Correlation Between the 6-Min Walk Test and Exercise Tolerance Test in Cardiac Rehabilitation After Coronary Artery Bypass Grafting: A Cross-sectional Study.

INTRODUCTION: Exercise capacity and quality of life are the main outcomes in cardiac rehabilitation (CR). Exercise capacity is one of the important prognostic and diagnostic measures acquired by the exercise tolerance test (ETT). The 6-min walk test (6MWT), as a functional walking test, is another tool for assessing exercise capacity. METHODS: Eighty postoperative coronary artery bypass grafting (CABG) participants admitted to three CR units were recruited for this cross-sectional and multicenter study, based on convenient non-probability sampling. All participants performed an ETT and two repeated 6MWTs. Maximum heart rate (HR), maximum blood pressure (BP), maximal oxygen uptake (VO2max), and peak metabolic equivalents of tasks (MET) during the tests and also the 6-min walk distance (6MWD) were the outcome measures. RESULTS: The mean age of all participants was 62.13 (7.12) years and 80% were male. Pearson correlation showed that maximum HR (r(78) = 0.67, P < 0.001) and maximum systolic BP (r(78) = 0.57, P < 0.001) during the 6MWT correlated moderately with those achieved during ETT. Maximum HR in the 6MWT corresponded to 86% of that achieved during ETT. The 6MWD showed a strong positive correlation with peak MET estimated during ETT as a measure of exercise capacity (r = 0.77, P < 0.001). CONCLUSIONS: The results from this study suggest that the 6MWT is a valid tool for assessing functional capacity for prescribing exercise in a group of postoperative CABG participants admitted to CR units. This finding is helpful for healthcare professionals and for patients, as the test is easy to administer and also well tolerated by patients. TRIAL REGISTRATION NUMBER: PHT-9923.

The effect of transcranial direct current stimulation on balance in healthy young and older adults: A systematic review of the literature.

Various studies have investigated the effect of noninvasive brain stimulation methods such as transcranial direct stimulation (tDCS) on postural control in healthy young and older adults. However, the use of different treatment protocols and outcome measures makes it difficult to interpret the research results. This systematic review provides a comprehensive overview of the current literature on the effect of tDCS on postural control. Nine databases were searched for papers assessing the effect of tDCS on postural control in young healthy and/or older adults. The data of included studies were extracted and methodological quality examined using PEDro. Sixteen studies met the inclusion criteria. The results showed that anodal tDCS (a-tDCS) of primary motor cortex may improve dynamic balance in young healthy individuals. In older adults, a-tDCS of dorsolateral prefrontal cortex and cerebellum showed a positive effect on dual task and dynamic balance, respectively. In conclusion, tDCS may improve both static and dynamic balance in younger and older adults. However, due to lack of consensus in the results, caution is required when drawing conclusions with regards to these findings.

Validation and responsiveness of the Persian version of HeartQoL questionnaire in cardiac rehabilitation after coronary artery bypass grafting: An observational study.

BACKGROUND: Decision making and the quality of care provided for chronic diseases have been shown to improve through patient participation. The HeartQoL questionnaire is a core health-related quality of life (HRQOL) tool specifically designed for individuals with ischemic heart disease (IHD) who have undergone interventions such as cardiac rehabilitation (CR). METHODS: In this observational and multicenter study, 150 patients were recruited. The participants completed the HeartQoL, MacNew Heart Disease Questionnaire, and Short Form Health Survey (SF-36) on entering CR for validity assessment. The HeartQoL along with a Global Rating of Change (GRoC) scale (for responsiveness measurement) were completed by 100 participants 3 months later. RESULTS: The mean age of all participants in validity assessment was 61.87 ± 8.13 years. Cronbach's alphas of the total scales ranged from 0.70 to 0.81 and of the subscales from 0.70 to 0.82. The Pearson correlation coefficient was used to determine construct validity; similar constructs were confirmed with correlation coefficients ranging from 0.50 to 0.69 and dissimilar constructs with correlation coefficients ranging from 0.28 to 0.29 (P < 0.010). The assessment of the responsiveness of the questionnaire indicated that the area under curve (AUC) was greater than 0.70 (range: 0.74 to 0.91) and the optimal cut-off point was 0.65. CONCLUSION: The Persian version of the HeartQoL questionnaire demonstrated satisfactory psychometric properties in the sample of participants admitted to CR after coronary artery bypass grafting (CABG). The present study results showed that the HRQOL can be used by clinicians and researchers in conjunction with other outcome measures to gain additional information about symptoms relevant to HRQOL in patients referred to CR and to evaluate change over time.

Patient Assessment of Constipation Quality of Life Questionnaire: Translation, Cultural Adaptation, Reliability, and Validity of the Persian Version.

BACKGROUND: The Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire is the most validated and the most specific tool for measuring the quality of life of patients with constipation. Over 120 million people live in countries whose official language is Persian. There is no reported Persian version of the PAC-QOL questionnaire yet. The aim of this study was to translate and culturally adapt the PAC-QOL questionnaire and to assess its reliability and validity among Persian patients with chronic constipation. METHODS: Following the translation and cultural adaptation of the PAC-QOL questionnaire to Persian, 100 patients (mean±SD age=40.51±13.67) with constipation were recruited for validity measurement and 20 patients were re-examined for reliability. Content validity was assessed based on the opinions of an expert committee and the floor/ceiling effect. Construct validity was evaluated according to the hypothesis test. The SF-36 questionnaire was used for concurrent criterion validity, intra-class correlation coefficient for reliability, and Cronbach's alpha for internal consistency. RESULTS: The content validity of the PAC-QOL questionnaire was proven, and there was no floor/ceiling effect. Construct validity also was confirmed based on the hypothesis test. The overall Cronbach's alpha of the PAC-QOL questionnaire was 0.92 (range=0.72-0.92), and the overall intra-class correlation coefficient of the questionnaire was 0.88 (range=0.69-0.87). The correlation between the SF-36 and PAC-QOL questionnaires was moderate. CONCLUSION: The Persian version of the PAC-QOL questionnaire demonstrated good validity and reliability properties in chronic constipation. Accordingly, Persian researchers and clinicians can benefit from this questionnaire in further research and assessment of treatment outcomes.