WALKING endurance tests are increasingly used to
|
|
- Gloria Higgins
- 5 years ago
- Views:
Transcription
1 Journal of Gerontology: MEDICAL SCIENCES 2003, Vol. 58A, No. 8, Copyright 2003 by The Gerontological Society of America Walking Performance and Cardiovascular Response: Associations With Age and Morbidity The Health, Aging and Body Composition Study Anne B. Newman, 1 Catherine L. Haggerty, 1 Stephen B. Kritchevsky, 2 Michael C. Nevitt, 3 and Eleanor M. Simonsick, 4 for the Health ABC Collaborative Research Group 1 Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania. 2 Department of Preventive Medicine, University of Tennessee, Memphis. 3 Prevention Sciences Group, University of California, San Francisco. 4 Intramural Research Program, National Institute on Aging, Baltimore, Maryland. Background. The long-distance corridor walk is a timed 400-meter walk test used to assess walking endurance in wellfunctioning men and women aged in the Health, Aging and Body Composition Study. Methods. We examined walking time along with heart rate and blood pressure response in relationship to prevalent chronic conditions, weight, physical activity, and markers of subclinical disease. Of 3075 participants, 2324 (76%) completed the test with heart rate and blood pressure responses in the range expected for a moderate level of exertion. Results. Slower walking time was influenced by both clinical and subclinical disease, and also was strongly related to both low and high body weight and low self-reported physical activity. Heart rate and blood pressure responses were higher with several clinical and subclinical diseases, but heart rate response and recovery were more strongly related to walking time than to disease. Higher body mass index and lower physical activity were associated with greater heart rate response and recovery. Conclusions. The independent contribution of both clinical and subclinical disease to walking time supports the use of walking tests as a summary measure of disease in older adults. The independent association of walking time with physical activity suggests that it is sensitive to levels of fitness as well. Together these findings show that walking performance is a valid indicator of physiologic reserve in older adults. WALKING endurance tests are increasingly used to estimate exercise capacity in older adults (1 3). The 6-minute walk test was developed to assess treatment response in patients with congestive heart failure (4) and chronic obstructive pulmonary disease (5) as an alternative to treadmill testing in those unable to maintain pace and balance (6). The long-distance corridor walk test (LDCW) was developed as an alternative to the 6-minute walk in order to extend the testing range of self-paced walking tests in older adults. It is similar to the 6-minute walk except that, instead of holding the time walking constant, it holds a distance (400 m) constant (7). In a head-to-head comparison in elderly subjects, the LDCW was more reproducible and more closely associated with VO 2 max than the 6-minute walk test (7). We used the LDCW to assess walking endurance in a cohort of well-functioning older adults to describe function in the normal to exceptionally high range. We also assessed heart rate and blood pressure response to the test, since heart rate and heart rate recovery are predictive of cardiovascular disease and mortality (8,9), and blood pressure response reflects myocardial work and oxygen consumption (10 12). In this article, we describe the range of performance and cardiovascular response to this test and associations with health factors. We hypothesized that walking endurance and cardiovascular response would vary substantially with the extent of common chronic conditions and also with subclinical disease. We further hypothesized that these conditions might explain a lower performance in older, overweight, and inactive participants. METHODS Population The study population consisted of 3075 men and women aged participating in the Health, Aging and Body Composition (Health ABC) study, designed to prospectively assess the impact of weight and health conditions on incident mobility limitation. Eligibility criteria included no reported difficulty with walking a quarter mile, climbing 10 steps, or performing activities of daily living. Those with life-threatening cancer or plans of leaving the area within 3 years were excluded. Long-Distance Corridor Walk Participants were asked to walk 400 meters after a 2- minute warm-up. The course consisted of 10 laps in a long hallway around cones set 20 meters apart (40 meters per lap) with instructions to walk at a pace that you can maintain for the full 10 laps. Standard encouragement was given at each lap. Persons with baseline potentially acute electrocardiogram (ECG) abnormalities, elevated blood pressure 715
2 716 NEWMAN ET AL. (200/110 mmhg), resting heart rate.120 or,40 beats per minute (bpm), recent exacerbation of chest pain, shortness of breath, or reporting a recent cardiac event or procedure were excluded for safety reasons. Heart rate was monitored with a Polar Pacer heart monitor (Model No ; Woodbury, NY). The test was stopped if heart rate exceeded 135 bpm or if a participant reported chest pain or dyspnea during the test. Heart rate was recorded at rest before starting the walk, at completion, and at recovery 2 minutes later (6). Systolic blood pressure (SBP) was measured while standing prior to the walk and at completion. Demographics and Health Age, gender, and race were assessed along with a detailed health history and medication inventory. Weight, height, and other anthropometrics, blood pressure, heart rate, pulmonary function testing, ECG, ankle arm blood pressure index (AAI), oral glucose tolerance test, and assessments of strength and physical functioning were assessed, in addition to dual energy x-ray absorptiometry (DEXA) for bone density as well as total and regional body composition (13). Prevalent health conditions were determined by a combination of self-report and use of specific medications. Knee pain was considered to be consistent with osteoarthritis if reported to be present for at least 1 month of the past year. Noninvasive tests including the AAI of,0.9 (14), major but nonacute ECG abnormalities (15), pulmonary function (FEV 1 /FVC [forced expiratory volume/forced vital capacity],70%) (16), fasting glucose.126 (17), blood pressure.140/90 (18), and a Center for Epidemiologic Studies Depression (CES-D) score of.15 (19) were examined as indicators of subclinical disease and as independent predictors of function and were not used to define prevalent disease. Physical activity was calculated as total kilocalories from metabolic equivalents assigned to self-reported physical activities and exercise (20). Body mass index (BMI) was calculated as kg/m 2, and total fat and bone-free lean mass were measured by DEXA scan (13) (Hologic, Waltham, MA). Analysis Participants who were excluded from the 400-meter walk, those starting but not completing, and those completing the walk were compared by analysis of variance (ANOVA) and the chi-square test of proportions. In those who completed the 400-meter walk, mean walk time, heart rate response, heart rate recovery, and SBP response were compared using ANOVA. Stepwise linear regression was used to model the predictors of 400-meter walk time, heart rate response, heart rate recovery, and SBP response. In one set of models, body composition (fat mass, bone-free lean mass) and height were substituted for BMI. Interactions with race and gender were evaluated, and none were significant. RESULTS Of 3075 participants, 2680 (87%) were eligible for the test and 2324 (76%) completed the full 400 meters. Of the 2680 that started the test, 1.8% could not complete the 2-minute walk, 2.2% did not start the 400-meter walk, and 9.4% did not complete the full distance due to elevated heart rate or symptoms. Those who were excluded or did not complete the 400-meter walk were slightly older, had a higher BMI, were less physically active, and had a greater prevalence of several conditions, compared with those who completed the test (Table 1). Participants completed the 400-meter walk, on average, in about 320 seconds (5 minutes and 20 seconds). Times were slower in each older age group (Table 2), in women, and in blacks. For each clinical condition, participants with the condition were slower than those without. Participants at the extremes of BMI had slower times, while those with higher physical activity had faster times. Participants with any subclinical disease marker were slower than those without. In a multivariate regression model (Table 3), age, female gender, black race, peripheral artery disease, stroke, knee pain, depression, AAI,0.9, major ECG abnormality, and an FEV 1 /FVC,70%, higher BMI, and lower physical activity were all independently associated with slower time. Even after adjustment, gender and race differences remained quite large, with women taking about 32 seconds longer, on average, than men, and blacks taking about 30 seconds longer than whites. The adjusted association with age was fairly small per year of age, but would indicate about 30 seconds slower time across the decade of age in this study. Analyses were repeated replacing BMI with body composition including total fat mass, bone-free lean mass, and height. In bivariate analyses, there was a direct relationship between time and both height and lean mass, such that taller individuals and those with more lean mass had faster times, and those at the extremes of fat mass had slower times. Moving average plots suggested that walk time was optimal at a percent fat range of 19% 27% in men and 28% 37% in women. In the final model, walk time was significantly and independently related to the square of fat mass but not height or lean mass. This did not alter the associations with clinical or subclinical disease, although the association with female gender was partly attenuated. The SBP response to the test averaged about 16.4 mmhg in men and 17.7 mmhg in women (Table 4). Within the men, there was no association with race, while among women, blacks had a higher SBP response. The SBP response varied very little by presence or absence of each health condition. The largest increase was noted in diabetics, whose SBP rose on average mmhg during the test compared with mmhg in those without diabetes ( p,.0001). SBP response was greater in each higher gender-specific quartile of BMI, ranging from 10.1 to 14.5 mmhg from lowest to highest quartile, p ¼.007. In a multivariate model (Table 5), stroke, diabetes, knee pain, BMI, AAI,0.9, and major ECG abnormalities were all independently associated with greater SBP response, but these factors explained only 5% of the variance. When walk time was added to this model, it was independently associated with SBP response (Beta [SE]) ¼ (0.01), p value ¼.0001, model r 2 ¼ 7%), but did attenuate associations with disease. Heart rate response averaged a little over 25 bpm, consistent with moderate exercise intensity (Table 4), and did not vary significantly with age, gender, or race. Those with coronary heart disease, stroke, and hypertension had
3 WALKING PERFORMANCE AND CARDIOVASCULAR RESPONSE 717 Table 1. Characteristics of Health, Aging and Body Composition Study Participants Who Were Excluded From, Stopped, or Completed the Long-Distance Corridor Walk Characteristic Excluded (N ¼ 395) Incomplete (N ¼ 356) Completed 400 m (N ¼ 2324) ANOVA p Value Age (y, mean 6 SD) Gender/race Men (n ¼ 1491) n ¼ 180 n ¼ 122 n ¼ 1189 Black (n ¼ 552) n ¼ 84 n ¼ 59 n ¼ 409 White (n ¼ 939) n ¼ 96 n ¼ 63 n ¼ Age (y, mean 6 SD) Women (n ¼ 1584) n ¼ 215 n ¼ 234 n ¼ 1135 Black (n ¼ 729) n ¼ 123 n ¼ 140 n ¼ 466 White (n ¼ 855) n ¼ 92 n ¼ 94 n ¼ Age (y, mean 6 SD) Body mass index (kg/m 2, mean 6 SD) Physical activity (kcal, mean 6 SD) Clinical disease n (%) n (%) n (%) Coronary heart disease (n ¼ 513/3075) 112 (28.8) 73 (20.5) 328 (14.1).0001 Peripheral arterial disease (n ¼ 158/3075) 25 (6.3) 40 (11.2) 93 (4.0).0001 Stroke (n ¼ 247/3075) 44 (11.1) 46 (12.9) 157 (6.8).0001 Hypertension (n ¼ 1366/3075) 222 (56.2) 188 (52.8) 956 (41.1).0001 Diabetes (n ¼ 468/3075) 81 (20.5) 77 (21.6) 310 (13.3).0001 Pulmonary disease (n ¼ 126/2885) 36 (9.9) 20 (5.9) 70 (3.2).0001 Knee pain (n ¼ 170/3035) 24 (6.2) 30 (8.5) 116 (5.1).0275 Depression (n ¼ 192/3075) 28 (7.1) 21 (5.9) 143 (6.2).7458 Subclinical disease* n (%) n (%) n (%) Ankle Arm Index,0.9 (n ¼ 448/2114) 82 (29.0) 80 (28.3) 286 (14.3).0001 Major ECG abnormalities (n ¼ 702/2562) 108 (38.2) 87 (30.7) 507 (25.4).0001 FEV 1 /FVC,70% (n ¼ 681/2759) 125 (38.1) 90 (13.2) 466 (22.1).0001 Fasting glucose.126 mmhg (n ¼ 109/2607) 69 (17.5) 67 (18.8) 275 (11.8).0001 SBP. 140 or DBP. 90 (n ¼ 545/1709) 180 (45.6) 156 (43.8) 884 (38.0).0043 CES-D score. 15 (n ¼ 98/2883) 29 (7.3) 12 (3.4) 80 (3.4).0009 Notes: *Among those without clinical disease. ECG ¼ electrocardiogram; FEV 1 ¼ forced expiratory volume in 1 second; FVC ¼ forced vital capacity; SBP ¼ systolic blood pressure; DBP ¼ diastolic blood pressure; CES-D ¼ Center for Epidemiologic Studies-Depression; SD ¼ standard deviation; ANOVA ¼ analysis of variance. somewhat lower heart rate responses of borderline significance, in accord with slower walk times for each of these groups. Those with higher BMI had slightly higher heart rate response varying from to from lowest to highest gender-specific quartile ( p ¼.002). The differences were similar across lowest to highest physical activity group. None of the subclinical disease markers were associated with heart rate response. In a multivariate model (Table 6), coronary artery disease, lower BMI, higher physical activity, and higher CES-D were all independently associated with a lower heart rate response. In these models, women and blacks had greater heart rate response, while age was not related. These factors together only explained 2% of the variance in heart rate. Walk time itself, when added to the model, was strongly and independently associated with heart rate response (Beta [SE] ¼ (0.01), p value ¼.0001). The variance explained by the full model including walk time and the other factors was 17%. Heart rate recovery at 2 minutes averaged about bpm or about one half of heart rate response (Table 4). Recovery was highly correlated with response (r ¼.55, p,.001) and varied little by age, race, gender, or with presence or absence of clinical or subclinical disease. Those in the highest quartile of BMI and with lower physical activity had greater heart rate recovery. In a regression model (not shown), the explained variance was 2%, and, with the addition of walk time to the models, the r 2 value increased to 14%. DISCUSSION The majority of these well-functioning, nondisabled year-old men and women in Health ABC were able to walk 400 meters, and completed the test with heart rate and blood pressure responses in the range expected for a moderate level of exertion. Walking performance was influenced by both clinical and subclinical disease, but was also strongly related to body weight and self-reported physical activity. The associations with BMI and physical activity were not explained by greater clinical or subclinical disease. Age, gender, and race remained associated with walk time after consideration of health, weight, and activity. These data support the use of this test as a measure of health status. The independent association with physical activity suggests that it is sensitive to levels of fitness as well. Higher resting heart rate (21) and slow heart rate recovery (8) of,12 beats in 2 or more minutes have been associated with future cardiovascular mortality. The extent of both heart rate and blood pressure response to the LDCW test was reassuring in that the levels of blood pressure and heart rates achieved indicate a safe range for testing outside of
4 718 NEWMAN ET AL. Table 2. Factors Associated With 400-Meter Walk Time in Bivariate Associations, Health, Aging and Body Composition Study Characteristic Walk Time (s) p Value Age quartiles Gender Men Women Race Men Black White Women Black White Body Mass Index gender-specific quartiles Q Q Q Q Physical activity (kcal/wk), Clinical disease Coronary heart disease Yes No Peripheral arterial disease Yes No Stroke Yes No Hypertension Yes No Diabetes Yes No Pulmonary disease Yes No Knee pain Yes No History of depression Yes No Subclinical disease* Ankle Arm Index,0.9 Yes No Major ECG abnormalities Yes No Table 2. Factors Associated With 400-Meter Walk Time in Bivariate Associations, Health, Aging and Body Composition Study (Continued ) Characteristic Walk Time (s) p Value FEV 1 /FVC,70% Yes No Fasting glucose.126 mmhg Yes No SBP.140 or DBP.90 Yes No CES-D.15 Yes No Notes: *Among those without clinical disease. ECG ¼ electrocardiogram; FEV 1 ¼ forced expiratory volume in 1 second; FVC ¼ forced vital capacity; SBP ¼ systolic blood pressure; DBP ¼ diastolic blood pressure; CES-D ¼ Center for Epidemiologic Studies-Depression. a clinical ECG-monitored setting. The LDCW test, while it encourages a good effort, is self-paced so that a participant can stop at any time. A substantial number (356, or 13%) of those who started the test stopped walking because of Table 3. Factors Associated With 400-Meter Walk Time: Multivariate Linear Regression, Health, Aging and Body Composition Study Characteristic Beta (SE) p Value Age (y) 3.78 (0.43).0001 Women (2.53).0001 Black race (2.67).0001 Body Mass Index gender-specific quartiles Q1 Q2 ÿ1.25 (3.34).7079 Q (3.41).0239 Q (3.62).0001 Physical activity (log kcal) ÿ6.59 (0.73).0001 Clinical disease Coronary heart disease Peripheral arterial disease (6.36).0011 Stroke (4.97).0015 Hypertension Diabetes Pulmonary disease Knee pain (5.49).0001 History of depression (5.10).0202 Subclinical disease Ankle Arm Index, (3.61).0005 Major ECG abnormalities 6.49 (2.72).0169 FEV 1 /FVC,70% (2.90).0001 Fasting glucose.126 mmhg SBP.140 or DBP.90 CES-D.15 Model R 2 ¼.2764 Note: ECG ¼ electrocardiogram; FEV 1 ¼ forced expiratory volume in 1 second; FVC ¼ forced vital capacity; SBP ¼ systolic blood pressure; DBP ¼ diastolic blood pressure; CES-D ¼ Center for Epidemiologic Studies-Depression; SE ¼ standard error.
5 WALKING PERFORMANCE AND CARDIOVASCULAR RESPONSE 719 Table 4. Cardiovascular Responses to 400-Meter Walk by Age, Gender, and Race SBP Response (mmhg, Mean 6 SD) HR Response (bpm, Mean 6 SD) HR Recovery (bpm, Mean 6 SD) p Value p Value p Value Age quartiles Gender Men Women Race Men Black White Women Black White Note: SBP¼ systolic blood pressure; HR ¼ heart rate; bpm ¼ beats per minute. Table 5. Factors Associated With Systolic Blood Pressure Response to 400-Meter Walk: Multiple Linear Regression SBP Response Beta (SE) p Value Age (y) Women Black race Coronary heart disease Peripheral arterial disease Stroke 3.24 (1.76).0660 Hypertension Diabetes 3.64 (1.73).0357 Pulmonary disease Knee pain ÿ4.27 (2.02).0347 Depression Body mass index (kg/m 2 )* Q (1.33).4197 Q (1.34).4029 Q (1.34).0025 Physical activity (log kcal) Ankle Arm Index, (1.25).0008 Major ECG abnormality 2.35 (1.04).0234 FEV 1 /FVC,70 Fasting glucose.126 mg/dl 2.94 (1.79).1008 SBP.140 or DBP.90 mmhg ÿ4.61 (0.96).0001 CES-D score.15 Model R 2 ¼.0478 Notes: *Gender-specific quartiles. ECG ¼ electrocardiogram; SBP ¼ systolic blood pressure; DBP ¼ diastolic blood pressure; FEV 1 ¼ forced expiratory volume in 1 second; FVC ¼ forced vital capacity; CES-D ¼ Center for Epidemiologic Studies-Depression. an elevated heart rate (.135 bpm), fatigue, dyspnea, or leg pain. There were no symptoms requiring medical intervention during or following the testing. Most of the heart rate response and recovery was explained by the walk time itself. Since we did not push for either a maximal effort or a target heart rate, the heart rate response would be less standardized than during a treadmill test with a specified target heart rate. These cardiovascular responses will be examined as predictors of future health outcomes in this cohort, but may not be independent of actual walk performance as predictors. The double product of heart rate and SBP is thought to reflect myocardial oxygen consumption (22). The blood pressure response varied little, but was highest in diabetics and at higher BMI, such that a calculated double product for these groups would be consistent with higher myocardial work with walking. The Cardiovascular Health Study (CHS) has also reported walk performance in community-dwelling older adults, Table 6. Factors Associated With Heart Rate Response to the Long-Distance Corridor Walk Test: Stepwise Multiple Linear Regression HR Response Beta (SE) p Value Age (y) Women Black race Coronary heart disease ÿ Peripheral arterial disease ÿ Stroke Hypertension Diabetes Pulmonary disease Knee pain Depression Body mass index (kg/m 2 )* Q (0.89).0042 Q (0.90).0002 Q (0.93).0001 Physical activity (log kcal) 1.01 (0.19).0001 Ankle Arm Index,0.9 Major ECG abnormality FEV 1 /FVC,70 ÿ Fasting glucose.126 mg/dl SBP.140 or DBP.90 mmhg CES-D score.15 ÿ Model R 2 ¼.0235 Notes: *Gender-specific quartiles. HR ¼ heart rate; ECG ¼ electrocardiogram; FEV 1 ¼ forced expiratory volume in 1 second; FVC ¼ forced vital capacity; SBP ¼ systolic blood pressure; DBP ¼ diastolic blood pressure; CES-D ¼ Center for Epidemiologic Studies- Depression.
6 720 NEWMAN ET AL. but used the 6-minute walk test (23). The associations with obesity and clinical and subclinical disease were quite similar to those reported here. Although either test can be used to evaluate older adults, the approach of using a set distance is more reproducible and more closely related to maximal oxygen consumption (7). The U-shaped association with BMI was also noted in the CHS. We were able to examine body composition in more detail, and the findings are similar in that those at the extremes of directly measured body fat had a worse performance than those in the middle range. The ranges of percent body fat for optimal walk performance are similar to the optimal range found for this cohort for muscle strength (24). Lean mass is the major location of oxygen uptake during exercise, but was not independently associated with walk time in these analyses. This latter finding is consistent with the finding that fat mass was more strongly associated than lean mass with lower extremity functioning in this cohort (25). Several factors should be considered when interpreting these data. We were cautious in excluding and stopping participants, and results may not generalize to those individuals. While we would assume that disease burden, higher weight, and lower activity would cause a lower walking ability, these data are cross-sectional and causality cannot be determined. Finally, we did not assess motivational factors, which can also influence performance (26). The independent contribution of both clinical and subclinical disease to performance supports the use of walking tests as a measure of health status in older adults. We dichotomized subclinical measures at levels consistent with undiagnosed disease. In many cases the subclinical diseases were just as common as reported diagnoses. Performance on this test may be capturing very early effects of disease before classic symptoms occur, or decline in walking ability might be considered an early symptom of disease itself. Use of this test in clinical practice might raise awareness as to the extent that older adults may be impaired in walking performance. ACKNOWLEDGMENTS This study was supported by National Institute on Aging contracts N01- AG , N01-AG , and N01-AG Address correspondence to Anne B. Newman, MD, MPH, Healthy Aging Research Program, University of Pittsburgh, Bellefield Professional Building, 130 North Bellefield Avenue, Room 532, Pittsburgh, PA newmana@edc.pitt.edu REFERENCES 1. Simonsick EM, Newman AB, Nevitt MC, et al. Measuring higher level physical function in well-functioning older adults: expanding familiar approaches in the HABC study. J Gerontol Med Sci. 2001;56A:M644 M Gill TM, DiPietro L, Krumholz HM. Role of exercise stress testing and safety monitoring for older persons starting an exercise program. JAMA. 2000;284: Enright PL, McBurnie MA, Bittner V, et al. The 6-minute walk test: a quick measure of functional status in elderly adults. Chest. 2003; 123: Bittner V, Weiner DH, Yusaf S, et al. Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. JAMA. 1993;270: Rejeski WJ, Foley KO, Woodard CM, Zaccaro DJ, Berry MJ. Evaluating and understanding performance testing in COPD patients. J Cardiopulm Rehab. 2000;20: Ettinger WH, Burns R, Messier SP, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis: the fitness arthritis and seniors trial (FAST). JAMA. 1997;277: Simonsick EM, Montgomery PS, Newman AB, Bauer DC, Harris T. Measuring fitness in healthy older adults: the Health ABC long distance corridor walk. Am Geriatrics Soc. 2001;49: Cole CR, Foody JM, Blackstone EH, Lauer MS. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med. 2000;132: Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS. Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: the case of stress echocardiography. Circulation. 2001;104: Blair SN, Goodyear N, Gibbons L, Cooper K. Physical fitness and incidence of hypertension in healthy normotensive men and women. JAMA. 1984;252: Duncan JJ, Farr JE, Upton SJ, Hagan RD, Oglesby ME, Blair SN. The effects of aerobic exercise on plasma catecholamines and blood pressure in patients with mild essential hypertension. JAMA. 1985; 254: McMurray RG, Ainsworth BE, Harrell JS, Griggs TR, Williams OD. Is Physical activity or aerobic power more influential on reducing cardiovascular disease risk factors? Med Sci Sports Exerc. 1998;30: Visser M, Fuerst T, Lang T, Salamone L, Harris TB. Validity of fanbeam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass: Health, Aging, and Body Composition Study Dual-Energy X-ray Absorptiometry and Body Composition Working Group. J Appl Physiol. 1999;87: Newman AB, Siscovick DS, Manolio TA, et al. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Circulation. 1993;88: Furberg CD, Manolio TA, Psaty BM, et al. Major electrocardiographic abnormalities in persons aged 65 years and older (the Cardiovascular Health Study). Am J Cardiol. 1992;69: Waterer GW, Wan JY, Kritchevsky SB, et al. Airflow limitation is underrecognized in well-functioning older people. J Am Gerontol Soc. 2001;49: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20: The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1997;157: Orlando M, Sherbourne CD, Thissen D. Summed-score linking using item response theory: application to depression measurement. Psychol Assess. 2000;12: Havlik RJ, Simonsick EM, Sutton-Tyrrell K, et al. Association of physical activity and improved vascular stiffness in year olds: the Health ABC Study. J Aging Phys Activ. In press. 21. Kannel WB, Kannel C, Paffenbarger RS, Cupples A. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J. 1987; 113: Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heartrate recovery immediately after exercise as predictor of mortality. N Engl J Med. 1999;341: Jorgensen CR, Wang K, Wang Y, Gobel FL, Nelson RR, Taylor HL. Effect of propranolol on myocardial oxygen consumption and its hemodynamic correlates during upright exercise. Circulation. 1973;48: Newman AB, Haggerty CL, Goodpaster B, et al. Strength and muscle quality in a well-functioning cohort of older adults: the Health Aging and Body Composition Study. J Am Geriatr Soc. 2003;51: Visser M, Deeg DJH, Lips P, Harris T, Bouter LM. Skeletal muscle mass and muscle strength in relation to lower-extremity performance in older men and women. J Am Gerontol Soc. 2000;48: Bean JF, Kiely DK, Leveille SG, et al. The 6-minute walk test in mobility-limited elders: what is being measured? J Gerontol Med Sci. 2002;57A:M751 M756. Received January 29, 2003 Accepted February 24, 2003
Association of Long-Distance Corridor Walk Performance With Mortality, Cardiovascular Disease, Mobility Limitation, and Disability
ORIGINAL CONTRIBUTION Association of Long-Distance Corridor Walk Performance With Mortality, Cardiovascular Disease, Mobility Limitation, and Disability Anne B. Newman, MD, MPH Eleanor M. Simonsick, PhD
More informationChanges in body composition, including a decrease in
Sarcopenia: Alternative Definitions and Associations with Lower Extremity Function Anne B. Newman, MD, MPH, Varant Kupelian, MS, Marjolein Visser, PhD, w Eleanor Simonsick, PhD, z Bret Goodpaster, PhD,
More informationMeasuring Higher Level Physical Function in Well-Functioning Older Adults: Expanding Familiar Approaches in the Health ABC Study
Journal of Gerontology: MEDICAL SCIENCES 2001, Vol. 56A, No. 10, M644 M649 Copyright 2001 by The Gerontological Society of America Measuring Higher Level Physical Function in Well-Functioning Older Adults:
More informationNIH Public Access Author Manuscript J Aging Phys Act. Author manuscript; available in PMC 2011 March 14.
NIH Public Access Author Manuscript Published in final edited form as: J Aging Phys Act. 2008 October ; 16(4): 408 415. Maximal Fitness Testing in Sedentary Elderly at Substantial Risk of Disability: LIFE-P
More informationImpaired Chronotropic Response to Exercise Stress Testing in Patients with Diabetes Predicts Future Cardiovascular Events
Diabetes Care Publish Ahead of Print, published online May 28, 2008 Chronotropic response in patients with diabetes Impaired Chronotropic Response to Exercise Stress Testing in Patients with Diabetes Predicts
More informationA Comparative Study of Physical Fitness among Rural Farmers and Urban Sedentary Group of Gulbarga District
AJMS Al Ameen J Med Sci (20 1 2 )5 (1 ):3 9-4 4 (A US National Library of Medicine enlisted journal) I S S N 0 9 7 4-1 1 4 3 C O D E N : A A J M B G ORIGI NAL ARTICLE A Comparative Study of Physical Fitness
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 informationARIC Manuscript Proposal # PC Reviewed: 2/10/09 Status: A Priority: 2 SC Reviewed: Status: Priority:
ARIC Manuscript Proposal # 1475 PC Reviewed: 2/10/09 Status: A Priority: 2 SC Reviewed: Status: Priority: 1.a. Full Title: Hypertension, left ventricular hypertrophy, and risk of incident hospitalized
More informationORIGINAL INVESTIGATION. C-Reactive Protein Concentration and Incident Hypertension in Young Adults
ORIGINAL INVESTIGATION C-Reactive Protein Concentration and Incident Hypertension in Young Adults The CARDIA Study Susan G. Lakoski, MD, MS; David M. Herrington, MD, MHS; David M. Siscovick, MD, MPH; Stephen
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 informationThe Lifestyle Interventions and Independence for Elders Pilot (LIFE-P): 2-Year Follow-up
Journal of Gerontology: MEDICAL SCIENCES The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. cite journal as: J Gerontol A Biol Sci Med Sci All rights
More informationLoss of lean mass with aging, and the associated declines
CLINICAL INVESTIGATION Protein Intake and Mobility Limitation in Community-Dwelling Older Adults: the Health ABC Study Denise K. Houston, PhD,* Janet A. Tooze, PhD,* Katelyn Garcia, MS,* Marjolein Visser,
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 informationEffect of Training Mode on Post-Exercise Heart Rate Recovery of Trained Cyclists
Digital Commons at Loyola Marymount University and Loyola Law School Undergraduate Library Research Award ULRA Awards Effect of Training Mode on Post-Exercise Heart Rate Recovery of Trained Cyclists Kelia
More informationThe role of physical activity in the prevention and management of hypertension and obesity
The 1 st World Congress on Controversies in Obesity, Diabetes and Hypertension (CODHy) Berlin, October 26-29 2005 The role of physical activity in the prevention and management of hypertension and obesity
More information3/25/2010. Age-adjusted incidence rates for coronary heart disease according to body mass index and waist circumference tertiles
Outline Relationships among Regional Adiposity, Physical Activity, and CVD Risk Factors: Preliminary Results from Two Epidemiologic Studies Molly Conroy, MD, MPH Obesity Journal Club February 18, 2010
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Bucholz EM, Butala NM, Ma S, Normand S-LT, Krumholz HM. Life
More informationWeight Loss and Regain and Effects on Body Composition: The Health, Aging, and Body Composition Study
Journal of Gerontology: MEDICAL SCIENCES The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. Cite journal as: J Gerontol A Biol Sci Med Sci All rights
More informationEffect of intravenous atropine on treadmill stress test results in patients with poor exercise capacity or chronotropic incompetence ABSTRACT
Effect of intravenous atropine on treadmill stress test results in patients with poor exercise capacity or chronotropic incompetence Samad Ghaffari, MD, Bahram Sohrabi, MD. ABSTRACT Objective: Exercise
More informationPHYSICAL EDUCATION HANDOUT 3º E.S.O. PHYSICAL FITNESS AND HEALTH FITNESS COMPONENTS
PHYSICAL EDUCATION HANDOUT 3º E.S.O. PHYSICAL FITNESS AND HEALTH FITNESS COMPONENTS CURSO 2010/2010 Teacher: Daniel Martínez Gallego IES LA SAGRA 1. PHYSICAL FITNESS AND HEALTH Healthy: to be free from
More informationK-STATE CROSSFIT PROGRAM EVALUATION SYSTEM NORMATIVE VALUES. Table of Contents
K-STATE CROSSFIT PROGRAM EVALUATION SYSTEM NORMATIVE VALUES Table of Contents Item Page(s) Health Measures 1-3 Body Mass Index 1 Waist Circumference 1 Body Fat Percentage 1-2 Resting Heart Rate 2-3 Resting
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 informationAdult Pre Participation Screening and Exercise Prescription Practicum
Adult Pre Participation Screening and Exercise Prescription Practicum Objectives of this exercise: To administer pre participation screening and risk stratification for clients To write an appropriate
More informationSYNOPSIS. Publications No publications at the time of writing this report.
Drug product: TOPROL-XL Drug substance(s): Metoprolol succinate Study code: D4020C00033 (307A) Date: 8 February 2006 SYNOPSIS Dose Ranging, Safety and Tolerability of TOPROL-XL (metoprolol succinate) Extended-release
More information36-Item Short Form Survey (SF-36) Versus Gait Speed as a Predictor of Preclinical Mobility Disability in Older Women
36-Item Short Form Survey (SF-36) Versus Gait Speed as a Predictor of Preclinical Mobility Disability in Older Women May 2018 WHI Investigator Meeting MS 2744 J Am Geriatr Soc. 2018 Feb 10. doi: 10.1111/jgs.15273.
More informationApproximately 60% of cancers are diagnosed in persons
Physical Performance and Subsequent Disability and Survival in Older Adults with Malignancy: Results from the Health, Aging and Body Composition Study HeidiD.Klepin,MD,MS, Ann M. Geiger, PhD, w JanetA.Tooze,PhD,
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 informationValue of cardiac rehabilitation Prof. Dr. L Vanhees
Session: At the interface of hypertension and coronary heart disease haemodynamics, heart and hypertension Value of cardiac rehabilitation Prof. Dr. L Vanhees ESC Stockholm August 2010 Introduction There
More informationSupplementary Online Content
Supplementary Online Content Regan EA, Lynch DA, Curran-Everett D, et al; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and radiologic disease in smokers with normal spirometry. Published
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 informationPrevention of Atrial Fibrillation and Heart Failure in the Hypertensive Patient
Prevention of Atrial Fibrillation and Heart Failure in the Hypertensive Patient The Issue of Primary Prevention of A.Fib. (and Heart Failure) and not the Prevention of Recurrent A.Fib. after Electroconversion
More informationThe magnitude and duration of ambulatory blood pressure reduction following acute exercise
Journal of Human Hypertension (1999) 13, 361 366 1999 Stockton Press. All rights reserved 0950-9240/99 $12.00 http://www.stockton-press.co.uk/jhh ORIGINAL ARTICLE The magnitude and duration of ambulatory
More informationEndpoints And Indications For The Older Population
Endpoints And Indications For The Older Population William J. Evans, Head Muscle Metabolism Discovery Unit, Metabolic Pathways & Cardiovascular Therapy Area Outline Functional Endpoints and Geriatrics
More informationLower extremity peripheral arterial disease (PAD) affects
Asymptomatic Peripheral Arterial Disease Is Independently Associated With Impaired Lower Extremity Functioning The Women s Health and Aging Study Mary McGrae McDermott, MD; Linda Fried, MD, MPH; Eleanor
More informationORIGINAL INVESTIGATION. Profile for Estimating Risk of Heart Failure
ORIGINAL INVESTIGATION Profile for Estimating Risk of Heart Failure William B. Kannel, MD, MPH; Ralph B. D Agostino, PhD; Halit Silbershatz, PhD; Albert J. Belanger, MS; Peter W. F. Wilson, MD; Daniel
More informationASSESSMENT OF CARDIAC AUTONOMIC FUNCTION BY POST EXERCISE HEART RATE RECOVERY IN DIABETICS
2017 ILEX PUBLISHING HOUSE, Bucharest, Roumania http://www.jrdiabet.ro Rom J Diabetes Nutr Metab Dis. 24(4):289-293 doi: 10.1515/rjdnmd-2017-0034 ASSESSMENT OF CARDIAC AUTONOMIC FUNCTION BY POST EXERCISE
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 informationWelcome! ACE Personal Trainer Virtual Exam Review: Module 5. Laura Abbott, MS, LMT. What We ll Cover This Module
Welcome! ACE Personal Trainer Virtual Exam Review: Module 5 Laura Abbott, MS, LMT Master s Degree, Sports Medicine Licensed Massage Therapist Undergraduate degree in Exercise Science Instructor of Kinesiology,
More informationSECONDARY HYPERTENSION
HYPERTENSION Hypertension is the clinical term used to describe a high blood pressure of 140/90 mmhg or higher (National Institute of Health 1997). It is such a health risk the World Health Organisation
More informationStroke A Journal of Cerebral Circulation
Stroke A Journal of Cerebral Circulation JULY-AUGUST VOL. 7 1976 NO. 4 Components of Blood Pressure and Risk of Atherothrombotic Brain Infarction: The Framingham Study WILLIAM B. KANNEL, M.D., THOMAS R.
More informationKnow Your Number Aggregate Report Single Analysis Compared to National Averages
Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics
More informationUniversity of Padova, Padua, Italy, and HARVEST Study Group, Italy
University of Padova, Padua, Italy, and HARVEST Study Group, Italy ISOLATED SYSTOLIC HYPERTENSION IN THE YOUNG DOES NOT IMPLY AN INCREASED RISK OF FUTURE HYPERTENSION NEEDING TREATMENT Mos L, Saladini
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 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 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 informationFitness Concepts + Principles Packet. Name: Period:
Fitness Concepts + Principles Packet Name: Period: Content Pages + Directions 5 Components of Fitness.................................................... Slides 3-12 FITT Principle.........................................................
More informationSGRQ Questionnaire assessing respiratory disease-specific quality of life. Questionnaire assessing general quality of life
SUPPLEMENTARY MATERIAL e-table 1: Outcomes studied in present analysis. Outcome Abbreviation Definition Nature of data, direction indicating adverse effect (continuous only) Clinical outcomes- subjective
More informationExercise treadmill testing is frequently used in clinical practice to
Preventive Cardiology FEATURE Case Report 55 Commentary 59 Exercise capacity on treadmill predicts future cardiac events Pamela N. Peterson, MD, MSPH 1-3 David J. Magid, MD, MPH 3 P. Michael Ho, MD, PhD
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 informationApproach to CPET. CPET Cases. Case 1 4/4/2018. Impaired? Cardiac factors? Ventilatory factors?
Approach to CPET CPET Cases Neil MacIntyre MD Duke University Medical Center Durham NC Impaired? Work,, /kg Cardiac factors?, /, BP, Rhythm Ventilatory factors? Ve/MVV (incl EIB, trapping), PaCO2 Gas exchange
More informationNFL PLAY 60 FITNESSGRAM Project
Welcome to Part 4 of our 6-part Welcome Series. I m Julie Stefko, Associate Director for the NFL PLAY 60 FITNESSGRAM project. In this segment, we will take a closer look into the specific FG test items
More informationScope
Scope Global burden of heart disease Physical activity trends Overview of CR A happy problem Principles of CR in athletes Classification of sport Existing guidelines Exercise testing & prescription HIIT
More informationKnow Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up
Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up... Study Population: 340... Total Population: 500... Time Window of Baseline: 09/01/13 to 12/20/13... Time Window of Follow-up:
More informationNomogram of the Relation of Brachial-Ankle Pulse Wave Velocity with Blood Pressure
801 Original Article Nomogram of the Relation of Brachial-Ankle Pulse Wave Velocity with Blood Pressure Akira YAMASHINA, Hirofumi TOMIYAMA, Tomio ARAI, Yutaka KOJI, Minoru YAMBE, Hiroaki MOTOBE, Zydem
More informationThe 6-Minute Walk Test in Mobility-Limited Elders: What Is Being Measured?
Journal of Gerontology: MEDICAL SCIENCES 2002, Vol. 57A, No. 11, M751 M756 Copyright 2002 by The Gerontological Society of America The 6-Minute Walk Test in Mobility-Limited Elders: What Is Being Measured?
More informationJOURNAL OF VASCULAR SURGERY Volume 32, Number 6 McDermott et al 1165 METHODS
Lower ankle/brachial index, as calculated by averaging the dorsalis pedis and posterior tibial arterial pressures, and association with leg functioning in peripheral arterial disease Mary McGrae McDermott,
More informationBiostats Final Project Fall 2002 Dr. Chang Claire Pothier, Michael O'Connor, Carrie Longano, Jodi Zimmerman - CSU
Biostats Final Project Fall 2002 Dr. Chang Claire Pothier, Michael O'Connor, Carrie Longano, Jodi Zimmerman - CSU Prevalence and Probability of Diabetes in Patients Referred for Stress Testing in Northeast
More informationAbnormal Heart Rate Recovery Immediately After Cardiopulmonary Exercise Testing in Heart Failure Patients
Abnormal Heart Rate Recovery Immediately After Cardiopulmonary Exercise Testing in Heart Failure Patients Tuba BILSEL, 1 MD, Sait TERZI, 1 MD, Tamer AKBULUT, 1 MD, Nurten SAYAR, 1 MD, Gultekin HOBIKOGLU,
More informationFitness and Wellness 12th Edition Hoeger TEST BANK Full download at:
Fitness and Wellness 12th Edition Hoeger TEST BANK Full download at: https://testbankreal.com/download/fitness-wellness-12th-edition-hoeger-testbank/ Fitness and Wellness 12th Edition Hoeger SOLUTIONS
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 informationHeart Rate Acceleration and Recovery Indices are Not Related to the Development of Ventricular Premature Beats During Exercise Test
Original Article Acta Cardiol Sin 2014;30:259 265 Electrophysiology & Arrhythmia Heart Rate Acceleration and Recovery Indices are Not Related to the Development of Ventricular Premature Beats During Exercise
More informationOriginal Article INTRODUCTION. Abstract
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/103 Isometric exercise and its effect on blood pressure and heart rate; a comparative study between healthy, young,
More informationMy Patient Needs a Stress Test
My Patient Needs a Stress Test Amy S. Burhanna,, MD, FACC Coastal Cardiology Cape May Court House, New Jersey Absolute and relative contraindications to exercise testing Absolute Acute myocardial infarction
More information11/5/2011. Disclosure. Evidence Based Medicine (EBM) ADAPT Clinical Outcomes. 18-month Clinical Outcomes
11/5/2011 and for Arthritis (IDEA) : 18-month Clinical Outcomes Disclosure Messier, S.P., Nicklas, B., Legault, C., Mihalko, S., Miller, G.D., DeVita, P., Hunter, D.J., Eckstein, F., Williamson, J.D.,
More informationPulmonary rehabilitation in severe COPD.
Pulmonary rehabilitation in severe COPD daniel.langer@faber.kuleuven.be Content Rehabilitation (how) does it work? How to train the ventilatory limited patient? Chronic Obstructive Pulmonary Disease NHLBI/WHO
More information심폐지구력검사로서 YMCA 스텝테스트와최대산소섭취량 ( O 2max ) 간의상관성
원저 심폐지구력검사로서 스텝테스트와최대산소섭취량 ( O 2max ) 간의상관성 이온김성수김연수손현진김유미최보율 서울대학교체육교육과 한양대학교의과대학예방의학교실 서론 [8] [34] [12] ( O 2max) [9] [5] [10] [6] [6-8] 72% 15 1 73 57 45 65 mass index) 4 연구대상및방법 1 연구대상 45 65 62 5 57
More informationThe patient with coronary heart disease at altitude: observations during acute exposure to 3100 meters
Journal of Wilderness Medicine 1, 147-153 (1990) The patient with coronary heart disease at altitude: observations during acute exposure to 3100 BJ. MORGAN!, J.K. ALEXANDER2*, S.A. NICOLI l and H.L. BRAMMELU
More informationDeterminants of Heart Rate Recovery in Patients with Suspected Coronary Artery Disease
Kobe J. Med. Sci., Vol. 53, No. 3, pp. 93-98, 2007 Determinants of Heart Rate Recovery in Patients with Suspected Coronary Artery Disease AKIKO NONAKA 1, HIDEYUKI SHIOTANI 2, KIMIKO KITANO 2 and MITSUHIRO
More informationIndividual Study Table Referring to Item of the Submission: Volume: Page:
2.0 Synopsis Name of Company: Abbott Laboratories Name of Study Drug: Meridia Name of Active Ingredient: Sibutramine hydrochloride monohydrate Individual Study Table Referring to Item of the Submission:
More informationHigh intensity exercise improves cardiac structure and function and reduces liver fat in adults with Type 2 diabetes
High intensity exercise improves cardiac structure and function and reduces liver fat in adults with Type 2 diabetes Sophie Cassidy, s.cassidy@ncl.ac.uk 1) Concentric remodelling 1.2 * Eccentricity ratio
More informationDrug Side Effects That Mimic Aging
Drug Side Effects That Mimic Aging Darrell R. Abernethy, MD, PhD Associate Director for Drug Safety FDA PHARMACOKINETIC CHANGES IN THE ELDERLY Process Change with Age Drug Elimination Renal Elimination
More informationExercise: System-Wide Effects
Exercise: System-Wide Effects John M. Jakicic, PhD University of Pittsburgh Distinguished Professor and Chair Department of Health and Physical Activity Director Healthy Lifestyle Institute Director Physical
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 informationASSESSMENT OF ENDURANCE FITNESS
ASSESSMENT OF ENDURANCE FITNESS There are two types of tests to assessment of the aerobic resistance: Maximum effort and submaximal effort. In this post, we have written about the submaximal effort because
More informationAnalyzing diastolic and systolic blood pressure individually or jointly?
Analyzing diastolic and systolic blood pressure individually or jointly? Chenglin Ye a, Gary Foster a, Lisa Dolovich b, Lehana Thabane a,c a. Department of Clinical Epidemiology and Biostatistics, McMaster
More informationYOUNG ADULT MEN AND MIDDLEaged
BRIEF REPORT Favorable Cardiovascular Profile in Young Women and Long-term of Cardiovascular and All-Cause Mortality Martha L. Daviglus, MD, PhD Jeremiah Stamler, MD Amber Pirzada, MD Lijing L. Yan, PhD,
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 informationDr. A. Manjula, No. 7, Doctors Quarters, JLB Road, Next to Shree Guru Residency, Mysore, Karnataka, INDIA.
Original Article In hypertensive patients measurement of left ventricular mass index by echocardiography and its correlation with current electrocardiographic criteria for the diagnosis of left ventricular
More informationAuthor Manuscript Faculty of Biology and Medicine Publication
Serveur Académique Lausannois SERVAL serval.unil.ch Author Manuscript Faculty of Biology and Medicine Publication This paper has been peer-reviewed but does not include the final publisher proof-corrections
More informationCOPD. Helen Suen & Lexi Smith
COPD Helen Suen & Lexi Smith What is COPD? Chronic obstructive pulmonary disease: a non reversible, long term lung disease Characterized by progressively limited airflow and an inability to perform full
More informationProf. Samir Morcos Rafla Alexandria Univ. Cardiology Dept.
Obesity as a risk factor for Atrial Fibrillation Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept. CardioAlex 2010 smrafla@hotmail.com 1 Obesity has reached epidemic proportions in the United
More informationFRAGILITÀ, DISABILITÀ E MALATTIE NELLO STUDIO PRO.V.A. Enzo Manzato (Padova)
FRAGILITÀ, DISABILITÀ E MALATTIE NELLO STUDIO PRO.V.A. Enzo Manzato (Padova) J Am Geriatr Soc 50, 1535, 2002 J Am Geriatr Soc 50, 1535, 2002 Odds Ratios for Activity of Daily Living Disability According
More informationExercise Considerations for Individuals with Cardiovascular Disease
Exercise Considerations for Individuals with Cardiovascular Disease Mary Woessner, PhD Candidate, MA Victoria University Institute of Health and Sport Cardiovascular Disease Definition: Heart conditions
More informationHypertension Management Controversies in the Elderly Patient
Hypertension Management Controversies in the Elderly Patient Juan Bowen, MD Geriatric Update for the Primary Care Provider November 17, 2016 2016 MFMER slide-1 Disclosure No financial relationships No
More informationClinical Treatment of Obesity in Older Women. Barbara Nicklas J. Paul Sticht Center on Aging
Clinical Treatment of Obesity in Older Women Barbara Nicklas J. Paul Sticht Center on Aging In my day, people died. In my day, people died. Trajectory of physical ability Functional Independence Impairment
More informationJournal of Undergraduate Kinesiology Research
Elliptical: Forward vs. Backward 25 Journal of Undergraduate Kinesiology Research Official Research Journal of the Department of Kinesiology University of Wisconsin Eau Claire Volume 2 Number 2 May 2007
More informationThis Protocol is applicable to Class 1, 2, and Class 3 applicants. Resting ECG shall be performed at the following intervals:
SCHEDULE 34: PROTOCOL ON ELECTROCARDIOGRAMS ( ECG ) 1. Applicability This Protocol is applicable to Class 1, 2, and Class 3 applicants. 2. Resting ECG Resting ECG shall be perfmed at the following intervals:
More informationSix minutes walk test outcome measures in children
International Journal of Contemporary Pediatrics Singh V et al. Int J Contemp Pediatr. 2017 May;4(3):921-926 http://www.ijpediatrics.com pissn 2349-3283 eissn 2349-3291 Original Research Article DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20171699
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 informationDiastolic dysfunction predicts impaired aerobic capacity in older HIVinfected
Diastolic dysfunction predicts impaired aerobic capacity in older HIVinfected men Hillary McClintic Virginia Tech Carilion School of Medicine John Gottdiener, MD Kristina Crothers, MD Adeel A. Butt, MD
More informationInternational Journal of Biomedical and Advance Research 318
International Journal of Biomedical and Advance Research 318 PRE AND POST-EXERCISE CHANGES IN CARDIO-PULMONARY FUNCTIONS IN HEALTHY SCHOOL CHILDREN OF GULBARGA DISTRICT Malipatil B.S * and Mohammed Ehtesham
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 informationClinical Study Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI
Journal of Obesity Volume 2013, Article ID 291371, 13 pages http://dx.doi.org/10.1155/2013/291371 Clinical Study Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better
More informationA n aly tical m e t h o d s
a A n aly tical m e t h o d s If I didn t go to the screening at Farmers Market I would not have known about my kidney problems. I am grateful to the whole staff. They were very professional. Thank you.
More informationEvidence-Based Management of CAD: Last Decade Trials and Updated Guidelines
Evidence-Based Management of CAD: Last Decade Trials and Updated Guidelines Enrico Ferrari, MD Cardiac Surgery Unit Cardiocentro Ticino Foundation Lugano, Switzerland Conflict of Interests No conflict
More informationFitness A complete approach to Health. Creating Balance
Fitness A complete approach to Health Creating Balance Fitness Learning Outcomes Phase 1 1. Explain the difference between Fat body weight and Lean body weight and the importance of balance. 2. Categorize
More informationGlossary. Dr Cuisle Forde, Dr Aine Kelly, Dr Mikel Egana and Dr Fiona Wilson
Glossary Dr Cuisle Forde, Dr Aine Kelly, Dr Mikel Egana and Dr Fiona Wilson Glossary A Accelerometer Accelerometers are small light devices and can be attached almost anywhere on the body, and give you
More informationSarcopenia una definicion en evolucion. Hélène Payette, PhD Centre de recherche sur le vieillissement
Sarcopenia una definicion en evolucion Hélène Payette, PhD Centre de recherche sur le vieillissement X Curso ALMA Cancun, Mexico, Julio 2011 NIA conference Epidemiologic and Methodologic Problems in Determining
More informationAdvanced Concepts of Personal Training Study Guide Answer Key
Advanced Concepts of Personal Training Study Guide Answer Key Lesson 22 Working with Special Populations LESSON TWENTY TWO Lesson Twenty Two Working with Special Populations WORKING WITH SPECIAL POPULATIONS
More informationMuscular Fitness and All-Cause Mortality: Prospective Observations
ORIGINAL RESEARCH Journal of Physical Activity and Health, 2004, 1, 7-18 2004 Human Kinetics Publishers, Inc. Muscular Fitness and All-Cause Mortality: Prospective Observations Shannon J. FitzGerald, Carolyn
More information