The 6-minute walk is a valid and reliable method of assessing functional ability in a Phase II/III CR population. A learning effect of 6% was observed over the three walks; however, it is unknown if this learning effect will be retained over time. This test may be particularly valuable to smaller CR centers that want to document functional improvements but do not have access to conventional treadmill tests.

After completing this course, the reader will be able to:1. Discuss cardiorespiratory fitness and cardiac functional reserve in postmenopausal women treated with chemoendocrine therapy.2. List the cardiovascular risk factors in this study that were found to be less favorable among patients than among controls.3. Explain the significance of peak aerobic power as a predictor of cardiovascular disease.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTPurpose. To examine cardiovascular function and risk profile of postmenopausal women treated with chemoendocrine therapy (CET) for hormone receptorpositive operable breast cancer. Methods. Forty-seven breast cancer patients and 11 age-matched healthy controls were studied. Participants performed a cardiopulmonary exercise test with expired gas analysis and impedance cardiography to assess peak aerobic power (VO 2peak ) and cardiovascular function (stroke volume, cardiac output, cardiac power output, and cardiac reserve). Traditional (i.e., body mass index, lipid profile, and fasting insulin and glucose) and novel (i.e., C-reactive protein, brain natriuretic peptide) cardiovascular risk biochemical factors were also assessed.Results. Breast cancer patients had significantly lower peak exercise stroke volume (68 ؎ 9 versus 76 ؎ 11 ml/ beat), cardiac output (10.4 ؎ 1.5 versus 11.7 ؎ 2.4 l/minute), cardiac power output (3.0 ؎ 0.5 versus 3.5 ؎ 0.9 Watts), cardiac power output reserve (1.7 ؎ 0.6 versus 2.4 ؎ 0.8 Watts), and VO 2peak (1.3 ؎ 0.3 versus 1.6 ؎ 0.2 l⅐min ؊1 ) than control subjects (p-values < .05). Patients with the greatest impairment in VO 2peak had the worse cardiovascular risk profile. Exploratory analyses Conclusion. Breast cancer patients treated with adjuvant CET have a significantly and markedly lower cardiorespiratory fitness and cardiac functional reserve compared with age-and sex-matched controls. AI therapy may be associated with a more unfavorable cardiovascular risk profile than TAM. Prospective studies are required to further investigate the clinical value of these findings.

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Background and Purpose-Cardiovascular and pulmonary factors contributing to impaired peak oxygen uptake (V O 2 ) in patients with stroke (SP) are not well known. We assessed cardiovascular function, pulmonary gas exchange, and ventilation in SP and healthy age, gender, and activity-matched control subjects. Methods-Ten hemiparetic SP and 10 control subjects were enrolled. Subjects completed cycle ergometry testing to assess peak and reserve V O 2 , carbon dioxide production, ventilation (tidal volume; breathing frequency; minute ventilation), and cardiac output. V O 2 , carbon dioxide production, and minute ventilation were measured throughout peak exercise recovery (off-kinetics) and at exercise onset (on-kinetics) along with heart rate during low-level exercise. Results-Peak V O 2 was 43% lower (PϽ0.001) in SP secondary to reduced peak and reserve cardiac output and minute ventilation. The impaired cardiac output reserve (PϽ0.001) was due to a 34% lower heart rate reserve (Pϭ0.001). The impaired minute ventilation reserve (Pϭ0.013) was due to a 41% lower tidal volume reserve (Pϭ0.009). Stroke volume and breathing frequency reserve were preserved. V O 2 off-kinetics were 29% slower in SP (PϽ0.001) and related to peak V O 2 (RϭϪ0.72, PϽ0.001) and peak cardiac output (RϭϪ0.75, PϽ0.001) for the study group. Additionally, carbon dioxide production (Pϭ0.016) and minute ventilation (Pϭ0.023) off-kinetics were prolonged in SP. V O 2 on-kinetics were 29% slower (Pϭ0.031) during low-level exercise in SP. Conclusions-The impaired peak V O 2 in SP is secondary to a decline in peak and reserve cardiac output and ventilation.Prolonged

The present study examined the factors contributing to performance of a backward overhead medicine ball throw (B-MBT) across 2 types of athletes. Twenty male volleyball players (jump athletes) and 20 wrestlers (nonjump athletes) were evaluated on 4 measures of power, including B-MBT, chest medicine ball throw (C-MBT), countermovement vertical jump (CMJ), and power index (PI). The athletes also completed 3 measures of strength: a 1-repetition-maximum (1RM) bench press (BP), a 1RM leg press (LP), and combined BP + LP strength. Jump athletes demonstrated greater absolute scores for CMJ, C-MBT, and B-MBT (p < 0.05), whereas nonjump athletes demonstrated greater strength scores for BP and for BP + LP (p < 0.05). When performances were examined on a relative basis, jump athletes achieved superior scores for C-MBT (p < 0.05), whereas nonjump athletes had greater scores for BP, LP, and BP + LP (p < 0.05). For both groups, B-MBT had strong correlations with PI (r = 0.817 [jump] and 0.917 [nonjump]), whereas for C-MBT, only nonjump athletes demonstrated a strong correlation (r = 0.842). When expressed in relative terms, B-MBT was strongly correlated with C-MBT (r = 0.762 [jump] and 0.835 [nonjump]) and CMJ (r = 0.899 [jump] and 0.945 [nonjump]). Only nonjump athletes demonstrated strong correlations with strength for absolute LP (r = 0.801) and BP + LP (r = 0.810) strength. The interaction of upper- and lower-body strength and power in the performance of a B-MBT appears complex, with the contributing factors differing for athletes with divergent skill sets and performance demands.