BACKGROUND AND OBJECTIVES: Empirical evidence is lacking on the cumulative disease burden of obesity and hypertension and its impact on cardiac function and exercise capacity. The purpose of this study was to determine whether the presence of obesity and hypertension together was associated with cardiac dysfunction and exercise capacity. SUBJECTS AND METHODS: Using a retrospective study design, medical records were reviewed for echocardiographic and treadmill exercise stress test data. Subjects were grouped according to four categories: normal control, obese, hypertensive, or obese and hypertensive. RESULTS: Obese, hypertensive persons showed significantly lower Ea and E/A ratio and greater E/Ea ratio, deceleration time, left ventricular (LV) mass, and LV mass index compared to their counter parts (normal control, obese and/or hypertensive) (all p<0.05), after controlling for age and sex. After controlling for age and sex, significant differences in exercise capacity indices were found, with the obese group having shorter exercise time, lower metabolic equivalents, and lower maximal oxygen uptake than the normal control, hypertensive, or both groups (all p<0.05). The hypertensive or obese and hypertensive group had greater maximal blood pressure compared with the normal control group (all p<0.001). Obese and hypertensive persons were approximately three times more likely to have diastolic dysfunction (odd ratio=2.96, p=0.001), when compared to the reference group (normotensive, non-obese, or hypertensive only persons). CONCLUSION: Diastolic dysfunction was associated with obesity and/or hypertension. The cumulative risk of obesity and hypertension and their impact on diastolic dysfunction which could be modifiable could reduce exercise capacity.
Blood Pressure ; Deceleration ; Echocardiography ; Exercise Test ; Humans ; Hypertension* ; Medical Records ; Metabolic Equivalent ; Obesity* ; Oxygen ; Retrospective Studies

BACKGROUND: Recommendations have been proposed for minimum aerobic fitness among firefighters but it is unclear if those criteria relate to performance on the fireground. Less fit individuals fatigue more quickly than fit individuals when working at comparable intensity and may have gait changes, increasing risk of falls. We evaluated the effect of fatigue during a live burn evolution on gait parameters and functional balance comparing them to aerobic fitness levels. METHODS: A total of 24 firefighters had gait and balance tested before and after a live burn evolution. Data were stratified by aerobic fitness of greater/less than 14 metabolic equivalents (METs). RESULTS: Analysis of gait cycles measurements before and after the live burn evolution revealed that single leg stance, cycle, and swing time decreased (p < 0.05) but there were no differences in the other measures. There were no differences in time to complete the functional balance test, or errors committed before or after a live burn evolution. When firefighters were sorted by fitness level of 14 METs, there were no differences for errors or time before or after the live burn evolution. Balance data were analyzed using a linear regression. Individuals with lower fitness levels required more time to complete the test. CONCLUSION: A 14-MET criterion failed to distinguish gait or balance characteristics in this group. However, less fit firefighters did require more time to complete the balance test (p = 0.003). Aerobic fitness alone does not predict gait changes among firefighters following a live burn evolution but does appear to influence functional balance.
Accidental Falls ; Burns* ; Fatigue ; Firefighters* ; Gait* ; Humans ; Leg ; Linear Models ; Metabolic Equivalent ; Protective Clothing

OBJECTIVES: This study is part of the ongoing development of treatment methods for metabolic syndrome (MS) project, which involves monitoring daily physical activity. In this study, we have focused on detecting walking activity from subjects which includes many other physical activities such as standing, sitting, lying, walking, running, and falling. Specially, we implemented an integrated solution for various physical activities monitoring using a mobile phone and PC. METHODS: We put the iPod touch has built in a tri-axial accelerometer on the waist of the subjects, and measured change in acceleration signal according to change in ambulatory movement and physical activities. First, we developed of programs that are aware of step counts, velocity of walking, energy consumptions, and metabolic equivalents based on iPod. Second, we have developed the activity recognition program based on PC. iPod synchronization with PC to transmit measured data using iPhoneBrowser program. Using the implemented system, we analyzed change in acceleration signal according to the change of six activity patterns. RESULTS: We compared results of the step counting algorithm with different positions. The mean accuracy across these tests was 99.6 +/- 0.61%, 99.1 +/- 0.87% (right waist location, right pants pocket). Moreover, six activities recognition was performed using Fuzzy c means classification algorithm recognized over 98% accuracy. In addition we developed of programs that synchronization of data between PC and iPod for long-term physical activity monitoring. CONCLUSIONS: This study will provide evidence on using mobile phone and PC for monitoring various activities in everyday life. The next step in our system will be addition of a standard value of various physical activities in everyday life such as household duties and a health guideline how to select and plan exercise considering one's physical characteristics and condition.
Acceleration ; Cellular Phone ; Deception ; Family Characteristics ; Metabolic Equivalent ; Monitoring, Ambulatory ; Motor Activity ; MP3-Player ; Running ; Walking

PURPOSE: This study aimed to analyze physical activity as measured by the International Physical Activity Questionnaire (IPAQ) and an actigraph in breast cancer survivors, as well as to identify their intention to participate in a physical activity program. METHODS: Breast cancer patients who had been diagnosed for more than six months (N=135) at a university hospital participated from June 2012 to May 2013. Physical activity was measured using the Korean version of the IPAQ-Short Form and Actigraph GT3X plus an accelerator for seven consecutive days. Data analyses were conducted using the SPSS WIN 19.0 program. RESULTS: Mean total physical activity was 2298.21 metabolic equivalent task (MET)-min/week as assessed by IPAQ and 150,140.57 counts/day as measured by an actigraph. There were statistically significant correlations between moderate physical activity from IPAQ and light intensity of physical activity from the actigraph (r=.735, p<.001), vigorous physical activity from IPAQ and vigorous intensity of physical activity from the actigraph (r=.871, p<.001), total physical activity from IPAQ and light intensity of physical activity from the actigraph (r=.825, p<.001), respectively. Most (80.7%) cancer survivors reported a positive attitude toward physical activity and 57.8% expressed a willingness to participate in a physical activity program. More than half (60%) of the subjects preferred walking, 80.6% preferred more than 30 minutes of exercise, and 57.1% wanted to engage in physical activity three times a week and preferred home-based activities. Perceived barriers included fatigue, lack of strength and pain. CONCLUSION: It is necessary to consider intensity, personal preferences, and patient-perceived barriers when developing physical activity programs for breast cancer survivors.
Breast Neoplasms* ; Breast* ; Fatigue ; Humans ; Intention* ; Metabolic Equivalent ; Motor Activity* ; Statistics as Topic ; Survivors* ; Walking

BACKGROUND: Regular exercise improves glycemic control and exercise capacity. However, 47.5% of Korean patients with type 2 diabetes do not take part in exercise at least once a week. A recommendation to accumulate 10,000 steps throughout the day has many advantages. The purpose of this study was to investigate the effects of increasing the number of walking steps per day on glycemic control and exercise capacity using a pedometer in newly diagnosed type 2 diabetics who did not take part in exercise at least once a week. METHODS: We included twenty nine Korean type 2 diabetic patients aged 46-62 years who presented with newly diagnosed type 2 diabetes and did not take part in exercise at least once a week. They were encouraged to walk more than 10,000 step/day and the daily steps were recorded using pedometers. A gradual loading exercise test was administered, with an electric stationary upright cycle ergometer, to estimate the rate of oxygen consumption (VO2), exercise time, load and metabolic equivalent (MET) before and after 12 weeks of walk training. Before and after the intervention, metabolic and lipid profiles and aerobic exercise levels were evaluated for all subjects. Subject descriptive comparisons were made with paired t-tests. The Pearson's correlation coefficients were calculated as well to analyze the linear relationship among variables. RESULTS: The results showed that the number of steps per day were increased to about 10,000 steps per day (p<0.001). Body mass index (p<0.001), abdominal circumference (p=0.011), aerobic exercise capacity level and glycemic control were significantly improved (p<0.001). However, lipid profiles were not affected during the exercise intervention. There was a positive correlation between increases in steps per day and changes of aerobic capacity such as peak VO2 (r=0.46, p<0.05). Also, increases in steps per day were negatively correlated with changes in HbA1c (r=-0.711, p<0.001). CONCLUSIONS: This study suggests that both glycemic control and aerobic capacity are improved with increasing the number of steps to over 10,000 steps per day in newly diagnosed Korean type 2 diabetics. Our result suggest that a pedometer may be used as a simple and effective method of encouraging physical activity to type 2 diabetics who did not take part in exercise at least once a week.
Body Mass Index ; Diabetes Mellitus ; Exercise ; Exercise Test ; Humans ; Metabolic Equivalent ; Motor Activity ; Oxygen Consumption ; Walking

BACKGROUND: Estimation of physical activity contributes to early screening and prevention of decrease in body function. This study was conducted to examine the reliability and validity of the International Physical Activity Questionnaire (IPAQ) short form in elderly people. METHODS: A total of 55 outpatients of 65 years old or older participated in this study. Physical activity over the last seven days was recorded on the IPAQ short form. Responses were converted to metabolic equivalent task minutes per week. The IPAQ short form was validated against accelerometer measurements as a gold standard. The test-retest method was performed over a two-week interval to examine the reliability of the IPAQ. RESULTS: The more physically active by the IPAQ short form, the higher the measured value of the accelerometer (P < 0.001). Pearson's correlation coefficient was 0.43 for the correlation between the results of two measurements. Spearman Rho coefficients and Kappa values of test-retest reliability in five elements (vigorous days, vigorous minutes, moderate days, moderate minutes, and walk days) were 0.299-0.605 and 0.307-0.418, respectively. CONCLUSION: The validity of the IPAQ short form was proven, but the reliability was found to be low. Nevertheless, IPAQ short form seems worthwhile tool for the measurement of physical activity levels, concerning daily variation in physical activity of the elderly.
Aged ; Humans ; Mass Screening ; Metabolic Equivalent ; Motor Activity ; Outpatients ; Reproducibility of Results

PURPOSE: The cardiopulmonary exercise test (CPET) is an important clinical tool for evaluating exercise capacity and is frequently used to evaluate chronic conditions including congenital heart disease. However, data on the normal CPET values for Korean children and adolescents are lacking. The aim of this study was to provide reference data for CPET variables in children and adolescents. METHODS: From August 2006 to April 2009, 76 healthy children and adolescents underwent the CPET performed using the modified Bruce protocol. Here, we performed a medical record review to obtain data regarding patient' demographics, medical history, and clinical status. RESULTS: The peak oxygen uptake (VO2Peak) and metabolic equivalent (METMax) were higher in boys than girls. The respiratory minute volume (VE)/CO2 production (VCO2) slope did not significantly differ between boys and girls. The cardiopulmonary exercise test data did not significantly differ between the boys and girls in younger age group (age, 10 to 14 years). However, in older age group (age, 15 to 19 years), the boys had higher VO2Peak and METMax values and lower VE/VCO2 values than the girls. CONCLUSION: This study provides reference data for CPET variables in case of children and adolescents and will make it easier to use the CPET for clinical decision-making.
Adolescent ; Bacterial Toxins ; Child ; Demography ; Exercise Test ; Heart Diseases ; Humans ; Medical Records ; Metabolic Equivalent ; Oxygen

OBJECTIVE: To evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification. METHODS: This prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions. RESULTS: Post-exercise cardiovascular and functional states, maximal oxygen uptake (VO2max), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. In particular, VO2max was significantly (p < 0.005) improved in the HIIT group (7.58 mL/kg/min) compared to that in the MICT group (2.42 mL/kg/min). In addition, post-exercise psychological states (i.e., scores of Fatigue Severity Scale [FSS] and depression items of the Hospital Anxiety and Depression Scale [HADS_D]) were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. HADS-D was improved by 1.89 in the HIIT group compared to decrement of 0.47 in the MICT group. FSS was improved by 6.38 in the HIIT group compared to decrement of 0.77 in the MICT group (p < 0.005). CONCLUSION: This study demonstrates that HIIT can improve cardiac function, psychological, and activity states in low and moderate risk MI patients. Compared to conventional MICT, HIIT can improve cardiovascular functions, activity states, depression, and fatigue more effectively.
Anxiety ; Depression ; Fatigue ; Humans ; Metabolic Equivalent ; Myocardial Infarction ; Outcome Assessment (Health Care) ; Oxygen ; Prospective Studies ; Walking

OBJECTIVES: Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population. METHODS: This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors. RESULTS: The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p < 0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend < 0.001) and depression scores (p for trend < 0.001). CONCLUSION: We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.
Adult* ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Male ; Metabolic Equivalent ; Motor Activity* ; Socioeconomic Factors ; Wrist

OBJECTIVES: Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population.METHODS: This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors.RESULTS: The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p < 0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend < 0.001) and depression scores (p for trend < 0.001).CONCLUSION: We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.
Adult ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Male ; Metabolic Equivalent ; Motor Activity ; Socioeconomic Factors ; Wrist