The importance of lower extremity involvement type on exercise performances, function, and quality of life in peripheral predominant forms of juvenile idiopathic arthritis

Abstract Background: Juvenile idiopathic arthritis (JIA) can cause reduced exercise capacity, deterioration in functional activities, and poor health-related quality of life. This study aims to objectively reveal lower extremity involvement in the peripheral predominant forms of juvenile idiopathic arthritis through qualitative evaluations and to determine the effects of these involvements on exercise, function, and quality of life. Methods: Thirty-two patients with a history of peripheral arthritis and aged between 7 and 16 years participated in the study. Demographics, JIA subtype, disease duration, arthritis and deformities of the lower extremity, disease activity score, 6-min walk test (6MWT), cycling exercise test (CYC-E), childhood health assessment questionnaire (CHAQ), and pediatric quality of life inventory (PedsQoL) scores were recorded. In case of clinical suspicion of arthritis, an ultrasonographic examination was performed for a definitive diagnosis. Regression analyses were performed to explore the most associated lower extremity involvement and patient characteristics for each of the dependent variables including 6MWT, CYC-E, CHAQ, and PedsQoL. Results: Of the total number of patients, with a mean age of 12.91 (SD 2.37) years, 28.1% had knee arthritis, 15.6% foot arthritis, 12.5% hip arthritis, and 37.5% lower extremity deformity. The parameters that were most associated with CHAQ and PedsQoL were hip and knee arthritis, whereas CYC-E was found to be most associated with knee arthritis and height, and 6MWT was found to be most associated with hip arthritis, knee arthritis, and demographic characteristics. Conclusion: This study emphasizes the importance of hip and knee arthritis, which are among the determinants of walking endurance, function, and quality of life; and knee arthritis, which is among the determinants of cycling performance in JIA with lower extremity involvement.

Correlation of Six Minute Walk Test and Lung Function Test Variables (% FEV1, % FVC, % DLCO) in Patients with Connective Tissue Disorder - Interstitial Lung Disease

Interstitial Lung Diseases (ILDs) also known as diffuse parenchymal lung disease, include a group of diffuse parenchymal infiltrative lung diseases. A restrictive defect is the most frequent pulmonary abnormality in patients with pulmonary fibrosis which is the usual consequence of many ILDs. Connective tissue disorders are usually rare, but are potentially life threatening conditions. The spectrum of ILD varies from mucocutaneous symptoms, arthralgia / arthritis to impairment of pulmonary and renal function. Systemic Lupus Erythematosus (SLE), Systemic Sclerosis (SSc), Sjogren’s Syndrome (SS), inflammatory muscle diseases and overlap-syndromes are grouped together as connective-tissue disorders. Involvement of lung and its function is the most common form of interstitial lung disease, leading to high morbidity and mortality among the group of connective tissue disorders. We wanted to correlate the 6-Min Walk Distance (6MWTD) with the Pulmonary Function Test values such as % FEV1, % FVC and FEV1 / FVC, among patients with connective tissue disorder associated Interstitial Lung Disease in SRM Medical College Hospital, a tertiary care hospital in Tamilnadu, South India. MethodsThis study was done as a cross sectional analytical study among 31 patients in the Department of Respiratory Medicine, Rheumatology and General Medicine in SRM medical college and hospital. Each patient was explained the purpose of the study and the need for complete co-operation. Those who satisfied the inclusion and exclusion criteria were included. Data was collected using a structured proforma. 6-minute walk test and pulmonary function tests were performed and correlated. ResultsThere appears to be a significant correlation between 6-minute walk test, % desaturation, 6 Minute Walk Test Distance, 6 Minute Walk Test Pre BDI and 6 Minute Walk Test Post BDI with spirometry values especially with the Spirometry FEV 1 %, Spirometry FVC % and % predicted DLCO. Conclusions6MWT can be used as a useful surrogate for pulmonary function tests especially among the population where spirometry is not possible. 6MWT has good reproducibility, is simple to perform and can be used as a screening tool for Interstitial Lung Disease in connective tissue disorder patients.

Effectiveness of Standard Treatment Outcome for Different Stages of Chronic Obstructive Pulmonary Disease Patients: Role of 6 Minute Walk Test

ABSTRACTBackground: Chronic Obstructive Pulmonary Disease (COPD)is defined as a avertible and curable disease characterized by“persistent airflow limitation” that is usually advanced andassociated with an heightened chronic inflammatory responsein the airways, and the lung tonoxious particles or gases.Habitual smoking of cigarette represents the most significantrisk for impeding COPD, as well as low birth weight, recurrentinfections, indoor air pollution with biomass fuel, low socioeconomic status, occupational exposure such as xoal dust,silica, cadmium etc, Different stages of COPD based on postbronchodilator FEV1, in patients with FEV1/FVC <0.70.Aim: To find out the effectiveness of the combined treatmentoutcomes by studying the patients with different stages ofseverity of Chronic Obstructive Pulmonary Disease.Methods: A Prospective study was carried out during theperiod from 1stJune 2018 to 31st December 2018 in theoutpatients department (OPD) of Patuakhali 250 Bed SadarHospital, Patuakhali. One Hundred and Fifty COPD patientswere included in this study. The study was conducted bymeasuring the response of patients with by following the “6Minute Walk Test” or

Performance in the 6-minute walk test and postoperative pulmonary complications in pulmonary surgery: an observational study

OBJECTIVES: To assess functional capacity in the preoperative phase of pulmonary surgery by comparing predicted and obtained values for the six-minute walk test (6MWT) in patients with and without postoperative pulmonary complication (PPC) METHOD: Twenty-one patients in the preoperative phase of open thoracotomy were evaluated using the 6MWT, followed by monitoring of the postoperative evolution of each participant who underwent the routine treatment. Participants were then divided into two groups: the group with PPC and the group without PPC. The results were also compared with the predicted values using reference equations for the 6MWT RESULTS: Over half (57.14%) of patients developed PPC. The 6MWT was associated with the odds for PPC (odds ratio=22, p=0.01); the group without PPC in the postoperative period walked 422.38 (SD=72.18) meters during the 6MWT, while the group with PPC walked an average of 340.89 (SD=100.93) meters (p=0.02). The distance traveled by the group without PPC was 80% of the predicted value, whereas the group with PPC averaged less than 70% (p=0.03), with more appropriate predicted values for the reference equations CONCLUSIONS: The 6MWT is an easy, safe, and feasible test for routine preoperative evaluation in pulmonary surgery and may indicate patients with a higher chance of developing PPC.

The Reliability of Functional Mobility Assessment Tools Among the Elderly in Malaysia / Jurnal Sains Kesihatan Malaysia

Functional mobility among the older population is an important element for a meaningful quality of life. The implementation of functional mobility assessments among the older people is vital to ensure appropriate steps can be taken in order to detect changes in functional mobility. There are varieties of functional mobility assessments available however most of the reliability test are based on Western countries. Therefore this study was to determine the reliability of three types of functional mobility status assessment of physical activity, especially among the older person. Sixty older respondents with the average age of 76.32 years and standard deviation of 8.66 participated in this study performed three types of functional assessments; Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Sit-to-Stand Test (STS). Two measurements were carried out with a week gap from the first measurement. Intraclass Correlation (ICC), Limits of Agreement (LOA) and Standard Error of Measurement (SEM) statistical tests followed by the combination of the three statistical analysis measurements were used for data analysis. The results showed all functional measurement tools using ICC, LOA, SEM and combination of three types analysis were highy reliable. The ICC value was exceeded 0.90 (ICC=0.94-0.99). The LOA graph for all activity measurement tools showed some degree of reliability while the SEM percentage recorded a value of less than 10% (SEM%=0.95%-9.95%). In conclusion, all three functional measurement tools are highly reliable and can be used as one of the functional test among the older people in Malaysia.

Relationship Between Patient-Reported Outcomes and Clinical Outcomes in Patients With Morquio A Syndrome

Abstract This cross-sectional analysis assessed the correlation between patient-reported outcomes (PROs) and clinical outcomes in 24 German patients with Morquio A. Clinical outcomes included 6-minute walk test (6MWT), 3-minute stair climb (3MSC) test, and joint range of motion as measures for endurance/mobility, forced vital capacity (FVC) and maximum voluntary ventilation (MVV) as measures for respiratory function, and height as an important manifestation. The PROs included the EuroQoL (EQ) 5D-5L (EQ5D-5L), to measure health-related QoL (HRQoL), and patients' rating of their ability to walk, climb, or breathe. In adults, endurance and pulmonary function measures and height showed strong and statistically significant correlation with the patients' EQ5D-5L (6MWT: R = .884, 3MSC test: R = .852, FVC: R = .815, MVV: R = .825, height: R = .842). The adult patients' rating of their ability to walk and climb also correlated strongly with 6MWT (R = .839) and 3MSC test (R = .700) results. Improvements in these clinical outcomes may be robust surrogate parameters of a better EQ5D-5L/HRQoL in patients with Morquio A.

Evaluation of therapeutic effects of spironolactone on schistosomal pulmonary arterial hypertension by echocardiography / 中国血吸虫病防治杂志

Objective To evaluate the therapeutic effect of spironolactone on schistosomal pulmonary arterial hypertension(SPAH). Methods A total of 62 patients suffered from hepatosplenic schistosomiasis with pulmonary arterial hypertension were divided into the spironolactone group(n=31) and control group (n=31). All the patients underwent serial echocardiography and the clinical effect before and after the treatment was evaluated by assessing the mean pulmonary arterial pressure (mPAP) and pulmonary arterial diameter (PAD). At the same time, the varieties of the clinical symptoms, signs and the distance of the 6-minute walking test (6-MWT) were investigated. Results In spironolactone group, mPAP(-x±s) decreased from (31.8±7.1) mmHg to (21.2±2.1) mmHg, PAD(-x±s) decreased from (28.0±5.0) mm to (20.0±3.5) mm before and after the treatment respectively(P<0.01). There were significant differences in mPAP, PAD, the distance of 6-MWT and the heart function before and after the treatment in the spironolactone group. However, the data did not show the significant difference in the control group. Conclusion The therapeutic effect of spironolactone in the treatment of SPAH is satisfactory.