Mossberg Kurt A, Greene Brandy P
Department of Physical Therapy, University of Texas Medical Branch, Galveston, Texas 77555-1144, USA.
Am J Phys Med Rehabil. 2005 Jul;84(7):492-500. doi: 10.1097/01.phm.0000166883.97562.cd.
To assess the reliability of the submaximal and peak responses to a treadmill graded exercise test in individuals recovering from traumatic brain injury.
A total of 15 individuals (11 men, 4 women; 28.5 +/- 9.2 yrs) with moderate to severe traumatic brain injury admitted into a postacute residential treatment center 10 +/- 7 mos after injury performed two treadmill graded exercise tests separated by 4-8 days. Heart rate, oxygen consumption (in milliliters per minute per kilogram), minute ventilation (in liters per minute), and respiratory exchange ratio (carbon dioxide output/oxygen consumption) were continuously monitored at 1-min intervals. Submaximal and peak values were analyzed for absolute level of agreement using the intraclass correlation coefficient.
The submaximal intraclass correlation coefficient values for all variables between minutes 3 and 7 ranged from 0.80 to 0.93. Submaximal intraclass correlation coefficients before and in the subsequent minutes were less than optimal for heart rate and minute ventilation. Lower intensity workloads elicited slightly better agreement than higher intensity workloads. The peak response intraclass correlation coefficients ranged from 0.77 (heart rate) to 0.92 (oxygen consumption).
Despite the presence of other co-morbidities, subjects recovering from traumatic brain injury provided consistent individual responses, allowing for reliable assessments of cardiorespiratory conditioning programs. Assessments of ambulatory efficiency, endurance, and aerobic fitness adaptations as a result of treatment for persons with traumatic brain injury should include analyses of submaximal responses to graded exercise.
评估创伤性脑损伤康复个体对跑步机分级运动试验的次最大反应和峰值反应的可靠性。
共有15名个体（11名男性，4名女性；28.5±9.2岁），他们在创伤性脑损伤后10±7个月入住一家急性后期住院治疗中心，患有中度至重度创伤性脑损伤，在间隔4 - 8天的时间里进行了两次跑步机分级运动试验。以1分钟的间隔连续监测心率、耗氧量（每千克每分钟毫升数）、分钟通气量（每分钟升数）和呼吸交换率（二氧化碳排出量/耗氧量）。使用组内相关系数分析次最大和峰值的绝对一致性水平。
第3至7分钟所有变量的次最大组内相关系数值在0.80至0.93之间。心率和分钟通气量在之前及随后分钟的次最大组内相关系数低于最佳水平。较低强度的工作量比高强度的工作量产生的一致性稍好。峰值反应组内相关系数范围从0.77（心率）至0.92（耗氧量）。
尽管存在其他合并症，但创伤性脑损伤康复个体提供了一致的个体反应，从而能够对心肺调节计划进行可靠评估。对创伤性脑损伤患者治疗后动态效率、耐力和有氧适能适应情况的评估应包括对分级运动次最大反应的分析。
