Assessment of Functional Capacity in Clinical and Research Settings

Arena, Ross; Myers, Jonathan; Williams, Mark A.; Gulati, Martha; Kligfield, Paul; Balady, Gary J.; Collins, Eileen G.; Fletcher, Gerald F.

doi:10.1161/circulationaha.106.184461

Cited by 479 publications

(233 citation statements)

References 163 publications

(125 reference statements)

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“…The relationship between physical fitness and functional capacity Morey et al (1998) (Cowley et al, 2010;Arena et al, 2007;Morey et al, 1998). Cowley et al (2010) performed a study on 35 young DS adults and determined whether physical fitness predicts timed performance of functional tasks.…”

Section: Bmentioning

confidence: 99%

“…In many clinical and research environments functional capacity provides important diagnostic and prognostic information (Arena et al, 2007). Traditionally, the usefulness of therapeutic interventions in patients with heart disease was measured with outcome measures such as mortality and myocardial infarction (Hlatky et al, 1989).…”

Section: A Introductionmentioning

confidence: 99%

“…However, it has been established that physical fitness is directly associated with functional capacity (Singh et al, 2006;Brill, 2004;Rikli et al, 2001;Morey et al, 1998). For instance, Arena et al (2007) found that functional capacity is associated with the ability to perform activities of everyday life that requires a sustained aerobic metabolism.…”

Section: A Introductionmentioning

confidence: 99%

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The functional fitness capacity of adults with Down syndrome in South Africa

Terblanche

Boer

2012

J intellect Disabil Res

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Background It is well established that there is a relationship between physical inactivity and increased risk for diseases of lifestyle. Persons with Down syndrome (DS) are especially at risk because of physical and health impairments, as well as perceived and real barriers to participation in exercise. The purpose of the study was to establish the functional fitness capacity and predictors of performance of DS adults. Methods Data were collected at various intellectual disability centres and private homes in seven provinces of South Africa. Three hundred and seventy‐one DS individuals (199 men and 172 women) from 18 to 66 years were tested for balance, flexibility, coordination, muscular strength and endurance, aerobic capacity and functional ability. Data were categorised according to gender and age groups (18–25, 26–35, 36–45, and >45 years). Multiple regression analysis was performed to determine the relationship between the functional task and physical test items. Results Down syndrome men performed significantly better on all but two tests compared with the women (P < 0.05). DS women performed better on the sit‐and‐reach flexibility item and the chair stand test; however, differences were not statistically significant from the men. Significant differences across age groups were observed for nine of the 13 functional fitness tests (P < 0.05). Muscular strength items, especially leg strength, significantly predicted functional performance in DS men and women. Aerobic capacity only predicted functional performance in DS men and sit‐and‐reach flexibility and dynamic balance only in DS women. Conclusions Findings of this study provide important information on the functional capacity of DS adults and show which physical attributes contribute to functional performance. Consequently appropriate training programmes can be tailored for this population whom is known to have poor functional fitness.

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Section: Bmentioning

confidence: 99%

Section: A Introductionmentioning

confidence: 99%

Section: A Introductionmentioning

confidence: 99%

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The functional fitness capacity of adults with Down syndrome in South Africa

Terblanche

Boer

2012

J intellect Disabil Res

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“…Due to its prognostic value in various settings [1][2][3][4][5] peak oxygen consumption (peak VO 2 ) is an important clinical parameter. Peak VO 2 is measured using maximal cardiopulmonary exercise testing (CPET), which due to required resources as well as a high degree of expertise is a demanding technique [6].…”

Section: Introductionmentioning

confidence: 99%

“…However, this recommendation has recently been challenged in a study amongst patients with severe COPD, where tests with an exercise duration between 4:04 and 8:46 min revealed similar peak VO 2 [41]. Fifth, cycle ergometer exercise yields a lower peak VO 2 than treadmill exercise, and thus we might have underestimated the 'true' peak VO 2 [5]. And finally, both biomarkers seem to reflect peak VO 2 in absolute terms but not the percentage of predicted peak VO 2 .…”

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confidence: 99%

B‐type natriuretic peptide and C‐terminal‐pro‐endothelin‐1 for the prediction of severely impaired peak oxygen consumption

Maeder

Brutsche

Staub

et al. 2009

Journal of Internal Medicine

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Objective. To assess the utility of B-type natriuretic peptide (BNP) and C-terminal-pro-endothelin-1 (CTproET-1) to predict a severely impaired peak oxygen consumption (peak VO 2 , < 14 mL kg )1 min )1 ) in patients referred for cardiopulmonary exercise testing.Design. Cross-sectional study.Setting. Tertiary care center.Methods. Peak VO 2 , BNP and CT-proET-1 were assessed in 141 consecutive patients referred for cardiopulmonary exercise testing.Results. B-type natriuretic peptide [median (interquartile range) 48 (38-319) vs. 33 (15-86) pg mL )1 ; P = 0.002] and vs. 60 (52-74) pmol L )1 ; P < 0.001] were higher in patients with a peak VO 2 < 14 mL kg )1 min )1 (n = 30) than in those with a peak VO 2 ‡ 14 mL kg )1 min )1 (n = 111). CT-pro-ET-1 had a higher area under the receiver-operator-characteristics curve (AUC) to predict a peak VO 2 < 14 mL kg )1 min )1 than BNP (0.79 vs. 0.68; P = 0.04). The optimal BNP cut-off of 37.2 pg mL )1 had a sensitivity of 80% and a specificity of 56%. The optimal CT-proET-1 cut-off of 74.4 pmol L )1 had a sensitivity of 80% and specificity of 76%. A five-item score composed of body mass index, diabetes, forced expiratory volume within the first second, alveolo-arterial oxygen pressure difference, and BNP had an AUC of 0.88 to predict a peak VO 2 < 14 mL kg )1 min )1 . Adding CT-proET-1 to the score resulted in an AUC of 0.92.Conclusions. C-terminal-pro-endothelin-1 is superior to BNP for the prediction of a peak VO 2 < 14 mL kg )1 min )1 in patients referred for CPET. A score incorporating body mass index, diabetes status, spirometry, blood gases, BNP and CT-proET-1 improves the prediction of a peak VO 2 < 14 mL kg )1 min )1 based on single biomarkers.

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