Clinical determinants of the modified incremental step test in adults with non-cystic fibrosis bronchiectasis / Determinantes clínicos do teste do degrau incremental modificado em adultos com bronquiectasia não fibrocística

ABSTRACT Objectives: This study primarily aimed to investigate the clinical determinants of the Modified Incremental Step Test (MIST) in adults with non-cystic fibrosis bronchiectasis (NCFB). A secondary objective was to compare the cardiopulmonary responses after the MIST and Incremental Shuttle Walk Test (ISWT), two commonly adopted symptom-limited maximum field tests in chronic respiratory diseases. Methods: Forty-six patients with clinically stable bronchiectasis participated in this cross-sectional study. MIST and ISWT were performed to determine exercise capacity, while disease severity, fatigue, and quality of life were assessed using the Bronchiectasis Severity Index (BSI), the Fatigue Severity Scale (FSS), and St. George's Respiratory Questionnaire (SGRQ), respectively. Quadriceps muscle strength was evaluated using a hand-held dynamometer, walking speed with a wireless inertial sensing device, and the level of physical activity (steps/day) with a pedometer. Results: The BSI score, quadriceps muscle strength, daily step count, and the SGRQ total score explained 61.9% of the variance in the MIST (p < 0.001, R2 = 0.67, AR2 = 0.619). The BSI score (r = -0.412, p = 0.004), quadriceps muscle strength (r = 0.574, p = 0.001), daily step count (r = 0.523, p < 0.001), walking speed (r = 0.402, p = 0.006), FSS score (r = -0.551, p < 0.001), and SGRQ total score (r = -0.570, p < 0.001) correlated with the MIST. The patients achieved higher heart rates (HR), HR%, desaturation, dyspnea, and leg fatigue in the MIST compared to the ISWT (p < 0.05). Conclusions: Disease severity, quadriceps muscle strength, physical activity level, and quality of life were determinants of MIST. The advantages of the MIST, including higher cardiopulmonary response than ISWT and greater portability, which facilitates its use in various settings, make MIST the preferred choice for investigating symptom-limited exercise capacity in patients with NCFB.

RESUMO Objetivos: Este estudo teve como objetivo principal investigar os determinantes clínicos do Teste do Degrau Incremental Modificado (TDIM) em adultos com bronquiectasia não fibrocística (BNFC). Um objetivo secundário foi comparar as respostas cardiopulmonares após o TDIM e o Teste Graduado de Caminhada (TGC), dois testes de campo máximos amplamente adotados e limitados por sintomas em doenças respiratórias crônicas. Métodos: Quarenta e seis pacientes com bronquiectasia clinicamente estável participaram deste estudo transversal. O TDIM e TGC foram realizados para determinar a capacidade de exercício, enquanto a gravidade da doença, fadiga e qualidade de vida foram avaliadas usando o Índice de Gravidade da Bronquiectasia (BSI), a Escala de Gravidade da Fadiga (FSS) e o Questionário Respiratório de Saint George (SGRQ), respectivamente. A força muscular do quadríceps foi avaliada usando um dinamômetro manual, a velocidade de caminhada com um dispositivo de sensor inercial sem fio e o nível de atividade física (passos/dia) com um pedômetro. Resultados: O escore BSI, a força muscular do quadríceps, a contagem diária de passos e o escore total do SGRQ explicaram 61,9% da variação no TDIM (p < 0,001, R2 = 0,67, AR2 = 0,619). O escore BSI (r = -0,412, p = 0,004), a força muscular do quadríceps (r = 0,574, p = 0,001), a contagem diária de passos (r = 0,523, p < 0,001), a velocidade de caminhada (r = 0,402, p = 0,006), o escore FSS (r = -0,551, p < 0,001) e o escore total do SGRQ (r = -0,570, p < 0,001) correlacionaram-se com o TDIM. Os pacientes atingiram maiores frequências cardíacas (FC), FC%, dessaturação, dispneia e fadiga nas pernas no TDIM em comparação com o TGC (p < 0,05). Conclusões: A gravidade da doença, a força muscular do quadríceps, o nível de atividade física e a qualidade de vida foram determinantes do TDIM. As vantagens do TDIM, incluindo uma resposta cardiopulmonar mais elevada que no TGC e maior portabilidade, que facilita sua utilização em diversos ambientes, fazem do TDIM a escolha preferencial para investigar a capacidade de exercício limitada por sintomas em pacientes com BNFC.

Comparison of physical fitness and mental stress in exercising and non-exercising medical students

Background: Both physical fitness and mental fitness are essential to achieve success, especially in medical college students, where the academic pressure is high. Studies have shown that exercise helps to reduce mental stress as well as to maintain the fitness. Aims and Objectives: The present study was aimed to compare the level of physical fitness and level of mental stress in exercising and non-exercising medical students. Materials and Methods: A study was done on 60 medical students of age group of 18–20 years with 30 in the exercise group and 30 in the non-exercise group. Modified Harvard step test was used to assess physical fitness index and perceived stress scale questionnaire to assess mental stress. Descriptive analysis and independent t-test were used for statistical analysis. Results: The study demonstrated higher physical fitness (P < 0.01) and lower mental stress levels (P < 0.01) in the exercising group when compared to the non-exercising group. Conclusion: There was better physical fitness and lower mental stress levels among the exercising group when compared with the non-exercising group.

Utility of Amrut Pushti Vardhakpowder in enhancing physical fitness

Background:Physical performance depends on physical fitness. Fit persons can accomplish the tasks. Fitness is modifiable and hence the fitness level can be increased. In this background a need was felt to validate the efficacy of the Amrut Pushti Vardhak(APV)powder, a product developed by DFRL Mysore, for its physical performance enhancing activity by fitness tests. The result of pre-clinical study of the product was encouraging; hence clinical trial was taken up.Methods:All norms of good clinical practiceand ethics were abided. The subjects were assigned in two homogenous groups, as control and trial groups. The trial group was given APVpowder 30gms/day for 21 days in the morning. The other group served as negative control. To evaluate the efficacy modified Harward step test was conducted before and after the intervention.Results:The test group showed statistically significant increase in the duration of exercise with pvalue 0.027 and increase in physical fitness index(PFI)with p value 0.01. The test group also showed statistically significant increase in the maximal oxygen consumption (VO2max) (p=0.004). The increase in physical fitness level can be attributed to ingredients of APVpowder.Conclusions:Healthy volunteers who received APVpowder 30 gms/day for the duration of 21 days reported statistically significant increase in their duration of exercise, PFIand VO2max. This indicates the APVpowder increases in the physical fitness level.

Reference equations of oxygen uptake for the step test in the obese population

The aim of this study was to establish reference equations for the six-minute step test (6MST) based on demographic, anthropometric, body composition, and performance variables able to predict oxygen uptake (V̇O2) in obese individuals. Seventy-three obese adults (42±14 years old, body mass index >30 kg/m2) from both sexes were included. They underwent anamnesis, body composition evaluation, and the 6MST with expired gases registered simultaneously. Three equations were developed for the obese population (n=73; 59% female). The first equation was composed of the up-and-down step cycles (UDS), sex, and age as predictors; the second equation was composed of the UDS, age, and lean mass (LM). Both equations collectively explained 68.1% of the V̇O2 variance in the 6MST, while the third equation, composed of the UDS, age, and body mass, accounted for 67.7% of the V̇O2 variance. UDS, sex, age, LM, and body mass were important V̇O2 predictors of 6MST in these obese individuals. This study contributes to the dissemination of a simple, inexpensive, and fast evaluation method that can provide important indicators of cardiorespiratory fitness and guide strategies for rehabilitation.

Reliability and validity of six-minute step test in patients with heart failure

Exercise intolerance is the hallmark consequence of advanced chronic heart failure (HF). The six-minute step test (6MST) has been considered an option for the six-minute walk test because it is safe, inexpensive, and can be applied in small places. However, its reliability and concurrent validity has still not been investigated in participants with HF with reduced ejection fraction (HFrEF). Clinically stable HFrEF participants were included. Reliability and error measurement were calculated by comparing the first with the second 6MST result. Forty-eight hours after participants underwent the 6MST, they were invited to perform a cardiopulmonary exercise test (CPET) on a cycle ergometer. Concurrent validity was assessed by correlation between number of steps and peak oxygen uptake (V̇O2 peak) at CPET. Twenty-seven participants with HFrEF (60±8 years old and left ventricle ejection fraction of 41±6%) undertook a mean of 94±30 steps in the 6MST. Intra-rater reliability was excellent for 6MST (ICC=0.9), with mean error of 4.85 steps and superior and inferior limits of agreement of 30.6 and -20.9 steps, respectively. In addition, strong correlations between number of steps and CPET workload (r=0.76, P<0.01) and peak V̇O2 (r=0.71, P<0.01) were observed. From simple linear regression the following predictive equations were obtained with 6MST results: V̇O2 peak (mL/min) = 350.22 + (7.333 × number of steps), with R2=0.51, and peak workload (W) = 4.044 + (0.772 × number of steps), with R2=0.58. The 6MST was a reliable and valid tool to assess functional capacity in HFrEF participants and may moderately predict peak workload and oxygen uptake of a CPET.

Performance, metabolic, hemodynamic, and perceived exertion in the six-minute step test at different heights in a healthy population of different age groups

Abstract Aim: This study aimed to compare the performance, metabolic, hemodynamic, and perceived exertion during the 6-minute step test (6MST) conducted with different step heights in healthy subjects and also to compare the performance between different age groups for each step height. The association between age, body mass index, level of physical activity, and lower limb measurements with performance were also evaluated. Methods: This is a cross-sectional study. Anthropometric measures, physical performance, and cardiovascular stress were evaluated during a self-paced 6MST with different step heights in healthy subjects in the age group of 18-59. All the participants underwent three-step tests (15 cm, 20 cm, and 30 cm) on the same day, in a randomized order. Results: Forty participants (20 men and 20 women) performed the tests. The performance in the test for the highest step was significantly lower compared to the step with the lowest height (152 ± 24 vs. 173 ± 27 and 184 ± 33; p < 0,05). The estimated peak oxygen consumption (VO2peak) increased by ∼2.5 mL.kg−1·min−1 with the increase in step height. Hemodynamic variables, such as percent of maximum heart rate (%HRmáx), and systolic blood pressure increased as the step height increased. There was a fair correlation between performance and the level of physical activity in the test with a step height of 15 cm and 20 cm. Conclusion: A higher step height caused greater cardiovascular stress, without exceeding the submaximal levels of the test, indicating that the 6MST can be used as an accurate instrument for evaluating aerobic capacity in healthy individuals.

Post-exercise Heart Rate Recovery in Patients with Chronic Respiratory Disease

Chronic respiratory diseases are frequently associated with cardiac autonomic dysfunction and this can be evaluated by measuring post-exercise heart rate recovery (HRR). There is evidence that the HRR calculated after one minute of rest following a Six-Minute Walk Test (6MWT) can predict mortality and acute exacerbations in patients with chronic respiratory diseases. The purpose of this study is to compare the heart rate recovery after finishing a Three-Minute Step Test (3MST) in chronic respiratory patients with that obtained after the 6MWT. The 3MST was performed without difficulty in a small doctor's office and all the patients were able to finish it. Applying the Pearson Correlation Index, the result was 0.84 when comparing the HRR one minute after stopping in both tests, showing a good correlation between them. In the Bland-Altman Plot, we can see that the results are within the confidence limits and show concordance despite being a small sample of patients. The 3MST is easily done in a small doctor's office. The results of the HRR after the 3MST are comparable to those obtained after finishing the 6MWT.

Comparison between incremental shuttle run test and Harvard’s step test on peak exercise performance in healthy males: a cross-sectional study

Background: Cardiovascular fitness is directly related to the physical health of the person. Aerobic capacity (VO2max) is one of the major criteria to decide the cardiovascular fitness of an individual. To help quantify the fitness level by calculating their VO2max, there are various indirect maximal tests available but out of these, which one would predict VO2max better, is a major concern. Hence the purpose of this study was to compare the effects of two indirect maximal tests i.e. Incremental Shuttle Run Test (ISRT) and Harvard’s Step Test (HST) on peak exercise performance in young healthy males.Methods: A cross-sectional study with purposive sampling was performed on healthy untrained 100 males of age group 18-25 years. Day 1 subjects performed ISRT on 20 m track and after a 48 hours rest period, on day 3 same subject performed Harvard’s step test. Pre and post-test parameters (Pulse rate, respiratory rate, systolic and diastolic blood pressure and RPE) were measured and predicted VO2max was calculated.Results: Post-test parameters i.e. PR, RR, SBP significantly increased (p=0.00*) by Harvard’s step test. The diastolic blood pressure did not change significantly (p=0.3) for both the tests. Rating of perceived exertion by both the test was of the range 17-19 (very hard to maximal). Calculated predicted VO2max was significantly more by ISRT than HST in males (p=0.00*).Conclusions: Incremental shuttle run test is more efficient in predicting VO2max than Harvard’s step test in healthy adult’s males.

Evaluation Of Postural Balance In Third Trimester Pregnancy

Background: Pregnancy is a state of various physiological and anatomical changes in a female’s body. The increasing body weight leads to the shift in COG and increase in abdominal contents leading to reduced stability and increased use of visual cues which occur in pregnant females as pregnancy advances. Several physiological responses to pregnancy diminish the body’s ability to maintain adequate balance, and place the women at a higher risk of injury and falls. Thus assessment for postural stability is very important to prevent such complications. Objective: To evaluate postural balance in third trimester pregnant females using Four square step test. Materials and methodology: Study was cross sectional observational study. Data was collected by convenient sampling method .60 Healthy women, 30 pregnant and 30 non-pregnant, of age group 20-30 years were selected. Evaluation of postural stability was done using 4 square step test (FSST). The mean of two time trial (in seconds) was noted. The data was collected and analysed using paired t-test. Results: There was statistically significant difference in mean time taken to complete the test between pregnant group and non-pregnant group. (p<0.05) Conclusion: Thus, our study showed that pregnant females took longer time to complete the postural balance test.

Knee Pain Presenting As Lumbar Radiculopathy: A Case Report

Background: Knee pain in general and if to be specific is the pain located anteriorly, and it is widespread among teenage, adults, and the old age population. Among the anterior knee pain etiologies, patellofemoral pain is one of the most common causes of knee pain. One of the significant issues with the patellofemoral pain is that most of the time it is misdiagnosed, or it is underrated for patients' problems, which in the long run lead to severe functional limitations and muscular atrophy. Right clinical diagnosis at an early phase in musculoskeletal conditions is vital. Case summary: The patient presented with chief complaints of diffused pain over right leg tracking it over to the lower back. She presented with a painful limping gait. No tenderness was noted over the lower back; the neural tension test was nonsignificant. Patellar compression test, Clark's test, eccentric step was positive. Severe disuse quadriceps muscular atrophy was noted over-involved limb. Tenderness over the retropatellar surface was significant. The patient was managed with cryotherapy at home, therapeutic ultrasound over the tender area along with Kinesio tapping, proprioception exercises, stretching, and strengthening exercises. Outcome measure: Pain, ROM, girth measurement, gait pattern. Significant improvement was noted in pain on NPS, ROM, and gait pattern in two weeks management. Conclusion: The Physiotherapy management in cases of anterior knee pain, specifically patellofemoral pain, mainly consisting of kinesiotaping, therapeutic ultrasound, cryotherapy, therapeutic exercises are very effective provided right clinical diagnosis, is made. The treatment outcome may be more fruitful if the correct clinical diagnosis is made at an early stage.

Validation of the ST3x1 Step Test as an estimator of peak VO2 in adults with cardiovascular risk factors / Validación del Test de Escalón ST3x1 como estimador del VO2 pico en adultos con factores de riesgo cardiovascular

Abstract Objective: To validate a tool for assessment and control of functional capacity and peak oxygen uptake. Methods: A transversal, correlational study was conducted in which 111 subjects (49.81 ± 11.16 years) were evaluated, their body mass index (BMI) was 31.42 ± 4.07, classified with moderate and high cardiovascular risk, according to the American Association of Cardiovascular and Pulmonary Rehabilitation. Its peak oxygen uptake was measured directly and also through the Step Test 3x1 (ST3x1). Results: Peak oxygen uptake in ST3x1 corresponded to 28.54 ml•kg-1•min-1 and direct measurement at 28.14 ml•kg-1•min-1, with a "strong positive" Pearson correlation r = 0.81, Student n/s p = 0.14 Conclusion: ST3x1 is a valid alternative to estimate peak oxygen uptake in the group studied, and can be used in mass public health physical activity programs.

Resumen Objetivo: Validar una herramienta de estimación y control de la capacidad funcional y el consumo de oxígeno pico. Materiales y métodos: Se realizó un estudio transversal, correlacional donde se evaluaron a 111 sujetos (49.81 ± 11.16 años), su índice de masa corporal (IMC) fue de 31.42 ± 4.07, clasificados con riesgo cardiovascular mediano y alto, según la American Association of Cardiovascular and Pulmonary Rehabilitation. Se midió su consumo pico de oxígeno en forma directa y también a través del Step Test 3x1 (ST3x1). Resultados: El consumo de oxígeno pico en ST3x1 correspondió a 28.54 mlŸkg -1 Ÿmin -1 y en la medición directa a 28.14 mlŸkg -1 Ÿmin -1, con una correlación de Pearson fuerte positiva r = 0.81, Student n/s p = 0.14. Conclusión: ST3x1 se presenta como alternativa para estimar el consumo de oxígeno pico en el grupo estudiado, pudiendo ser usado en programas masivos de actividad física en salud pública.

Calidad científica de las pruebas de campo para el cálculo del VO2max. Revisión sistemática / Scientific Quality of Field Tests to Calculate VO2max: Systematic Review / Qualidade científica das provas de campo para o cálculo do VO2max. revisão sistemática

Objetivo: establecer la calidad científica de las pruebas de campo utilizadas para calcular el consumo máximo de oxígeno (VO2max) en adultos sanos no entrenados. Materiales y métodos: se hizo una revisión sistemática de la literatura científica publicada en español, inglés y portugués, entre 1943 y 2013, sobre pruebas diagnósticas para calcular el VO2max por medio de pruebas de campo, con el propósito de sintetizar los resultados y establecer cuáles son las que mejor se correlacionan con la medición directa (ergoespirometría). Fueron consultadas las bases de datos MedLine, PubMed, ProQuest, Ovid, Hinari, Ebsco y BVS. Se siguieron las recomendaciones del Cochrane Handbook for Systematic Reviews of Interventions 2006. Resultados: inicialmente, 952 artículos, de los cuales después del proceso de descarte, se encontraron diez que cumplían con todos los requisitos. Las pruebas de campo analizadas que se correlacionan bien con el protocolo de laboratorio son el UMTT (1984) con r = 0,99, QCST y 1000m para hombres r = 0,95; el RWFT para hombres r = 0,93; 1,000m para mujeres y 1,5M r = 0,86; QCST para mujeres r = 0,83 y RWFT para mujeres r = 0,74; para adultos el UMTT r = 0,96 y 20m-SRT r=0,9. Conclusiones: dado el coeficiente de validez y el SEE, es posible utilizar pruebas de campo para calcular rápida y económicamente el VO2max en adultos sanos no entrenados. Según edad, sexo, condición física y patologías se recomiendan diferentes pruebas de campo.

Objective: To establish the scientific quality of the field tests used to calculate the maximum oxygen consumption (VO2max) in untrained healthy adults. Materials and methods: A systematic review of the scientific literature on diagnostic tests for calculating VO2max through field tests published between 1943 and 2013 in Spanish, English and Portuguese, , in order to synthesize the results and establish which are the best to correlate with direct measurement (ergospirometry). MedLine, PubMed, ProQuest, Ovid, Hinari, Ebsco and BVS databases were consulted. The recommendations of the Cochrane Handbook for Systematic Reviews of Interventions 2006 were followed. Results: Initially, 952 articles were found, after the elimination process was reached, ten of these met all requirements. Field tests analyzed to correlate well with the laboratory protocol are: UMTT (1984) r = 0.99, QCST and 1000m. men r = 0.95; RWFT men's r = 0.93; 1,000m. Women and 1.5M r = 0.86; QCST women r = 0.83 and RWFT for women r = 0.74, for adults UMTT r = 0.96 and 20m-SRT r = 0.9. Conclusions: Given the validity coefficient and the SEE, it is possible to use field tests to swiftly and economically calculate VO2max in untrained healthy adults. Different field tests are recommended according to age, gender, physical condition and pathologies.

Objetivo: Estabelecer a qualidade científica das provas de campo utilizadas para calcular o consumo máximo de oxigênio (VO2max) em adultos sãos não treinados. Materiais e métodos: se revisou sistematicamente a literatura científica publicada em espanhol, inglês e português, entre 1943 e 2013, sobre provas diagnósticas para calcular o VO2max através de provas de campo, com o propósito de sintetizar os resultados e estabelecer quais são as que melhor se correlacionam com a medição direta (ergoespirometria). Foram consultadas as bases de dados MedLine, PubMed, ProQuest, Ovid, Hinari, Ebsco e BVS. Seguiram-se as recomendações do Cochrane Handbook for Systematic Reviews of Interventions 2006. Resultados: Inicialmente 952 artigos, dos quais depois do processo de descarte encontramos dez que cumpriam com todos os requisitos. As provas de campo analisadas que se correlacionam bem com o protocolo de laboratório são: o UMTT (1984) com r = 0,99, QCST e 1000m para homens r = 0,95; o RWFT para homens r = 0,93; 1,000m para mulheres e 1,5M r = 0,86; QCST para mulheres r=0,83 e RWFT para mulheres r = 0,74; para adultos o UMTT r = 0,96 e 20m-SRT r = 0,9. Conclusões: Dado o coeficiente de validez e o SEE, é possível utilizar provas de campo para calcular rápida e economicamente o VO2max em adultos sãos não treinados. Segundo idade, sexo, condição física e patologias se recomendam diferentes provas de campo.

In-hospital cardiac rehabilitation improves exercise capacity after cardiac surgery / 中华物理医学与康复杂志

Objective To explore the effect of an in-hospital cardiac rehabilitation program on exercise capacity after cardiac surgery.Methods Forty-two patients with valvular heart disease or coronary heart disease were recruited and randomly divided into a rehabilitation group (n=22) and a control group (n=20).Both groups were given preoperative education and breathing guidance on the basis of conventional clinical treatment,but the rehabilitation group was also provided with in-hospital cardiac rehabilitation after the operation.The two-minute stepping test (2-MST) and the left ventricular ejection fraction test (LVEF) were performed before and after the intervention for both groups.Their hospital stays were also compared.One month after discharge,the exercise capacity of both groups was followed-up by telephone using the Veterans-specific Activity Questionnaire (VSAQ).Results After the intervention,there was no significant difference in average LVEF between the two groups (53.73±9.29％ and 56.25± 11.01％ respectively).The average 2-MST stepping frequency of the rehabilitation group was significantly greater than the control group (79.41± 10.99 times and 71.25± 14.21 times respectively,P＜0.05).One month after discharge,the exercise capacity of the rehabilitation group was also significantly higher than the control group for (5.77± 1.46 METs versus 4.75± 1.34 METs,P＜0.05).Stepping frequency at discharge and exercise capacity at one month after discharge were both positively correlated to 2-MST stepping frequency at admission(r =0.869,P＜0.01;r=0.752,P＜O.01).The average hospital stay of the rehabilitation group was significantly shorter (by about 3 days) than the control group (15.59±3.08 days versus 18.45±3.63 days,P＜0.01).Conclusions In-hospital cardiac rehabilitation can significantly improve exercise capacity after cardiac surgery and reduce the length of hospital stays.The 2-minute step test is a simple and practical way to assess the exercise capacity of patients early after cardiac surgery.

A Comparison of the Physical Activity of Hematopoietic Stem Cell Transplantation Patients and Healthy People

PURPOSE: The study aimed to compare the physical activity of hematopoietic stem cell transplantation (HSCT) patients with healthy people (HP). METHODS: The research design of this study was cross sectional and, descriptive study. It was conducted from January 26th to May 22nd, 2013. We matched HSCT patients to HP based on age and gender, and measured physical activity using a pedometer. Patient's clinical information were gathered by the medical record reviews. RESULTS: The number of steps was significantly less in HSCT patients (HSCT: 214 (7~3,373) vs HP: 7,921 (3,180~17,539), p<.001). Physical activity time was significantly less in HSCT patients (HSCT: 840 (680~1,320)min vs HP: 990 (540~1,090)min, p<.001). Step count showed a significant relationship with platelet count (r=.40, p=.004). CONCLUSION: HSCT patients perform very low intensity of physical activities. The study shows the necessity to apply programs to promote physical activities in isolation rooms for patients undergoing HSCT.

Reproducibility of step tests in patients with bronchiectasis / Reprodutibilidade de testes do degrau em pacientes bronquiectasicos

BACKGROUND: The step test has been used to assess exercise capacity in patients with chronic respiratory disease; however, its use has not been described with regard to patients with bronchiectasis (BCT). OBJECTIVE: This study assessed the reliability of the Chester step test (CST) and the modified incremental step test (MIST) and also correlated these tests with pulmonary function, heart rate (HR), and distance walked during the 6-min walk test (6-MWT). METHOD: On separate days, 17 patients randomly underwent two CSTs, two MISTs, and two 6-MWTs. Number of steps (NOSs), HR, and perceived exertion were recorded immediately before and after these tests. RESULTS: NOSs were similar across CSTs (124±65 and 125±67) and MISTs (158±83 and 156±76). Differences were not found across the CSTs and MISTs with regard to HR (138±25 bpm and 136±27 bpm), SpO2 (91±5% and 91±3%), perceived exertion (dyspnea=4 [3-5] and 4 [2-4.5]) and fatigue (4 [2-6] and 4 [3-5]). The CST was significantly briefer than the MIST (6.0±2.2 min and 8.6±3.0 min) and had fewer associated NOS (125±67 and 158±83). NOSs were correlated with FEV1, the 6-MWD, and HR for both tests. CONCLUSIONS: The CST and MIST are reliable in patients with BCT. Patients tolerated the MIST more than the CST. Better lung function and 6-MWT scores predicted the greater NOSs and greater peak HR. .

Correlação entre o teste de caminhada de seis minutos e o teste do degrau em idosos / Correlation between the six-minute walk test and the step test in elderly

O teste do degrau pode ser uma alternativa para substituir o teste de caminhada de seis minutos quando não há um espaço físico amplo para sua realização. Existem, no entanto, poucos dados na literatura comparando e correlacionando ambos os testes. Dessa forma, o objetivo deste estudo foi correlacionar o teste de caminhada de seis minutos com o teste do degrau. Uma amostra de 38 idosos (68,5 ± 2,1 anos) realizou aleatoriamente o teste de caminhada de seis minutos e o teste do degrau, duas vezes cada teste, sendo considerado para fins de análise o maior valor obtido em cada teste. Frequência cardíaca, percepção subjetiva de esforço, de fadiga muscular e o VO2máx estimados ao final do teste do degrau foram significativamente maiores que ao final do teste de caminhada de seis minutos (p=0,001; 0,010; 0,017; 0,001, respectivamente). No presente estudo, não houve correlação entre a distância percorrida no teste de caminhada de seis minutos e o número de subidas e descidas no teste do degrau. Sendo assim, não se pode afirmar que um teste possa substituir o outro, mas levando-se em consideração os valores estatisticamente maiores para o teste do degrau nas variáveis analisadas e, por necessitar de espaço físico mínimo, sugere-se que o teste do degrau pode ser uma alternativa para a avaliação de idosos.

The step test may be an alternative to replace the six-minute walk test when there is not enough space to perform the walk test; however, there are few data in the literature comparing and correlating both tests and their interferences in physical abilities. This study aims to correlate the six-minute walk test with the step test. The sample comprised 38 active seniors (68.5 ± 2.1 years old). The six-minute walk test and the step test were randomly performed twice each and the highest value obtained for each test was taken into consideration. Heart rate, perceived exertion, perceived muscle fatigue and estimated VO2max at the end of the step test were significantly higher than in the end of the six-minute walk test (p=0.001; 0.010; 0.017; 0.001, respectively). There was no correlation between the distance in the walk test and the number of ascents and descents in the step test. Thus it cannot be stated that a test can replace the other, but taking into account the statistically higher values for the step test variables, besides the fact that the step test requires minimum physical space, this test can be an alternative to assess elderly people.

Assessing Endothelial Function in Normotensive Overweight Adolescent Using Dundee Step Test.

Aim Normotensive overweight adolescents may have endothelial dysfunction which is not clinically detected in a routine clinical examination. The purpose of this study was to detect endothelial dysfunction in normotensive overweight using Dundee step test. Methods Sixty two subjects consist of 31 normoweight and 31 overweight group participated in this study. Blood pressure measurement was taken at rest and after 3 minutes Dundee step test. Hyper-responder was defined if systolic blood pressure reach 180 mmHg or more after 3 minutes exercise. Results Mann-Whitney test showed that overweight subjects had significantly higher resting systolic blood pressure, post exercise blood pressure anf magnitude of SBP change (Δ SBP) compared to control subjects (116.5 vs 112.8; 163.8 vs 142.7 vs; and 47.3 vs 29.9; P<0.05). Twenty six percent of overweight was diagnosed as hyper-responder. Conclusion There was significant association between overweight and ExSBP indicating endothelial dysfunction in normotensive overweight adolescents.

Correlation between YMCA step-test and maximum oxygen consumption (VO2max) as measurement tools for cardiorespiratory / 한국역학회지

The purpose of this study is to determine that YMCA step-test is useful method of cardiovascular fitness field-test for large scale study of epidemiology. 57 adults participated in this study. They are recruited considering subject's clinic status and gender proportion. Cardiorespiratory fitness of each participant was determined by grade exercise testing(GXT) with gas analysis and YMCA step-test. There are at least more two days an interval between the tests. Data were analyzed with a statistics program, SPSS version 14.0, by applying Spearman correlation coefficient and independent t-test and Fisher's exact test with a statistical significant level of alpha.001). Our result is that validity of YMCA step-test is acceptable. YMCA step test is vary efficient as dimension of investigator's and subject's effort then the other field-test for assessment of cardiorespiratory. Therefore, Step test is useful for large scale study of epidemiology.

New Technique of Implantation of Posterior Chamber Intraocular Lens in the Absence of Capsular Support: 4 Step Test for Sulcus Fixation

In the aphakic eye of no posterior capsular support, the posterior chamber intracoular lens implantation with suture fixation of the haptics to the sclera at the ciliary sulcus have been popular method. But there are difficulty to know whether the hclptics are exactly fixated in the ciliary sulcus or not and more surgical techniques are required. We have devised a simple and safe methods -4 step test (Guiding up test, Spring test, Knocking test, Lifting and rotating test) for implantation of posterior chamber intraocular lenses in the absence of capsular support with or without suture fixation. We have used this surgical technique for implantation of posterior chamber intraocular lenses in 41 eyes with no capsular support at Kim's eye clinic from July, 1989 to December, 1990. The patients were devided into 3 group-without scleral fixation group (Group A), with superior one point scleral fixation group (Group B), with two point scleral fixation groups (Group C). The results were as followed: 1. Follow up ranged from 6 months to 15 months. 2. The postoperative visual acuity was maintained or improved in 11 eyes (91.6%) of Group A, 9 eyes (69.2%) of Group B, and 12 eyes (75%) of Group C. 3. The most common complication was cystoid macular edema and the others were decentration, hyphema, retinal detachment, ocular hypertension in that order.

A STUDY OF SYSTOLIC TIME INTERVALS OF ATHLETES / 中国运动医学杂志

The purpose of this study is to investagate the meaning of systolic time intervals (STI) in evaluating cardiac functional condition of athletes.1. STI and step test were examined on 13 sprinters, 8 jumpers, 5 throwers and 5 distance runners during early, middle and the last phases in summer training season.No significant changes of the left ventricular ejection time (LVET), the pre-ejection period (PEP) and PEP/LVET ratio were found from examinations on athletes in the three different phases.The cases were divided into two groups of PEP/LVET ratio increased more than 0.05 (N=8) and PEP/LVET ratio decreased more than 0.05 (N=10) by the different of PEP/LVET ratio between linked phases examinations. Athough two of PEP/LVET ratio of each group were different evidently (P