Background Our purpose was to evaluate the reliability, validity, and responsiveness of the 6-minute walk test (6MWT) in patients with heart failure (HF) enrolled in the Randomized Evaluation of Strategies for Left Ve...
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Background Our purpose was to evaluate the reliability, validity, and responsiveness of the 6-minute walk test (6MWT) in patients with heart failure (HF) enrolled in the Randomized Evaluation of Strategies for Left Ventricular Dysfunction (RESOLVD) pilot study. Methods A total of 768 patients was enrolled in a multicenter randomized clinical trial evaluating the effect of candesartan, enalapril, and metoprolol on left ventricular ejection fraction (LVEF), 6MWT distance, neurohormones, and quality of life. The 6MWT was performed once at screening and twice at baseline, 18 weeks, and 43 weeks by a standardized method. Results Test-retest reliability at baseline (intraclass correlation coefficient [ICC] = 0.90), 18 weeks (ICC = 0.88), and 43 weeks (ICC = 0.91) was very good. Baseline 6MWT distance was weakly inversely correlated to the quality-of-life cumulative score (r = -0.26, P = .0001) and moderately inversely correlated to the New York Heart Association functional classification (NYHA-FC) (r = -0.43, P = .001). In the RESOLVD study, the 6MWT was not responsive to change when effect sizes and standardized response means were used. Disease-specific quality of life was responsive to change in patients treated with candesartan and enalapril and NYHA-FC was responsive to change in the candesartan and enalapril combination and for enalapril alone with small effect sizes. The 6MWT, NYHA-FC, and quality of life were not responsive to change during the metoprolol or placebo phase. Conclusions The 6MWT is highly reproducible in patients with symptoms of HF. It is somewhat correlated to NYHA-FC and quality of life. Overall, quality of life was most responsive to change, whereas 6MWT and NYHA-FC were comparable but less responsive to change in the RESOLVD study.
Previous work showed that subjects naturally adopt a walking speed which optimizes energy cost of locomotion and stability of stride;however, no studies have examined whether these criteria are affected by carrying an...
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Previous work showed that subjects naturally adopt a walking speed which optimizes energy cost of locomotion and stability of stride;however, no studies have examined whether these criteria are affected by carrying an external load. The purpose of this study was to compare optimization characteristics during loaded or unloaded walking. Energy cost and stride characteristics were measured for 10 subjects with and without a load on the trunk of the body of 10% of the body weight during 4 sessions. The first 2 sessions represent free walking at 2.5, 3, 3.5, 4, 4.5, and 5 km . hr.(-1). The last sessions represent free vs forced walking at constant speed (preferred frequency and +/- 10 PF and +/- 20% of preferred frequency). Results show an effect of load on energy cost of walking but no effect on the optimal speed for stability. Furthermore, when carrying a load the subject does not adopt systematically the speed that minimizes physiological cost. Our findings suggest the necessity to consider this effect to prevent gait disturbance and maintain the health benefits of walking.
The purpose of this study is to develop and evaluate a theoretically appropriate measure for adherence to a self-care fitness walking routine. Self-care activities are very different from prescribed therapeutic regime...
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The purpose of this study is to develop and evaluate a theoretically appropriate measure for adherence to a self-care fitness walking routine. Self-care activities are very different from prescribed therapeutic regimens. One important difference is the determination of the activity prescription or behavioral standard. When the activity is classified as self-care, the behavioral standard is determined by the individual. When the activity is a prescribed therapeutic regimen, it is determined by the health care provider. Adherence to health related activities is usually calculated by comparing actual behaviors with an expert determined standard. When this technique is used to measure adherence to a self-care regimen, the theoretical assumption that self-care activities are self-prescribed has been ignored. In this study, adherence to the self-care activity fitness walking is calculated by comparing actual recorded fitness walking behaviors with the walker's own fitness walking intention.
This study examined the three-dimensional kinematics and motor development patterns in early walking gait longitudinally over 8 mo. and presents an example of walking development of one normal child which might be use...
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This study examined the three-dimensional kinematics and motor development patterns in early walking gait longitudinally over 8 mo. and presents an example of walking development of one normal child which might be used for comparative purposes in the clinical assessment of gait.
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