Chuang M L, Lin I F, Wasserman K
Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
Respir Med. 2001 Jul;95(7):618-26. doi: 10.1053/rmed.2001.1115.
The product of walking distance and body weight (D x W) mimics the work of walking. We hypothesized the superiority of D x W to walking distance (D) alone in any correlation with lung function, anaerobic threshold (AT) and maximal oxygen uptake (VO2max). We further hypothesized that the D x W product for a 6-min walk test (6 MWT) would correlate with the AT and VO2max because all three are markers of exercise ability. Thirty-three male chronic obstructive pulmonary disease (COPD) patients with mean forced expiratory volume in 1 sec (FEV1) of 1.2+/-0.4 l (range 0.58-1.86 l) were enrolled. Six patients were excluded due to inability to achieve a maximal test. Lung function and self-assessed every-day activities using a oxygen-cost diagram were evaluated before entry of the study. A maximal effort ramp-pattern cardiopulmonary exercise test (CPET) and a 6 MWT were conducted in random order. Borg score, heart rate, and O2 saturation with pulse oximetry (SpO2) were measured during both exercise tests. VO2 AT and minute ventilation were also measured during the CPET. Correlations were sought between the distance covered in the 6 MWT, and the D x W product with AT, VO2max and other variables. The average D and D x W were 456 m and 27.5 kg km(-1), respectively. D x W was superior to D alone when correlated with the VO2max and AT determined from the CPET, while modestly correlated with the change (delta) in Borg score and delta SpO2 in the 6 MWT and self-assessed every-day activities. Distance x weight product was correlated with the AT and VO2max. In addition, D x W was better correlated with diffusing capacity for carbon monoxide and vital capacity than D alone. We conclude that D x W mimics the work of walking better than D and is suggested as a parameter for evaluation of patients' fitness if gas exchange measurements are not available.
步行距离与体重的乘积(D×W)模拟了步行的工作量。我们假设在与肺功能、无氧阈值(AT)和最大摄氧量(VO₂max)的任何相关性方面,D×W优于单独的步行距离(D)。我们进一步假设,6分钟步行试验(6MWT)的D×W乘积将与AT和VO₂max相关,因为这三者都是运动能力的指标。招募了33名男性慢性阻塞性肺疾病(COPD)患者,其1秒用力呼气量(FEV₁)平均为1.2±0.4升(范围0.58 - 1.86升)。6名患者因无法完成最大测试而被排除。在研究入组前评估了肺功能以及使用氧耗图进行的自我评估日常活动。以随机顺序进行了最大负荷斜坡式心肺运动试验(CPET)和6MWT。在两次运动试验期间测量了Borg评分、心率以及脉搏血氧饱和度(SpO₂)下的氧饱和度。在CPET期间还测量了VO₂、AT和分钟通气量。研究了6MWT中覆盖的距离以及D×W乘积与AT、VO₂max和其他变量之间的相关性。平均D和D×W分别为456米和27.5千克·千米⁻¹。当与通过CPET确定的VO₂max和AT相关时,D×W优于单独的D,而与6MWT中Borg评分的变化(δ)和δSpO₂以及自我评估的日常活动有适度相关性。距离×体重乘积与AT和VO₂max相关。此外,与单独的D相比,D×W与一氧化碳弥散能力和肺活量的相关性更好。我们得出结论,D×W比D更能模拟步行的工作量,并且建议在无法进行气体交换测量时,将其作为评估患者健康状况的一个参数。