共查询到20条相似文献，搜索用时 31 毫秒
1.
Purpose
Following a cardiac event patients are at risk for deficits in mobility and function. However, measures of physical performance are not commonly used and have not been extensively studied in patients enrolled in cardiac rehabilitation. The purpose of this study was to determine the reliability and the minimal detectable change (MDC) of gait speed, 5 times sit to stand (5 STS) and hand grip strength for individuals enrolled in cardiac rehabilitation.Methods
Forty-nine individuals enrolled in phase II or III cardiac rehabilitation participated in the study. Gait speed, 5 STS, and hand grip strength were measured over two sessions held on the same day. Intraclass correlation coefficient was used to determine reliability and MDC95 was calculated to measure responsiveness.Results
All 3 measures showed high reliability (ICC for gait speed = 0.96, 5 STS = 0.87, right hand grip strength = 0.97, left hand grip strength = 0.97). The MDC95 for gait speed was 0.16 meters/second, 3.12 seconds for 5 STS, 5.2 kilograms for right and 5.1 kilograms for left hand grip strength.Conclusion
Gait speed, 5 STS, and hand grip strength are reliable and responsive measures for patients in cardiac rehabilitation. Findings support their use in clinical practice and future cardiac rehabilitation studies.Key Words: cardiac rehabilitation, gait speed, sit to stand 相似文献2.
Michael J. Shoemaker Amy B. Curtis Eric Vangsnes Michael G. Dickinson 《Cardiopulmonary Physical Therapy Journal》2012,23(3):5-15
Purpose
The purpose of the present review was to use existing, published data to provide an estimate of the amount of change in six-minute walk test distance (Δ6MWT) that represents a clinically meaningful change in individuals with chronic heart failure (CHF).Methods
The present review included two separate literature searches of the CINAHL and Medline databases for articles that: (1) reported the intraclass correlation coefficient (ICC) of the 6MWT in individuals with CHF, and (2) used the 6MWT along with either aerobic capacity or health-related quality of life (HRQL) as study endpoints in randomized controlled trials (RCTs) of exercise-based intervention for individuals with CHF. The ICCs were used to calculate the minimum detectable difference (MDD) at the 95% confidence interval for each included study. The Δ6MWT associated with aerobic capacity and HRQL within-group effect sizes for the intervention and control groups in each included RCT was analyzed using receiver operating characteristic (ROC) curves.Results
Thirteen articles reported the ICC for the 6MWT. The mean (standard deviation) MDD calculated based on these data was 43.1(16.8) m. Eighteen RCTs measured the 6MWT and either aerobic capacity and/or HRQL. A Δ6MWT of 40–45 m was associated with at least moderate aerobic capacity and HRQL effect sizes in the intervention groups. The Δ6MWT thresholds that discriminated between intervention and control groups using ROC curves revealed the following sensitivity/specificity for the respective thresholds: 19 m, 94.4/83.3%, 32 m, 83.3/94.4%, and 48 m 44.4/100% (AUC = .935, p = .009, CI95% .855, 1.015).Conclusions
A Δ6MWT of approximately 45 m appears to exceed measurement error and be associated with significant changes in either aerobic capacity and/or HRQL.Key Words: heart failure, six-minute walk test, clinically meaningful change, minimum detectable difference 相似文献3.
Neeti Pathare Esther M. Haskvitz Marjane Selleck 《Cardiopulmonary Physical Therapy Journal》2012,23(4):12-18
PURPOSE
The primary purpose of this study was to investigate 6-minute walk test (6MWT) performance in young children who were normal weight (NW) and overweight (OW).METHODS
Seventy children, 5-9 years of age, participated in this study. The 6MWT was performed on an indoor walkway. Heart rate (HR), blood pressure (BP), and oxygen saturation (SaO2) were measured. A self-reported physical activity questionnaire was completed by a parent/guardian. Data were analyzed with independent t tests, ANOVA, correlation analyses, and logistic regression.RESULTS
The systolic BP values were higher in the children who were OW compared with their NW peers (resting mean 104.1 (8.9) mmHg vs. 97.5 (7.8) mmHg, P < 0.05; post-6WMT: mean 118.4 (10.78) mmHg vs. 109.9 (9.1) mmHg, P < 0.05). The SaO2 values were lower in the children who were OW compared to their NW counterparts (resting: mean 97.2 (1.1) % vs. 98.0 (1.0) %, P < 0.05; post-6WMT: mean 96.8 (1.0) % vs. 97.7 (1.0) %, P < 0.05).CONCLUSIONS
The children who were OW had higher systolic BP and lower SaO2 levels at rest and post-6WMT. More research is needed to determine if these differences contribute to children who are OW having difficulty performing exercise.Key Words: obesity, children, exercise capacity 相似文献4.
Michael J. Shoemaker Amy B. Curtis Eric Vangsnes Michael G. Dickinson 《Cardiopulmonary Physical Therapy Journal》2013,24(3):21-29
Purpose
The purpose of the present pilot study was to provide a preliminary estimate of the minimum detectable difference (MDD) and minimum clinically important difference (MCID) of the six-minute walk test (6MWT) and daily activity in outpatients with chronic heart failure (CHF).Methods
A convenience sample of 22 adults with stable New York Heart Association Functional Class II and III CHF performed two baseline 6MWTs separated by 30 minutes of rest. Subjects then wore a triaxial accelerometer for 7 days to monitor daily activity. After 7 weeks of usual care, subjects again wore the accelerometer for 7 days and then returned to the clinic to complete the Global Rating of Change Scale (GRS) with regard to their heart disease and perform another set of 6MWTs. For the 6MWT, the MDD was calculated using the two baseline 6MWT distances. For daily activity, the MDD was calculated using two methods: (1) day-to-day test-retest reliability during baseline monitoring, and (2) baseline to follow-up test-retest reliability in those who reported no change on the GRS. The MCID for the 6MWT and daily activity was calculated using the mean and 95% confidence interval (CI95%) for those subjects who reported ‘improvement’ on the GRS.Results
The MDD at the CI95% for the 6MWT was 32.4 meters. The MCID for the 6MWT was 30.1 (CI95% 20.8, 39.4) meters. The MDD for daily activity was 5,909 vector magnitude units (VMU·hr.−1) The MCID for daily activity was 1,337 VMU·hr.−1 There was good alignment of the MDD and MCID for the 6MWT, suggesting that clinically meaningful change is approximately 32 meters. However, the calculated MCID was substantially less than measurement error as represented by the MDD, indicating that the MCID was underestimated in this sample or that daily activity may be robust to change in overall disease status.Key Words: six-minute walk test, daily activity, heart failure, clinically meaningful change 相似文献5.
Gayle L. Flo Robb W. Glenny Peter J. Kudenchuk Cynthia M. Dougherty 《Cardiopulmonary Physical Therapy Journal》2012,23(3):16-22
Purpose
Performing exercise tests in patients with an implantable cardioverter defibrillator (ICD) presents specific challenges because of susceptibility to ventricular arrhythmias during maximal levels of exertion. The purpose of this paper is to outline the exercise testing protocol from the Anti-Arrhythmic Effects of Exercise after an ICD trial and to report baseline test results and safety outcomes using the protocol.Methods and Results
Maximal cardiopulmonary exercise testing was performed to assess levels of physical fitness as part of a randomized trial of walking exercise in patients with ICDs. Subjects were randomized after baseline testing to aerobic exercise plus usual care or usual care alone. A modified Balke treadmill exercise test was used and specific ICD programming procedures were implemented to avoid unnecessary shocks, which included programming off ventricular tachycardia (VT) therapies during testing. To date, 161 baseline tests have been performed. One ventricular fibrillation (VF) cardiac arrest occurred following completion of an exercise test and three tests were stopped by the investigators due to nonsustained ventricular tachycardia. Eleven subjects were not able to achieve maximum exercise, defined as reaching an anaerobic threshold (AT) at baseline testing. There have been no deaths as a result of exercise testing.Conclusions
Symptom-limited maximal exercise testing can be performed safely and effectively in patients with ICDs for both primary and secondary prevention indications. Specific strategies for ICD programming and preparation for treating ventricular arrhythmias needs to be in place before exercise testing is performed.Key Words: implanted cardioverter defibrillator, exercise testing, treadmill protocol 相似文献6.
7.
Lissa M. Spencer Jennifer A. Alison Zoe J. McKeough 《Cardiopulmonary Physical Therapy Journal》2013,24(3):30-35
Purpose
To determine the opinions and attitudes toward exercise in people with chronic obstructive pulmonary disease (COPD) who had completed a randomised controlled trial of 12-months maintenance exercise.Methods
Participants were eligible for recruitment to the maintenance exercise study if they had COPD and had completed an 8-week pulmonary rehabilitation program. They were randomized into an Intervention Group (IG) that consisted of once weekly, supervised hospital-based maintenance exercise plus home exercise for 12 months or a Control Group that undertook unsupervised home maintenance exercise for 12 months. At the end of the 12 months, participants completed a survey consisting of 23 questions using a visual analogue scale (VAS) of 100 mm.Results
Forty-eight participants completed the 12 month study and 36 participants (75%) completed the survey [IG mean (SD): age 65 (8) years, FEV1 58 (20) % predicted; CG: age 66 (8) years, FEV1 67 (17) % predicted]. No between group difference was found for the importance of exercise, the benefits of the program or the importance of support from the physiotherapist. However, the IG reported exercising more regularly, having more enjoyment of being involved in the maintenance exercise program, greater benefit in general well-being, and better physical fitness.Conclusions
At the completion of the 12 month exercise study, the survey results showed that all participants reported positive attitudes towards both supervised and unsupervised maintenance exercise programs, with the IG reporting greater benefits.Key Words: COPD, survey, maintenance exercise program 相似文献8.
9.
10.
Christiane Perme Theresa Nalty Chris Winkelman Ricardo Kenji Nawa Faisal Masud 《Cardiopulmonary Physical Therapy Journal》2013,24(2):12-17
Introduction
There are limited data describing mobility interventions provided to patients with femoral catheters. The purpose of this study was to examine the incidence of femoral catheter related adverse effects during physical therapy (PT) sessions in a cardiovascular intensive care unit (ICU).Methods
This was a prospective, observational study and included patients with at least one femoral catheter. Data were collected after each PT session.Results
There were 77 subjects with a total of 92 femoral catheters (50 arterial, 15 central venous, and 27 dialysis) treated. A total of 210 separate PT sessions occurred with 630 mobility activities including sitting on side of bed, standing at the bedside, transfers to stretcher chair or regular chair, and walking. There were no catheter related mechanical or thrombotic complications during any of the PT sessions.Conclusions
Physical therapy sessions, including standing and walking were feasible and safe in cardiovascular ICU patients with femoral catheters who met the criteria for mobility interventions. The results from this study support the hypothesis that early mobilization in patients with femoral catheters is important to minimize functional decline and provide evidence that the presence of femoral catheters alone should not be a reason to limit progressive mobility interventions.Key Words: physical therapy, ICU, early mobilization, femoral catheter 相似文献11.
Joseph F. Norman Bunny J. Pozehl Kathleen A. Duncan Melody A. Hertzog Steven K. Krueger 《Cardiopulmonary Physical Therapy Journal》2012,23(4):19-25
Purpose
The purpose of this study was to compare an Exercise Training Group (EX) with an Attention-Control Group (AT-C) to more specifically assess the impact of exercise training on individuals with heart failure (HF).Methods
Forty-two individuals with HF were randomized to AT-C or EX that met with the same frequency and format of investigator interaction. Baseline, 12- and 24-week measurements of B-type naturetic peptide (BNP), 6-minute walk test (6-MWT), and the Kansas City Cardiomyopathy Questionnaire (KCCQ) were obtained.Results
BNP tended to increase in the AT-C while remaining stable in the EX over time. A clinically significant increase in 6-MWT was demonstrated by the EX but not the AT-C. The EX achieved a clinically significant change on the KCCQ at 12 weeks, with further improvement by 24 weeks, while the AT-C demonstrated a clinically significant change at 24 weeks.Conclusions
Attention alone was inadequate to positively impact BNP levels or 6-MWT distances, but did have a positive impact on quality of life after 24 weeks. Although exercise offers enhanced benefits, individuals with HF unable to participate in an exercise program may still gain quality of life benefits from participation in a peer-support group that discusses topics pertinent to HF.Key Words: heart failure, attention, exercise 相似文献12.
Anna E. Mattlage Abigail L. Ashenden Angela A. Lentz Michael A. Rippee Sandra A. Billinger 《Cardiopulmonary Physical Therapy Journal》2013,24(3):14-20
Purpose
Reduced cardiovascular fitness post-stroke may negatively impact recovery. There is little information regarding exercise testing performance and cardiorespiratory response to an aerobic exercise intervention in subacute stroke. The purpose of this study was to examine cardiorespiratory response in subacute stroke after an 8-week aerobic exercise intervention using a total body recumbent stepper (TBRS).Methods
Nine individuals with mean age 61.2 (SD 4.7) years and mean 66.7 (SD 41.5) days post-stroke completed the exercise intervention. Participants had a mean Fugl-Meyer score of 100.3 (SD 29.3). Outcome measures were obtained at baseline and postintervention. A peak exercise test using a TBRS assessed oxygen consumption, heart rate, and minute ventilation. Participants completed an 8-week exercise intervention on a recumbent stepper 3 times per week at a prescribed heart rate intensity.Results
Submaximal VO2 was significantly lower from baseline to postintervention with a main effect of Study Visit (F1,8 = 8.5, p = 0.02). Heart rate was not significantly different pre- to postintervention. Minute ventilation exhibited no main effect of Study Visit or Test Minute.Conclusion
Moderate-high intensity aerobic exercise in subacute stroke appears to be beneficial for improving cardiovascular outcomes during submaximal performance of an exercise test.Key Words: oxygen uptake, cerebrovascular accident, cardiovascular fitness, submaximal exercise 相似文献13.
I Anne Leditschke Margot Green Joelie Irvine Bernie Bissett Imogen A. Mitchell 《Cardiopulmonary Physical Therapy Journal》2012,23(1):26-29
Purpose
Recently there has been increased interest in early mobilization of critically ill patients. Proposed benefits include improvements in respiratory function, muscle wasting, intensive care unit (ICU), and hospital length of stay. We studied the frequency of early mobilization in our intensive care unit in order to identify barriers to early mobilization.Methods
A 4-week prospective audit of 106 patients admitted to a mixed medical-surgical tertiary ICU (mean age 60 ± 20 years, mean APACHE II score 14.7 ± 7.8) was performed. Outcome measures included number of patient days mobilized, type of mobilization, adverse events, and reasons for inability to mobilize.Results
Patients were mobilized on 176 (54%) of 327 patient days. Adverse events occurred in 2 of 176 mobilization episodes (1.1%). In 71 (47%) of the 151 patient days where mobilization did not occur, potentially avoidable factors were identified, including vascular access devices sited in the femoral region, timing of procedures and agitation or reduced level of consciousness.Conclusions
Critically ill patients can be safely mobilized for much of their ICU stay. Interventions that may allow more patients to mobilize include: changing the site of vascular catheters, careful scheduling of procedures, and improved sedation management.Key Words: intensive care units, mobility, physical therapy 相似文献14.
15.
16.
Purpose
The purpose of this review is to evaluate the literature related to mobilization of the critically ill patient with an emphasis on functional outcomes and patient safety.Methods
We searched the electronic databases of PubMed, CINAHL, Medline (Ovid), and The Cochrane Library for a period spanning 2000–2011. Articles used in this review included randomized and nonrandomized clinical trials, prospective and retrospective analyses, and case series in peer-reviewed journals. Sackett''s Levels of Evidence were used to classify the current literature to evaluate the strength of the outcomes reported.Results
Fifteen studies met inclusion criteria and were reviewed. According to Sackett''s Levels of Evidence, 9 studies were level 4 evidence, one study was level 3, 4 studies were level 2, and one study was level one evidence. Ten studies pertained to patient safety/feasibility and 10 studies pertained to functional outcomes with 5 fitting into both categories.Conclusion
A search of the scientific literature revealed a limited number of studies that examined the mobilization of critically ill patients in the intensive care unit. However, literature that does exist supports early mobilization and physical therapy as a safe and effective intervention that can have a significant impact on functional outcomes.Key Words: mobilization, exercise, intensive care unit, critical illness, physical therapy 相似文献17.
Suh-Jen Lin Jessica McElfresh Benjamin Hall Rachel Bloom Kellie Farrell 《Cardiopulmonary Physical Therapy Journal》2012,23(3):29-36
Purpose
The purpose of this review was to assess the quality of evidence on inspiratory muscle training (IMT) in patients with heart failure and to provide an overview on subject selection, training protocols, and outcome achieved with IMT.Methods
Literature search was first performed via the PubMed database, and additional references were identified from the Scopus citation index. Articles of the review type and of clinical trials published in English were included. Quality of the articles was assessed using Sackett''s levels of evidence and rigor of methodology was assessed using PEDro (Physiotherapy Evidence Database) criteria for randomized controlled trials and the Downs & Black tool for cohort studies.Results
Twelve articles of clinical trials were included. Typical training protocols involved daily training with intensity greater than 30% of maximal inspiratory pressure (PImax), duration of 20 to 30 minutes (continuous or incremental) and using a pressure threshold muscle trainer. The effect sizes of PImax, walk test distance, and dyspnea were moderate to large across these studies. Effects on quality of life scores were inconsistent.Conclusion
Inspiratory muscle training is beneficial for improving respiratory muscle strength, functional capacity, and dyspnea in patients with stable heart failure and respiratory muscle weakness.Key Words: inspiratory muscle training, heart failure, maximal inspiratory pressure 相似文献18.
Jaca L. Stephens John D. Lowman Cecilia L. Graham David M. Morris Connie L. Kohler Jonathan B. Waugh 《Cardiopulmonary Physical Therapy Journal》2013,24(1):14-23
Purpose
Physical therapists (PTs) have a unique opportunity to intervene in the area of health promotion. However, no instrument has been validated to measure PTs’ views on health promotion in physical therapy practice. The purpose of this study was to evaluate the content validity and test-retest reliability of a health promotion survey designed for PTs.Methods
An expert panel of PTs assessed the content validity of “The Role of Health Promotion in Physical Therapy Survey” and provided suggestions for revision. Item content validity was assessed using the content validity ratio (CVR) as well as the modified kappa statistic. Therapists then participated in the test-retest reliability assessment of the revised health promotion survey, which was assessed using a weighted kappa statistic.Results
Based on feedback from the expert panelists, significant revisions were made to the original survey. The expert panel reached at least a majority consensus agreement for all items in the revised survey and the survey-CVR improved from 0.44 to 0.66. Only one item on the revised survey had substantial test-retest agreement, with 55% of the items having moderate agreement and 43% poor agreement.Conclusions
All items on the revised health promotion survey demonstrated at least fair validity, but few items had reasonable test-retest reliability. Further modifications should be made to strengthen the validity and improve the reliability of this survey.Key Words: health promotion, physical therapy, validity, reliability 相似文献19.
Pamela R. Bosch Joseph Poloni Andrew Thornton James V. Lynskey 《Cardiopulmonary Physical Therapy Journal》2012,23(2):13-29