Search Results (174)

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

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: Systemic lupus erythematosus is an autoimmune disease. The musculoskeletal system is affected in 90% of patients. The most common symptoms are myalgia, arthralgia, and arthritis. The objective was to analyze the efficacy of an intervention using myofascial techniques and proprioceptive neuromuscular facilitation in patients with systemic lupus erythematosus. Methods: A randomized, single-blind, crossover clinical trial. Seventeen patients with systemic lupus erythematosus were randomly assigned to two sequences: Sequence A–B (intervention phase first, then control phase) and Sequence B–A (control phase first, then intervention phase). The intervention lasted for four weeks, with two weekly sessions lasting 50 min each. The intervention consisted of myofascial and proprioceptive neuromuscular facilitation techniques. The variables were: pain intensity (Visual Analog Scale), functional capacity of lower limbs (2-Minute Walk Test), physical function (Timed Up and Go Test), and fatigue (Fatigue Assessment Scale). After a 2-week follow-up and a 2-week washout period, the patients switched groups, and the methodology was replicated. Results: None of the patients developed injury or adverse effects as a direct consequence of the intervention. There were statistically significant differences between groups (p < 0.001) in the intensity of ankle (η²_p = 0.38) and knee (η² = 0.37) pain, functional capacity (η² = 0.33), and physical function (η² = 0.56). There were also intergroup changes in fatigue (η² = 0.52), and the relevant mental (η² = 0.26) and physical (η² = 0.45) components. Conclusions: Proprioceptive myofascial and neuromuscular facilitation techniques are safe in patients with systemic lupus erythematosus. This physical therapy protocol can improve the intensity of knee and ankle joint pain in these patients. This intervention can improve functional capacity, physical function, and fatigue in people with systemic lupus erythematosus. 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

Background/Objectives: Physical exercise and curcumin supplementation can positively influence parameters related to cognition and neuro-oxidative status. However, research on the combined effects of resistance training with elastic bands and supplementation with a curcumin-based formulation is limited. Moreover, different types of contractions (e.g., concentric and eccentric) may elicit distinct neurophysiological effects. This study evaluated the effectiveness of two high-resistance training (high-RT) programs using elastic bands in improving neuro-oxidative markers (brain-derived neurotrophic factor [BDNF] and F2-isoprostanes), cognitive function, physical performance, and quality of life, and examined the additional benefits of curcumin supplementation. Methods: Eighty-one sedentary older adults were randomly assigned to one of the following groups: accentuated eccentric training with either a bio-optimized curcumin formulation (Aecc-Cur) or placebo (Aecc-Pla); maximum strength training with either curcumin (Max-Cur) or placebo (Max-Pla); or a control group receiving curcumin (C-Cur) or placebo (C-Pla) without training. The training groups participated in a 16-week full-body high-RT program using elastic bands. Results: BDNF significantly increased in Aecc-Cur and Aecc-Pla (both p ≤ 0.020) but showed no changes after Max-Cur or Max-Pla (both p ≥ 0.256). All other dependent variables improved similarly across training groups (all p ≤ 0.50). Curcumin supplementation combined with exercise significantly reduced F2-isoprostanes in the Max-Cur group compared to Aecc-Pla, and enhanced 6-Minute Walk Test performance in Aecc-Cur and Max-Cur compared to their placebo counterparts. C-Cur showed nonsignificant changes in BDNF, F2-isoprostanes, social functioning, and vitality, while C-Pla worsened these parameters. Notably, at least half of the participants in the experimental groups exhibited clinically significant improvements in 11 of 14 dependent variables. Conclusions: Both high-RT protocols led to improvements in almost all dependent variables, with the Aecc program demonstrating greater effectiveness in boosting BDNF, a key neuroprotection marker. Curcumin supplementation alone and with exercise positively influenced neuro-oxidative markers and quality of life. 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

Background: Oral bronchodilators may serve as an adjunctive therapy in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the effects of oral doxofylline and oral procaterol on lung function and clinical symptoms in COPD patients. Methods: A crossover randomized controlled trial was conducted in patients with clinically stable COPD. Participants first received either doxofylline or procaterol for 4 weeks, followed by a 1-week washout period. Assessments included the modified Medical Research Council (mMRC) dyspnea scale, COPD assessment test (CAT) scores, and 6-minute walking distance (6MWD). Pulmonary function was evaluated using spirometry with bronchodilator (BD) testing and all adverse events were recorded. Results: Twenty patients were randomly assigned to begin treatment with either doxofylline or procaterol. Their mean age was 71.7 ± 9.4 years. After four weeks of treatment, the doxofylline group showed significantly greater improvement in pulmonary function parameters (post-BD peak expiratory flow and post-BD forced expiratory flow 25–75) compared to the procaterol group. However, there were no significant differences in mMRC scores, CAT scores, or 6MWD between the two groups. More neurological adverse events were observed in the doxofylline group compared to the procaterol group (35% vs. 5%, p = 0.044). Conclusions: Doxofylline improved pulmonary function in COPD patients but did not provide superior functional performance compared to procaterol. Neurological adverse events were more frequently associated with doxofylline. Doxofylline may serve as an adjunctive therapy to enhance pulmonary function in COPD patients, but caution is advised due to its potential side effects. Full article

Background: Firefighters have an increased risk of both mental and physical health conditions due to experiencing various forms of extreme stress regularly. High levels of resiliency may help firefighters overcome stressful situations and promote better mental and physical health. Objectives: The primary aim of the present study was to examine the relationship between resilience and other psychological variables. The secondary aim was to determine the relationship between psychological variables and firefighter fitness outcomes. Methods: Participants included 79 full-time male firefighters with a mean age of 35.9. They completed the following psychological questionnaires in this order: PTSD checklist for DSM-5, Dispositional Resilience Scale 15-item, State–Trait Anxiety Inventory for Adults and Beck Depression Inventory. They completed the following fitness tests in this order: maximum number of push-ups in two minutes, maximum time holding a plank and minimum time completing running and/or walking 1.5 miles. Results: Resilience was correlated with and predicted significant variance in depression, trait anxiety, state anxiety and PTSD symptoms in firefighters (all p’s < 0.025). Further, all psychological variables were significantly correlated with and predictive of each other. However, only scores on the Beck Depression Inventory were associated with push-ups completed (p = 0.014). No other psychological variable was related to fitness outcomes in firefighters. Conclusions: This study demonstrated resilience was significantly related to anxiety, depressive symptoms and PSTD symptoms in firefighters but not fitness outcomes. This highlights the protective effects of resilience on mental health, but future work needs to explore other psychological mechanisms to predict physiological performance variables in firefighters. Full article

We assessed the test validity of the Apple Watch series 6 measure of heart rate variability (HRV) by comparing it with the reference measure assessed via a Biopac 3-lead electrocardiogram (ECG). We recruited 78 healthy adults (aged 20–75 years). HRV was measured using an in-lab protocol while resting, talking, watching a movie, before walking, and after walking. We conducted a synchronized countdown for each condition to guarantee that the recordings would be aligned between the two devices by using event markers in the Biopac at the exact time that the Apple Watch Breathe app began and ended. We assessed test validity using the Bland–Altman method, and both precision and accuracy were estimated using Lin’s concordance correlation coefficient. The highest level of agreement and concordance between devices occurred during rest. We observed near-perfect agreement for R-R intervals and beats per minute (BPM) measures, with mean absolute percentage errors (MAPE) of 1.15% during resting conditions. We observed moderate levels of agreement and concordance for N-N intervals at rest with a MAPE of 31.31% during resting conditions. The Apple Watch provides a high level of validity for measuring R-R intervals and BPM in healthy adults. Further research is needed to determine if HRV measures with the Apple Watch offer a significant opportunity for the surveillance of CVD risk. Full article

This pilot study aimed to assess the feasibility and preliminary effects of a supervised, home-based exercise program in patients recovering from laparoscopic colorectal cancer surgery. A total of 23 patients were included, with 13 participating in the exercise intervention and 10 receiving standard postoperative care. The exercise group (intervention group) followed a two-month structured program, while the control group received no structured exercise. Feasibility was demonstrated by 98% adherence in the intervention group and no reported adverse events. At T1, the intervention group showed significant improvements in role function, cognitive function, and reduced fatigue compared to the control group. At T2, a significant difference was observed in physical function. Functional capacity, assessed by the Six-Minute Walk Test, was significantly better in the intervention group at T1, T2, and T3, as was physical performance measured by the Short Physical Performance Battery (SPPB) at T1, T2, and T3. No significant differences were observed between the groups in anxiety, depression, sleep quality, or body composition parameters. This study highlights the feasibility of a supervised home-based exercise program in the early postoperative phase, demonstrating positive effects on Quality of Life, functional recovery, and fatigue in colorectal cancer patients. Full article

Background/Objectives: Parkinson’s disease (PD) is a complex neurodegenerative disorder responsible for both motor and non-motor disturbances impairing motor behavior. This complexity necessitates integrated, multidisciplinary, and comprehensive models of care. A new and interesting complementary approach is represented by “Dance Well”, i.e., an artistic, multisensory dance intervention based on art and music. This pilot study aims to evaluate the efficacy, feasibility, and safety of a 4-week Dance Well (DW) program in PD patients in early–medium disease stages. Methods: Twenty-four PD patients (H&Y ≤ 3; MoCA score ≥ 13.8) were enrolled and randomly allocated into two groups, both with a twice-per-week frequency and lasting 4 weeks: one group underwent the DW program, while the other underwent conventional physiotherapy (CPT). Demographic, biometric, and clinical data were collected. To study the treatment effect, motor (Unified PD Rating Scale-III, Timed Up and Go Test, Berg Balance Scale, 6-Minute Walk Test, and Falls Efficacy Scale), cognitive (Corsi Supra Span Test, Trail Making Test A and B-A), and emotional–motivational (Beck Depression Inventory, State-Trait Anxiety Inventory, Apathy Evaluation Scale) outcome measures were assessed, before and after the rehabilitation program. To study treatment compliance and safety, the number of dropouts and any adverse events (such as injuries and falls) were recorded. Results: All outcome measures improved in both groups. The percentage of improvement in outcome measures assessing attention and motivation was greater in the DW group. No dropouts, falls, or injuries occurred. Conclusions: In the early–medium stages of PD, DW could be considered a feasible and safe complementary treatment, useful in improving motor, cognitive, and emotional–motivational symptoms. Full article

Background/Objectives: The GO-TRYKE^® Kid (GTK^®) is an arm- and leg-powered tricycle which, in addition to promoting strength, endurance, and coordination, aims to reactivate the central pattern generators of the spine for locomotion through cyclical movements. The present study investigated the effects of GTK^® training on walking ability, GTK^® riding performance, and health-related quality of life in children with walking disabilities. Methods: Nine children trained with the device twice a week for nine weeks. Short- and long-term effects on walking ability were measured using the timed up and go test (TUG) and the two-minute walk test (2MWT). GTK^® riding performance and health-related quality of life were compared before and after the intervention period. Results: While no long-term effect on walking was found, a significant short-term effect on functional walking ability was observed (p = 0.009). GTK^® riding performance improved significantly over the training period (p = 0.004). There were no significant changes in health-related quality of life. Conclusions: GTK^® enables children with walking disabilities to participate in cycling as part of play and sport. Further research is required to investigate its functional and participatory effects, as there is significant potential to improve physical activity and overall well-being in this population. Full article

Long COVID represents a significant challenge in understanding the prolonged impact of the disease. Despite its increasing recognition, detailed insights into the long-term cardiopulmonary consequences remain sparse. This study aimed to evaluate the functional capacity of individuals with persistent symptoms after severe COVID-19 infection compared to control individuals without symptomatic COVID or mild COVID after 17 months. This is a case-control study assessing 34 individuals divided into two groups regarding functional capacity by distance in a 6-min walk test (D6MWT) associated with gas analysis, spirometry, respiratory muscle strength, and quality of life. During the 6 MWT, an important lower heart rate (HR) was observed for the COVID group (106 ± 10 bpm, difference mean: 21.3; p < 0.001), with greater exertional perception (Borg dyspnea: 4.5 [2.0–9.0], p < 0.001 and Borg fatigue: 4.0 [2.0–7.0], p = 0.01), a significant decrease in the distance covered (416 ± 94 m, difference mean: 107; p = 0.002), and a low value of O₂ uptake ($\dot{V}$_O2) (11 ± 5.0 mL/(kg min), difference mean: 8.3; p = 0.005) and minute ventilation (22 ± 8 L/min, difference mean: 18.6; p = 0.002), in addition to very low quality of life scores. Regression analysis showed a significant association between D6MWT and Borg fatigue and Borg dyspnea at rest (p = 0.003; p = 0.009). $\dot{V}$_O2 and HR were also significantly associated with the outcomes of the D6MWT (p = 0.04 and p = 0.004, respectively). In conclusion, individuals who have severe COVID-19 and persist with symptoms have low functional capacity, low $\dot{V}$_O2, low HR behavior, and low quality of life. Full article

Background/Objectives: The common heart failure (HF) symptoms—dyspnea, fatigue, and edema—often prompt emergency visits. Dyspnea notably affects activities of daily living (ADLs), making its assessment crucial for evaluating therapeutic success. This study assesses the reliability and validity of the European Portuguese version of the London Chest Activity of Daily Living (LCADL) scale, originally validated in 2010, to evaluate ADL limitations in patients with HF. Methods: Following international guidelines for translation and cultural adaptation, 46 patients with HF from two cardiology departments were enrolled. The Six Minute Walk Test (6MWT) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used for construct validity. Results: A significant correlation was found between the results of the 6MWT and the LCADL total score (r = −0.504; p < 0.001) and the LCADL scale and the MLHFQ (r = 0.703; p < 0.001), except for the domestic activities dimension (r = 0.278; p = 0.062). Reliability revealed an α of 0.917. Conclusions: The study presents the validation of the European Portuguese version of the LCADL scale in patients with HF, emphasizing its reliability and cultural appropriateness. The LCADL scale has proven effective in assessing dyspnea-induced limitations in ADLs, and this study expands its utility by suggesting broader clinical setting applications. Future research should explore its adaptability in diverse healthcare settings, potentially enhancing personalized care strategies and patient outcomes. This work underscores the LCADL scale’s role in facilitating more targeted and effective interventions for managing ADL limitations in patients with HF, suggesting a significant impact on clinical practices and patient care management. Full article

A history of bronchiolitis may lead to changes in health-related physical fitness in children and adolescents. The aim of this study was to analyze the influence of history of bronchiolitis on health-related physical fitness components (muscle strength and cardiorespiratory fitness) in children and adolescents. A cross-sectional study was conducted, and 86 participants (aged 7–14 years; all males) were divided into two groups: a group with (n = 40) and without (n = 46) history of bronchiolitis. Muscle strength was assessed with handgrip and isometric quadriceps strength tests with handheld dynamometers and the five-times sit-to-stand test. Cardiorespiratory fitness was assessed with the six-minute walk test (6MWT). The Mann–Whitney test was used to compare the health-related physical fitness tests between groups and the binary logistic regression model was used to estimate the potential risk or protective factors in participants. No significant differences were observed between the groups in muscle strength tests. Participants without bronchiolitis walked a greater distance in the 6MWT than those with bronchiolitis (p = 0.002), and this appears to reproduce a protective factor in the group without bronchiolitis with an odds ratio of 0.99 [95% confidence interval: 0.98–0.99]. In this study, a history of bronchiolitis appears to influence cardiorespiratory fitness, but not muscle strength, in children and adolescents. Full article