Six-Minute Walk Test in Persons With Transtibial Amputation. 4 arm-leg ergometry, 5 and treadmill exercise. 5 During rehabilitation,
|
|
- Douglas Arnold
- 6 years ago
- Views:
Transcription
1 2354 ORIGINAL ARTICLE Six-Minute Walk Test in Persons With Transtibial Amputation Suh-Jen Lin, PT, PhD, Nisha Hathi Bose, PT, MS ABSTRACT. Lin S-J, Bose NH. Six-minute walk test in persons with transtibial amputation. Arch Phys Med Rehabil 2008;89: Objective: This study was to report the within-day testretest reliability and the measurement properties of the sixminute walk test (6MWT) in persons with lower-limb (transtibial) amputation. Design: Test-retest study design. Setting: University research laboratory. Participants: Subjects (N 13) with transtibial amputation (9 men and 4 women; mean age, 46y). Interventions: Three trials of the 6MWT were conducted within 1 day with 20 to 30 minutes of rest between consecutive trials. Timed Up & Go (TUG) test and timed one-leg balance tests were conducted on another day. Main Outcome Measures: (1) Distance, heart rate, symptoms and signs of exercise intolerance during the walk test, (2) times of the TUG test and the one-leg balance test. Results: The intraclass correlation coefficient (ICC 3,1 ) value was.94. Bland and Altman graphs showed no systemic variations between trials and a small learning effect. The peak heart rate approximated 72% to 78% of the age-predicted maximal heart rate. Moderate degrees of correlation were observed in: (1) the 6MWT versus the TUG test (r.76, P.05), and (2) the 6MWT versus the timed prosthetic-leg stance (with eyes open: r.63, P.05; with eyes closed: r.61, P.05). Conclusions: These findings suggest that the 6MWT could be considered as a reliable measure of functional capacity, involves a moderate degree of exercise intensity, and is related in a moderate degree to postural control abilities in persons with transtibial amputation. Key Words: Amputees; Rehabilitation by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation THE REPORTED PREVALENCE of falling in communitydwelling amputees is about 52.4%, 1 which is higher than that reported among the elderly; additionally, 62% of these amputees are reported to have more than 2 common health problems. 1 With a lower-limb amputation, a person tends to live a sedentary lifestyle, possibly due to a fear of falling and the increased energy expenditure associated with prosthetic ambulation, particularly in the presence of multiple chronic diseases. To design a fitness training program for amputees, a reliable and feasible exercise test is important for quantifying exercise capacity, identifying symptoms and signs of exercise intolerance, and prescribing safe exercise programs in a community setting. Determination of exercise capacity in persons with lower-limb amputation has been a challenge. Different modes of exercise testing have been reported, such as one-leg cycling, 2,3 arm ergometry, 4 arm-leg ergometry, 5 and treadmill exercise. 5 During rehabilitation, arm ergometry might be a good choice due to weakness of the amputated leg, yet increased cardiac demand is a concern. The combined arm and leg ergometer exercise could challenge an amputee to a higher capacity than that of the arm ergometer, 5 but the equipment is expensive. When able to walk independently in the community with a prosthesis, an amputee has a better aerobic capacity than those still in rehabilitation, but may not have the skillful balance to walk comfortably on a treadmill. Therefore, a field exercise test (eg, walk tests) might better reflect an amputee s exercise capacity in the community than the aforementioned traditional exercise tests. Walk tests measure how far a person can walk within a certain limit of time. They are related to day-to-day activities, are easy to administer, and yield valuable information. Originally, a 12-minute running test was reported as a reliable field test of exercise capacity in healthy adults and it correlated modestly with a person s maximum oxygen consumption. 6 Later, this test was modified to a walk test in patients with chronic obstructive pulmonary disease. 7 The 12-minute test was timeconsuming for clinicians, so 2- and 6- minute versions of walk tests were evolved, and the 6MWT was shown to adequately differentiate exercise capacities among subjects while saving time. 8 Many factors affect the performance in walk tests, such as verbal encouragement, 9 walkway layout and length, 10 and the number of practice trials. 11 With advances in technology, a variety of physiologic monitoring can be incorporated into walk tests, such as pulse oximetry, metabolic analysis, and telemetry electrocardiography. Not only could functional capacity be quantified, but also the limiting factors of exercise intolerance, such as arrhythmia, oxygen desaturation, and anaerobic threshold could be identified Initially, the 6MWT was primarily applied in patients with cardiac or respiratory diagnoses. 11,18,19 Later, it was applied to the elderly, 17,20 to children, 21 and to patients with renal failure, 22 fibromyalgia, 23 and cerebral palsy. 24 In the above stud- From the School of Physical Therapy, Texas Woman s University, (Lin) and the Department of Physical Medicine and Rehabilitation, Baylor University Medical Center, (Hathi), Dallas, TX. Presented to the Texas Physical Therapy Association, October 27 29, 2006, Ft Worth, TX, and to the American Physical Therapy Association, February 14 17, 2007, Boston, MA. Supported by the Texas Physical Therapy Foundation. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. Reprint requests to Suh-Jen Lin, PT, PhD, 8194 Walnut Hill Ln, Dallas, TX 75231, slin@twu.edu. Published online November 1, 2008 at /08/ $34.00/0 doi: /j.apmr ANOVA BMI CI ICC LOA LSD RPE 6MWT TUG List of Abbreviations analysis of variance body mass index confidence interval intraclass correlation coefficient limit of agreement least significant difference rating of perceived exertion six-minute walk test Timed Up & Go
2 SIX-MINUTE WALK TEST IN PERSONS WITH TRANSTIBIAL AMPUTATION, Lin 2355 ies, the test-retest reliability values were high, with ICC values ranging from.82 to.99, except for patients with fibromyalgia (ICC.73). Taking learning effect into consideration, 1 practice trial of the 6MWT is generally recommended. 11 For the criterion-related validity of the 6MWT, the distance ambulated has been consistently shown to correlate moderately to a person s peak oxygen consumption. 11,18,19,21 Besides aerobic capacity, other factors such as one-leg balance and postural control might affect performance in walk tests. Timed one-leg balance was shown to have moderate to high reliability in healthy adults and could predict falls in the elderly. 25 Gait asymmetry and reduced prosthetic leg stance time are characteristics of amputee gait. 26 A good one-leg balance should enable an amputee to walk a longer distance because walking is a series of alternating cycles between the stance phase and the swing phase. The TUG test is another measure of physical mobility. The test involves asking a subject to stand up from an armchair, walk 3m, turn, walk back to the chair, and sit down. The TUG test is similar to many daily activities involving transfer, balance, walking speed, and turning around. The TUG test was shown to have high intrarater and interrater reliability values, 27 and good content validity and concurrent validity with other balance measures and walking speed. 28 The postural control of turning around at the end of 3-m walking seems to be similar to the turning around movement at the end of each lap of walking during walk tests. Hence, it is likely that an amputee with a better walking speed and efficiency in turning around during the TUG test could also walk a longer distance in the 6MWT. The distance of the 6MWT reflects whether a person could practically ambulate in the community. The requirements of typical community ambulation such as walking in a supermarket or a department store involve a distance of about 132m to 342m for communities of different sizes. 29 Previously, the 2-minute walk test in amputees showed good reliability, was capable of predicting rehabilitation potential, 30 and correlated well to other physical functions. 31 However, the distance covered in 2 minutes is too short compared with typical community ambulation. In this study, we explored the within-day test-retest reliability and other measurement properties of the 6MWT in persons with lower-limb amputations. We hypothesized that the first trial would be as reliable as the second and the third trials (ie, there will be good agreement among the 3 trials of the 6MWT). Secondly, we quantified the exercise intensity and described possible symptoms and signs of exercise intolerance associated with the 6MWT in amputees, such as shortness of breath, chest pain, fatigue, leg claudication, oxygen desaturation, or arrhythmia. Thirdly, we examined its clinical measurement properties by correlating the distance of walking in the 6MWT to 2 postural control measures: the TUG test and the timed one-leg balance test at eyes-open and eyes-closed conditions. We hypothesized that subjects who had a better postural control, indicated by a longer one-leg balance time and a quicker (shorter time in the) TUG test, would walk a longer distance in the 6MWT. METHODS Subjects Thirteen subjects (9 men and 4 women; 1 Hispanic, 1 black, and 11 whites) with unilateral below-knee (transtibial) amputation participated in this study. Subjects were recruited through local advertisement as well as a support group for people with amputations. The causes of amputation included trauma (in 9 subjects) and vascular problems (in 4 subjects). The inclusion criteria included the following: with transtibial amputation, walking independently with a prosthesis in the community, absence of skin breakdown of the residual limb in the past 3 months, and having well-controlled medical conditions. All prospective subjects who fulfilled the inclusion criteria were recruited as subjects. In addition, participants in previously mentioned studies of the 6MWT walked independently; therefore, we chose to use similar criteria and to exclude those amputees who used assistive devices, had recent illness, or had hospital admissions. Informed consent was obtained. The experimental protocol was approved by the Institutional Review Board of the Texas Woman s University. Study Protocol Two test sessions were conducted. The first session consisted of informed consent, basic data collection, and 3 trials of the 6MWT. The second session scheduled within 2 weeks of the first session was for the TUG test and the timed one-leg balance test. In order to minimize the drop-out rate and to reduce the number of testing sessions, we conducted the 3 trials of 6MWT within 1 day, but provided participants with 20 to 30 minutes of rest between trials to minimize the influence of fatigue. Procedure Basic data included medical history, age, height, weight, and the amputee Day activity questionnaire. 32 The Day activity questionnaire is a brief scoring form which evaluates an amputee s ability in the following categories: putting on and taking off the prosthesis, the length of time using the prosthesis, stairs climbing, details of employment, ambulation aids used, domestic responsibilities, regular walking habits, and social activities. Based on the assessment of clinical records of the amputee participants by experienced clinicians, the activity levels of participants were classified into 5 categories. It was found that the 5 activity levels corresponded to specific ranges of the Day activity scores (very high, 30; high, 10 29; average, 9 to 9; restricted, 40 to 10; inactive, 40). In addition, the activity score was shown to correlate linearly to annual step counts. 32 Six-minute walk test. The 6MWT was conducted according to published standards. 11 Heart rhythms were monitored continuously with a modified chest lead V 5 by the ECG telemetry system. a Blood pressure, oxygen saturation through a pulse oximeter, b and RPE of the 10-point Borg scale 33 were recorded prior to and immediately at the completion of each trial. Subjects had at least 20 minutes of rest between consecutive trials to allow the heart rate to return to baseline. Prior to each trial, subjects were instructed to walk in an extended stretch (45.72m or 150ft) of hallway with cones marking the distance according to the following standardized written instructions: The object of this test is to walk as far as possible for 6 minutes. You are to walk back and forth in this corridor. Six minutes is a long time to walk, so you will be exerting yourself. You will probably get out of breath or become exhausted. You can speed up, slow down, or take a rest. You may lean against the wall while resting, but resume walking as soon as you are able To partially account for a possible memory effect, each subject began the 3 trials at 3 different starting points along the path. Standardized words of encouragement were called out to each subject at each minute mark ( Keep up the good work, you have x minutes left! ). One investigator provided the encouragement, monitored the signs and symptoms of exercise intolerance when a subject passed by, and recorded the number of laps walked.
3 2356 SIX-MINUTE WALK TEST IN PERSONS WITH TRANSTIBIAL AMPUTATION, Lin Difference of Trial 2 Trial Bland-Altman Plot LOA %CI 9.45 mean 95%CI LOA Average of Trial 1 and Trial 2 (meter) Fig 1. Bland-Altman graph with LOA. The differences between trial 2 and 1 (trial 2 minus trial 1) plotted against their mean for each subject, together with the 95% CI and the 95% LOA. Timed Up & Go test. Each subject was instructed to rise from a standard armchair, walk a 3-m short distance, turn around, walk back, and return to sit in the chair according to the original guideline. 28 The time to complete the TUG test was recorded, and the average of 3 trials was used for data analysis. Timed one-leg balance test. We demonstrated the procedures to subjects first. Initially, each subject stood on both legs with eyes open. Then, one researcher counted down backward from 3 seconds to 1 second, and called out go, and the subject was expected to maintain one-leg balance on one leg while raising the other leg. The test was terminated when either the nonsupporting leg touched the ground or the subject maintained the balance for 30 seconds 25 (the ceiling of the test). Subjects started with the sound leg, then the amputated leg. After 3 trials on each leg, they repeated the procedures with eyes closed. One research assistant stood in front of the subject timing the test, and another assistant stood behind the subject for protection from falls. The variability of the 3 trials for each condition was analyzed and the average of the 3 trials for each condition was used for final data analysis. Data Analysis Data were analyzed using SPSS version c Descriptive statistics were used for basic data analysis. The relative reliability among the 3 trials was analyzed with the ICC (model 3) because this model is appropriate for test-retest reliability. We also used the Bland-Altman graphs with limits of agreement to express the actual units of measurement, as well as the paired t test with a 95% CI to assess whether there was a systemic change in the mean (absolute reliability). A separate 1-way repeated measures ANOVA was conducted to test for differences on peak heart rate and mean arterial blood pressure. If significant effect existed, the post hoc Fisher s LSD pairwise comparison was conducted. The Friedman 1-way repeated measures ANOVA by ranks was used for the RPE scale for the 3 trials. Fisher s LSD pairwise comparisons were calculated for significant effects. Reliability of the 3 trials of the timed one-leg balance test was examined with ICC 3,1. The Pearson correlation analysis was used to analyze the relationships between the distance ambulated and: the mean time of the TUG test, and the mean times of the timed one-leg balance test on the prosthetic leg and on the sound leg under eyes-open and eyes-closed conditions. The level of significance ( ) was set at.05. RESULTS The subject characteristics were as follows: age, years; height, cm; weight, kg; BMI, kg/m 2. The average number of years of prosthesis experience was , ranging from 6 months to 32 years for the 4 vascular amputees and from 3 months to 18 years for the 9 traumatic amputees. Four traumatic amputees did not have any medical comorbidities: 3 had used prosthesis for 1 month to 1.5 years, and 1 who had amputation in childhood had used prosthesis for over 15 years. Nine of the 13 amputees had multiple cardiovascular comorbidities, where 8 had hypertension, 7 were overweight (BMI, kg/m 2 ), 6 had metabolic syndrome, 5 reported high cholesterol, 4 were class I obese (BMI, kg/m 2 ), 3 had arrhythmia, 3 had diabetes, 2 had peripheral vascular disease, and 1 had undergone coronary artery bypass. Nine of 13 subjects had more than 2 common health problems. The average Day activity score was The subjects were either part-time employed or fulltime homemakers, except for 1 subject who was temporarily unemployed. The ICC for the 3 trials of the 6MWT was.94. Figure 1 shows the Bland-Altman graph on the difference of distance ambulated between trials 2 and 1 (trial 2 minus trial 1) plotted against their means for each subject, with 95% CI and 95% LOA. There are no systemic errors and no statistically significant difference between trial 2 and trial 1 (zero was included in the 95% CI). In figure 2, the Bland-Altman graph also shows no systemic variation but with a significant difference between trial 3 and trial 2 (zero was not included in the 95% CI). All 13 subjects completed the 3 trials without the need of rest during the 6MWT. One subject had occasional abnormal heart rhythm of premature ventricular contraction at rest, but no further abnormal rhythms were observed during the test and no other abnormal symptoms or signs of exercise intolerance were elicited. No subjects experienced intermittent claudication, chest pain, or oxygen desaturation. Three subjects with hypertension had a higher blood pressure response (up to 180 mmhg), but it did not reach the level required for termination of the walk test. The detailed results of peak heart rate, mean arterial blood pressure, RPE, and distance of the 6MWT are shown in table 1. Difference of Trial 3 Trial Bland-Altman Plot LOA % CI mean 16 95% CI LOA Average of Trial 2 and 3 (meter) Fig 2. Bland-Altman graph with LOA. The differences between trial 3 and 2 (trial 3 minus trial 2) plotted against their mean for each subject, together with the 95% CI and the 95% LOA.
4 SIX-MINUTE WALK TEST IN PERSONS WITH TRANSTIBIAL AMPUTATION, Lin 2357 Table 1: Results of the 3 Trials of the 6MWT Categories Trial 1 Trial 2 Trial 3 Mean SD Mean SD Mean SD Distance (m) Average speed (m/s) Peak heart rate (% age-predicted maximal*) Mean arterial pressure (mmhg) RPE *(Peak heart rate/[220 age]) 100%. (Diastolic pressure 1/3 [systolic pressure diastolic pressure]). Paired t test showed significant differences between trial 3 and trial 1, and between trial 3 and trial 2 (P.05). 1-way repeated measures ANOVA (P.05). Pairwise comparisons showed significant differences between trial 1 and trial 2, and between trial 1 and trial 3 (P.05). Results showed a significant main effect for peak heart rate (F 2, , P.02). Results of mean arterial blood pressure did not show a significant main effect (F 2,24.23, P.74), indicating that mean arterial pressure did not significantly change among the 3 trials. Results of RPE also did not show a significant main effect (F 2, , P.16), indicating that RPE did not significantly change among the 3 trials. Twelve subjects performed the TUG test and the timed one-leg balance test. One man dropped out for the second test session. The relationship between the walk test and the TUG test was shown in figure 3 (P.004). The reliability of the 3 trials of the timed one-leg balance test was high, except for the 2 conditions of the prosthetic leg (table 2). There were moderate correlations between the distance ambulated and the times of the mean timed one-leg balance on the prosthetic leg at eyes-open and eyes-closed conditions (r.63 and r.61, P.05, respectively). The correlation coefficients between the distance ambulated and the times of the timed one-leg balance test on the sound leg were low (eyes open, r.00; eyes closed, r.42). DISCUSSION The prevalence of cardiovascular comorbidity in our subjects was alarming. This prevalence was close to that reported for community-dwelling amputees (62%). 1 Five of the 9 traumatic amputee subjects seemed to have developed multiple cardiovascular comorbidities over the years, which was possibly due to physical inactivity. One limitation of our study is that we had a mixed group of amputees. It could not be determined whether the comorbidities in vascular amputees were due simply to a sedentary lifestyle or to a combination of vascular problems and sedentary lifestyle. Although our subjects average activity level was classified as high based on the amputee Day activity questionnaire, 32 it only reflected that they could carry out daily activities most of the time and did not indicate that they actively participated in regular exercises. The high prevalence of comorbidity reflected the urgent need of secondary prevention in persons with lower-limb amputation. With the standardized protocol, the learning effect of the 6MWT was likely minimized. The high ICC value for the distance of walking among the 3 trials indicated excellent test-retest reliability, which was close to those reported in the literature. 11,18,19 Although we found a statistically significant learning effect from trial 2 to trial 3, the difference of 16m was small when compared with the suggested clinically significant distance of improvement for the 6MWT after interventions (ie, 54 80m). 11,18,34 Based on the high ICC value and the absence of systemic errors from trial to trial, we consider that the 6MWT has a good within-day test-retest reliability of functional capacity in persons with lower-limb amputation, but 2 practice trials are recommended. However, whether the 6MWT is sensitive to change after exercise training in this population would await further studies. Although there were no systemic variations in the distance of walking, we observed 2 outliers on the Bland-Altman graphs. One subject walked a much shorter distance on the second trial. Because similar rest periods between trials were provided to all subjects, and this subject s third trial was actually close to his first trial, it was unclear whether it was due to fatigue. Further studies involving between-day tests could help elucidate the possible role of fatigue. Another subject walked a much longer distance on the third trial. We speculate that this subject might have perceived the third trial as his last trial, and thus wanted to do his best. Future studies incorporating feedback from participants on how they accomplished those distances in the 6MWT, on whether they used their usual speed or tried their best for each trial, might provide us with more insights on this issue. The peak heart rate responses seemed to have a different trend. Our amputee subjects might have worked harder for trial 2 and trial 3. However, neither the mean arterial pressure nor the RPE scale was significantly different. Because we have only examined the within-day reliability of the 6MWT, further studies involving the 6MWT on different days might rule out the possible effects of any cumulative physiologic effects. Incorporation of metabolic analysis during the 6MWT might yield more objective information on exercise capacity than what was available with the measurement of heart rate alone, because factors other than exercise could affect the heart rate response. Our subjects appeared to have achieved their best performance. As shown in table 1, their average walking speeds ranged from 1.51 to 1.58m/s ( mph), which were faster than the common comfortable walking speeds of healthy adults aged 20 to 60 years (1.29m/s to 1.46m/s). 35 In addition, their relative exercise intensities were about 72% to 78% of their age-predicted maximal heart rates, which were slightly lower than those reported in the literature (about 78% 85% of the Timed Up and Go Test (sec) r = Distance of Trial 1 (meter) Fig 3. Relationship between the distance of walking and time of the TUG test.
5 2358 SIX-MINUTE WALK TEST IN PERSONS WITH TRANSTIBIAL AMPUTATION, Lin Table 2: Three Trials of the Timed One-Leg Balance at Eyes-Open and Eyes-Closed Conditions and the Corresponding ICC Groups Trial Sound Leg (s) ICC 3,1 Prosthetic Leg (s) ICC 3,1 Eyes open (n 12) Eyes closed (n 12) Mean Mean NOTE. Values are mean SD unless otherwise noted. peak heart rate). 12,13,15-17 A few of our subjects took beta blockers, which could blunt heart rate response. Some subjects had multiple cardiovascular comorbidities. These factors limit the accuracy of predicting maximal heart rate from the agepredicted equation. Hence, we could have overestimated their maximal heart rate. On the relationships with clinical measurement properties, the 6MWT seems to examine similar aspects of postural control as the TUG test. With a small sample size, we observed a moderately negative linear relationship between the distance walked and the time of the TUG test the better the performance in the TUG test (ie, quicker, shorter time), the greater the distance an amputee can walk in the 6MWT. Our TUG test results were close to those of elderly people in their sixties. 36 Previously, the 2-minute walk test in amputees also showed a negative correlation between the distance ambulated and the time of the L-Test (a modified version of TUG test), 31 but it was in a curvilinear fashion. That was probably due to the ceiling effect of the 2-minute walk test, which was not observed in this study. Furthermore, the loss of voluntary ankle control after transtibial amputation has likely contributed to the impaired prosthetic-leg balance and the shorter distance of walking, as shown by the moderately positive correlations between the prosthetic-leg balance and the distance ambulated. Additionally, the redundancy of postural control from visual and proprioceptive inputs also seemed to have been reduced for the sound leg. These findings point to the need to incorporate balance training into traditional fitness programs for persons with lower-limb amputation. An improved balance could potentially reduce the fear of falling and increase participation in physical activities. This hypothesis would require further studies. CONCLUSIONS Overall, the current study suggests that the 6MWT can be considered as a reliable and practical exercise test to be used in health promotion programs for community-dwelling amputees, because it showed excellent within-day test-retest reliability and seemed to adequately challenge an amputee s functional capacity, balance, and postural control abilities, as required in community ambulation. However, the findings of this study should be substantiated by further studies with a larger sample size and between-day trials. Acknowledgments: We thank Lori Hall, PT, MS, for her assistance in funding procurement at the initial stage of the project, and the following physical therapists for their assistance in data collection and data analysis: Erin George, MS, Jeff Hogan, MS, Paul Walters, MS, Cassie Sommerlad, MS, Tracy Dingman, MS, and Lola Elder, MS. References 1. Miller WC, Speechley M, Deathe B. The prevalence and risk factors of falling and fear of falling among lower extremity amputees. Arch Phys Med Rehabil 2001;82: Chin T, Sawamura S, Fujita H, et al. The efficacy of the one-leg cycling test for determining the anaerobic threshold (AT) of lower limb amputees. Prosthet Orthot Int 1997;21: Chin T, Sawamura S, Fujita H, et al. Physical fitness of lower limb amputees. Am J Phys Med Rehabil 2002;81: Davidoff G, Lampman R, Westbury L, Deron J, Finestone H, Islam S. Exercise testing and training of persons with dysvascular amputation: safety and efficacy of arm ergometry. Arch Phys Med Rehabil 1992;73: Fletcher G, Lloyd A, Waling J, Fletcher B. Exercise testing in patients with musculoskeletal handicaps. Arch Phys Med Rehabil 1988;69: Cooper KH. A means of assessing maximal oxygen intake: correlation between field and treadmill testing. JAMA 1968;203: McGavin C, Gupta S, McHardy G. Twelve-minute walking test for assessing disability in chronic bronchitis. BMJ 1976;1: Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease. BMJ 1982;284: Guyatt GH, Pugsley SO, Sullivan MJ, et al. Effect of encouragement on walking test performance. Thorax 1984;39: Sciurba F, Criner GJ, Lee SM, et al. Six-minute walk distance in chronic obstructive pulmonary disease: reproducibility and effect of walking course layout and length. Am J Respir Crit Care Med 2003;167: American Thoracic Society. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166: Turner SE, Eastwood PR, Cecins NM, Hillman DR, Jenkins SC. Physiologic responses to incremental and self-paced exercise in COPD: a comparison of three tests. Chest 2004;126: Peel C, Ballard D. Reproducibility of the 6-minute walk test in older women. J Aging Phys Act 2001;9: Deboeck G, Niset G, Vachiery JL, Moraine JJ, Naeije R. Physiological response to the six-minute walk test in pulmonary arterial hypertension. Eur Respir J 2005;26: Paap E, van der Net J, Helders PJ, Takken T. Physiologic response of the six-minute walk test in children with juvenile idiopathic arthritis. Arthritis Rheum 2005;53: Troosters T, Vilaro J, Rabinovich R, et al. Physiological responses to the 6-min walk test in patients with chronic obstructive pulmonary disease. Eur Respir J 2002;20: Kervio G, Carre F, Ville NS. Reliability and intensity of the six-minute walk test in healthy elderly subjects. Med Sci Sports Exerc 2003;35:
6 SIX-MINUTE WALK TEST IN PERSONS WITH TRANSTIBIAL AMPUTATION, Lin Solway S, Brooks D, Lacasse Y, Thomas S. A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest 2001;119: Sadaria KS, Bohannon RW. The 6-minute walk test: a brief review of literature. Clin Exerc Physiol 2001;3: Harada ND, Chiu V, Stewart AL. Mobility-related function in older adults: assessment with a 6-minute walk test. Arch Phys Med Rehabil 1999;80: Li AM, Yin J, Yu CC, et al. The six-minute walk test in healthy children: reliability and validity. Eur Respir J 2005;25: Fitts SS, Guthrie MR. Six-minute walk by people with chronic renal failure. Assessment of effort by perceived exertion. Am J Phys Med Rehabil 1995;74: King S, Wessel J, Bhambhani Y, Maikala R, Sholter D, Maksymowych W. Validity and reliability of the 6 minute walk in persons with fibromyalgia. J Rheumatol 1999;26: Andersson C, Asztalos L, Mattsson E. Six-minute walk test in adults with cerebral palsy. A study of reliability. Clin Rehabil 2006;20: Bohannon RW. One-leg balance test times. Percept Mot Skills 1994;78: Sanderson D, Martin P. Lower extremity kinematic and kinetic adaptations in unilateral below-knee amputees during walking. Gait Posture 1997;6: Schoppen T, Boonstra A, Groothoff JW, de Vries J, Göeken LN, Eisma WH. The timed up and go test: reliability and validity in persons with unilateral lower limb amputation. Arch Phys Med Rehabil 1999;80: Podsiadlo D, Richardson S. The timed Up & Go : a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39: Robinett CS, Vondran MA. Functional ambulation velocity and distance requirements in rural and urban communities. A clinical report. Phys Ther 1988;68: Brooks D, Hunter JP, Parsons J, Livsey E, Quirt J, Devlin M. Reliability of the two-minute walk test in individuals with transtibial amputation. Arch Phys Med Rehabil 2002;83: Deathe A, Miller W. The L test of functional mobility: measurement properties of a modified version of the timed up & go test designed for people with lower-limb amputations. Phys Ther 2005;85: Day H. The assessment and description of amputee activity. Prosthet Orthot Int 1981;5: Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14: Wise RA, Brown CD. Minimal clinically important differences in the six-minute walk test and the incremental shuttle walking test. COPD 2004;2: Bohannon RW. Comfortable and maximum walking speed of adults aged years: reference values and determinants. Age Ageing 1997;26: Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six- Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther 2002;82: Suppliers a. Life Sensing Instrument Co, 329 W Lincoln St, Tullahoma, TN b. Smiths Medical PM Inc, N7W22025 Johnson Dr, Waukesha, WI c. SPSS Inc, 233 S Wacker Dr, 11th Fl, Chicago, IL
William C Miller, PhD, FCAOT Professor Occupational Science & Occupational Therapy University of British Columbia Vancouver, BC, Canada
William C Miller, PhD, FCAOT Professor Occupational Science & Occupational Therapy University of British Columbia Vancouver, BC, Canada THE L TEST MANUAL Version: November 2014 Table of Contents Introduction...
More informationSUBMAXIMAL EXERCISE TESTING: ADVANTAGES AND WEAKNESS IN PERFORMANCE ASSESSMENT IN CARDIAC REHABILITATION
SUBMAXIMAL EXERCISE TESTING: ADVANTAGES AND WEAKNESS IN PERFORMANCE ASSESSMENT IN CARDIAC REHABILITATION Dr Saari MohamadYatim M.D Rehabilitation Physician Hospital Serdang APCCRC, Hong Kong, 6-9 Nov 2014
More informationASSESSMENT OF THE WALKING ability of patients
190 Assessing Walking Ability in Subjects With Spinal Cord Injury: Validity and Reliability of 3 Walking Tests Hubertus J. van Hedel, PT, MS, Markus Wirz, PT, Volker Dietz, MD, FRCP ABSTRACT. van Hedel
More informationEffect of endurance training program based on anaerobic threshold (AT) for lower limb amputees
Journal of Rehabilitation Research and Development Vol. 38 No. 1, January/February 2001 Pages 7 11 Effect of endurance training program based on anaerobic threshold (AT) for lower limb amputees T. Chin,
More informationScoring The score of the test is the distance a patient walks in 6 minutes (measured in meters and can round to the nearest decimal point).
Core Measure: Six Minute Walk Test (6MWT) Overview The 6MWT is a sub-maximal exercise test used to assess walking endurance and aerobic capacity. Participants will walk around the perimeter of a set circuit
More informationCreated in January 2005 Duration: approx. 20 minutes
1 1 The Timed Up and Go Test Created in January 2005 Duration: approx. 20 minutes 2 Credits 2005 Stein Gerontological Institute. All rights reserved. Principal medical contributors: Alan Katz, MD Francois
More informationMobilization and Exercise Prescription
1 Clinicians can use this job aid as a tool to guide them through mobilization and exercise prescription with patients who have cardiopulmonary conditions. Mobilization and Exercise Prescription Therapy
More informationSubject: Outpatient Phase Ii Cardiac Rehab Individualized Treatment Plan And Exercise Prescription
CARDIAC REHAB POLICY & PROCEDURES Policy #: CR 208 Subject: Outpatient Phase Ii Cardiac Rehab Individualized Treatment Plan And Exercise Prescription Purpose: To establish guidelines for developing and
More informationPatient assessment assessing exercise capacity
Patient assessment assessing exercise capacity STEP 1 Learning objectives This module will provide you with an understanding of what is required when assessing a patient s exercise capacity. By the end
More informationSUMMARY. Applied exercise physiology in rehabilitation of children with cerebral palsy
S SUMMARY Applied exercise physiology in rehabilitation of children with cerebral palsy Summary Cerebral palsy (CP) is the most common cause of physical disability in childhood. CP is defined as a group
More informationOUTCOME MEASURES USEFUL FOR TOTAL JOINT ARTHROPLASTY
The following outcome measures (and weblinks) are OUTCOME MEASURES USEFUL FOR TOTAL JOINT ARTHROPLASTY Measure Arthritis Self- Efficacy Scale What: Self-efficacy (current) Who: Pre-and post arthroplasty
More informationSignificance of Walking Speed. Maggie Benson Virginia Commonwealth University Department of Physical Therapy
Significance of Walking Speed Maggie Benson Virginia Commonwealth University Department of Physical Therapy The 6 th Vital Sign Walking speed is considered the 6 th vital sign A valid and reliable measure
More informationExercise, Physical Therapy and Fall Prevention
Exercise, Physical Therapy and Fall Prevention University of Davis Medical Center Rosy Chow Neuro Clinical Specialist Physical Therapist Outline of Talk Role of Physical Therapy in care of people with
More informationOUTCOME MEASURES are becoming increasingly important
1478 PROSTHETICS/ORTHOTICS/DEVICES The 2-Minute Walk Test as a Measure of Functional Improvement in Persons With Lower Limb Amputation Dina Brooks, PhD, Janet Parsons, MSc, Judith P. Hunter, MSc, Michael
More informationTest-Retest Reliability of the StepWatch Activity Monitor Outputs in Healthy Adults
Journal of Physical Activity and Health, 2010, 7, 671-676 2010 Human Kinetics, Inc. Test-Retest Reliability of the StepWatch Activity Monitor Outputs in Healthy Adults Suzie Mudge, Denise Taylor, Oliver
More informationBerg Balance Scale. CVA, Parkinson Disease, Pediatrics
CVA, Parkinson Disease, Pediatrics CVA Highly recommended for inpatient and outpatient rehabilitation Recommended for acute care Parkinson s Disease Recommended for H and Y stages 2 and 3 G code-changing
More informationTo Correlate Ejection Fraction with 6 Minute Walked Distance and Quality of Life in Patients with Left Ventricular Heart Failure
To Correlate Ejection Fraction with 6 Minute Walked Distance and Quality of Life in Patients with Left Ventricular Heart Failure Pramila S Kudtarkar*, Mariya P Jiandani*, Ashish Nabar** Abstract Purpose
More informationResearch Report. Predicting the Probability for Falls in Community-Dwelling Older Adults Using the Timed Up & Go Test
Research Report Predicting the Probability for Falls in Community-Dwelling Older Adults Using the Timed Up & Go Test Background and Purpose. This study examined the sensitivity and specificity of the Timed
More informationOptimizing the Lung Transplant Candidate through Exercise Training. Lisa Wickerson BScPT, MSc Canadian Respiratory Conference April 25, 2014
Optimizing the Lung Transplant Candidate through Exercise Training Lisa Wickerson BScPT, MSc Canadian Respiratory Conference April 25, 2014 Conflicts of Interest None to declare Learning Objectives At
More informationCHAPTER THREE JOURNAL MANUSCRIPT
CHAPTER THREE JOURNAL MANUSCRIPT 13 PHYSIOLOGICAL AND METABOLIC RESPONSES TO CONSTANT-LOAD EXERCISE ON AN INCLINED STEPPER AND TREADMILL by Brian W. Rieger Dr. Shala Davis, Chairman Department of Human
More informationValidation of the 2-Minute Walk Test with the 6-Minute Walk Test and Other Functional. Measures in Persons with Multiple Sclerosis.
Validation of the 2-Minute Walk Test with the 6-Minute Walk Test and Other Functional Measures in Persons with Multiple Sclerosis David A. Scalzitti, PhD; Kenneth J. Harwood, PhD; Joyce R. Maring, EdD;
More informationEquipment Stopwatch A clear pathway of at least 10 m (32.8 ft) in length in a designated area over solid flooring 2,3.
Core Measure: 10 Meter Walk Test (10mWT) Overview The 10mWT is used to assess walking speed in meters/second (m/s) over a short distance. Number of Test Items 1 item Scoring The total time taken to ambulate
More informationFunctional Muscle Power Testing in Young, Middle-Aged, and Community-Dwelling Nonfrail and Prefrail Older Adults
ORIGINAL ARTICLE Functional Muscle Power Testing in Young, Middle-Aged, and Community-Dwelling Nonfrail and Prefrail Older Adults Astrid Zech, PhD, PT, Simon Steib, Dipl Sportwiss, Ellen Freiberger, PhD,
More informationDoes Fear of Falling Relate to Low Physical Function in Frail Elderly Persons?: Associations of Fear of Falling, Balance, and Gait
REPORT Does Fear of Falling Relate to Low Physical Function in Frail Elderly Persons?: Associations of Fear of Falling, Balance, and Gait Yumi HIGUCHI 1, Hiroaki SUDO 2, Noriko TANAKA 1, Satoshi FUCHIOKA
More informationGait Assessment & Implications in Geriatric Rehabilitation
Gait Assessment & Implications in Geriatric Rehabilitation Therapy Network Seminars, Inc. Nicole Dawson, PT, PhD, GCS Learning Objectives Following completion of this webinar, participants will be able
More informationFunctional Ability Screening Tools for the Clinic
Functional Ability Screening Tools for the Clinic Shelley Hockensmith,, P.T., NCS Objectives Review screening tools for physical or functional ability including Five Times Sit to Stand, Walking Speed,
More informationPRESENTED BY BECKY BLAAUW OCT 2011
PRESENTED BY BECKY BLAAUW OCT 2011 Introduction In 1990 top 5 causes of death and disease around the world: Lower Respiratory Tract Infections Diarrhea Conditions arising during pregnancy Major Depression
More informationA Study of relationship between frailty and physical performance in elderly women
Original Article Journal of Exercise Rehabilitation 2015;11(4):215-219 A Study of relationship between frailty and physical performance in elderly women Bog Ja Jeoung 1, *, Yang Chool Lee 2 1 Department
More informationHome Exercise Program Progression and Components of the LTP Intervention. HEP Activities at Every Session Vital signs monitoring
Home Exercise Program Progression and Components of the LTP Intervention HEP Activities at Every Session Vital signs monitoring Blood pressure, heart rate, Borg Rate of Perceived Exertion (RPE) and oxygen
More informationCORE MEASURE: CORE MEASURE: BERG BALANCE SCALE (BBS)
OVERVIEW NUMBER OF TEST ITEMS SCORING EQUIPMENT TIME (NEW CLINICIAN) TIME (EXPERIENCED CLINICIAN) COST o The BBS is a widely-used, clinician-rated scale used to assess sitting and standing, static and
More informationParental Overview Document of FITNESSGRAM Assessment in Georgia
F I T N E S S G R A M R e f e r e n c e G u i d e P a g e 1 Parental Overview Document of FITNESSGRAM Assessment in Georgia The FITNESSGRAM Reference Guide is intended to provide answers to some common
More informationCHF Exercise Tutorial
CHF Exercise Tutorial This template can be accessed from: AAA Home 1 of 9 LESS Initiative 2 of 9 Main Tool Bar When the Template button is clicked you will be presented with the preference list. If the
More informationOutcome Measures for the Clinician
Outcome Measures for the Clinician Timed up and Go (TUG) Special contribu=ons made by: Jason Kahle - Jason Highsmith Brian Kaluf - Tyler Klenow 1 Introduc=on Outcome measures are clinical tests that are
More informationPathophysiology Department
UNIVERSITY OF MEDICINE - PLOVDIV Pathophysiology Department 15A Vasil Aprilov Blvd. Tel. +359 32 602311 Algorithm for interpretation of submaximal exercise tests in children S. Kostianev 1, B. Marinov
More informationTHE WORLD HEALTH ORGANIZATION defines mobility
9 Validity and Reliability Comparison of 4 Mobility Measures in Patients Presenting With Neurologic Impairment Philippe Rossier, MD, Derick T. Wade, MA, MD, FRCP ABSTRACT. Rossier P, Wade DT. Validity
More informationDivision of Pulmonary, Critical Care, and Sleep Medicine, Jacksonville, FL. Department of Internal Medicine, Wichita, KS
in Patients with Respiratory Disease Furqan Shoaib Siddiqi, M.D. 1, Said Chaaban, M.D. 2, Erin Petersen, M.S.N., A.P.R.N. 3, K James Kallail, Ph.D. 2, Mary Hope, B.H.S., A.R.T., R.R.T., C.P.F.T. 3, Daniel
More informationVALIDITY AND RELIABILITY OF THE INCREMENTAL SHUTTLE WALK TEST AND SIX-MINUTE WALK TEST IN CHRONIC HEART FAILURE
VALIDITY AND RELIABILITY OF THE INCREMENTAL SHUTTLE WALK TEST AND SIX-MINUTE WALK TEST IN CHRONIC HEART FAILURE Cowie, A.*, Thow, M.K., Granat, M., Mitchell, S.L. *PhD Student, Glasgow Caledonian University,
More informationSlide 1. Slide 2 Overview of Course. Slide 3 Overview of Course. Gait and Balance Standardized Assessment in Geriatric Fallers
Slide 1 Gait and Balance Standardized Assessment in Geriatric Fallers Dianna Saunders, MS, PT Nicole Prieto, MSPT NF/SG Veterans Health System Gait and Balance Clinic Gainesville, FL Lenni Jo Yarchin,
More informationObjectives. Saturday Morning Cartoon Memories! Too Bad It s Not That Funny. Golden Years in the Golden State? Not According to Data for California
P R E S E N T E D B Y The OC (Anaheim), CA August 12 16, 2009 August 14, 2009 Session 230 Exercise Program Design for Falls Prevention Dr. Christian Thompson & Rodney Corn Objectives 1. Describe the prevalence
More informationHigher Body Weight Influences Functional Mobility in Older Adults
Higher Body Weight Influences Functional Mobility in Older Adults Charlotte R. Slate Dain P. LaRoche Summer B. Cook Erik E. Swartz Kinesiology: Exercise Science The University of New Hampshire Introduction
More informationExercise Prescription Certificate Course
Exercise Prescription Certificate Course Session 2: Principles and Frameworks for Exercise Prescription Dr. Raymond CHAN Hoi-fai MBChB (DUNDEE), MSc Sports Medicine (Glasg), MScSMHS(CUHK), MSpMed (New
More informationOverview The BBS is a widely-used, clinician-rated scale used to assess sitting and standing, static and dynamic balance.
Core Measure: Berg Balance Scale (BBS) Overview The BBS is a widely-used, clinician-rated scale used to assess sitting and standing, static and dynamic balance. Number of Test Items The BBS consists of
More informationReliability of the incremental shuttle walk test and the Chester step test in cardiac rehabilitation
Reliability of the incremental shuttle walk test and the Chester step test in cardiac rehabilitation Item Type Thesis or dissertation Authors Reardon, Melanie Publisher University of Chester Download date
More informationPrapaporn Pornsuriyasak, M.D. Pulmonary and Critical Care Medicine Ramathibodi Hospital
Prapaporn Pornsuriyasak, M.D. Pulmonary and Critical Care Medicine Ramathibodi Hospital Only 20-30% of patients with lung cancer are potential candidates for lung resection Poor lung function alone ruled
More informationPEOPLE WITH STROKE often have difficulties changing
2156 ORIGINAL ARTICLE The Four Square Step Test is a Feasible and Valid Clinical Test of Dynamic Standing Balance for Use in Ambulant People Poststroke Jannette M. Blennerhassett, PhD, Victoria M. Jayalath,
More informationKnee Joint Moments of Transtibial Amputees While Cycling. Laura Jones April 16, 2008
Knee Joint Moments of Transtibial Amputees While Cycling Laura Jones April 16, 2008 INTRODUCTION Main Goal Improve Quality of Life for Amputees Rehabilitation Exercise Amputees less active than nonamputees
More informationExercise Stress Testing: Cardiovascular or Respiratory Limitation?
Exercise Stress Testing: Cardiovascular or Respiratory Limitation? Marshall B. Dunning III, Ph.D., M.S. Professor of Medicine & Physiology Medical College of Wisconsin What is exercise? Physical activity
More informationCardiac Rehabilitation & Exercise Training in Congenital Heart Disease. Jidong Sung Division of Cardiology Sungkyunkwan University School of Medicine
Cardiac Rehabilitation & Exercise Training in Congenital Heart Disease Jidong Sung Division of Cardiology Sungkyunkwan University School of Medicine Cardiac rehabilitation Agency of Health Care Policy
More informationWhat are the assessments? Why is aerobic capacity important?
What are the assessments? Aerobic Capacity- The PACER or the One-Mile Run Body Composition- Height/Weight Abdominal Strength - Curl-Up Upper Body Strength - Push-Up Flexibility - Back-Saver Sit and Reach
More informationAssessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function
White et al. BMC Palliative Care (2019) 18:4 https://doi.org/10.1186/s12904-018-0386-1 RESEARCH ARTICLE Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching
More informationMetabolic Calculations
Metabolic Calculations Chapter 5 and Appendix D Importance of Metabolic Calculations It is imperative that the exercise physiologist is able to interpret test results and estimate energy expenditure. Optimizing
More informationChapter # 3 Aerobic Exercise
Chapter # 3 Aerobic Exercise Know how your aerobic exercise program works You Will Learn: 1) What aerobic exercise is and why it is important 2) The components of your aerobic exercise program 3) Why it
More informationExercise Progression for the Cardiac, Pulmonary & PAD Patient
Exercise Progression for the Cardiac, Pulmonary & PAD Patient Thomas P. Mahady MS CSCS CCRP Hackensack University Medical Center Hackensack Meridian Health Learning Objectives The Art of Exercise Prescription.
More informationSensitivity and Specificity of the Minimal Chair Height Standing Ability Test: A Simple and Affordable Fall-Risk Screening Instrument
Sensitivity and Specificity of the Minimal Chair Height Standing Ability Test: A Simple and Affordable Fall-Risk Screening Instrument By: Nadia C. Reider, MSc ; Patti-Jean Naylor, PhD ; Catherine Gaul,
More informationImpact of Exercise on Patients with Diabetes Mellitus. Learning Objectives. Definitions Physical Activity and Health
Impact of Exercise on Patients with Diabetes Mellitus Bret Goodpaster, Ph.D. Exercise Physiologist Assistant Professor of Medicine University of Pittsburgh Division of Endocrinology and Metabolism Learning
More informationCardiopulmonary Physical Therapy. Haneul Lee, DSc, PT
Cardiopulmonary Physical Therapy Haneul Lee, DSc, PT Clinical Laboratory Studies Other Noninvasive Diagnostic Tests Other Imaging Modalities Exercise Testing Pharmacologic Stress Testing Cardiac Catheterization
More informationThe Effects of Upper -Body and Lower -Body Fatigue on Standing Balance
The Effects of Upper -Body and Lower -Body Fatigue on Standing Balance F. Cogswell 1, B. Dietze 1, F. Huang 1 1 School of Kinesiology, The University of Western Ontario No conflicts of interest declared.
More informationHands on Sports Therapy KNOWLEDGE REVIEW QUESTIONS 2004 Thomson Learning It can help to shape a basic fitness training programme
Hands on Sports Therapy KNOWLEDGE REVIEW QUESTIONS 2004 Thomson Learning 1 CHAPTER 13 Knowledge Review Q1: Why is fitness testing useful? A1: Fitness testing is useful for various reasons: 1. It can help
More informationFunctional Tests and Measures Missouri Alliance for Home Care Annual Conference April Vicki D Landers PT DPT CEEAA
Functional Tests and Measures Missouri Alliance for Home Care Annual Conference April 26 2017 Vicki D Landers PT DPT CEEAA Test Selection What do you want to test? Aerobic Capacity Strength ROM Balance
More informationCommon Chronic diseases An Evidence Base for Yoga Intervention in Advanced Years & at End of Life
Common Chronic diseases An Evidence Base for Yoga Intervention in Advanced Years & at End of Life Coronary artery disease Arthritis Hypertension Diabetes mellitus Obesity 1 2 Taking it easy Contributes
More informationRELATIVE EXERCISE INTENSITY, HEART RATE, OXYGEN CONSUMPTION, AND CALORIC EXPENDITURE WHEN EXERCISING ON VARIOUS NON-IMPACT CARDIO TRAINERS
RELATIVE EXERCISE INTENSITY, HEART RATE, OXYGEN CONSUMPTION, AND CALORIC EXPENDITURE WHEN EXERCISING ON VARIOUS NON-IMPACT CARDIO TRAINERS Kirsten Hendrickson, B.S. John P. Porcari, Ph.D. Carl Foster,
More informationEXERCISES FOR AMPUTEES. Joanna Wojcik & Niki Marjerrison
EXERCISES FOR AMPUTEES Joanna Wojcik & Niki Marjerrison Amputation A condition of disability resulting from the loss of one or more limbs 1.7 million people living with limb loss in the US (1 out of every
More informationDevelopment of a self-reported Chronic Respiratory Questionnaire (CRQ-SR)
954 Department of Respiratory Medicine, University Hospitals of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK J E A Williams S J Singh L Sewell M D L Morgan Department of Clinical Epidemiology and
More informationBUFFALO CONCUSSION BIKE TEST (BCBT) INSTRUCTION MANUAL
Purpose BUFFALO CONCUSSION BIKE TEST (BCBT) INSTRUCTION MANUAL To investigate exercise tolerance in patients with persistent post-concussive symptoms (PCS) lasting more than 2-4 weeks. The definition of
More informationGulf Indian High School, Dubai
Gulf Indian High School, Dubai Department of Physical Education Workout Routine for Overweight /Obese children s GRADES 4 12 Best Workouts for Overweight Beginners Beginner Exercises foroverweight /Obesechildren
More informationThe Reliability of Four Different Methods. of Calculating Quadriceps Peak Torque Angle- Specific Torques at 30, 60, and 75
The Reliability of Four Different Methods. of Calculating Quadriceps Peak Torque Angle- Specific Torques at 30, 60, and 75 By: Brent L. Arnold and David H. Perrin * Arnold, B.A., & Perrin, D.H. (1993).
More informationPerformance Enhancement. Cardiovascular/Respiratory Systems and Athletic Performance
Performance Enhancement Cardiovascular/Respiratory Systems and Athletic Performance Functions of the Cardiovascular System Deliver oxygen & nutrients to body tissues Carry wastes from the cells Anatomy
More informationQ&A. DEMO Version
ACSM Exercise Specialist Exam Q&A DEMO Version Copyright (c) 2010 Chinatag LLC. All rights reserved. Important Note Please Read Carefully For demonstration purpose only, this free version Chinatag study
More informationRole of Aerobic Exercise in Post-polio Syndrome. Dr. Jülide Öncü,MD İstanbul Sisli Etfal Teaching Hospital
Role of Aerobic Exercise in Post-polio Syndrome Dr. Jülide Öncü,MD İstanbul Sisli Etfal Teaching Hospital julide.oncu@sislietfal.gov.tr Why is aerobic exercise important? Post-polio symptoms Impaired functional
More informationReliability of time to stabilization in single leg standing
Northern Michigan University The Commons Conference Papers in Published Proceedings 2009 Reliability of time to stabilization in single leg standing Randall L. Jensen Northern Michigan University Follow
More informationSTRENGTH & CONDITIONING
Introduction to player profiling Introduction We have previously described the demands of the sevens game for both men and women. We noted that conditioning for the game should take into account the increased
More informationIN (FRAIL) OLDER PEOPLE, maintaining or improving
1892 ORIGINAL ARTICLE Reproducibility and Validity of the Dutch Translation of the de Morton Mobility Index (DEMMI) Used by Physiotherapists in Older Patients With Knee or Hip Osteoarthritis Marielle P.
More informationPHYSICAL FITNESS 1 MOTOR SKILLS
PHYSICAL FITNESS The concept of physical fitness first arose in 1916, in a scientific study that tried to accurately measure the different physical characteristics of individuals. The idea of fitness suggests
More informationApplied Exercise and Sport Physiology, with Labs, 4e
Applied Exercise and Sport Physiology, with Labs, 4e hhpcommunities.com/exercisephysiology/chapter-10-aerobic-exercise-prescriptions-for-public-health-cardiorespiratory-fitness-and-athletics/chap Chapter
More informationYour Home Exercise Plan
A Home Exercise Plan is designed for people who are unable to attend Pulmonary Rehabilitation classes in a community setting. This may be for a number of reasons such as travelling difficulties, personal
More informationFall Prevention for Community Dwelling Older Adults: An Update on Assessment and Intervention Strategies
Fall Prevention for Community Dwelling Older Adults: An Update on Assessment and Intervention Strategies Erica A. Pitsch, PT, MPT, DPT, NCS UCSF/SFSU Graduate Program in Physical Therapy Objectives Be
More informationChapter 10 Measurement of Common Anaerobic Abilities and Cardiorespiratory Responses Related to Exercise
Chapter 10 Measurement of Common Anaerobic Abilities and Cardiorespiratory Responses Related to Exercise Slide Show developed by: Richard C. Krejci, Ph.D. Professor of Public Health Columbia College 3.26.13
More informationBlood Pressure Laboratory
Introduction The blood that circulates throughout the body maintains a flow and pressure. The nervous system can change the flow and pressure based on the particular needs at a given time. For example,
More informationCardiac Rehabilitation Exercise Programs Diabetic Management & Weight Loss Exercise Programs
Cardiac Rehabilitation Exercise Programs Diabetic Management & Weight Loss Exercise Programs Information for participants Welcome to our cardiac rehabilitation, diabetic & weight loss exercise programs.
More informationPrescription Fitness. Robert M. Pepper, DO, FAAFP. ACOFP 55th Annual Convention & Scientific Seminars
Prescription Fitness Robert M. Pepper, DO, FAAFP 8 ACOFP 55th Annual Convention & Scientific Seminars RX: FITNESS Robert M Pepper, DO, FAAFP Assistant Dean for Predoctoral Clinical Education West Virginia
More informationOverview Functional Training
Overview Functional Training Exercises with Therapist 1. Sitting 2. Standing up vs. Sitting down 3. Standing 4. Stance phase ( Static and dynamic ) 5. Swing phase 6. Gait Evaluation 7. Walking level ground
More informationClinical Considerations of High Intensity Interval Training (HIIT)
Clinical Considerations of High Intensity Interval Training (HIIT) Jenna Taylor Exercise Physiologist & Dietitian The Wesley Hospital PhD Candidate The University of Queensland What is High Intensity Interval
More informationSurvival rates in dysvascular lower limb amputees
International Journal of Surgery (26) 4, 217e221 journal homepage: www.int-journal-surgery.com Survival rates in dysvascular lower limb amputees J. Kulkarni*, S. Pande, J. Morris Rehabilitation Medicine,
More informationHow Biodex programs give UHS Pruitt the clinical advantage BIODEX
CASESTUDY How Biodex programs give UHS Pruitt the clinical advantage UHS Pruitt Corporation BIODEX Biodex Medical Systems, Inc. 20 Ramsey Road, Shirley, New York, 11967-4704, Tel: 800-224-6339 (Int l 631-924-9000),
More informationlntertester and lntratester Reliability of a Dynamic Balance Protocol Using the Biodex Stability System
Journal of Sport Rehabilitation, 1998, 7, 95-101 0 1998 Human Kinetics Publishers, Inc. lntertester and lntratester Reliability of a Dynamic Balance Protocol Using the Biodex Stability System Randy Schmitz
More informationPHYSICAL FITNESS 1.- ENDURANCE TRAINING SYSTEMS
PHYSICAL FITNESS 1.- ENDURANCE TRAINING SYSTEMS 1.1.- TYPES Last year we learnt that there are two types, depending on the intensity of the exertion: this intensity depends on whether the oxygen for the
More informationA Healthy Heart. IN BRIEF: Your Guide to
IN BRIEF: Your Guide to A Healthy Heart If you re like most people, you may think of heart disease as a problem for other folks. If you re a woman, you may believe that being female protects you from heart
More informationBC Alpine Fitness Testing Field Protocols Revised June 2014
BC Alpine Fitness Testing Field Protocols Revised June 2014 The following tests are important markers of athleticism in young athletes and relevant to the development of fitness in alpine ski racers. These
More informationCardiac & Pulmonary Rehab Individual Treatment Plan
Initial Assessment Date: Re-Assessment Date: Re-Assessment Date: Follow-Up Discharge Date: Risk Assessment Risk Assessment Risk Assessment Risk Assessment BP SpO2 BP SpO2 BP SpO2 BP SpO2 HR Edema HR Edema
More information6 min Walking Test: η σημασία του στην κλινική πράξη Καρακώστας Γεώργιος
6 min Walking Test: η σημασία του στην κλινική πράξη Καρακώστας Γεώργιος Διευθυντής Καρδιολογικής Κλινικής, Γ.Ν. Κιλκίς Definition The 6 minute walking test (6MWT) is a sub-maximal exercise test used to
More informationExercise tolerance in children with cystic fibrosis undergoing lung transplantation assessment
Eur Respir J 21; 18: 293 297 Printed in UK all rights reserved Copyright #ERS Journals Ltd 21 European Respiratory Journal ISSN 93-1936 Exercise tolerance in children with cystic fibrosis undergoing lung
More informationLecture 6 Fitness Fitness 1. What is Fitness? 2. Cardiorespiratory Fitness 3. Muscular Fitness 4. Flexibility 5. Body Composition
Lecture 6 Fitness 1 Fitness 1. What is Fitness? 2. Cardiorespiratory Fitness 3. Muscular Fitness 4. Flexibility 5. Body Composition 2 1 Americans (on average) are not a healthy bunch 3 Sitting is the new
More informationDr B. Egger Service de Pneumologie Hôpital de Rolle
Dr B. Egger Service de Pneumologie Hôpital de Rolle Planning COPD/rehabilitation introduction COPD rehabilitation programs : Benefits Components/Modalities COPD and congestive heart failure COPD and ischemic
More informationPhysical activity guidelines To the Minister of Health, Welfare and Sport No. 2017/08e, The Hague, August 22, 2017
Physical activity guidelines 2017 To the Minister of Health, Welfare and Sport No. 2017/08e, The Hague, August 22, 2017 Contents Physical activity guidelines 2017 page 2 of 45 contents Executive summary
More informationChapter # 4 Angina. Know what to do if you feel angina
Chapter # 4 Angina Know what to do if you feel angina You will learn: 1) What angina is 2) How angina affects you 3) How to prevent and manage angina during exercise Chapter 4 Angina pg. 23 What is Angina?
More information6/30/2015. Quadriceps Strength is Associated with Self-Reported Function in Arthroscopic Partial Meniscectomy Patients. Surgical Management
Quadriceps Strength is Associated with Self-Reported Function in Arthroscopic Partial Meniscectomy Patients Meniscal tears no cause for concern? Among the most common injuries of the knee in sport and
More informationOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO Subject Index ACE inhibitors, see Angiotensin-converting enzyme inhibitors Aging
More informationTwo minute walking distance in cystic fibrosis
Archives of Disease in Childhood, 1988, 63, 14441448 Two minute walking distance in cystic fibrosis C J UPTON, J C TYRRELL, AND E J HILLER Department of Paediatrics, City Hospital, Nottingham SUMMARY We
More informationAdding Exercise to Your Life
Adding Exercise to Your Life Beginning to Exercise When you return home, you should do activities similar to those in the hospital for 2 to 3 days. You will be showering, napping, deep breathing, and walking
More information