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两分钟步行试验作为心脏手术患者功能能力的一项指标。

The two-minute walk test as a measure of functional capacity in cardiac surgery patients.

作者信息

Brooks Dina, Parsons Janet, Tran Diem, Jeng Bonnie, Gorczyca Barbara, Newton Janet, Lo Vincent, Dear Cheryl, Silaj Ellen, Hawn Therese

机构信息

Department of Physical Therapy, University of Toronto, ON, Canada.

出版信息

Arch Phys Med Rehabil. 2004 Sep;85(9):1525-30. doi: 10.1016/j.apmr.2004.01.023.

Abstract

OBJECTIVE

To examine construct validity and sensitivity of the two-minute walk test (2MWT) in cardiac surgery patients.

DESIGN

Measurements were made in patients preoperatively, during the postoperative in-hospital stay, and 6 to 8 weeks after discharge from hospital.

SETTING

Ambulatory and hospitalized care.

PARTICIPANTS

Patients (N=122; mean age +/- standard deviation, 63+/-9 y) undergoing coronary artery bypass grafting.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The 2MWT, New York Heart Association (NYHA) functional classification for cardiac disease, the Nottingham Extended Activities of Daily Living scale, and the Medical Outcomes Survey 36-Item Short-Form Health Questionnaire (SF-36).

RESULTS

Distance walked in 2 minutes decreased significantly postoperatively (from 138+/-26 m to 84+/-33 m, P<.001), but increased again at follow-up (151+/-31 m, P<.0001). Distance walked on the 2MWT correlated significantly to SF-36 (physical function subscale) preoperatively (r=.44) and at follow-up (r=.48) (P<.001). There was a significant difference in distance walked between those with NYHA class I and II compared with those classified as III or IV (P=.04). However, there was no significant difference in distance walked in 2 minutes between those who developed cardiac or pulmonary complications postoperatively (P> or =0.2).

CONCLUSIONS

The 2MWT was sensitive to change after cardiac surgery and showed moderate correlation with measures of physical functioning in this population. However, the 2MWT could not identify those who developed complications in the postoperative period.

摘要

目的

探讨心脏手术患者两分钟步行试验(2MWT)的结构效度和敏感性。

设计

在患者术前、术后住院期间以及出院后6至8周进行测量。

地点

门诊和住院护理。

参与者

接受冠状动脉旁路移植术的患者(N = 122;平均年龄±标准差,63±9岁)。

干预措施

不适用。

主要观察指标

2MWT、纽约心脏协会(NYHA)心脏病功能分级、诺丁汉扩展日常生活活动量表以及医学结局调查36项简短健康调查问卷(SF - 36)。

结果

术后两分钟步行距离显著下降(从138±26米降至84±33米,P <.001),但在随访时再次增加(151±31米,P <.0001)。术前(r =.44)和随访时(r =.48),2MWT步行距离与SF - 36(身体功能分量表)显著相关(P <.001)。NYHA I级和II级患者与III级或IV级患者的步行距离存在显著差异(P =.04)。然而,术后发生心脏或肺部并发症的患者与未发生并发症的患者在两分钟步行距离上无显著差异(P≥0.2)。

结论

2MWT对心脏手术后的变化敏感,且与该人群的身体功能测量指标具有中度相关性。然而,2MWT无法识别术后发生并发症的患者。

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