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Background: Oxygen uptake (V̇O2) and heart rate (HR) kinetics during a constant work-rate test (CWRT) are used to evaluate the response to exercise in healthy subjects as well as subjects with various pathologies.
Objectives: This study aimed to explore the feasibility of these measures and their responsiveness to a prehabilitation program in patients with non-small cell lung cancer (NSCLC).
Method: This study is preregistered (NCT04041297) ancillary analysis of a subgroup of individuals with NSCLC included in the Preo-Dens study (NCT03936764). Thirty individuals performed a moderate-CWRT before and after a 15-session prehabilitation program between July 2019 and April 2021. V̇O2 and HR on-kinetics were extracted from the first 240 s of breath-by-breath data using Box-Jenkins transfer functions.
Results: Pre/post V̇O2 on-kinetic feature values were reliable for 25/30 participants, and pre/post HR kinetic feature values were reliable for 19/30. V̇O2 time constant (τ) and mean response time reduced from pre-post prehabilitation (mean difference -7.8 s; 95% CI: -14.6 to -1.0, and -8.4 s; 95% CI: -14.7 to -2.0, respectively). For HR on-kinetics, τ did not change from pre-post prehabilitation (median difference -4.0 s; 95% CI: -36.0 to +11.0). V̇O2 and HR response amplitudes reduced significatively from pre-post prehabilitation (mean difference -38.6 mL/min; 95% CI: -73.3 to -3.9, and -3.1 beats/min; 95% CI: -6.4 to -0.2, respectively).
Conclusion: V̇O2 on-kinetic analysis during moderate-CWRT is feasible in individuals with scheduled NSCLC resection, and results are responsive to prehabilitation. These results support a true speeding of the adaptation of aerobic metabolism after a 15-session prehabilitation program.
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http://dx.doi.org/10.1159/000528718 | DOI Listing |
Phys Ther
December 2024
Leni and Peter W. May Department of Orthopaedics and Institute for Healthcare Delivery Science, Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
Objective: Prehabilitation may have benefits for total hip arthroplasty (THA) and total knee arthroplasty (TKA), given an aging population with multimorbidity and the growth of value-based programs that focus on reducing postoperative costs. We aimed to describe prehabilitation use and examine predictors of utilization in fee-for-service Medicare beneficiaries.
Methods: This retrospective cohort study using the Medicare Limited Data Set included fee-for-service Medicare beneficiaries who were ≥ 66 years old and who underwent inpatient elective THA or TKA between January 1, 2016, and September 30, 2021.
J Clin Anesth
December 2024
Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America; Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States of America. Electronic address:
Background: Frailty, a syndrome of decreased resilience to physiologic stress, has been associated with increased postoperative length of stay (LOS) for specific procedures. Yet, the literature lacks large-scale analyses examining the relationship between frailty and LOS across surgical procedure.
Study Design: We conducted a retrospective cohort study of patients aged 65+ undergoing inpatient surgery including emergency procedures between 2015 and 2019 using American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) data.
J Geriatr Oncol
December 2024
Dana Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Introduction: We performed a qualitative study to explore key stakeholders' perspectives about the impact of frailty on ovarian cancer care and evaluate a candidate prehabilitation intervention.
Materials And Methods: We conducted semi-structured interviews with patient-caregiver dyads and multi-disciplinary clinicians. Patients were ≥ 50 years of age with a new diagnosis of advanced stage (III/IV) ovarian cancer who received cancer-directed treatment (chemotherapy and/or surgery) during the past year and met criteria as pre-frail or frail using the FRAIL scale.
Eur Radiol
December 2024
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Objectives: To evaluate the prevalence and predictors of ischemic lesions on thin-slice DWI (2 mm) in endovascular treatments for unruptured intracranial aneurysms (UIA), particularly explore the potential relationship with pathway plaques.
Methods: Participants eligible for endovascular treatments with UIA at a national stroke center between March 2023 and August 2023 were prospectively enrolled. All participants performed thin-slice DWI (slice thickness of 2 mm) before and after procedures.
Brain Behav Immun
December 2024
Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission of China, Peking University, Beijing 100191, China; Medical Innovation Center (Taizhou) of Peking University, Taizhou 225316, China. Electronic address:
Postoperative cognitive dysfunction (POCD) is common in the aged population and associated with poor clinical outcomes. Irisin, an endogenous molecule that mediates the beneficial effects of exercise, has shown neuroprotective potential in several models of neurological diseases. Here we show that preoperative serum level of irisin is reduced in dementia patients over the age of 70.
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