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Petkus AJ, Jarrahi B, Holschneider DP, Gomez ME, Filoteo JV, Schiehser DM, Fisher BE, Van Horn JD, Jakowec MW, McEwen SC, Petzinger G. Thalamic volume mediates associations between cardiorespiratory fitness (VO 2max) and cognition in Parkinson's disease. Parkinsonism Relat Disord 2021; 86:19-26. [PMID: 33819900 DOI: 10.1016/j.parkreldis.2021.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Cognitive deficits occur in Parkinson's disease (PD). Cardiorespiratory fitness (CRF) is associated with better cognitive performance in aging especially in executive function (EF) and memory. The association between CRF and cognitive performance is understudied in people with PD. Brain structures underlying associations also remains unknown. This cross-sectional study examined the associations between CRF and cognitive performance in PD. We also examined associations between CRF and brain structures impacted in PD. Mediation analysis were conducted to examine whether brain structures impacted in PD mediate putative associations between CRF and cognitive performance. METHODS Individuals with PD (N = 33) underwent magnetic resonance imaging (MRI), CRF evaluation (estimated VO2max), and neuropsychological assessment. Composite cognitive scores of episodic memory, EF, attention, language, and visuospatial functioning were generated. Structural equation models were constructed to examine whether MRI volume estimates (thalamus and pallidum) mediated associations between CRF and cognitive performance (adjusting for age, education, PD disease duration, sex, MDS-UPDRS motor score, and total intracranial volume). RESULTS Higher CRF was associated with better episodic memory (Standardized β = 0.391; p = 0.008), EF (Standardized β = 0.324; p = 0.025), and visuospatial performance (Standardized β = 0.570; p = 0.005). Higher CRF was associated with larger thalamic (Standardized β = 0.722; p = 0.004) and pallidum (Standardized β = 0.635; p = 0.004) volumes. Thalamic volume mediated the association between higher CRF and better EF (Indirect effect = 0.309) and episodic memory (Indirect effect = 0.209) performance (p < 0.05). The pallidum did not significantly mediate associations between CRF and cognitive outcomes. CONCLUSION The thalamus plays an important role in the association between CRF and both EF and episodic memory in PD.
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Affiliation(s)
- Andrew J Petkus
- Department of Neurology, University of Southern California, 1520 San Pablo St., HCC-2, Suite 3000, Los Angeles, CA, 90033, USA.
| | - Behnaz Jarrahi
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, 94305, USA
| | - Daniel P Holschneider
- Department of Neurology, University of Southern California, 1520 San Pablo St., HCC-2, Suite 3000, Los Angeles, CA, 90033, USA; Department of Psychiatry and the Behavioral Sciences, University of Southern California, 1333 San Pablo St., Los Angeles, CA, 90033, USA
| | - Megan E Gomez
- Department of Psychology, Tibor Rubin Veterans Administration Medical Center, Long Beach, CA, 90822, USA
| | - J Vincent Filoteo
- Psychology and Research Services, Veterans Administration San Diego Health Care System, San Diego, CA, 92161, USA; Departments of Psychiatry and Neurosciences, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Dawn M Schiehser
- Psychology and Research Services, Veterans Administration San Diego Health Care System, San Diego, CA, 92161, USA; Departments of Psychiatry and Neurosciences, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Beth E Fisher
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, 90033, USA
| | - John D Van Horn
- Department of Psychology and School of Data Science, University of Virginia, Charlottesville, VA, 22904, USA
| | - Michael W Jakowec
- Department of Neurology, University of Southern California, 1520 San Pablo St., HCC-2, Suite 3000, Los Angeles, CA, 90033, USA
| | - Sarah C McEwen
- Department of Translational Neurosciences and Neurotherapeutics, Saint John's Cancer Institute, Santa Monica, CA, 90404, USA
| | - Giselle Petzinger
- Department of Neurology, University of Southern California, 1520 San Pablo St., HCC-2, Suite 3000, Los Angeles, CA, 90033, USA
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Mazzoni G, Myers J, Sassone B, Pasanisi G, Mandini S, Raisi A, Pizzolato M, Franchi M, Caruso L, Missiroli L, Chiaranda G, Grazzi G. A moderate 200-m walk test estimates peak oxygen uptake in elderly outpatients with cardiovascular disease. J Sports Med Phys Fitness 2020; 60:786-793. [PMID: 32438791 DOI: 10.23736/s0022-4707.20.10387-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND A moderate 1-km treadmill walk test (1k-TWT) has been demonstrated to be a valid tool for estimating peak oxygen uptake (VO2peak) in outpatients with cardiovascular disease (CVD). The results obtained by the 1k-TWT predict survival and hospitalization in men and women with CVD. We aimed to examine whether shorter versions of the full 1k-TWT equally assess VO2peak in outpatients with CVD. METHODS One hundred eighteen outpatients with CVD, aged 70±9 years, referred to an exercise-based secondary prevention program, performed a moderate and perceptually-regulated (11-13/20 on the Borg Scale) 1k-TWT. Age, height, weight, heart rate, time to walk 100-m, 200-m, 300-m, and 400-m, and the full 1000-m, were entered into equations to estimate VO2peak. RESULTS The minimal distance providing similar VO2peak results of the full 1k-TWT was 200-m: 23.0±5.3 mL/kg/min and 23.0±5.5 mL/kg/min, respectively. The concordance correlation coefficient between the two was 0.97 (95%CI 0.96 to 0.98, P<0.0001). The slope and the intercept of the relationship between the values obtained by the 200-m and the full 1k-TWT were not different from the line of identity. Bland-Altman analysis did not show systematic or proportional error. CONCLUSIONS A moderate 200-m treadmill-walk is a reliable method for estimating VO2peak in elderly outpatients with CVD. A 200-m walk enables quick and easy cardiorespiratory fitness assessment, with low costs and low burden for health professionals and patients. These findings have practical implications for the transition of patients from clinically-based programs to fitness facilities or self-guided exercise programs.
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Affiliation(s)
- Gianni Mazzoni
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy.,Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,Department of Public Health, AUSL Ferrara, Ferrara, Italy
| | - Jonathan Myers
- Division of Cardiology, VA Palo Alto Health Case System, Palo Alto, CA, USA.,Stanford University School of Medicine, Stanford, CA, USA
| | - Biagio Sassone
- Division of Cardiology, Department of Medicine, AUSL Ferrara, Ferrara, Italy
| | - Giovanni Pasanisi
- Division of Cardiology, Department of Medicine, AUSL Ferrara, Ferrara, Italy
| | - Simona Mandini
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy - .,Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Raisi
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy
| | - Matteo Pizzolato
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy
| | - Michele Franchi
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy
| | - Lorenzo Caruso
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Loretta Missiroli
- Unit of Bibliometric and Dataset, Research Office, University of Ferrara, Ferrara, Italy
| | - Giorgio Chiaranda
- Department of Public Health, AUSL Ferrara, Ferrara, Italy.,Department of Public Health and Integration Policy, Emilia-Romagna Region, Bologna, Italy
| | - Giovanni Grazzi
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy.,Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,Department of Public Health, AUSL Ferrara, Ferrara, Italy
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Impact of a Supervised Twelve-Week Combined Physical Training Program in Heart Failure Patients: A Randomized Trial. Cardiol Res Pract 2019; 2019:1718281. [PMID: 31637054 PMCID: PMC6766120 DOI: 10.1155/2019/1718281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/07/2019] [Accepted: 07/20/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to compare the effects of supervised combined physical training and unsupervised physician-prescribed regular exercise on the functional capacity and quality of life of heart failure patients. Methods This is a longitudinal prospective study composed of 28 consecutive heart failure with reduced ejection fraction patients randomly divided into two age- and gender-matched groups: trained group (n = 17) and nontrained group (n = 11). All patients were submitted to clinical evaluation, transthoracic echocardiography, the Cooper walk test, and a Quality of Life questionnaire before and after a 12-week study protocol. Categorical variables were expressed as proportions and compared with the chi-square test. Two-way ANOVA was performed to compare the continuous variables considering the cofactor groups and time of intervention, and Pearson correlation tests were conducted for the associations in the same group. Results No significant differences between groups were found at baseline. At the end of the protocol, there were improvements in the functional capacity and ejection fraction of the trained group in relation to the nontrained group (p < 0.05). There was time and group interaction for improvement in the quality of life in the trained group. Conclusions In patients with heart failure with reduced ejection fraction, supervised combined physical training improved exercise tolerance and quality of life compared with the unsupervised regular exercise prescribed in routine medical consultations. Left ventricular systolic function was improved with supervised physical training.
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Outdoor Reproducibility of a 1-km Treadmill Walking Test to Predict Peak Oxygen Uptake in Cardiac Patients. J Cardiopulm Rehabil Prev 2018; 37:347-349. [PMID: 28671933 DOI: 10.1097/hcr.0000000000000266] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The aim of this study was to determine whether the 1-km treadmill walking test, previously developed to predict peak oxygen uptake ((Equation is included in full-text article.)O2peak) in stable cardiac outpatients, could be reproduced outdoors. METHODS Fifty male cardiac outpatients performed the 1-km walking test on a treadmill and on a flat track within 1 week. (Equation is included in full-text article.)O2peak was estimated for both testing conditions considering age, height, weight, walking speed, and heart rate. RESULTS Average walking speed was slightly higher during outdoor conditions (5.73 ± 0.77 km/h vs 5.55 ± 0.84 km/h), whereas mean heart rates were similar for both testing conditions (102 ± 18 beats/min vs 103 ± 16 beats/min). (Equation is included in full-text article.)O2peak values for treadmill and outdoor tests were not significantly different (26.4 ± 4.1 mL/kg/min vs 26.8 ± 4.5 mL/kg/min) and were strongly correlated (r = 0.93, P < .0001). The slope and the intercept of the (Equation is included in full-text article.)O2peak values were not different from the line of identity. CONCLUSIONS This moderate and perceptually regulated 1-km walking test administered outdoors gives similar results compared with a similar test performed on a treadmill. Therefore, (Equation is included in full-text article.)O2peak can be reasonably estimated using both testing modalities. This suggests that the outdoor 1-km test can be applied for indirect estimations of cardiorespiratory fitness in an outpatient setting.
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Mazzoni G, Sassone B, Pasanisi G, Myers J, Mandini S, Volpato S, Conconi F, Chiaranda G, Grazzi G. A moderate 500-m treadmill walk for estimating peak oxygen uptake in men with NYHA class I-II heart failure and reduced left ventricular ejection fraction. BMC Cardiovasc Disord 2018; 18:67. [PMID: 29661150 PMCID: PMC5902976 DOI: 10.1186/s12872-018-0801-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 04/04/2018] [Indexed: 12/20/2022] Open
Abstract
Background Maximal cardiopulmonary exercise testing (CPX) is the gold-standard for cardiorespiratory fitness assessment in chronic heart failure (CHF) patients. However, high costs, required medical supervision, and safety concerns make maximal exercise testing impractical for evaluating mobility-impaired adults. Thus, several submaximal walking protocols have been developed and currently used to estimate peak oxygen consumption (VO2peak) in CHF patients. However, these tests have to be performed at close to maximum exercise intensity. The aim of this study was to examine the validity of a 500-m treadmill-walking test carried out at moderate intensity for estimating VO2peak in community-dwelling adult and elderly patients with CHF and reduced left ventricular ejection fraction (HFrEF). Methods Forty-three clinically stable men with HFrEF (age 67.7 ± 9.2 years, and left ventricular ejection fraction, LVEF 38% ± 6%) underwent exercise testing during an outpatient cardiac rehabilitation/secondary prevention program. Each patients completed a CPX, and a moderate and self-paced (11–13/20 on the Borg scale) 500-m treadmill-walking test. Age, weight, height, walk time, and heart rate during the 500-m test were entered into prediction equations previously validated for VO2peak estimation from a 1000-m walking test in patients with cardiovascular disease and preserved LVEF. Results Directly measured and estimated VO2peak values were not different (21.6 ± 4.9 vs 21.7 ± 4.6 mL/kg/min). The comparison between measured and estimated VO2peak values yielded a correlation of R = 0.97 (SEE = 0.7 mL/kg/min, P < 0.0001). The slope and the intercept coincided with the line of identity (Passing and Bablock analysis, P = 0.50). Residuals were normally distributed, and the examination of the Bland-Altman analysis do not show systematic or proportional error. Conclusions A moderate and self-regulated 500-m treadmill-walking test is a valid tool for VO2peak estimation in patients with HFrEF. These findings may have practical implications in the context of transitioning from clinically based programs to fitness facilities or self-guided exercise programs in adults and elderly men with HFrEF. Electronic supplementary material The online version of this article (10.1186/s12872-018-0801-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gianni Mazzoni
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,Public Health Department, AUSL Ferrara, Ferrara, Italy
| | - Biagio Sassone
- Department of Medicine, Division of Cardiology, Cento Hospital, AUSL Ferrara, Ferrara, Italy
| | - Giovanni Pasanisi
- Department of Medicine, Division of Cardiology, "Delta" Hospital, AUSL Ferrara, Ferrara, Italy
| | - Jonathan Myers
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Stanford University School of Medicine, Stanford, CA, USA
| | - Simona Mandini
- Center of Biomedical Studies Applied to Sport, University of Ferrara, via Gramicia 35 -, 44123, Ferrara, Italy.
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Francesco Conconi
- Center of Biomedical Studies Applied to Sport, University of Ferrara, via Gramicia 35 -, 44123, Ferrara, Italy
| | - Giorgio Chiaranda
- General Directorship for Public Health and Integration Policy, Emilia-Romagna Region, Bologna, Italy
| | - Giovanni Grazzi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,Public Health Department, AUSL Ferrara, Ferrara, Italy
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Oza N, Takahashi H, Eguchi Y, Kitajima Y, Kuwashiro T, Ishibashi E, Nakashita S, Iwane S, Kawaguchi Y, Mizuta T, Ozaki I, Ono N, Eguchi T, Fujimoto K, Anzai K. Efficacy of ezetimibe for reducing serum low-density lipoprotein cholesterol levels resistant to lifestyle intervention in patients with non-alcoholic fatty liver disease. Hepatol Res 2014; 44:812-7. [PMID: 23721476 DOI: 10.1111/hepr.12176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 05/09/2013] [Accepted: 05/27/2013] [Indexed: 02/08/2023]
Abstract
AIM To investigate the efficacy of ezetimibe and lifestyle intervention for treating patients with non-alcoholic fatty liver disease (NAFLD) and residual dyslipidemia via a combination of ezetimibe and lifestyle intervention. METHODS Patients with NAFLD with residual dyslipidemia after a 6-month lifestyle intervention program were included. After completion of the 6-month program, the patients received p.o. administration of ezetimibe at 10 mg/day, in addition to lifestyle intervention, for 6 months. RESULTS Of the 59 patients with NAFLD who had participated in the 6-month lifestyle intervention program between 2007 and 2012, 21 with residual dyslipidemia (10 males and 11 females) were enrolled. Median age was 58 years (range, 27-75), median bodyweight was 63.0 kg (range, 39.4-109.0), median body mass index was 25.4 kg/m2 (range, 18.2-37.1), median alanine aminotransferase was 23 IU/L (14-73), median high-density lipoprotein (HDL) was 58 mg/dL (range, 37-93), median triglycerides (TG) was 105 mg/dL (range, 42-216) and median low-density lipoprotein (LDL) was 153 (66-209) mg/dL. After 6 months of treatment with ezetimibe, serum LDL levels were improved in 15 of 20 (75%) patients (P = 0.0015), while no improvements were observed in the remaining five patient (25%). Ezetimibe was discontinued in one patient who developed skin rash. CONCLUSION Ezetimibe is effective for treating residual dyslipidemia after lifestyle intervention in patients with NAFLD.
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Affiliation(s)
- Noriko Oza
- Department of Internal Medicine, Saga Medical School, Nabeshima, Japan
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Sartor F, Vernillo G, de Morree HM, Bonomi AG, La Torre A, Kubis HP, Veicsteinas A. Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings. Sports Med 2014; 43:865-73. [PMID: 23821468 DOI: 10.1007/s40279-013-0068-3] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Assessment of the functional capacity of the cardiovascular system is essential in sports medicine. For athletes, the maximal oxygen uptake [Formula: see text] provides valuable information about their aerobic power. In the clinical setting, the (VO(2max)) provides important diagnostic and prognostic information in several clinical populations, such as patients with coronary artery disease or heart failure. Likewise, VO(2max) assessment can be very important to evaluate fitness in asymptomatic adults. Although direct determination of [VO(2max) is the most accurate method, it requires a maximal level of exertion, which brings a higher risk of adverse events in individuals with an intermediate to high risk of cardiovascular problems. Estimation of VO(2max) during submaximal exercise testing can offer a precious alternative. Over the past decades, many protocols have been developed for this purpose. The present review gives an overview of these submaximal protocols and aims to facilitate appropriate test selection in sports, clinical, and home settings. Several factors must be considered when selecting a protocol: (i) The population being tested and its specific needs in terms of safety, supervision, and accuracy and repeatability of the VO(2max) estimation. (ii) The parameters upon which the prediction is based (e.g. heart rate, power output, rating of perceived exertion [RPE]), as well as the need for additional clinically relevant parameters (e.g. blood pressure, ECG). (iii) The appropriate test modality that should meet the above-mentioned requirements should also be in line with the functional mobility of the target population, and depends on the available equipment. In the sports setting, high repeatability is crucial to track training-induced seasonal changes. In the clinical setting, special attention must be paid to the test modality, because multiple physiological parameters often need to be measured during test execution. When estimating VO(2max), one has to be aware of the effects of medication on heart rate-based submaximal protocols. In the home setting, the submaximal protocols need to be accessible to users with a broad range of characteristics in terms of age, equipment, time available, and an absence of supervision. In this setting, the smart use of sensors such as accelerometers and heart rate monitors will result in protocol-free VO(2max) assessments. In conclusion, the need for a low-risk, low-cost, low-supervision, and objective evaluation of VO(2max) has brought about the development and the validation of a large number of submaximal exercise tests. It is of paramount importance to use these tests in the right context (sports, clinical, home), to consider the population in which they were developed, and to be aware of their limitations.
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Affiliation(s)
- Francesco Sartor
- Personal Health Solutions, Philips Research, High Tech Campus 34, P.O. Box WB61, 5656 AE Eindhoven, The Netherlands.
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Sun WH, Song MQ, Jiang CQ, Xin YN, Ma JL, Liu YX, Ma L, Lin ZH, Li CY, Liu L, Zhang M, Chu LL, Jiang XJ, Wan Q, Zhou L, Ren R, Meng LF. Lifestyle intervention in non-alcoholic fatty liver disease in Chengyang District, Qingdao, China. World J Hepatol 2012; 4:224-30. [PMID: 22855698 PMCID: PMC3409357 DOI: 10.4254/wjh.v4.i7.224] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Revised: 06/20/2012] [Accepted: 07/21/2012] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the effect of a 6 and 12 mo lifestyle modification intervention in nonalcoholic fatty liver diseases (NAFLD) in Chengyang District of Qingdao. METHODS Participants with NAFLD who had resided in Chengyang District for more than 5 years were enrolled in this study. After the 6 and 12 mo lifestyle modification intervention based on physical activity, nutrition and behavior therapy, parameters such as body weight, body mass index (BMI), waist circumference, serum alanine aminotransferase (ALT), aspartate aminotransferase values, serum cholesterol, triglycerides, fasting glucose, fasting insulin and visceral fat area (VFA), the liver-spleen ratio and the homeostasis model assessment of insulin resistance (HOMA-IR) were evaluated and compared between participants with and without the intervention. RESULTS Seven hundred and twenty-four participants were assigned to the lifestyle intervention group (LS) and 363 participants were assigned to the control group (CON). After the intervention, body weights in the LS group were significantly decreased compared to those in the CON group at 6 mo (11.59% ± 4.7% vs 0.4% ± 0.2%, P = 0.001) and at 12 mo (12.73% ± 5.6% vs 0.9% ± 0.3%, P = 0.001). Compared with the CON group, BMI was more decreased in the LS group after 6 and 12 mo (P = 0.043 and P = 0.032). Waist circumference was more reduced in the LS group than in CON (P = 0.031 and P = 0.017). After the 6 and 12 mo intervention, ALT decreased significantly in the LS group (P = 0.003 and P = 0.002). After 6 and 12 mo, the metabolic syndrome rate had decreased more in the LS group compared with the CON group (P = 0.026 and P = 0.017). After 12 mo, the HOMA-IR score decreased more obviously in the LS group (P = 0.041); this result also appeared in the VFA after 12 mo in the LS group (P = 0.035). CONCLUSION Lifestyle intervention was effective in improving NAFLD in both 6 and 12 mo interventions. This intervention offered a practical approach for treating a large number of NAFLD patients in the Chengyang District of Qingdao.
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Affiliation(s)
- Wei-Hui Sun
- Wei-Hui Sun, Jian-Lin Ma, Ying-Xun Liu, Lei Ma, Qiang Wan, Lin Zhou, Rong Ren, Ling-Fang Meng, Hepatology Department, Qingdao Chengyang People's Hospital, Qingdao 266100, Shandong Province, China
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Williams K, Frei A, Vetsch A, Dobbels F, Puhan MA, Rüdell K. Patient-reported physical activity questionnaires: a systematic review of content and format. Health Qual Life Outcomes 2012; 10:28. [PMID: 22414164 PMCID: PMC3349541 DOI: 10.1186/1477-7525-10-28] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 03/13/2012] [Indexed: 01/24/2023] Open
Abstract
Background Many patients with chronic illness are limited in their physical activities. This systematic review evaluates the content and format of patient-reported outcome (PRO) questionnaires that measure physical activity in elderly and chronically ill populations. Methods Questionnaires were identified by a systematic literature search of electronic databases (Medline, Embase, PsychINFO & CINAHL), hand searches (reference sections and PROQOLID database) and expert input. A qualitative analysis was conducted to assess the content and format of the questionnaires and a Venn diagram was produced to illustrate this. Each stage of the review process was conducted by at least two independent reviewers. Results 104 questionnaires fulfilled our criteria. From these, 182 physical activity domains and 1965 items were extracted. Initial qualitative analysis of the domains found 11 categories. Further synthesis of the domains found 4 broad categories: 'physical activity related to general activities and mobility', 'physical activity related to activities of daily living', 'physical activity related to work, social or leisure time activities', and '(disease-specific) symptoms related to physical activity'. The Venn diagram showed that no questionnaires covered all 4 categories and that the '(disease-specific) symptoms related to physical activity' category was often not combined with the other categories. Conclusions A large number of questionnaires with a broad range of physical activity content were identified. Although the content could be broadly organised, there was no consensus on the content and format of physical activity PRO questionnaires in elderly and chronically ill populations. Nevertheless, this systematic review will help investigators to select a physical activity PRO questionnaire that best serves their research question and context.
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Affiliation(s)
- Kate Williams
- Patient Reported Outcomes Centre of Excellence, Global Market Access, Primary Care Business Unit, Pfizer Ltd, Walton Oaks, Surrey, UK
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Orosia Lucha-López M, Carmen Lucha-López A, Vidal-Peracho C, Miguel Tricás-Moreno J, Estebanez-De Miguel E, Salavera-Bordás C, Hidalgo-García C, Caudevilla-Polo S. Impact of Supervised Physiotherapeutic Exercises for Obese Adults with Diabetes Mellitus Type 2. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.1299] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Oza N, Eguchi Y, Mizuta T, Ishibashi E, Kitajima Y, Horie H, Ushirogawa M, Tsuzura T, Nakashita S, Takahashi H, Kawaguchi Y, Oda Y, Iwakiri R, Ozaki I, Eguchi T, Ono N, Fujimoto K. A pilot trial of body weight reduction for nonalcoholic fatty liver disease with a home-based lifestyle modification intervention delivered in collaboration with interdisciplinary medical staff. J Gastroenterol 2010; 44:1203-8. [PMID: 19728009 DOI: 10.1007/s00535-009-0115-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 07/27/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome. The aim of this study was to evaluate a 6-month home-based lifestyle modification intervention delivered in collaboration with physicians, hygienists, registered dietitians, and nurses. METHODS Outpatients with NAFLD diagnosed by abdominal ultrasonography were eligible for this study. Abdominal computed tomography (CT) scan evaluated liver fat deposition by the liver-spleen ratio (L/S ratio) and visceral fat accumulation as the visceral fat area (VFA; cm(2)). During the 6-month home-based lifestyle modification intervention, each patient was examined by physicians, nurses, hygienists, and registered dietitians, who provided individualized advice to the patients. Patients recorded their daily weight for self-control of weight with recommended diet and exercise regimens. RESULTS Sixty-seven NAFLD patients were enrolled in this study and 22 patients (32.8%) completed the 6-month intervention. Nineteen of the 22 patients achieved significant improvements in body weight, body mass index (BMI), waist circumference, VFA, L/S ratio, and systolic blood pressure, with improved laboratory data. Overall, 39 patients withdrew from the intervention. The mean age of the patients who withdrew was 50.0 +/- 11.0 years, which was significantly younger than that of the patients who were followed up (60.1 +/- 10.1 years; P < 0.01). CONCLUSIONS The reduction in body weight achieved by NAFLD patients during the 6-month intervention was associated with improved fat deposition and liver function. This intervention offers a practical approach for treating a large number of NAFLD patients with lifestyle modification therapy.
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Affiliation(s)
- Noriko Oza
- Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan
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CAO ZHENBO, MIYATAKE NOBUYUKI, HIGUCHI MITSURU, TABATA IZUMI. DEVELOPMENT OF VO2max PREDICTION MODELS FROM 3-MINUTE WALK TEST. ACTA ACUST UNITED AC 2009. [DOI: 10.7600/jspfsm.58.527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nakajima K, Kusuhara M, Yonemura A, Ayaori M, Saionji K, Tamai S, Ohsuzu F. Increasing physical fitness does not proportionally decrease circulating C-reactive protein level in men with varying fitness. Metabolism 2008; 57:650-657. [PMID: 18442628 DOI: 10.1016/j.metabol.2007.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 12/13/2007] [Indexed: 01/03/2023]
Abstract
Several studies have shown that low physical fitness is associated with high levels of C-reactive protein (CRP), a marker of future cardiovascular events. However, whether increasing physical fitness proportionally decreases the circulating CRP level has not been evaluated. We first evaluated the basic relationship between physical fitness, assessed by running velocity, and circulating CRP level along with cardiovascular risk factors in 1065 healthy middle-aged men. Afterward, we examined the association between annual change in fitness and changes in CRP level in 482 subjects who had the same parameters measured 1 year later without any intervention. In the cross-sectional study, physical fitness was significantly correlated with circulating CRP level (r=0.28, P<.0001). This significance still remained after adjustment for other cardiovascular risks (beta=-.12, P=.0004). In the follow-up study, several variables, including CRP, were significantly improved (CRP geometric mean, from 0.35 to 0.26 mg/L; P<.001). Improvements in fitness did not reach statistical difference (P=.067). Annual change in CRP was significantly correlated with creatinine kinase level 1 year later (r=0.16, P=.004) and with annual changes in some other risks, but not with annual change in fitness. When follow-up subjects were divided into tertiles according to increase in fitness, the greatest reduction in CRP was found in subjects with mildly increased fitness and favorable risk profiles (n=159; CRP geometric mean, from 0.35 to 0.21 mg/L; P<.0001), but not in those with moderately to highly increased fitness (n=113; geometric mean, from 0.36 to 0.28 mg/L; P=.03). In conclusion, although physical fitness was significantly associated with circulating CRP level in a cross-sectional study, increasing fitness did not proportionally decrease circulating CRP level. Improving coincidental risks, relieving intensity of exercise-induced muscle damage, or both, in addition to increasing fitness, might be important to effectively reduce CRP level.
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Affiliation(s)
- Kei Nakajima
- First Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Japan.
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Iriberri M, Gáldiz JB, Gorostiza A, Ansola P, Jaca C. Comparison of the distances covered during 3 and 6 min walking test. Respir Med 2002; 96:812-6. [PMID: 12412981 DOI: 10.1053/rmed.2002.1363] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS To determine the reproducibility of the distance covered in 3 min and its correlation with the 6 min walking test, as well as compare the distances covered at different time intervals. Secondly, to evaluate the relationship between the distances covered during these time periods and the maximum oxygen intake obtained during a bicycle ergometer test. METHODS Forty-five Chronic Obstructive Pulmonary Disesase patients were included in the study. Subjects who were either physically limited or familiar with the test, or those with acute exacerbation in the month prior to the study, were excluded. Three walking tests were carried out each day. In 30 patients for three consecutive days, and the distances covered in periods of 3 and 6 min were measured with 20 min rest between each walk. No incentive was given and the patients knew that the distances covered in 3 and 6 min would be quantified. Oxygen saturation, heart rate and degree of breathlessness (modified Borg scale) were registered at baseline. After 3 min, the distance covered and degree of breathlessness were also measured. After 6 min, oxygen saturation, heart rate, degree of breathlessness and distance covered in meters were registered. Spirometry was performed daily on each patient, and those with an FEV1 variation of less than 10% were considered clinically and functionally stable. An exercise test using bicycle ergometer was carried out to determine maximum oxygen intake. A 3 min walking test was performed in 15 patients, independently on the same day, which was followed after 20 min rest with a 6 min walking test. RESULTS A significant increase was observed in the distance covered over 3 and 6 min in the first 5 walks, with the greatest increase seen in the first 3 walks. The correlation between the distance covered in 3 and 6 min was 0.98. The correlation between the distance covered in 3 min and oxygen intake was 0.64. No significant differences were observed between the distances covered in the 0-3 and 3 to 6 min periods. During the walking test, breathlessness was measured using the modified Borg scale, which was 1.8 after 3 min, and 3.2 after six min and 8.6 at the end of bicycle ergometer test. No significant differences were observed between the distance covered during the 3 minute test and the distance in the first 3 min of the 6 min walking test. CONCLUSIONS A learning effect was observed when the walking test is carried out repeatedly over short time periods, with a significant increase in the first 5 walks. Correlation between the distances covered in 3 and 6 min is very good, and acceptable when the distance covered over these periods is compared with oxygen intake and walking speed is constant.
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Affiliation(s)
- Milagros Iriberri
- Unit of Respiratory Pathology, Cruces Hospital, Baracaldo, Basque Country, Spain.
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Nakagaichi M, Lee MS, Tanaka K. Accuracy of two simple methods for the assessment of health-related physical fitness. Percept Mot Skills 2001; 92:37-49. [PMID: 11322604 DOI: 10.2466/pms.2001.92.1.37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We have developed a useful equation for estimating health-related physical fitness age. This version of health-related fitness age was developed as an extension of the biological age index and is useful for evaluation of individual differences in functional abilities of middle-aged and older adults. This measure consists of 4 independent variables fitness (VO2 max, standing trunk flexibility, %fat, and grip strength). However, direct measurement of maximal oxygen uptake (VO2 max) is an invasive clinical procedure and not practical for large scale work. In the current study, we attempted to assess the fitness age more feasibly. We selected a questionnaire method and a 12-min. submaximal treadmill walk test as substitutes for the VO2 max test. The three fitness ages were computed for 23 Japanese men (M(age) 54.7 +/- 10.7 yr.), using actual VO2 max (actual fitness age), questionnaire VO2 max (predicted questionnaire fitness age), and treadmill VO2 max (predicted treadmill fitness age). Predicted questionnaire fitness age (61.0 +/- 10.5 yr.) and predicted treadmill fitness age (60.0 +/- 12.4 yr.) were significantly correlated with actual fitness age (60.1 +/- 12.4 yr.) (r= .96 and .97, respectively). There were no significant differences among the three indices, but there was a significant difference between actual fitness age and chronological age (p<.05). For VO+/-2 max substituting the questionnaire for the treadmill estimate is acceptable in assessing fitness age and reducing the clinical risk for middle-aged and older Japanese men.
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Affiliation(s)
- M Nakagaichi
- Institute of Health and Sport Sciences, Center for Tsukuba Advanced Research Alliance, Ibaraki, Japan.
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