Pérez-Castilla, A, Piepoli, A, Delgado-García, G, Garrido-Blanca, G, and García-Ramos, A. Reliability and concurrent validity of seven commercially available devices for the assessment of movement ...velocity at different intensities during the bench press. J Strength Cond Res 33(5): 1258-1265, 2019-The aim of this study was to compare the reliability and validity of 7 commercially available devices to measure movement velocity during the bench press exercise. Fourteen men completed 2 testing sessions. One-repetition maximum (1RM) in the bench press exercise was determined in the first session. The second testing session consisted of performing 3 repetitions against 5 loads (45, 55, 65, 75, and 85% of 1RM). The mean velocity was simultaneously measured using an optical motion sensing system (Trio-OptiTrack; "gold-standard") and 7 commercially available devices: 1 linear velocity transducer (T-Force), 2 linear position transducers (Chronojump and Speed4Lift), 1 camera-based optoelectronic system (Velowin), 1 smartphone application (PowerLift), and 2 inertial measurement units (IMUs) (PUSH band and Beast sensor). The devices were ranked from the most to the least reliable as follows: (a) Speed4Lift (coefficient of variation CV = 2.61%); (b) Velowin (CV = 3.99%), PowerLift (3.97%), Trio-OptiTrack (CV = 4.04%), T-Force (CV = 4.35%), and Chronojump (CV = 4.53%); (c) PUSH band (CV = 9.34%); and (d) Beast sensor (CV = 35.0%). A practically perfect association between the Trio-OptiTrack system and the different devices was observed (Pearson's product-moment correlation coefficient (r) range = 0.947-0.995; p < 0.001) with the only exception of the Beast sensor (r = 0.765; p < 0.001). These results suggest that linear velocity/position transducers, camera-based optoelectronic systems, and the smartphone application could be used to obtain accurate velocity measurements for restricted linear movements, whereas the IMUs used in this study were less reliable and valid.
The importance of cardiorespiratory fitness (CRF) is well established. This report provides newly developed standards for CRF reference values derived from cardiopulmonary exercise testing (CPX) ...using cycle ergometry in the United States. Ten laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the "Fitness Registry and the Importance of Exercise: A National Database" (FRIEND) Registry from April 2014 through May 2016. Data from 4494 maximal (respiratory exchange ratio, ≥1.1) cycle ergometer tests from men and women (20-79 years) from 27 states, without cardiovascular disease, were used to develop these references values. Percentiles of maximum oxygen consumption (VO
) for men and women were determined for each decade from age 20 years through age 79 years. Comparisons of VO
were made to reference data established with CPX data from treadmill data in the FRIEND Registry and previously published reports. As expected, there were significant differences between sex and age groups for VO
(P<.01). For cycle tests within the FRIEND Registry, the 50th percentile VO
of men and women aged 20 to 29 years declined from 41.9 and 31.0 mLO
/kg/min to 19.5 and 14.8 mLO
/kg/min for ages 70 to 79 years, respectively. The rate of decline in this cohort was approximately 10% per decade. The FRIEND Registry reference data will be useful in providing more accurate interpretations for the US population of CPX-measured VO
from exercise tests using cycle ergometry compared with previous approaches based on estimations of standard differences from treadmill testing reference values.
In the setting of early acute kidney injury (AKI), no test has been shown to definitively predict the progression to more severe stages.
We investigated the ability of a furosemide stress test (FST) ...(one-time dose of 1.0 or 1.5 mg/kg depending on prior furosemide-exposure) to predict the development of AKIN Stage-III in 2 cohorts of critically ill subjects with early AKI. Cohort 1 was a retrospective cohort who received a FST in the setting of AKI in critically ill patients as part of Southern AKI Network. Cohort 2 was a prospective multicenter group of critically ill patients who received their FST in the setting of early AKI.
We studied 77 subjects; 23 from cohort 1 and 54 from cohort 2; 25 (32.4%) met the primary endpoint of progression to AKIN-III. Subjects with progressive AKI had significantly lower urine output following FST in each of the first 6 hours (p<0.001). The area under the receiver operator characteristic curves for the total urine output over the first 2 hours following FST to predict progression to AKIN-III was 0.87 (p = 0.001). The ideal-cutoff for predicting AKI progression during the first 2 hours following FST was a urine volume of less than 200mls(100ml/hr) with a sensitivity of 87.1% and specificity 84.1%.
The FST in subjects with early AKI serves as a novel assessment of tubular function with robust predictive capacity to identify those patients with severe and progressive AKI. Future studies to validate these findings are warranted.
In the past several decades, cardiopulmonary exercise testing (CPX) has seen an exponential increase in its evidence base. The growing volume of evidence in support of CPX has precipitated the ...release of numerous scientific statements by societies and associations. In 2012, the European Association for Cardiovascular Prevention & Rehabilitation and the American Heart Association developed a joint document with the primary intent of redefining CPX analysis and reporting in a way that would streamline test interpretation and increase clinical application. Specifically, the 2012 joint scientific statement on CPX conceptualized an easy-to-use, clinically meaningful analysis based on evidence-vetted variables in color-coded algorithms; single-page algorithms were successfully developed for each proposed test indication. Because of an abundance of new CPX research in recent years and a reassessment of the current algorithms in light of the body of evidence, a focused update to the 2012 scientific statement is now warranted. The purposes of this update are to confirm algorithms included in the initial scientific statement not requiring revision, to propose revisions to algorithms included in the initial scientific statement, to propose new algorithms based on emerging scientific evidence, to further clarify the application of oxygen consumption at ventilatory threshold, to describe CPX variables with an emerging scientific evidence base, to describe the synergistic value of combining CPX with other assessments, to discuss personnel considerations for CPX laboratories, and to provide recommendations for future CPX research.
Some patients with COVID-19 who have recovered from the acute infection after experiencing only mild symptoms continue to exhibit persistent exertional limitation that often is unexplained by ...conventional investigative studies.
What is the pathophysiologic mechanism of exercise intolerance that underlies the post-COVID-19 long-haul syndrome in patients without cardiopulmonary disease?
This study examined the systemic and pulmonary hemodynamics, ventilation, and gas exchange in 10 patients who recovered from COVID-19 and were without cardiopulmonary disease during invasive cardiopulmonary exercise testing (iCPET) and compared the results with those from 10 age- and sex-matched control participants. These data then were used to define potential reasons for exertional limitation in the cohort of patients who had recovered from COVID-19.
The patients who had recovered from COVID-19 exhibited markedly reduced peak exercise aerobic capacity (oxygen consumption VO
) compared with control participants (70 ± 11% predicted vs 131 ± 45% predicted; P < .0001). This reduction in peak VO
was associated with impaired systemic oxygen extraction (ie, narrow arterial-mixed venous oxygen content difference to arterial oxygen content ratio) compared with control participants (0.49 ± 0.1 vs 0.78 ± 0.1; P < .0001), despite a preserved peak cardiac index (7.8 ± 3.1 L/min vs 8.4±2.3 L/min; P > .05). Additionally, patients who had recovered from COVID-19 demonstrated greater ventilatory inefficiency (ie, abnormal ventilatory efficiency VE/VCO
slope: 35 ± 5 vs 27 ± 5; P = .01) compared with control participants without an increase in dead space ventilation.
Patients who have recovered from COVID-19 without cardiopulmonary disease demonstrate a marked reduction in peak VO
from a peripheral rather than a central cardiac limit, along with an exaggerated hyperventilatory response during exercise.
In the present practice review, we will explain how to perform and interpret a cardiopulmonary exercise test (CPET) in heart failure patients. Specifically, we will explain why cycle ergometer should ...be preferred to treadmill, the type of protocol needed, and the ideal exercise duration. Thereafter, we will discuss how to interpret CPET findings and determine the parameters that should be included. We will focus specifically on: peak VO2 (absolute value and a percentage of its predicted value), exercise duration, respiratory exchange ratio, peak work rate, heart rate, O2 pulse, end-tidal carbon dioxide pressure (PetCO2), PetO2, and -if blood gas samples are obtained-dead space to tidal volume ratio. Moreover, we will discuss the physiological and clinical value of anaerobic threshold, respiratory compensation point, ventilation vs. VCO2 and VO2 vs. work relationships. Finally, attention will be dedicated to exercise-induced periodic breathing. We will also discuss when and why CPET should be integrated with other measurements in the so-called complex CPET. Specifically: a) when and how to use a complex non-invasive CPET, which integrates CPET measurements with non-invasive cardiac output determination, working muscle near-infrared spectroscopy, transthoracic echocardiography, thoracic ultrasound, and lung diffusion analysis; b) when and how to use a complex minimally invasive CPET, in which CPET is combined with esophageal balloon recordings or with serial arterial blood sampling for blood gas analysis; c) when and how to use a complex invasive CPET, which usually implies the presence of a Swan Ganz catheter in the pulmonary artery and an arterial line.
•CPET has a pivotal role in HF prognosis and therapy management.•Exercise protocol must be patient-tailored.•Anaerobic threshold and respiratory compensation point have peculiar prognostic role.•CPET may be integrated with several other procedures.
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