Articles: exercise-test-statistics-numerical-data.
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Recent evidence suggests that stress testing prior to emergency department (ED) release in low-risk chest pain patients identifies those who can be safely discharged home. When immediate stress testing is not feasible, rapid outpatient stress testing has been recommended. The objective of this study was to determine compliance rate and incidence of adverse cardiac events in patients presenting to the ED with low-risk chest pain referred for outpatient stress testing. ⋯ No significant differences in adverse cardiac events were documented in patients who did and did not comply with outpatient stress testing. Compliance with outpatient stress testing is poor in low-risk chest pain patients following ED release. Despite poor compliance, the documented incidence of adverse cardiac events in this low-risk cohort was lower than that reported in patients with negative provocative testing prior to ED release.
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J Cardiopulm Rehabil Prev · Nov 2007
Clinical cardiopulmonary exercise testing: patient and referral characteristics.
Cardiopulmonary exercise testing (CPET) is a well-established procedure for which applications have evolved in several different medical specialties. There are limited data describing how CPET is actually used in clinical practice. Such information would be useful for understanding the clinical conditions and questions likely to be encountered by a referral laboratory, and for informing future research related to the use of CPET. ⋯ The experience of this laboratory mirrored the range of indications for CPET found in published literature. The spectrum of indications and referral sources underscore both the many causes and implications of exercise intolerance relevant to clinical practice, and the challenges to laboratory personnel for appropriate testing and reporting of data.
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To evaluate the feasibility of the 6-minute and 2-minute walk tests in frail older persons. ⋯ The 2-minute walk test is a feasible measure of functional capacity and was better tolerated than the 6-minute walk test in older persons in geriatric rehabilitation. Consideration needs to be given to the potential of a training effect or the need for repeated measures to obtain a best estimate for the 2-minute walk test.
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Simple walking tests are widely used for the assessment of functional status in patients with cardiorespiratory disorders. These tests require far less instrumentation than formal cardiopulmonary exercise tests, but they do require standardization of procedures to achieve reproducible results. The most widely used tests for patients with COPD are the 6-minute walking test (6MWT) and the incremental shuttle walking test (SWT). ⋯ The SWT results improve with pulmonary rehabilitation and bronchodilation, and are highly correlated with maximum oxygen consumption. There are no studies that address the issue of MCID for the SWT. In addition to the MCID, the design and interpretation of COPD clinical trials should take into account the severity of initial impairment, the asymmetry between positive and negative changes, the proportion of patients who show substantial improvement, and the costs and risks of the treatment.
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Comparative Study
Neuromuscular and biomechanical coupling in human cycling: modulation of cutaneous reflex responses to sural nerve stimulation.
This study tested the hypothesis that the modulation of cutaneous reflexes during human cycling would be dependent on muscle biomechanical function and phase of leg movement. The coupling between neuromuscular (electromyographic, EMG), kinetic and kinematic responses to brief innocuous (75% of the pain threshold PnT) and noxious (125% PnT) sural nerve stimulation were studied. Stimuli were delivered pseudorandomly at eight equidistant (45 degrees) positions of the crank cycle. ⋯ We conclude that sural nerve stimulation during human cycling evokes distinct reflex responses in muscles operating around the knee (BF and RF) and the ankle (TA and SOL). These reflexes are modulated in a phase-dependent manner depending on muscle biomechanical function to generate energy for limb and crank propulsion during a specific region in the cycle. This modulation contributed to a specific adaptation of joint motion and force production in order to maintain task performance.