Search Results (325)

The Red River Jig is a traditional Métis dance practiced among Indigenous and non-Indigenous Peoples. While exercise improves physical health and fitness, the impacts of cultural dances on wholistic health are less clear. This study aimed to investigate the psychosocial (cultural and mental), social, physical function, and physical fitness benefits of a Red River Jig intervention. In partnership with Li Toneur Nimiyitoohk Métis Dance Group, Indigenous and non-Indigenous adults (N = 40, 39 ± 15 years, 32 females) completed an 8-week Red River Jig intervention. Social support, cultural identity, memory, and mental wellbeing questionnaires, seated blood pressure and heart rate, weight, pulse-wave velocity, heart rate variability, baroreceptor sensitivity, jump height, sit-and-reach flexibility, one-leg and tandem balance, and six-minute walk test were assessed pre- and post-intervention. Community, family, and friend support scores, six-minute walk distance (553.0 ± 88.7 m vs. 602.2 ± 138.6 m, p = 0.002), jump, leg power, and systolic blood pressure low-to-high-frequency ratio increased after the intervention. Ethnic identity remained the same while affirmation and belonging declined, leading to declines in overall cultural identity, as learning about Métis culture through the Red River Jig may highlight gaps in cultural knowledge. Seated systolic blood pressure (116.5 ± 7.3 mmHg vs. 112.5 ± 10.7 mmHg, p = 0.01) and lower peripheral pulse-wave velocity (10.0 ± 2.0 m·s⁻¹ vs. 9.4 ± 1.9 m·s⁻¹, p = 0.04) decreased after the intervention. Red River Jig dance training can improve social support, physical function, and physical fitness for Indigenous and non-Indigenous adults. Full article

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/Objectives: Patients undergoing open aortic and valvular surgery often experience postoperative deconditioning, yet research on the role of inpatient cardiac rehabilitation (CR) in this population remains limited. This study aimed to examine the effects of inpatient CR on muscle strength, mobility, psychological well-being, and quality of life in patients recovering from open aortic surgery. Methods: We conducted a retrospective study using the medical records of patients who participated in inpatient CR after open aortic surgery. Functional and psychological outcomes were evaluated using the Medical Research Council (MRC) sum score, Timed Up and Go (TUG) test, Five Times Sit-to-Stand test (5STS), Six-Minute Walk Distance (6MWD), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Patient Health Questionnaire-9 (PHQ-9), and the EuroQol-5D (EQ-5D). Pre- and post-rehabilitation scores were compared to assess changes in functional status, mobility, and quality of life. A post-discharge satisfaction survey was also analyzed. Results: A total of 33 patients were included. Significant improvements were observed in MBI (p < 0.001), MRC sum score (p < 0.001), 6MWD (p < 0.001), BBS (p < 0.001), TUG (p = 0.003), 5STS (p < 0.001), EQ-5D (p = 0.011), and PHQ-9 (p = 0.009) following inpatient CR. Patients with lower baseline mobility (6MWD ≤ 120 m) exhibited greater improvement in MBI (p = 0.034). Of the 33 patients, 26 completed the satisfaction survey; most reported high satisfaction, perceived health improvements, and willingness to recommend the program. Conclusions: Inpatient CR following open aortic and valvular surgery resulted in significant gains in muscle strength, mobility, psychological health, and overall quality of life. Patients with greater initial impairment demonstrated especially notable functional improvement, supporting the value of tailored CR in this population. Full article

Background/Objectives: Prehabilitation is a multimodal intervention introduced in preparation for various surgical procedures. The most effective treatment for obesity is bariatric surgery. Physiotherapy during prehabilitation for bariatric surgery may be an effective method of functional capacity improvement. We aimed to evaluate the impact of an individual outpatient 12-week, exercise-based physiotherapy program featuring prehabilitation on functional status, exercise tolerance, everyday mobility, and fatigue among patients qualified for bariatric surgery. Methods: The completion of an individual outpatient 12-week, exercise-based physiotherapy program during prehabilitation was an inclusion criterion for the study group. Participants included in the study and control groups were assessed twice, after enrollment into the prehabilitation program (the first assessment) and after prehabilitation but before surgery (the second assessment). Both assessments involved functional tests (a six-minute walking test [6MWT], a timed up and go test [TUG], a chest mobility test, anthropometric measures, a mobility index [Barthel], and a modified Borg scale). The collected anthropometric data and values from the 6MWT were used to create original linear models. This study followed STROBE recommendations. Results: The study group and control group did not differ statistically in terms of their anthropometric data. Statistically significant results were obtained between the first and second assessments in both groups in terms of body weight and waist circumference. However, only the study group showed improved results in the TUG test (p = 0.0001) and distance in the 6MWT (p = 0.0005). The study group presented with the normalization of blood pressure (BP) after exertion in the second assessment (systolic BP p = 0.0204; diastolic BP p = 0.0377), and the 6MWT results were close to the norms. According to the original linear model used to predict performance in the 6MWT, the primary modifiable determinant of exercise tolerance was the participant’s weight, while gender served as a non-modifiable determinant. Conclusions: Exercise-based physiotherapy in prehabilitation was associated with improved functional capacity in patients preparing for bariatric surgery, contributing to the improvement in 6MWT results in relation to the norms as well as exercise tolerance. Body weight may be an independent factor determining distance in the 6MWT for patients undergoing prehabilitation for bariatric surgery. Full article

In low- and middle-income countries, notably in rural agricultural populations exposed to environmental and occupational dangers, respiratory impairment and noncommunicable diseases (NCDs) are major public health issues. This cross-sectional study examined the associations between lung function, functional capacity, and cardiovascular responses to the Six-Minute Walk Test (6MWT) in 137 adults from San Pa Tong District, Northern Thailand. Lung function was assessed using spirometry, and participants were classified accordingly. Hemodynamic parameters, including blood pressure, heart rate, rate-pressure product, and oxygen saturation, were measured before and after the 6MWT. Participants with impaired lung function walked significantly shorter distances (p = 0.004), and walking distance was positively correlated with forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁). Logistic regression confirmed that walking distance independently predicted lung function impairment after adjusting for age and sex. Cardiovascular responses to exercise also varied significantly across demographic subgroups. These findings support the use of the 6MWT as a practical, cost-effective, and scalable method for detecting lung function impairments in resource-limited rural settings. To our knowledge, this is among the first studies to demonstrate the predictive value of the 6MWT for lung function impairment in a Southeast Asian agricultural population. Full article

Introduction: Knee osteoarthritis (OA) is defined by articular cartilage loss, increased discomfort, and functional restrictions. Changes in lifestyle, painkillers, intra-articular injections, and, as a last resort, surgery are all part of clinical therapy. In this setting, intra-articular injections of hyaluronic acid (HA) represent a relevant and diffused therapeutic option. Materials and Methods: A prospective observational study was performed from October 2024 to May 2025 in 70 patients with knee OA. HA was administered in three intra-articular injections and was followed up at 3 and 6 months from the last injection. Knee Injury and Osteoarthritis Outcome Score (KOOS) was evaluated as primary outcome measure; Visual Analogue Scale (VAS), time up and go test, six-minute walking test, general health assessment with 36-Item Short Form Health Survey (SF-36), Zung’s Self-Rating Anxiety Scale (Zung SAS), and Zung’s Self-Rating Depression Scale (Zung SDS) as secondary outcome measures. Results: We observed a statistically significant improvement in clinical scores at 3 months in both HA formulations compared to the control group. No relevant side effects were described during the study. Conclusion: Hyalubrix 30 mg/2 mL and DIART 1.8%/2 mL are two safe and effective therapeutic options to manage knee OA, offering benefits in pain control, functionality and emotional wellness. Full article

Background/Objectives: In the context of active ageing, functional assessment is key to preserving autonomy in older women. The six-minute walk test (6MWT) is a practical tool for estimating general health, but its results can be influenced by various factors. This study analysed cardiorespiratory variations during the 6MWT in older women according to their physical activity level and age-related variables such as pain, sarcopenia, frailty, and motivation to exercise. Methods: A total of 163 older women with musculoskeletal pain, but without cardiac or respiratory conditions, were classified into groups with high (HPA), moderate (MPA), and low (LPA) physical activity. During the 6MWT, heart rate (HR), dyspnoea, and oxygen saturation (SpO₂) were recorded. Pain, sarcopenia, frailty, and motivation to exercise were also assessed. A repeated-measures multivariate analysis of (co)variance (RM-MANCOVA) was performed. Results: The results showed differences in HR depending on the level of physical activity, conditioned by sarcopenia (p < 0.05) and walked distance (p < 0.001), and in dyspnoea conditioned by pain perception (p < 0.01) and social (p < 0.001) and psychological (p < 0.05) motivation to exercise. There were also differences in SpO₂ depending on the level of physical activity (p < 0.0001). There were differences between the HPA group and both the MPA and LPA group, which had higher HR, higher dyspnoea, and lower SpO₂ when undergoing the 6MWT test. Conclusions: To accurately interpret 6MWT results in older adult women, it is essential to consider physical activity level, perceived pain, sarcopenia, and motivation to exercise, as these factors influence HR, dyspnoea, and SpO₂. These variables should guide physical activity recommendations for healthy ageing. Full article

Background: This study compared performance-based function and self-report function in lower-limb prosthesis users. Methods: Twenty-two lower-limb prosthesis users (aged 52.1 ± 14.2) were administered the Orthotic Prosthetic User Survey (OPUS) Lower Extremity Functional Status (LEF), Satisfaction With Devices (SWD), alongside the Godin Leisure-Time Exercise Questionnaire (GLTQ), Timed Up and Go (TUG) test, two-minute walk test (2MWT), and six-minute walk test (6MWT). Body composition and standing postural sway displacement and velocity were also measured. Pearson’s Product Moment coefficients were used to assess relationships between the OPUS and other outcome variables. ANOVAs were used to identify differences in all outcome variables between lower unilateral (LU) and all other (AO) amputees. Results: There was a moderate correlation between LEF and center of pressure (CoP) path length with eyes open (r₍₁₉₎ = −0.43, p = 0.048) and eyes closed (r₍₁₉₎ = −0.43, p = 0.049). While the relationship between LEF and TUG was significant (r₍₂₀₎ = −0.49, p = 0.021), this was not so with SWD and TUG (r₍₂₀₎ = −0.17, p = 0.456). Both the 2MWT (r₍₂₀₎ = 0.48, p = 0.023) and 6MWT (r₍₂₀₎ = 0.47, p = 0.028) were moderately correlated with LEF. GLTQ was significantly correlated with LEF (r₍₂₀₎ = 0.70, p = 0.001). The LU group outperformed the AP group during the TUG and 6MWT (p < 0.05). LU group scored significantly higher on LEF compared to the AO group (p < 0.05). The reliability of LEF between the measurement on day 1 (54.3 ± 12.0) and day 2 (53.6 ± 12.8) was high (α = 0.94). Conclusions: This study provides an insight into associations of balance and self-reported function in lower limb prosthesis users. Future work can target rehabilitation strategies to address challenges faced by multiple limb prosthesis users. Full article

Patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) and concomitant interstitial lung disease (ILD) are particularly challenging to manage due to concerns about ventilation–perfusion mismatch with systemic vasodilators. In this case series, we evaluated the effects of selexipag in eight prostacyclin-naïve CTD-PAH patients with concomitant ILD. Clinical, functional, and laboratory data were collected at baseline and after 16 weeks of treatment. After 16 weeks of treatment, the mean six-minute walk distance increased by 101.75 m (p < 0.05), and the mean estimated right ventricular systolic pressure decreased significantly (p < 0.05). Mean N-terminal pro b-type natriuretic peptide levels declined by 63%, though this reduction did not reach statistical significance. Importantly, supplemental oxygen requirements trended downward (p < 0.05) and pulmonary function tests remained stable. Pulmonary vasodilators have long been unsuccessfully studied in PH-ILD patients until the INCREASE trial. While other systemic agents used in PAH have not shown as much success as inhaled treprostinil in treating PH-ILD, our case series highlights the potential role of selexipag in patients with concomitant CTD-PAH and ILD. Further investigation of selexipag in pure Group 3 PH-ILD patients is warranted. Full article

Background/Objectives: Type 2 Diabetes Mellitus (T2DM) is associated with reduced exercise capacity. The six-minute-walk test (6MWT) is the gold standard submaximal test but has practical challenges, such as space constraint, time dependency and feasibility in clinical settings. This study aimed to determine if the one-minute sit-to-stand (1 min STS) test could predict walking capacity, as assessed by the 6MWT, among individuals with T2DM. Methods: Ninety-five individuals with T2DM participated in this cross-sectional study. Participants performed 1 min STS and 6MWT tests and completed the Arabic version of the International Physical Activity Questionnaire (Ar-IPAQ). Pearson’s correlation was used to determine the correlation between one min STS and 6MWT tests. Multiple regression analysis was performed to determine whether 1 min STS predicted 6MWT while controlling for age, gender, BMI, IPAQ, and duration of diabetes. Results: Participants (mean age: 65.4 ± 6.4 years; 26.3% female; mean diabetes duration: 11.6 ± 6.4 years) demonstrated a significant moderate correlation between 1 min STS and 6MWT (r = 0.636, 95% CI [0.47–0.79], p < 0.001). Regression analysis revealed that the 1 min STS significantly predicted the 6MWT (β = 0.48, p < 0.001), regardless of age, gender, BMI, IPAQ, and duration of diabetes. Conclusions: The 1 min STS is inexpensive, simple to use, requires less space and materials that are widely available, and does not require experienced clinicians or researchers to administer. This test can be an alternative to the 6MWT for individuals with T2DM. Full article

Background/Objectives: The prevalence of heart failure with preserved ejection fraction (HFpEF) is expected to surpass that of heart failure with reduced ejection fraction (HFrEF), yet it remains under-researched. Compared to HFrEF, patients with HFpEF have similarly poor survival rates, physical impairments, and quality of life (QOL) and similar improvements following exercise training. However, Medicare currently excludes coverage for cardiopulmonary rehabilitation (CR) for HFpEF. The purpose of this study was to evaluate the impact of HF at baseline and the effects of CR in both subtypes. Methods: Ninety-nine patients (forty-three with HFrEF and fifty-six with HFpEF) who completed CR were included. Demographic data and outcome measures were assessed pre- and post-CR, including weight, body mass index (BMI), 5x-sit-to-stand (5xStS), timed-up-and-go (TUG), 6-minute walk test (6MWT), Ferrans and Powers Quality of Life (F&P QOL), waist circumference, BERG balance, and Patient Health Questionnaire-9 (PHQ-9). Independent and paired t-tests were performed with statistical significance set at p < 0.05. Results: At baseline, compared to patients with HFrEF, patients with HFpEF were older with a significantly lower 6MWT distance (350.6 m vs. 299.6 m), lower BERG balance scores (52/56 vs. 49/56, respectively), and a 5xSTS score indicating a fall risk (16.9 ± 6.5). Following CR, both groups had significant improvements in all functional and self-reported outcome measures (p < 0.001), with no significant differences between HF subtypes. Patients with HFpEF also had a significant improvement in waist circumference. Conclusions: Compared to patients with HFrEF, patients with HFpEF presented with similar or greater impairments and had similar or greater improvements following CR. These results underscore the effectiveness of CR for HFpEF management and the need for insurance coverage. Full article

Background/Objectives: Long-term effects of post-COVID-19 on several health outcomes remain unclear. We assessed PA and sedentary behaviour changes and explored behaviour-change factors twelve months post-COVID-19 in people with and without Long COVID. Methods: A prospective cohort study followed people treated for COVID-19 in different settings (home, hospital ward, intensive care unit) from twelve months to eighteen months post-COVID-19. Participants with and without Long COVID were identified. PA (Light PA-LPA, Moderate-to-Vigorous PA-MVPA, Steps·day⁻¹), sedentary time, functional capacity (six-minute walk test-6MWT), muscle strength (quadriceps maximal voluntary contraction-QMVC), dyspnoea (modified Medical Research Council scale-mMRC), fatigue, symptoms of anxiety and depression, and health-related quality of life-HRQoL were assessed. Results: Among 148 participants (58 ± 15 years, 54% male), 101 had Long COVID. All remained physically inactive. People with Long COVID significantly increased LPA (LPA_LongCOVID +28 [1; 55] min·day⁻¹; LPA_Controls +6 [−32; 45] min·day⁻¹), and decreased MVPA (MVPA_LongCOVID −4 [−7; −2] min·day⁻¹; MVPA_Controls −4 [−8; 1] min·day⁻¹) and sedentarism (Sedentarism_LongCOVID −47 [−89; −4] min·day⁻¹; Sedentarism_Controls −30 [−88; 28] min·day⁻¹). At eighteen months, higher proportions of individuals with Long COVID had impaired 6MWT (17% vs. 0%), reduced QMVC (25% vs. 6%), dyspnoea (24% vs. 0%), fatigue (67% vs. 13%), symptoms of anxiety (47% vs. 9%) and depression (26% vs. 0%) as well as poor HRQoL (50% vs. 6%). PA and sedentary behaviour changes at eighteen months were associated with dyspnoea and impaired QMVC at twelve months (LPA: mMRC ≥ 2: −41.56 [−129.30; 46.00] min·day⁻¹, Steps·day⁻¹: mMRC: −416.13 [−1223.83; 391.57]; QMVC ≤ 70% predicted: −1251.39 [−2661.69; 158.91], Sedentarism: mMRC ≥ 2: +47.21 [−90.57; 184.99] min·day⁻¹; 0.24 ≤ R² ≤ 0.32). Conclusions: PA and sedentary behaviour remain altered long after COVID-19, with people with Long COVID adjusting to fit lower PA levels, possibly driven by physical limitations and symptoms. Dyspnoea and muscle weakness may influence PA and sedentary behaviour. Full article

Wearable sensors are increasingly used to provide objective quantification of spatiotemporal and kinematic parameters post-stroke. This study aimed to evaluate the practical value of sensor-based gait reports in delivering augmented feedback and informing the development of home training programmes following a 2-week supervised intensive intervention after stroke. Four patients with chronic stroke were assessed on four occasions (pre- and post-intervention, 3-month, and 6-month follow-ups) using clinical gait tests, during which a portable sensor-based system recorded kinematic data. The meaningfulness of individual changes in gait parameters was interpreted based on established minimal detectable change values (MDC). Three participants improved their gait speed, joint angles, and/or cadence in the Ten-Metre Walk Test, and three participants improved their walking distance in the Six-Minute Walk Test. The improvements were most evident at the 3-month follow-up (with the most obvious changes above MDC estimates) and indicated the reappearance of normal gait patterns, adjustments of gait patterns, or a combination of both. Participants showed interest in and understanding of the information derived from the gait reports (ratings of 5–10 out of 10). In conclusion, augmented feedback derived from gait reports provides a valuable complement to traditional clinical assessments used in stroke rehabilitation to optimize treatment outcomes. Full article

Background/Objectives: This study aims to investigate the effects of a home-based cardiac rehabilitation (HBCR) program via a LINE application on functional capacity and quality of life (QOL) in open-heart surgery patients. Methods: This study involved 54 open-heart surgery patients divided into a control group and an experimental group (27 intervention, 27 control) using pair matching. Participants in the intervention group participated in the HBCR program, while the control group received standard care. Orem’s self-care theory was used as the conceptual framework. Functional capacity was measured via a six-minute walk test and the Duke Activity Status Index, while QOL was measured via the Thai version of the Short Form-36 Survey. Results: The findings from the study reveal that the patients who underwent open-heart surgery in the experimental group had significantly higher functional capacity compared to those in the control group (p < 0.05). Additionally, the overall QOL of the open-heart surgery patients in the experimental group was significantly better than that of the control group, alongside physical functioning, emotional roles, vitality, mental health, social functioning, and general health (p < 0.05). However, there were no significant differences between the two groups in terms of physical roles and bodily pain (p > 0.05). Conclusions: Using an HBCR program via the LINE application has the potential to enhance the at-home self-care ability of post-open-heart surgery patients, thus improving their functional capacity and QOL. Full article

Wearable monitoring devices, such as smart bands, have emerged as accessible and non-invasive tools for assessing physiological and spatiotemporal gait parameters in various clinical tests. This study aimed to validate the use of the Xiaomi Mi Band 6 for recording gait parameters during the six-minute walk test (6MWT). Seventy participants without gait impairments were recruited, and the measurements obtained with the smart band were compared to reference methods (evaluator, pedometer, and pulse oximeter). The physiological parameter results showed that the smart band demonstrated good accuracy in heart rate monitoring but lower agreement in oxygen saturation measurements. Gait parameters indicated excellent agreement in step count (ICC > 0.9) and step frequency (ICC > 0.75), whereas step length and distance estimations showed higher variability. These findings suggest that the Xiaomi Mi Band 6 is a viable alternative for measuring specific gait parameters, though with limitations in certain aspects of accuracy. Full article