Petrella R J, Koval J J, Cunningham D A, Paterson D H
Departments of Family Medicine, Physical Medicine and Rehabilitation, Epidemiology and Biostatistics, School of Kinesiology, Faculty of Health Sciences, London, Ontario, Canada.
J Am Geriatr Soc. 2001 May;49(5):632-8. doi: 10.1046/j.1532-5415.2001.49124.x.
To study the potential usefulness of a submaximal self-paced step test as a prediction of maximal aerobic capacity (VO2max) in older adults in the primary care setting.
Data were collected during a prospective randomized study of an exercise program.
Four university family medical clinics in London, Ontario, Canada.
A random sample of 240 healthy older (> or =65) men (n = 118) and women (n = 122) from four family medical clinics underwent self-paced step testing in the clinic with a family physician (n = 16), and step testing and a maximal exercise treadmill test with measurement of respired gases in an exercise laboratory. Testing was done in random order (clinic/laboratory) separated by 2 weeks and then repeated at 52 weeks, following introduction of an exercise program. Relationships between outcome variables were examined by Pearson correlation coefficients while prediction of VO2max was examined using multivariate regression analysis. Cross-validation with 30 age-matched hypertensive and 40 age-matched post-hip arthroplasty patients was used to test the accuracy of the predictive models.
Measured VO2max, predicted VO2max, step test time, step test heart rate, body mass index (BMI), and O2 pulse.
Two hundred women (n = 108) and men (n = 92) completed both the initial and 52-week assessments. Stepping time, heart rate, age, BMI, and O2 pulse were strongly associated with VO2max for both a normal and a fast step pace and were chosen to develop the predictive model. Normal step-pace correlation with VO2max (ml/kg/min) was no different (female 0.93: male 0.91) from fast pace (0.95:0.90) with no difference between clinic and laboratory measurement at baseline or 52 weeks. Cross-validation showed no significant difference from the main group using the predictive model.
The self-paced step test is a safe and simple clinical instrument that strongly and reliably predicts VO2max, is sensitive to change, and is generalizable in the family practice setting among community-dwelling older adults differing in fitness and health status.
研究次极量自定步速台阶试验对基层医疗环境中老年人最大有氧能力（VO₂max）的预测价值。
在一项运动项目的前瞻性随机研究中收集数据。
加拿大安大略省伦敦市的四家大学家庭医疗诊所。
从四家家庭医疗诊所随机抽取240名健康老年人（年龄≥65岁），其中男性118名，女性122名。他们在诊所接受了由家庭医生进行的自定步速台阶试验（16人），并在运动实验室进行了台阶试验和最大运动平板试验，同时测量呼吸气体。测试以随机顺序（诊所/实验室）进行，间隔2周，并在引入运动项目后的52周重复进行。通过Pearson相关系数检验结果变量之间的关系，使用多元回归分析检验VO₂max的预测情况。采用30名年龄匹配的高血压患者和40名年龄匹配的髋关节置换术后患者进行交叉验证，以检验预测模型的准确性。
实测VO₂max、预测VO₂max、台阶试验时间、台阶试验心率、体重指数（BMI）和氧脉搏。
200名女性（108名）和男性（92名）完成了初始和52周的评估。无论是正常步速还是快速步速，蹬台阶时间、心率、年龄、BMI和氧脉搏都与VO₂max密切相关，并被选入预测模型。正常步速与VO₂max（毫升/千克/分钟）的相关性（女性0.93，男性0.91）与快速步速（0.95，0.90）无差异，基线或52周时诊所和实验室测量结果也无差异。交叉验证显示，使用预测模型时与主要组无显著差异。
自定步速台阶试验是一种安全、简单的临床工具，能强有力且可靠地预测VO₂max，对变化敏感，并且在家庭医疗环境中适用于不同健康和体能状况的社区居住老年人。
