Stride: Experimental and Statistical Design Considerations (original) (raw)
Tracking the path traversed by temporary pacing lead
Indian Heart Journal, 2012
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Six-Minute Walk Testing -are we following the established guidelines
The 6-minute walk test (6MWT) has been used in different chronic lung diseases as a tool to assess the functional exercise capacity, response to treatment and as a predictive tool of morbidity and mortality. The American Thoracic Society (ATS) guidelines were established in 2002 and were used to develop local guidelines for use of 6MWT. The primary outcome of the audit was to assess referral indication adherence to ATS guidelines. The secondary outcome was to assess the influence of 6MWT results on subsequent management. Method: We conducted a retrospective clinical audit of all 6MWTs done at Palmerston North hospital, a 350 bed secondary centre in New Zealand between July 2012 and May 2013. 90 subjects were assessed ranging between 19-88 years of age. The collected data included baseline patient demographics and function, indications for the 6MWT, number of tests performed, results, and the influence of the 6MWT result on patient management. Results: A total of 90 patients had 6MWTs completed over a 10-month period. Assessment of functional status in patients with interstitial lung disease (ILD) was the most frequent indication (9 patients). 28 patients (31%) had accepted indications for referral. Of those patients, 23 (82%) had management of their disease modified as a result. This included referral to pulmonary rehabilitation (6 patients). Of the remaining 67 (69%) patients without clear referral indication, only 1 (1.6%) patient had clinical management alteration as a result. Conclusion: The 6MWT is a useful test if used according to ATS guidelines. Currently less than a third of patients are referred appropriately. When used as a general investigation without a clear indication for its use, little clinical benefit is gained.
Utility of Timed Up and Go in Outpatient Cardiology Clinics
Rehabilitation Nursing, 2018
The aim of the study was to examine if the Timed Up and Go (TUG) Test would be a feasible, reproducible, and valid measure in patients post-coronary artery bypass grafting (CABG). Design: Cross-sectional study, controls and patients post-CABG, outpatient clinic. Methods: Participants performed the TUG Test and the 6-Minute Walking Distance (6MWD) Test. Reliability was measured within observer on two occasions. Findings: Patients and controls were similar in age. The patients had greater TUG mean (SD) of 14.4 seconds (4.9 seconds) and lower 6MWD of 358 m (76 m) compared with TUG of 8.2 seconds (2.7 seconds) and 6MWD of 487 m (56 m) in controls. In patients, intraclass correlation for the TUG was .98 (95% CI [.96, .98]) between the measurements. In patients, there was a high correlation between the TUG Test and the 6MWD Test, r = −.70, p < .001. Conclusion: The TUG Test demonstrated to be a feasible, reproducible, and valid measure in patients post-CABG. Clinical Relevance: The TUG Test could serve as a screening tool for physical performance inside clinics.
Swiss Medical Weekly
BACKGROUND: Objective mobility goals for elderly hospitalised medical patients remain debated. We therefore studied steps parameters of elderly patients hospitalised for an acute illness, to determine goals for future interventional trials and medical practice. METHODS: Observational study conducted from February to November 2018 in a medical ward of the Lausanne University Hospital, Switzerland. We measured the step parameters of consecutive medical patients aged ≥65 years admitted for an acute medical illness using a wrist accelerometer (Geneactiv). We also collected demographic, somatic and functional factors. RESULTS: Overall, 187 inpatients had their step parameters (daily step count, walking cadence and bout duration) measured with accelerometers worn for a mean of 3.6 days (standard deviation [SD] 3.2). Elderly inpatients (81.5 years, SD 8.5) walked a median of 603 steps daily (interquartile range [IQR] 456–809), at a median cadence of 100 steps/minute (IQR 99–101) with media...
International Journal of Health Sciences and Research
Background: Exercise capacity plays an essential role in determining quality of life in both disease & health. Field tests can be used to determine aerobic capacity since they are easy to perform. The step test is another exercise test that can be used to assess aerobic capacity. An alternative to 6MWT is 6-minute step test which is a self-paced test. The 6-minute step test (6MST) requires less time and space to be performed and might be used as an alternative to assess exercise capacity in primary care. Materials and methodology: 300 healthy participants of both genders were included. Each participant performed a 6-minute step test on a 20 cm high wooden step. The participants were instructed to walk up and down the step as much as possible within the time duration. Individuals with neuromuscular, orthopedic, or cardiopulmonary diseases were excluded from study. Pre & post vitals such as heart rate & SPO2 were recorded. The steps were counted by the therapist. Results: The included...
Value Health, 2010
The user has requested enhancement of the downloaded file. Abstracts A151 mated. Therefore prescriptions causing interaction coming from one office should be prevented. But prescriptions from different offices cannot be avoided by the use of this isolated solution. Only a comprehensive e-health solution summoning up medication of a patient from different sources has the potential to improve patient safety. There are pharmacologic interactions with different clinical relevance. OBJECTIVES: The aim of this study was to conduct a meta-analysis to identify the potential differences of cardiovascular risk factors between men and women in primary prevention. METHODS: A systematic review was performed identifying prospective cohorts studies in which cardiovascular risk factors were analyzed (tobacco use, hypertension, diabetes, obesity and dyslipdemia) associated to the development of acute myocardial infarction, angina pectoris or cardiovascular death, and in which results were segmented between men and women. The search was done in October 2009 in Medline, EMBASE and the Cochrane Collaboration. Two independent reviewers identified the abstracts, selected full articles and extracted the data. Relative risk(RR) with 95% confidence intervals (95%CI) were calculated. Random effects models were employed in the meta-analyses using Meta-Analyst v.2.0 software. A meta-regression was also conducted. RESULTS: From 3,712 studies, 21 cohort studies were selected. The number of participants among the trials varied between 5,000 and 600,000 per study with a follow-up from 5 to 40 years. The meta-analyses showed that premenopausal women in comparison to men had a higher risk of having cardiovascular event when they have diabetes mellitus (RR 2.79 vs. 2.03), obesity (1.62 vs. 1.41), hypercholesterolemia (1.91 vs. 1.49), increase in LDL levels (2.08 vs. 1.72) or increase in HDL levels (2.22 vs. 1.61); however, men showed higher risk of cardiovascular events when they have hypertension (RR 1.771; 95%CI 1.714-1.830 vs. RR 1.812; 95%CI 1.759-2.305
Evaluating effects of method of administration on Walking Impairment Questionnaire
Journal of Vascular Surgery, 2003
Background: Intermittent claudication resulting from peripheral arterial disease (PAD) can substantially impair walking function. The Walking Impairment Questionnaire (WIQ) assesses patient self-reported difficulty in walking. Currently this questionnaire is validated for interviewer administration only. Since this can be burdensome in a large clinical trial, we examined the effects of alternative methods of administration on patient responses on the WIQ. Methods: The WIQ, which consists of four subscales (pain severity, distance, speed, stairs), was modified to be self-administered or interviewer-administered by telephone. Patients with PAD were recruited from two sites and randomized into two groups: in group 1 the WIQ was self-administered, then telephone-administered; in group 2 the WIQ was telephone-administered, then self-administered. The two administrations occurred 4 to 7 days apart. Additional measures (SF-36, EQ-5D, and PAD symptom scale) and clinical data were included to further assess the validity of the WIQ and symptoms in patients with claudication. Telephone interviews were conducted by trained interviewers using standardized scripts. Two-week test-retest reliability was assessed for both the self-administered WIQ (group 1) and the telephone-administered WIQ (group 2). Results: Sixty patients were recruited at two sites (n ؍ 30 per group). Seventy-eight percent were men; mean patient age was 67.1 years; and 83% of patients were white. Mean duration of PAD symptoms was 6.8 years. No significant differences were observed in WIQ subscale scores between self administration and telephone administration. No interaction effects between order and method of administration were detected. Cronbach ␣ for distance, speed, and stair-climbing subscales ranged from 0.82 to 0.94. Correlations among WIQ subscales and the symptom scale were good (r ؍ ؊0.34 to ؊0.57). Correlations of WIQ subscales with physical health subscales of the SF-36 (r ؍ 0.24-0.59) were higher than for mental health-related subscales (r ؍ 0.08-0.26).
Journal of Advanced Nursing, 2002
Background. The ideal duration of intravascular administration set use is unknown. Studies have compared the infective implications of one to seven days of use. The Centers for Disease Control recommend at least three days usage. No previous study has evaluated the accuracy of volume delivery or integrity of administration sets after prolonged use. Aim. To evaluate the accuracy and condition of intravascular administration sets used continuously for 7 days. Design. Prospective, randomised, experimental study in the laboratory setting. Methods. Four administration sets were randomly assigned to deliver 2 mL/h (IMED ® syringe set 2280-0000), 20, 50 or 100 mL/h (IMED ® infusion sets 2210-0500) of crystalloid solution continuously for 7 days through an IMED ® Gemini ® four channel infusion pump (PC4). At study commencement and daily for 7 days, a 4 hour volume measurement and an inspection for leaks/erosion of administration sets occurred for each administration set (total measurements = 32). Results. Mean volume outputs over four hours were 7.84mL (2mL/h), 80.66 mL (20mL/h), 205.35 (50 mL/h) and 406.37 (100 mL/h). These differed significantly from the programmed volumes (p = 0.00-0.01). Usage duration did not influence performance (F = 0.866, p = 0.55). Accuracy of volume delivery differed significantly with pump speed (F = 106.933, p < 0.001) exhibiting increased volume to 50 mL/h then a reduction at 100 mL/h. Differences were within manufacturer specifications (+/-5%) and were clinically acceptable. All administration sets remained in appropriate condition displaying no leakage or erosion. 3 Conclusion. There were small inaccuracies found between programmed and delivered volumes however there was no deterioration in performance over time. This suggests that inaccuracies were due to normal pump performance rather than the administration sets. Administration sets retain acceptable accuracy and condition after 7 days continuous use. Further research should assess the infective and other impacts of prolonged usage.