Background: Obesity rates have continued to increase and much of this increase is due to physical inactivity. One of the major contributors to physical inactivity is excessive participation in sedentary activities such as playing video games. However, game developers recently have begun developing more active gaming and many of these games are available across a variety of gaming systems. With several platforms available for active video gaming, there is limited research comparing differences in energy expenditure (EE) across the different devices. Objective: The purpose of this study was to compare EE and heart rate (HR) responses while playing an activity-based dance game on the Xbox Kinect, Playstation Move, and Nintendo Wii. Design: This was a repeated-measures study design. Methods: Fifty-one participants played Just Dance 3 on each system for 15 minutes per session in a randomized order. Energy expenditure in kilocalories per minute was estimated using a triaxial accelerometer, and HR in beats per minute was measured with a HR belt monitor. Results: Participants burned significantly more kilocalories on the Kinect compared with the Playstation and the Wii. There was no significant difference in EE between the Playstation and the Wii. As regards average HR, the Kinect resulted in a higher HR compared with the Playstation and the Wii. There was no difference in HR response between the Playstation and Wii. Conclusions: This study demonstrates that the Kinect is the best gaming platform for promoting higher EE and HR when playing an activity-based dance game.

BACKGROUND & PURPOSE:Tuberculosis is an infectious disease that affects the lungs and results in poor lung compliance secondary to diffuse fibrotic changes to lung tissue. Consequently, people with pulmonary tuberculosis experience impaired gas exchange resulting in a decline in functional capacity. The purpose of this study was to evaluate the physical functional capacity (VO(2)max) in a group of older (50 - 65 years) people with pulmonary tuberculosis and to compare them to an age-matched healthy group. A secondary purpose was to develop reference equations that could be used to predict 6 minute walk test (6MWT) distance in older, healthy people in India.METHODS:Sixty healthy subjects (30 male and 30 female) and 60 subjects with a diagnosis of pulmonary tuberculosis (30 male and 30 female) participated in the study. All subjects underwent a 6MWT. Walk-work was calculated and used for evaluating functional capacity. Group comparison for functional capacity was done using 2-tailed t-tests. Pearson product correlation was used to examine for significant relationships and regression analysis was used to derive reference equations.RESULTS:There was a significant difference between groups in regard to functional capacity and 6MWT distance (p < 0.001). Reference equations were developed that use age, height, and weight as predictors for 6MWT distance in the healthy group.CONCLUSION:The sequelae from pulmonary tuberculosis have considerable impact on functional capacity in older people in India.

Bowers, Sheronda SPT, BS; Cannizzaro, Katie SPT, BS; Gregus, Jessica SPT, BS; Scott, Quanteria SPT, BS; Eason, Jane PT, PhD Author Information

Chronic obstructive pulmonary disease (COPD) affects over 12 million people and is the fourth leading cause of death in the United States.1 Chronic obstructive pulmonary disease is a slowly progressing lung disease which includes the diagnoses of emphysema and bronchitis. Both emphysema and bronchitis are characterized by patients exhibiting compromised breathing patterns and inefficient movement of air into and out of the lungs. When the airways become obstructed as a result of these disease processes, patients experience excess sputum production, difficulty breathing, coughing, hypoxemia, and hypercapnea.2 While there are many medical treatments used to manage symptoms of COPD, this condition is not curable and slowly progresses despite treatments and medications. Further progression of the disease leads to a progressive loss of function of the pulmonary system and decreased ability to perform previously enjoyed activities. Patients whose disease process leads to decreased functional capacity may experience a sense of loss of self and feel that their quality of life has diminished. Realizing that COPD and other chronic diseases have not only physical, but also emotional and psychological consequences, it is important for health care providers to examine all aspects of patients' health. Limited availability of resources for patient care in today's health care system requires that treatments and interventions used be both cost- and time-efficient, while providing the highest level of care possible for all patients. Various outcome measures are often used to ensure that this level of care is provided. It is no longer sufficient to use only physiologic measures to ensure quality of care as these measures often do not correlate to improved health-related quality of life (HRQL).3–5 Instead, health care providers must also examine how changes in a patient's status and mood may affect their functional ability and how these functional outcomes translate into their HRQL. Quality of life, as defined by the World Health Organization, is “an individual's perception of their position in life in the context of the cultural and value systems in which they live, and in relation to their goals, expectations, standards and concerns.”6 Health-related quality of life describes a subset of quality of life directly related to an individual's health. Tools that assess HRQL can provide important information about the person's overall health status that otherwise may be overlooked or not taken into consideration. There are currently many outcome tools measuring HRQL, most of which use a questionnaire format and may be completed by an interviewer assisting the patient or by the patient independently. Some tools are targeted towards the effects of a specific disease on HRQL, whereas others are generic and can be used for patients with a variety of diseases. For such a tool to be useful, however, it must be proven to be reliable, valid, responsive, and interpretable.7 The Sickness Impact Profile (SIP) is a measure of health status designed to be broadly applicable across varying types and severities of illness and across an array of demographic and cultural subgroups.8 This article will endeavor to describe the Sickness Impact Profile and assess its usefulness for determining HRQL in patients with COPD

In today's medical system, limited resources are available for patient care. For this reason, it is important to evaluate the outcomes of various interventions to ensure that patients are receiving the most efficient and best available care. Recently, clinicians and payers are recognizing that physiological measures do not necessarily relate to function, and functional outcomes need to be measured independently.1–3 Measuring health related quality of life (HRQL) is one method of evaluating functional outcomes. HRQL is commonly assessed through self or interviewer administered questionnaires, and may be discriminative (evaluating cross-sectional differences between patients at a single point in time) or evaluative (measuring longitudinal changes within patients over a period of time).1 For a HRQL instrument to be effective and useful it must be valid, reliable, responsive, and interpretable.4 In general, disease specific measures of HRQL are more responsive than generic tools and may have more face validity to both the patient and clinician.1,5 The Chronic Respiratory Disease Questionnaire (CRQ) is the most commonly used disease specific measurement tool to assess HRQL in patients with chronic respiratory disease.5 The developers suggest that this tool be used to evaluate the effects of treatment in clinical trials as well as in clinical practice.2 As it is so widely used, it is important to understand the psychometric properties of this tool in order to truly understand its effectiveness and practical application. This paper describes the current research regarding the reliability, validity, responsiveness, minimally clinical important difference, and suggested use of the Chronic Respiratory Disease Questionnaire in clinical practice.

BACKGROUND:An increase was previously found in relative beta myosin heavy chain (MyHC) in the right ventricle of rats following thoracic spinal transection. It was hypothesized that the MyHC remodelling that was observed might be due, in part, to autonomic influences on the right ventricle.OBJECTIVE:To evaluate cardiac myosin phenotype following 21 days of reduced sympathetic activity.METHODS:Adult male Sprague-Dawley rats underwent either adrenodemedullectomy/chemical sympathectomy (SX) or sham operation/sham injection (CN). Twenty-one days following surgery, the animals were sacrificed and both ventricles were harvested. The ventricles were denatured and run on sodium dodecyl sulfate-polyacrylamide gel electrophoresis for identification of MyHC isoforms.RESULTS:SX resulted in a significant decline in catecholamines. In the right ventricle, beta MyHC ratio was twofold higher in SX animals than in CN rats, but there was no difference between groups in beta MyHC concentration in the left ventricle (P<0.05). Uniquely, we found a decrease in relative alpha MyHC in the right ventricle but no change in the myosin phenotype in the left ventricle.CONCLUSIONS:These data potentially indicate that MyHC concentrations in the left ventricle are less sensitive than the right ventricle to decreased sympathetic activity.

The myosin heavy chain (MyHC) isoform composition of six adult (>7 months old) male and female rabbit masseter muscles was studied using seven monoclonal antibodies. In matched serial tissue sections, muscle fibers in 10 different neuromuscular compartments were analyzed. Nearly all fibers were found to express one of five phenotypes. They either contained one of four different slow/beta MyHC phenotypes (I1–I4), nearly all of which co-express cardiac alpha MyHC, or they contained type IIa MyHC. Very few fibers contained slow/beta or cardiac alpha MyHC only or both the alpha/slow/beta and IIa isoforms. Most, but not all, of the compartments studied contained similar proportions of fibers of the five major phenotypes, at least within sex. For 7 of the 10 compartments studied, significant sex differences in the proportion of I1 and IIa fibers were found. Males contained more IIa fibers and fewer I1 fibers than females. Fibers of the IIa phenotype were significantly larger than fibers of all of the other phenotypes and larger in males than females.

Differences in the phenotype of different mammalian muscle fibres are usually attributed to differences in the expression of the product of different myosin heavy chain (MyHC) genes, which are known as isoforms. We studied differences in phenotype among fibres containing a single MyHC isoform (slow/beta) of the masseter muscle of adult rabbits. Four different monoclonal antibodies to slow/beta MyHC were used to stain serial sections from muscles in males and females. All antibodies recognize a single band on immunoblots and stain the same set of fibres in rabbit postcranial muscles. However, differential staining was observed in the masseter muscles. Antibody BA-D5 reacts with the most fibres, antibody A4.951 reacts with a subset of these fibres, and antibody A4.840 reacts with a subset of the A4.951-positive fibres. Antibody S58 reacts only with an even smaller subset of fibres. Even though differential staining using four antibodies might allow for the expression of as many as 15 different staining patterns, or phenotypes, only four were observed in>99% of over 30000 fibres studied. In females, nearly 40% of the fibres stain exclusively with antibody BA-D5, while in males, fewer than 8% of the fibres express this phenotype. The proportions of fibres of the other phenotypes do not differ so strikingly with gender. We conclude that an epitope diversity exists among muscle fibres in the adult rabbit masseter and that it is not necessarily a consequence of differences in gene expression. We feel that it is a regulated process and that, at least for some phenotypes, this regulation may be hormonally influenced.