Patients with coronary artery- or chronic obstructive pulmonary disease walk with mechanical inefficiency

Høydal, Kjetil Laurits; Helgerud, Jan; Karlsen, Trine; Støylen, Asbjørn; Steinshamn, Sigurd; Hoff, Jan

doi:10.1080/14017430701601636

Cited by 18 publications

(16 citation statements)

References 21 publications

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“…This is similar to values found in patients with coronary artery disease (19.2%) and lower than in healthy controls (24.7%) (32). It could be assumed that patients with schizophrenia walk with mechanical inefficiency.…”

Section: Discussionsupporting

confidence: 89%

Effects of high aerobic intensity training in patients with schizophrenia—A controlled trial

Heggelund

Nilsberg

Hoff

et al. 2011

Nordic Journal of Psychiatry

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117

125

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Background: Patients with schizophrenia have a high risk of cardiovascular disease (CVD). High aerobic intensity training (HIT) improve peak oxygen uptake (VO2peak), net mechanical efficiency of walking and risk factors for CVD but has not been investigated in patients with schizophrenia. Aims: To investigate effects from HIT on VO2peak, net mechanical efficiency of walking and risk factors for CVD in patients with schizophrenia. Methods: 25 inpatients (F20-29, ICD-10) were allocated to either HIT or playing computer games (CG), 3 days per week for 8 weeks. HIT consisted of 4 × 4-min intervals with 3-min break periods, at 85-95% and 70% of peak heart rate, respectively. Results: 12 and seven patients completed HIT and CG, respectively. The baseline VO2peak in both groups combined (n = 19) was 36.8 ± 8.2 ml/kg/min and 3.12 ± 0.55 1/min. The HIT group improved VO2peak by 12% from 3.17 ± 0.59 to 3.56 ± 0.68 1/min (P < 0.001), more than the CG group (P = 0.014). Net mechanical efficiency of walking improved by 12% in the HIT group from 19.8 ± 3.0% to 22.2 ± 4.5% (P = 0.005), more than the CG group (P = 0.031). The psychiatric symptoms, expressed as the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS), did not improve in either group. Conclusions: VO2peak and net mechanical efficiency of walking improved significantly by 8 weeks of HIT. HIT should be included in rehabilitation in order to improve physical capacity and contribute risk reduction of CVD.

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Section: Discussionsupporting

confidence: 89%

Effects of high aerobic intensity training in patients with schizophrenia—A controlled trial

Heggelund

Nilsberg

Hoff

et al. 2011

Nordic Journal of Psychiatry

Self Cite

117

125

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show abstract

“…The ϵ net values in the present study are similar to values found in patients with coronary artery disease (19.2%) and lower than in healthy controls (24.7%) [22]. Gait deficits in schizophrenia have been reported, with the poorest gait patterns found in patients treated with conventional antipsychotics [1].…”

Section: Discussionsupporting

confidence: 83%

“…The initial ϵ net of 17.3% (MST) and 19.4% (CG) can be considered low and within the range of patients that walk with mechanical inefficiency [8,22]. The ϵ net values in the present study are similar to values found in patients with coronary artery disease (19.2%) and lower than in healthy controls (24.7%) [22].…”

Section: Discussionsupporting

confidence: 78%

Therapeutic effects of maximal strength training on walking efficiency in patients with schizophrenia – a pilot study

et al. 2012

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BackgroundPatients with schizophrenia frequently have disabling gait deficits. The net mechanical efficiency of walking (ϵnet) is an accurate measure often used to evaluate walking performance. Patients with gait deficits have a reduced ϵnet with excessive energy expenditure during sub-maximal walking. Maximal strength training (MST) improves ϵnet in healthy individuals and is associated with reduced risk of mortality. The aim of this study was to investigate whether MST improves ϵnet in patients with schizophrenia.MethodsPatients (ICD-10 schizophrenia, schizotypal or delusional disorders (F20-F29)) were included in a non-randomized trial. Patients were assigned to one of two groups: 1) MST consisting of 4x4 repetitions at 85-90% one repetition maximum (1RM) performed in a leg press apparatus or 2) playing computer games (CG). Both groups carried out their activity three days per week for eight weeks. 1RM, ϵnet at 60 watt walking, peak oxygen uptake (VO2peak), the Positive and Negative Syndrome Scale (PANSS) and the 36-items short form (SF-36) were measured pre and post intervention.ResultsThe baseline ϵnet was 17.3 ± 1.2% and 19.4 ± 3.0% in the MST (n = 6) and CG groups (n = 7), respectively, which is categorized as mechanical inefficiency. The MST group improved 1RM by 79 kg (p = 0.006) and ϵnet by 3.4% (p = 0.046) more than the CG group. The MST group improved 1RM and ϵnet, by a mean of 83 kg (p = 0.028) and 3.4% (p = 0.028), respectively. VO2peak at baseline was 34.2 ± 10.2 and 38.3 ± 9.8 ml·kg-1·min-1 in the MST and CG groups, respectively, and did not change (p > 0.05). No change was observed in PANSS or SF-36 (p > 0.05).ConclusionsMST improves 1RM and ϵnet in patients with schizophrenia. MST could be used as a therapeutic intervention for patients with schizophrenia to normalize their reduced ϵnet.

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“…Patients with COPD have a larger active energy expenditure [35] even though it is well recognized that they are moving less. This is consistent with findings of reduced mechanical efficiency in these patients compared to healthy controls [36], [37]. An activity monitor cannot be expected to incorporate such a complex change in an estimate of energy expenditure, so perhaps greater weight should be placed upon direct monitor outputs (steps, activity counts, vector magnitude units, etc.).…”

Section: Discussionsupporting

confidence: 80%

Validity of Six Activity Monitors in Chronic Obstructive Pulmonary Disease: A Comparison with Indirect Calorimetry

et al. 2012

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Reduced physical activity is an important feature of Chronic Obstructive Pulmonary Disease (COPD). Various activity monitors are available but their validity is poorly established. The aim was to evaluate the validity of six monitors in patients with COPD. We hypothesized triaxial monitors to be more valid compared to uniaxial monitors. Thirty-nine patients (age 68±7years, FEV1 54±18%predicted) performed a one-hour standardized activity protocol. Patients wore 6 monitors (Kenz Lifecorder (Kenz), Actiwatch, RT3, Actigraph GT3X (Actigraph), Dynaport MiniMod (MiniMod), and SenseWear Armband (SenseWear)) as well as a portable metabolic system (Oxycon Mobile). Validity was evaluated by correlation analysis between indirect calorimetry (VO2) and the monitor outputs: Metabolic Equivalent of Task [METs] (SenseWear, MiniMod), activity counts (Actiwatch), vector magnitude units (Actigraph, RT3) and arbitrary units (Kenz) over the whole protocol and slow versus fast walking. Minute-by-minute correlations were highest for the MiniMod (r = 0.82), Actigraph (r = 0.79), SenseWear (r = 0.73) and RT3 (r = 0.73). Over the whole protocol, the mean correlations were best for the SenseWear (r = 0.76), Kenz (r = 0.52), Actigraph (r = 0.49) and MiniMod (r = 0.45). The MiniMod (r = 0.94) and Actigraph (r = 0.88) performed better in detecting different walking speeds. The Dynaport MiniMod, Actigraph GT3X and SenseWear Armband (all triaxial monitors) are the most valid monitors during standardized physical activities. The Dynaport MiniMod and Actigraph GT3X discriminate best between different walking speeds.

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Patients with coronary artery- or chronic obstructive pulmonary disease walk with mechanical inefficiency

Cited by 18 publications

References 21 publications

Effects of high aerobic intensity training in patients with schizophrenia—A controlled trial

Effects of high aerobic intensity training in patients with schizophrenia—A controlled trial

Therapeutic effects of maximal strength training on walking efficiency in patients with schizophrenia – a pilot study

Validity of Six Activity Monitors in Chronic Obstructive Pulmonary Disease: A Comparison with Indirect Calorimetry

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