Haccoun Charles, Smountas Argyrios A, Gibbons William J, Bourbeau Jean, Lands Larry C
Montreal Children's Hospital-McGill University Health Centre, Montreal, PQ, Canada.
Chest. 2002 Apr;121(4):1079-84. doi: 10.1378/chest.121.4.1079.
Exercise limitation in patients with COPD has been attributed to impaired ventilation and reduced skeletal muscle function. We have previously used a combination of FEV(1) and leg muscle function (work achieved during a 30-s isokinetic sprint test) to predict progressive exercise capacity. However, the 30-s test may not be well tolerated in patients with advanced lung disease. We studied the relationship between progressive exercise capacity, FEV(1), and isokinetic work in patients with COPD and in healthy control subjects to assess whether the work accomplished at time intervals of < 30 s could also be used to predict progressive maximal exercise capacity (Wmax).
Twenty-seven patients with COPD and 29 control subjects underwent anthropometric measures, spirometry, progressive cycle ergometry, and 30-s isokinetic cycling.
There was no significant difference for weight, height, or body mass index between the groups. The COPD group was slightly older and had a significantly lower FEV(1) than control subjects. They also had a lower Wmax (56 +/- 28.3 W vs 141.9 +/- 46.7 W) and isokinetic work accomplished over 10 s (W10), over 15 s (W15), over 20 s (W20), over 25 s (W25), and over 30 s (W30). Wmax correlated in both patients with COPD and in control subjects with W10, W15, W20, W25, W30, and FEV(1). Combining FEV(1) and isokinetic work (W10, W15, W20, W25, or W30) in a two-factor model to predict Wmax, the coefficients of determination (r(2)) for patients with COPD were 0.57, 0.57, 0.58, 0.59, and 0.58, and for control subjects were 0.69, 0.69, 0.71, 0.71, and 0.73, respectively. Wmax correlated with weight only in control subjects.
Both ventilatory function and leg muscle function contribute to exercise limitation, and a 20-s isokinetic test can be utilized to assess leg function in patients with COPD.
慢性阻塞性肺疾病（COPD）患者的运动受限归因于通气功能受损和骨骼肌功能下降。我们之前曾联合使用第一秒用力呼气容积（FEV₁）和腿部肌肉功能（30秒等速冲刺试验中的做功量）来预测渐进性运动能力。然而，30秒试验对于晚期肺病患者可能耐受性不佳。我们研究了COPD患者和健康对照者的渐进性运动能力、FEV₁与等速做功之间的关系，以评估小于30秒时间间隔内的做功量是否也可用于预测渐进性最大运动能力（Wmax）。
27例COPD患者和29名对照者接受了人体测量、肺功能测定、渐进性踏车运动试验和30秒等速踏车运动试验。
两组在体重、身高或体重指数方面无显著差异。COPD组年龄稍大，FEV₁显著低于对照组。他们的Wmax（56±28.3瓦对141.9±46.7瓦）以及10秒（W10）、15秒（W15）、20秒（W20）、25秒（W25）和30秒（W30）内完成的等速做功量也较低。COPD患者和对照者的Wmax均与W10、W15、W20、W25、W30以及FEV₁相关。在双因素模型中联合FEV₁和等速做功（W10、W15、W20、W25或W30）来预测Wmax，COPD患者的决定系数（r²）分别为0.57、0.57、0.58、0.59和0.58，对照者的决定系数分别为0.69、0.69、0.71、0.71和0.73。仅在对照者中Wmax与体重相关。
通气功能和腿部肌肉功能均导致运动受限，20秒等速试验可用于评估COPD患者的腿部功能。
