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Physical Fitness Evaluation
Published in James M. Rippe, Lifestyle Medicine, 2019
Peter Kokkinos, Jonathan R. Miller
A systematic review of this issue was performed using 13 non-exercise test equations developed using various combinations of age, gender, body weight (or BMI, percentage of body fat, or waist circumference), physical activity patterns (self-reported or measured), smoking, resting heart rate, or perceived functional ability as predictors of CRF.34 The R2 values (with measured or estimated peak VO2 as the dependent variable) ranged from 0.50 to 0.86. Non-exercise CRF estimates have been shown to be similar in accuracy to submaximal exercise prediction models.34,35,40,41 Although most of these studies have focused on healthy asymptomatic populations, non-exercise test approaches that include assessment of symptoms during daily activities are more applicable to clinically referred populations. The latter include the Veterans Specific Activity Questionnaire (VSAQ) and Duke Activity Status Index (DASI) and similarly correlate well with measured exercise capacity.31,32
Vascular surgery
Published in Brian J Pollard, Gareth Kitchen, Handbook of Clinical Anaesthesia, 2017
Medical history including metabolic equivalents (METs) and scoring systems (e.g. the Duke Activity Status Index) have been used to assess maximum physical activity. Exercise can be limited by claudication and mobility, although if a patient can climb two flights of stairs, equivalent to >4 METs, they may not require further testing.
Percutaneous mitral valve repair and replacement
Published in Ever D. Grech, Practical Interventional Cardiology, 2017
Despite poor outcome on some of these patients, the two patients with good outcomes may provide proof-of-concept that trans-catheter MV replacement may be an option for non-surgical candidates. However, patient selection process is clearly important. Altisent et al. recently reported the outcome and 6-month follow-up of three patients treated with the Fortis valve.25 The mean age was 71 ± 9 years, two were male and all had functional MR and high surgical risk with a mean STS risk score of 9.3%. The procedures were performed successfully with the standard trans-apical approach. There were no major complications. There was residual MR in two patients and no residual leak in one. The mean trans-mitral gradient post-implant was 3 mmHg. All patients were discharged between 7 and 13 days post-procedure. At 3-month follow-up, all patients showed improvement in NYHA functional class, functional status (by Duke Activity Status Index), distance walked in 6-MWT and quality of life. The functional improvement persisted at 6-month follow-up.
Arterial stiffness and functional capacity in individuals with chronic stroke: a cross-sectional study
Published in Physiotherapy Theory and Practice, 2023
Cleucia Procópio, Brenno Cordeiro Da Silva, Maria Rodrigues-Machado, Janaine Cunha Polese
To determine functional capacity, the Duke activity status index (DASI – score) was used (Hlatky et al., 1989). It is a self-report questionnaire, containing 12 questions, which are based upon activities of daily living. With DASI, it is possible to obtain information on the energy expenditure in METs (Coutinho-Myrrha et al., 2014). In addition, it is also possible to stratify individuals with better (≥31.95) and poor (<31.95) functional capacity (Polese et al., 2021). A previous study (Polese et al., 2016) demonstrated that DASI scores presented association with distance covered (in meters) (r = 0.68) and oxygen consumption (r = 0.45) in individuals after chronic stroke. In addition, DASI may be a possibility for assessing the functional capacity during preoperative period of cardiac surgery, being a possible way to assess risks (Wijeysundera et al., 2018).
The effect of exercise training interventions in adult kidney transplant recipients: a systematic review and meta-analysis of randomised control trials
Published in Physical Therapy Reviews, 2022
Thomas J. Wilkinson, Nicolette C. Bishop, Roseanne E. Billany, Courtney J. Lightfoot, Ellen M. Castle, Alice C. Smith, Sharlene A. Greenwood
Two studies [31,40] used the ‘sit-to-stand-60’ test (STS-60) including 62 participants provided data appropriate for meta-analysis. A significant improvement of 4.8 repetitions [95%CI: 0.1 to 9.5, Z = 2.01, p = 0.04, Figure 3] was observed following an exercise intervention compared to a control/usual care group. Statistical heterogeneity was low (I2 = 10%). Improvements in handgrip strength and ‘timed-up-and-go’ (TUAG) test were seen following resistance training by Hernandez-Sanchez et al. [40]. Greenwood et al. also revealed a significant mean difference in the Duke Activity Status Index (DASI) score between resistance training arm and usual care group at 12-weeks (8.8 ± 3.4, 95%CI 2.0 to 15.6). There was no change in DASI score in the aerobic arm.
Duke Activity Status Index cut-off scores for assessing functional capacity after stroke
Published in Disability and Rehabilitation, 2021
Janaine Polese, Silvia da Silva, Iza Faria-Fortini, Christina Faria, Luci Teixeira-Salmela
The Duke Activity Status Index (DASI), a brief 12-item scale, was developed to assess functional capacity, based upon the individual's ability to perform a wide range of common daily living activities, by predicting oxygen consumption (VO2) without the need of maximal cardiopulmonary exercise tests [8]. It is a simple measure, which was previously validated against physiological measurements, such as VO2 in cardiac [9], chronic obstructive pulmonary disease [10], and stroke individuals [11]. The DASI includes activities that represent major aspects of physical function along with their correspondent metabolic equivalents (METS) [8]. Each item is weighted based upon the MET level associated with the activity. It has shown to be a predictor of death by myocardial infarction and has a direct correlation with ergometric test results using the Bruce Protocol [12,13]. The DASI has been widely used in several health conditions, such as coronary diseases, heart failure, ischemia, and acute myocardial infarction [12,14,15]. It provides information on the severity of the diseases, effects of rehabilitation interventions, and relevant information for clinical decision-making [16–18].