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中重度创伤性脑损伤患者心肺峰值反应的可靠性

Reliability of peak cardiorespiratory responses in patients with moderate to severe traumatic brain injury.

作者信息

Bhambhani Yagesh, Rowland Gary, Farag Mamdouh

机构信息

Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.

出版信息

Arch Phys Med Rehabil. 2003 Nov;84(11):1629-36. doi: 10.1053/s0003-9993(03)00343-5.

Abstract

OBJECTIVE

To examine the test-retest reliability of acute physiologic responses in patients with traumatic brain injury (TBI).

DESIGN

Repeated measures within 1 week.

SETTING

Brain injury rehabilitation program and community rehabilitation hospital.

PARTICIPANTS

Thirty-six inpatients or their legal guardians.

INTERVENTIONS

Each patient performed a symptom-limited incremental cycle ergometer test to voluntary fatigue on 2 separate occasions within 1 week.

MAIN OUTCOME MEASURES

Peak values of power output and cardiorespiratory responses measured with a metabolic cart interfaced with an electrocardiogram.

RESULTS

Intraclass correlations between the 2 trials were as follows: power output,.96; absolute oxygen uptake,.98; relative oxygen uptake,.97; heart rate,.82; ventilation rate,.96; and respiratory exchange ratio,.81. Bland-Altman plots showed that all data points were within the 95% confidence limits of the mean value of the 2 trials for each variable.

CONCLUSIONS

The reliability of the peak cardiorespiratory responses during non-weight-bearing exercise was high in patients with TBI in a controlled laboratory setting. Therefore, aerobic exercise programs can be accurately prescribed, and changes resulting from such interventions can be confidently evaluated in this population.

摘要

目的

探讨创伤性脑损伤(TBI)患者急性生理反应的重测信度。

设计

1周内重复测量。

地点

脑损伤康复项目及社区康复医院。

参与者

36名住院患者或其法定监护人。

干预措施

每位患者在1周内分2次进行症状限制递增式蹬车测力计测试,直至自觉疲劳。

主要观察指标

通过与心电图相连的代谢仪测量的功率输出峰值及心肺反应。

结果

两次测试间的组内相关系数如下:功率输出,0.96;绝对摄氧量,0.98;相对摄氧量,0.97;心率,0.82;通气率,0.96;呼吸交换率,0.81。Bland-Altman图显示,每个变量的所有数据点均在两次测试平均值的95%置信区间内。

结论

在受控实验室环境中,TBI患者非负重运动期间心肺反应峰值的信度较高。因此,有氧运动项目可以准确制定,并且可以在此人群中可靠地评估此类干预措施产生的变化。

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