Functional tests are commonly used for chronic kidney disease (CKD) patients undergoing hemodialysis (HD). However, the relative and absolute reliability of such physical performance-outcome assessments must first be determined in specific patient cohorts. The aims of this study were to assess the relative and the absolute reliability of the Short Physical Performance Battery (SPPB), One-Legged Stance Test (OLST), and Timed Up and Go (TUG) test, as well as the minimal detectable change (MDC) scores for these tests in CKD patients receiving HD. Seventy-one end-stage CKD patients receiving HD therapy, aged between 21 and 90 years, participated in the study. The patients completed two testing sessions one to two weeks apart and performed by the same examiner, comprising the following tests: the SPPB (n = 65), OLST (n = 62), and TUG test (n = 66). High intraclass correlation coefficients (≥0.90) were found for all the tests, suggesting that their relative reliability is excellent. The MDC scores for the 90% confidence intervals were as follows: 1.7 points for the SPPB, 11.3 seconds for the OLST, and 2.9 seconds for the TUG test. The reliability of the SPPB, OLST, and TUG test for this sample were all considered to be acceptable. The MDC data generated by these tests can be used to monitor meaningful changes in the functional capacity of the daily living-related activity of CKD patients on HD.
Background and Objectives: Breast cancer survivors often experience long-term physical and psychological impairments that negatively affect quality of life. Exercise-based rehabilitation strategies are increasingly recommended in this population. This study aimed to analyze the physical and psychological benefits of Nordic walking (NW) in breast cancer survivors. Materials and Methods: A systematic review (registered in PROSPERO ref: CRD42024613292) was conducted in accordance with PRISMA guidelines. SPORTDiscus, CINAHL, Cochrane, Embase, Medline Ovid and PubMed were searched from database inception to 30 December 2025, with no restrictions applied regarding the language of the included studies, using the terms “breast cancer”, “walking poles”, “pole walking” and “Nordic walking”. Studies involving adult women (≥18 years) with breast cancer were included. Data on study design, participant characteristics, intervention protocols and outcomes were extracted. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: From 281 records identified, 17 studies were included that evaluated NW alone or in combination with other exercise. Improvements in cardiovascular capacity were reported in five studies (four out of five reported significant improvement after NW), while gains in shoulder range of motion were observed in three out of four studies assessing this outcome, mainly after standalone NW interventions. Positive changes in body posture were significantly reported after NW in all three studies investigating this parameter. Improvements in strength were reported in five studies, while gains in flexibility were observed in one study, within multimodal interventions combining NW with other exercise. Among seven studies evaluating lymphedema, sustained reductions were primarily reported after multiweek programs, especially when NW was combined with the ISA method. Several studies also reported improvements in pain, psychological alterations, and quality of life. Conclusions: NW appears to be an effective, holistic exercise modality for enhancing both physical and psychological aspects for breast cancer survivors.
The protective effect of physical activity on breast cancer recurrence may be mediated changes in by sex hormone levels. In this study, we examined the association between habitual physical activity and estrogen and androgen plasma levels in postmenopausal women with localised breast cancer. We conducted a cross-sectional study among 47 postmenopausal women who were breast cancer survivors with estrogen receptor-positive tumours (enrolled at the Medical Oncology Department of University Hospital Dr. Peset, Valencia, Spain). Habitual physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), and a weighted estimate of total physical activity per week (MET∙min∙wk−1) was calculated. Total plasma levels of estrone, 17β-estradiol, progesterone, androstenedione, testosterone, and dehydroepiandrosterone-sulphate (DHEA-sulphate) were measured. Bivariate analyses by the Spearman correlation test were done between physical activity and each hormone concentration. Multivariate analyses (linear regression) using concentration of each hormone as the dependent variable and physical activity, age, marital status, BMI, Charlson Comorbidity Index, tumour stage, previous radiotherapy, or previous chemotherapy as predictor variables. Estrone concentration was positively and significantly correlated with BMI (ρ = 0.332, p = 0.022), but no other correlations were found between BMI and the other hormone concentrations, nor were concentrations of any hormone associated with age or Charlson Comorbidity Index (p > 0.05 in all cases). Physical activity was significantly and inversely correlated with estrone concentration (ρ = −0.308; p = 0.035). Linear regression analysis confirmed a statistically significant association between estrone concentration and BMI and physical activity, after adjusting for all potential confounders (for BMI: standardised β coefficient = 0.407; non-standardised β coefficient = 1.054; t = 2.898; p = 0.006; 95% CI for non-standardised beta: 0.318- to 1.790; for physical activity: standardised β coefficient = −0.300; non-standardised β coefficient = −0.005; t = −2.135; p = 0.039; 95% CI for non-standardised beta: −0.010- to 0.000). The relationship between estrone concentration and physical activity may be further explored as a biomarker for evaluating the protective effect of physical activity against breast cancer recurrence in women receiving anti-estrogen therapies.
2 May 2024 in International Journal of Sports Physical Therapy
Background and Purpose: The characteristics of Proximal Hamstring Tendinopathy (PHT) include deep, localized pain in the region of the ischial tuberosity. Chronic lesions are often found in long-distance runners. Compression of the tendon and shear force at its insertion at the ischial tuberosity during hip flexion/adduction is a key etiologic factor. The aim of this case report is to analyze the effectiveness of an exercise protocol with progression of tendon loading in PHT in an amateur runner, by assessing pain and functional capacity. Case Description: The subject was a 30-year-old male runner. After participating in a 10km race, he experienced an insidious onset of deep buttock pain in the right ischial tuberosity. His pain was aggravated by running on sloped roads and prolonged sitting on hard surfaces, particularly while driving. The visual analog scale (VAS) for pain, the Puranen-Orave test (PO), the Bent-Knee stretch test (BK stretch), the supine plank test, the Victorian Institute of Sport Assessment-proximal hamstring tendons (VISA-H) questionnaire, and the sciatic nerve mobility (via the Slump test) were assessed. The intervention involved a 12-week progressive loading exercise program divided into four phases. Outcomes: The initial pain was reduced at 6 weeks of intervention and further decreased at 12 weeks (VAS from 7, to 5 and to 1). Function increased at 6 weeks and at 12 weeks (VISA-H from 23, to 53, to 80). Sciatic nerve mobility was normal. Conclusion: The progression of training in a subject with PHT tendon injury based on isometric exercise, concentric/eccentric, energy storage, progressively increasing hip flexion was beneficial, increasing function and decreasing pain. Studies with a larger sample size and a more precise methodological design would be necessary to support this type of intervention in clinical practice. Level of Evidence: 5