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Affective responses during physical activity (PA) are important for engagement in PA programs and for adherence to a physically active lifestyle. Little is known about the affective responses to PA bouts lasting longer than 45 minutes. Therefore, the aims of the present study were to analyse acute effects on affective responses of a three-hour outdoor PA intervention (mountain hiking) compared to a sedentary control situation and to an indoor treadmill condition. Using a randomized crossover design, 42 healthy participants were randomly exposed to three different conditions: outdoor mountain hiking, indoor treadmill walking, and sedentary control situation (approximately three hours each). Measures included the Feeling Scale, Felt Arousal Scale and a Mood Survey Scale. Repeated measures ANOVAs were used to analyse differences between the conditions. Compared to the control situation, the participants showed a significant increase in affective valence (d = 1.21, p < .001), activation (d = 0.81, p = .004), elation (d = 1.07, p < .001), and calmness (d = 0.84, p = .004), and a significant decrease in fatigue (d = -1.19, p < .001) and anxiety (d = -.79, p < .001) after mountain hiking. Outdoor mountain hiking showed significantly greater positive effects on affective valence, activation, and fatigue compared to indoor treadmill walking. The results indicate that a three-hour PA intervention (mountain hiking) elicits higher positive and lower negative affective responses compared to a sedentary control situation and to an indoor PA condition. Outdoor mountain hiking can be recommended by health professionals as a form of PA with the potential to positively influence affective responses. ClinicalTrials.gov NCT02853760. https://clinicaltrials.gov/. Date of registration: 08/02/2016 (retrospectively registered). Date of enrolment of the first participant to the trial: 05/01/2014.

BackgroundThis study aimed to investigate whether adjunctive inspiratory muscle training (IMT) can enhance the well-established benefits of pulmonary rehabilitation (PR) in patients with COPD.Methods219 patients with COPD (FEV1: 42%±16% predicted) with inspiratory muscle weakness (PImax: 51±15 cm H2O) were randomised into an intervention group (IMT+PR; n=110) or a control group (Sham-IMT+PR; n=109) in this double-blind, multicentre randomised controlled trial between February 2012 and October 2016 (ClinicalTrials.gov NCT01397396). Improvement in 6 min walking distance (6MWD) was a priori defined as the primary outcome. Prespecified secondary outcomes included respiratory muscle function and endurance cycling time.FindingsNo significant differences between the intervention group (n=89) and the control group (n=85) in improvements in 6MWD were observed (0.3 m, 95% CI −13 to 14, p=0.967). Patients who completed assessments in the intervention group achieved larger gains in inspiratory muscle strength (effect size: 1.07, p<0.001) and endurance (effect size: 0.79, p<0.001) than patients in the control group. 75 s additional improvement in endurance cycling time (95% CI 1 to 149, p=0.048) and significant reductions in Borg dyspnoea score at isotime during the cycling test (95% CI −1.5 to −0.01, p=0.049) were observed in the intervention group.InterpretationImprovements in respiratory muscle function after adjunctive IMT did not translate into additional improvements in 6MWD (primary outcome). Additional gains in endurance time and reductions in symptoms of dyspnoea were observed during an endurance cycling test (secondary outcome)Trial registration number NCT01397396; Results.

Hereditary transthyretin amyloidosis is caused by the deposition of misfolded transthyretin proteins in peripheral nerves and other tissues. This phase 3 trial tested patisiran, a small interfering RNA targeting transthyretin messenger RNA, to treat the disease.

Despite a practical guideline of 30-meter walking path during 6-minute walk test (6MWT), such walking course length is not possible in every clinical setting due to unavailable sufficient space. Existing evidence has investigated using several shorter course lengths, it remains unclear whether a walking course length shorter than the standard walking course length is appropriate for 6MWD testing. This study aimed (i) to compare maximum walking distances at various shorter walking course lengths (i.e., 10, 20, and 25 meters) and 30 meters, and (ii) to assess agreements in maximum walking distances achieved at intervals below 30 meters, specifically 10, 15, 20, and 25 meters. This study was a cross-sectional with cross-over design. Forty-eight healthy participants were randomly ordered to perform 6MWT with five different walkways (10, 15, 20, 25, 30 meters). The maximum walking distance (six-minute walk distance, 6MWD) covered was recorded. Eligible participants aged 41.0 ± 17.2 years, with equal sex (24 males) participated in this study. The 6MWD at 10, 15, and 20-meter walkways significantly shorter than the 30-meter standard walkway (489.6 ± 59.3 m, 513.1 ± 62.6 m, 524.7 ± 63.7 m vs 539.1 ± 63.1 m, respectively (P<0.01)). Very strong agreement was observed at 15, 20, and 25 meters with the standard 30 meters (0.819-0.875, P<0.001). Subgroup analysis showed strong to very strong agreement in 10-meter walkway length onwards with the standard walkway length among older adults (0.757-0.918, P<0.001). Testing on 20 meters walkway and shorter yielded varied results compared to the standard 30-meter walk, with exceptional congruence observed at 15 meters onwards. In particular, a minimum walkway of 10 meters had strong agreement with a standard 30-meter walkway in elderly.

This phase 2, double-blind, placebo-controlled, hypothesis-generating study evaluated the effects of oral reldesemtiv, a fast skeletal muscle troponin activator, in patients with spinal muscular atrophy (SMA). Patients ≥ 12 years of age with type II, III, or IV SMA were randomized into 2 sequential, ascending reldesemtiv dosing cohorts (cohort 1: 150 mg bid or placebo [2:1]; cohort 2: 450 mg bid or placebo [2:1]). The primary objective was to determine potential pharmacodynamic effects of reldesemtiv on 8 outcome measures in SMA, including 6-minute walk distance (6MWD) and maximum expiratory pressure (MEP). Changes from baseline to weeks 4 and 8 were determined. Pharmacokinetics and safety were also evaluated. Patients were randomized to reldesemtiv 150 mg, 450 mg, or placebo (24, 20, and 26, respectively). The change from baseline in 6MWD was greater for reldesemtiv 450 mg than for placebo at weeks 4 and 8 (least squares [LS] mean difference, 35.6 m [p = 0.0037] and 24.9 m [p = 0.058], respectively). Changes from baseline in MEP at week 8 on reldesemtiv 150 and 450 mg were significantly greater than those on placebo (LS mean differences, 11.7 [p = 0.038] and 13.2 cm H2O [p = 0.03], respectively). For 6MWD and MEP, significant changes from placebo were seen in the highest reldesemtiv peak plasma concentration quartile (Cmax > 3.29 μg/mL; LS mean differences, 43.3 m [p = 0.010] and 28.8 cm H2O [p = 0.0002], respectively). Both dose levels of reldesemtiv were well tolerated. Results suggest reldesemtiv may offer clinical benefit and support evaluation in larger SMA patient populations.

This was a 2×2 randomized crossover control trial. To compare the cardiovascular endurance of healthy volunteers using a 2-minute marching test (2MMT) and a 6-minute walk test (6MWT). This study included 254 participants of both sexes, aged 20-50 years, with a height and body mass index (BMI) of ≥150 cm and ≤25 kg/m2, respectively. Participants were hospital staff who could perform activities independently and had normal annual chest radiographs and electrocardiograms. A group-randomized design was used to assign participants to Sequence 1 (AB) or 2 (BA). The tests were conducted over 2 consecutive days, with a 1-day washout period. On day 1, the participants randomly underwent either a 6MWT or 2MMT in a single-anonymized setup, and on day 2, the tests were performed in reverse order. We analyzed maximal oxygen consumption (VO2max) as the primary outcome and heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturation, dyspnea, and leg fatigue as secondary outcomes. Data were collected from 127 participants, categorized into two groups for different testing sequences. The first (AB) and second groups had 63 and 64 participants, respectively. The estimated VO2max was equivalent between both groups. The 2MMT and 6MWT estimated VO2max with a mean of 41.00 ± 3.95 mL/kg/min and 40.65 ± 3.98 mL/kg/min, respectively. The mean difference was -0.35 mL/kg/min (95% confidence interval: -1.09 to 0.38; p <0.001), and no treatment and carryover effect were observed. No significant changes were observed in HR, RR, and systolic BP (p = 0.295, p = 0.361 and p = 0.389, respectively). However, significant changes were found in the ratings of perceived exertion (p <0.001) and leg fatigue scale (p <0.001). The 2MMT is practical, simple, and equivalent to the 6MWT in estimating VO2max. TCTR20220528004 https://www.thaiclinicaltrials.org.

Gait assessment is key in Parkinson’s disease (PD), but the psychometric properties of common tests like the 6-Minute Walk Test (6MWT) are not fully established. Inertial Measurement Units (IMUs) offer objective gait measures, potentially reducing repeated testing. This study evaluated whether the resampling of the first 2 min of the 6MWT (2’6MWT) reflects full-test performance in 43 early-to-mild PD patients (median age 65) at baseline, 1-year, and 2-year follow-ups. A trunk-mounted IMU recorded distance covered, walking duration, stride length, gait speed, cadence, and symmetry. Analysis focused on participants with complete longitudinal data from a multicenter original cohort of 62. Stride length and gait speed (2’6MWT vs. 6MWT) demonstrated strong correlations (r > 0.98), near-perfect agreement, <5% error, and stability across follow-ups; cadence showed slightly more variability. The analysis of consecutive 2-min intervals of the 6MWT revealed stable stride length and gait speed, with modest decreases in distance and cadence over time. Exploratory associations of 2’6MWT and 6MWT with motor severity and cognitive status were consistent. These results indicate the 2’6MWT is a reliable, time-efficient alternative to the full 6MWT for assessing walking capacity in PD, especially in outpatient or fatigue-prone patients. The full 6MWT remains valuable for detecting subtle endurance- or fatigue-related changes.

The 6-minute-walk distance (6MWD) test predicts mortality in chronic obstructive pulmonary disease (COPD). Whether variability in study type (observational vs. interventional) or region performed limits use of the test as a stratification tool or outcome measure for therapeutic trials is unclear. To analyze the original data from several large observational studies and from randomized clinical trials with bronchodilators to support the qualification of the 6MWD test as a drug development tool in COPD. Original data from 14,497 patients with COPD from six observational (n = 9,641) and five interventional (n = 4,856) studies larger than 100 patients and longer than 6 months in duration were included. The geographical, anthropometrics, FEV , dyspnea, comorbidities, and health status scores were measured. Associations between 6MWD and mortality, hospitalizations, and exacerbations adjusted by study type, age, and sex were evaluated. Thresholds for outcome prediction were calculated using receiver operating curves. The change in 6MWD after inhaled bronchodilator treatment and surgical lung volume reduction were analyzed to evaluate the responsiveness of the test as an outcome measure. The 6MWD was significantly lower in nonsurvivors, those hospitalized, or who exacerbated compared with those without events at 6, 12, and greater than 12 months. At these time points, the 6MWD receiver operating characteristic curve-area under the curve to predict mortality was 0.71, 0.70, and 0.68 and for hospitalizations was 0.61, 0.60, and 0.59, respectively. After treatment, the 6MWD was not different between placebo and bronchodilators but increased after surgical lung volume reduction compared with medical therapy. Variation across study types (observational or therapeutic) or regions did not confound the ability of 6MWD to predict outcome. The 6MWD test can be used to stratify patients with COPD for clinical trials and interventions aimed at modifying exacerbations, hospitalizations, or death.

The 6‐min walk test (6MWT) has significant prognostic value, but requires long walking distances and lacks evaluation of exercise speed. This study aimed to investigate the clinical utility of a new walk test, the 18‐meter walk test (18MWT), in patients with pulmonary arterial hypertension (PAH) as a complement to the 6MWT. In summary, a total of 117 patients with PAH from January 2018 to December 2022 were included. Spearman correlation, Cox regression, and Kaplan–Meier analysis were utilized to demonstrate the value of 18MWT in predicting disease severity and clinical worsening. The median time to complete the 18MWT was 12.8 s (interquartile range: 11.3–14.6 s). 18MWT completion time showed significant correlations with indicators such as N‐terminal pro‐brain natriuretic peptide and 6MWT distance. Adjusted Cox regression showed 18MWT time remained an independent predictor of clinical worsening (hazard ratio = 1.10; 95% confidence interval: 1.01–1.21; p = 0.026). A simplified risk stratification using WHO functional class, 6MWT distance, 18MWT time and NT‐proBNP was predictive of 1‐year clinical outcome. These results suggest that the 18MWT provides clinicians with an efficient measure that can be used to evaluate the disease severity of PAH patients and to identify those patients at greater risk for future clinical worsening as a complement to the 6MWT.

The 1-minute sit-to-stand (STS) test could be valuable to assess the level of exercise tolerance in chronic obstructive pulmonary disease (COPD). There is a need to provide the minimal important difference (MID) of this test in pulmonary rehabilitation (PR). COPD patients undergoing the 1-minute STS test before PR were included. The test was performed at baseline and the end of PR, as well as the 6-minute walk test, and the quadriceps maximum voluntary contraction (QMVC). Home and community-based programs were conducted as recommended. Responsiveness to PR was determined by the difference in the 1-minute STS test between baseline and the end of PR. The MID was evaluated using distribution and anchor-based methods. Forty-eight COPD patients were included. At baseline, the significant predictors of the number of 1-minute STS repetitions were the 6-minute walk distance (6MWD) ( =0.574; <10 ), age ( =-0.453; =0.001), being on long-term oxygen treatment ( =-0.454; =0.017), and the QMVC ( =0.424; =0.031). The multivariate analysis explained 75.8% of the variance of 1-minute STS repetitions. The improvement of the 1-minute STS repetitions at the end of PR was 3.8±4.2 ( <10 ). It was mainly correlated with the change in QMVC ( =0.572; =0.004) and 6MWD ( =0.428; =0.006). Using the distribution-based analysis, an MID of 1.9 (standard error of measurement method) or 3.1 (standard deviation method) was found. With the 6MWD as anchor, the receiver operating characteristic curve identified the MID for the change in 1-minute STS repetitions at 2.5 (sensibility: 80%, specificity: 60%) with area under curve of 0.716. The 1-minute STS test is simple and sensitive to measure the efficiency of PR. An improvement of at least three repetitions is consistent with physical benefits after PR.