition to academic results, relies on additional skills not evaluated in pre-clinical assessments. It emphasises the need for holistic assessment frameworks to better bridge the gap between academic and clinical training, ensuring future physiotherapists are prepared for diverse clinical challenges. Full article

Objective: This systematic review examined whether siblings act as facilitators or barriers to children’s motor competence and physical fitness. Methods: Following PRISMA guidelines, systematic searches were conducted in four databases (Web of Science, Scopus, SPORTDiscus, and MEDLINE/PubMed) up to September 2025. Results: Seventeen studies (total n = 116,827) met eligibility criteria. Eleven studies were rated fair quality and the remainder poor. Twelve studies assessed motor competence, four assessed physical fitness, and one addressed both. Children with older siblings often showed better coordination and motor skills, whereas some evidence indicated earlier gross motor development in only children and no consistent differences in fine motor skills. The presence of younger siblings was associated with lower motor skill scores in infants, while older siblings were linked to higher scores. Across motor competence outcomes, the available evidence is concentrated in object control and fine/hand motor skills, with comparatively fewer data on locomotor and stability domains. Regarding physical fitness, siblings generally exerted a positive influence across several dimensions, but these findings are based on a small number of studies, and results for cardiorespiratory fitness are conflicting. Conclusions: Given the heterogeneity in ages and measurement tools, along with the predominance of methodological constraints, readers should interpret the findings with caution. In summary, the available evidence suggests that having siblings may be associated with higher motor competence and some aspects of physical fitness, yet the certainty of evidence is limited by heterogeneity (age ranges and measurement tools) and methodological constraints. Full article

Background/Objectives: Cardiovascular disease is the leading cause of non-cancer mortality in cancer survivors. Exercise interventions are widely used to enhance cardiorespiratory fitness, typically assessed by VO₂peak, which predicts postoperative complications and poorer clinical outcomes. Prehabilitation provides an opportunity to optimize health. Given time constraints, high-intensity interval training (HIIT) may represent a time-efficient strategy to improve fitness during prehabilitation. This meta-analysis examines the effects of HIIT-based prehabilitation versus usual care on VO₂peak in cancer patients. Methods: A systematic search was conducted in Cinahl, Embase, PubMed, Scopus, and Web of Science from database inception to August 1, 2024 using terms related to cancer, prehabilitation, and HIIT. Random-effects meta-analysis was performed on studies assessing the effects of HIIT versus usual care on VO₂peak in adults with cancer undergoing prehabilitation. Seven studies comprising 352 participants (aged 56–73 years) with mixed cancer types were analyzed. Methodological quality was assessed using the Cochrane Risk of Bias tool (v2) and the Consensus on Exercise Reporting Template (CERT). The primary outcome was VO₂peak, analyzed using standardized mean differences (SMD) with 95% confidence intervals (CI). Results: The meta-analysis demonstrated a small but statistically significant effect in favor of HIIT over UC (SMD = 0.31, 95% CI = 0.09–0.52, p < 0.01), with low between-study heterogeneity (I² = 10%). Conclusions: This meta-analysis shows that HIIT-based prehabilitation can improve cardiorespiratory fitness in cancer patients and may provide a clinically relevant, time-efficient strategy to optimize functional capacity before treatment. However, the included studies exhibited substantial clinical heterogeneity, and although all interventions were labeled as HIIT, exercise intensity was not assessed consistently across studies, underscoring the need for cancer-specific randomized controlled trials with standardized HIIT protocols and objective intensity verification. Full article

Background and Objectives: Childhood acute lymphoblastic leukemia (ALL) carries substantial morbidity, mortality, and economic burden, particularly in middle-income countries. The Pediatric Early Warning System (PEWS) is designed to trigger timely escalation of care, yet its independent impact on survival among critically ill leukemic children has not been well defined in Kazakhstan and Central Asia. Materials and Methods: We conducted a retrospective review all ICU admissions for patients aged 0–18 years with ALL at the National Center of Pediatrics, Almaty, across two periods: pre-implementation (January 2020–December 2022) and post-implementation of 24 h PEWS monitoring (September 2023–December 2024). The primary outcome was ICU mortality. Seven domains of covariates—demographic, clinical history, transfusion, vital signs, symptoms, laboratory, and instrumental data—were extracted. Univariable and multivariable logistic regression models were used to assess associations with mortality. Results: Among 255 admissions (105 during PEWS implementation; 150 prior to PEWS implementation), overall ICU mortality was 21.7%. After adjustment, PEWS implementation was not associated with reduced ICU mortality (AOR 0.89), despite a lower unadjusted mortality (15.9% vs. 26.6%). The most clinically relevant secondary findings included strong associations between mortality and bilateral pneumonia (AOR 7.45), ≥4 episodes of hyperthermia within 24 h of ICU admission (AOR 5.42), and systemic inflammatory response syndrome (AOR 4.61). Conclusions: These findings suggest that, within this high-acuity cohort, inflammatory and cardiorespiratory derangements outweigh any potential survival benefit from ward-based PEWS surveillance. Optimizing outcomes will require integrating early warning systems with timely deterioration management, focused cardiopulmonary support, and resource allocation tailored to the clinical context—rather than relying solely on surveillance scores. Full article

Background: High-intensity interval training (HIIT) is effective for improving body composition and cardiorespiratory fitness, but individual variability in responsiveness remains a challenge. This study examined the dose–response effects of three HIIT session durations (6, 8, and 10 min) and whether previously non-responsive adolescents could benefit from a modified program. Methods: A total of 137 adolescents completed one of three school-based HIIT interventions. Body fat percentage (BF%), systolic and diastolic blood pressure, and maximal oxygen uptake (VO₂max) were assessed before and after the intervention. Responders and non-responders were classified using a Bayesian approach. Statistical analyses included ANOVA, McNemar’s test, logistic regression, and generalized estimating equations. Results: All protocols improved outcomes, with the 10 min sessions producing the most consistent VO₂max gains. No significant differences were observed for BF% or blood pressure. Individual analysis showed that more than half of the participants responded positively to training, depending on the outcome. Among prior non-responders, 70–100% showed improvements after the modified intervention. The number of previously non-responsive outcomes strongly predicted improvement (Odds Ratio > 2.4, p < 0.01). Conclusions: School-based HIIT can induce meaningful adaptations even in previously non-responsive adolescents. Individualized monitoring and adjustment of training dose may optimize responsiveness and support health promotion in youth. Full article

Heart failure (HF) remains a leading cause of recurrent hospitalisations worldwide, largely driven by acute episodes of decompensation. Early identification of impending decompensation could enable timely intervention and potentially prevent costly admissions. Non-invasive wearable devices have emerged as promising tools for continuously monitoring physiological parameters and detecting early signs of deterioration. This review summarises recent advances in wearable technologies designed to predict HF decompensation and appraises their ability to generate clinically useful alerts. It will examine various modalities designed to monitor different aspects of cardiorespiratory physiology that have the potential to detect abnormalities preceding heart failure decompensation. Broadly, these devices either monitor physical activity capacity and cardiac function or monitor changes in pulmonary fluid congestion. We will also cover evidence exploring whether these devices can generate timely alerts for interventions to improve patient outcomes and reduce hospitalisations. However, despite advances in these technologies, challenges remain regarding their accuracy and usability for remote monitoring, as well as concerns with data storage, processing, patient adherence, and integration into existing healthcare workflows. While current limitations exist, previous results warrant further research into this area, with a focus on larger randomised trials, exploring both single- and multi-sensor systems, using artificial intelligence and cost-effectiveness analysis. Overall, non-invasive wearables represent an opportunity to create a more proactive approach to HF management, with the potential to shift the paradigm from reactive treatment to anticipatory care. Full article