Respiratory Epidemiology and Clinical Research Unit of the Montreal Chest Institute, McGill University Health Center, Montreal, Quebec, Canada.
COPD. 2009 Oct;6(5):330-9. doi: 10.1080/15412550903156317.
This study reports on the development and test-retest reproducibility of a modified shuttle walking and step testing protocols to assess exertional dyspnea in patients with COPD. Patients with COPD randomly performed four externally paced 3-min bouts of shuttle walking at 1.5, 2.5, 4.0 and 6.0 km x h(- 1) or stepping at constant rate of 18, 22, 26 and 32 steps x min(- 1). Walking and stepping procedures were repeated once, on a separate occasion. Ventilation, heart rate, gas exchange parameters and dyspnea Borg scores were obtained at the end of each exercise bout. Most patients completed walking or stepping at the slow and middle speed cadences but only 33% completed walking at 6.0 km x h(- 1) and 40% completed stepping at 32 steps x min(- 1). Walking and stepping at progressively faster pace caused a progressive increase in ventilation and dyspnea. Test-retest Pearson correlation coefficients for ventilation, heart rate, gas exchange parameters and dyspnea scores over the four exercise bouts, all exceeded 0.80. Intra-class correlation coefficients were at least as strong as Pearson coefficients. Bland & Altman representation showed that for repeated Borg scores, 92 and 96% of points lied within 2 SD of the mean difference between test-retest values for walking and stepping. The majority of moderate and severe COPD patients completed the 3-min shuttle waking testing at 1.5 to 4.0 km x h(- 1) and the 3-min of step testing at rates between 18 and 26 steps x min(- 1). Both field tests were highly reproducible in patients with COPD.
本研究报告了改良的穿梭步行和台阶测试方案的开发和重测可重复性，用于评估 COPD 患者的运动性呼吸困难。COPD 患者随机进行四次外部 paced 的 3 分钟穿梭步行测试，速度分别为 1.5、2.5、4.0 和 6.0 km/h，或以 18、22、26 和 32 步/min 的恒定速率进行台阶测试。在另一个单独的场合，重复进行步行和台阶测试。在每次运动结束时，记录通气、心率、气体交换参数和呼吸困难 Borg 评分。大多数患者可以完成慢和中速的步行或台阶测试，但只有 33%的患者可以完成 6.0 km/h 的步行测试，40%的患者可以完成 32 步/min 的台阶测试。随着步伐速度的逐渐加快，通气和呼吸困难逐渐增加。四个运动阶段的通气、心率、气体交换参数和呼吸困难评分的重测 Pearson 相关系数均超过 0.80。组内相关系数至少与 Pearson 系数一样强。Bland & Altman 表示，对于重复的 Borg 评分，92%和 96%的点位于步行和台阶测试的重测值之间的平均差异的 2 SD 范围内。大多数中度和重度 COPD 患者可以完成 3 分钟的 1.5 至 4.0 km/h 的穿梭步行测试和 3 分钟的 18 至 26 步/min 的台阶测试。这两种现场测试在 COPD 患者中均具有高度可重复性。
