Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
Chest. 2011 Sep;140(3):737-743. doi: 10.1378/chest.10-3104. Epub 2011 Mar 10.
Patients with chronic respiratory diseases often have the simple goal of wanting to walk for longer. We evaluated the properties of a patient goal-oriented, symptom-limited, self-paced walk (SPW).
Patients with symptomatic chronic respiratory disease, referred for a 6-week course of pulmonary rehabilitation (PR), were screened for eligibility. Baseline assessments included two SPWs with both time and speed measured, two 6-min walk tests (6MWTs), and the Medical Research Council dyspnea scale. On program completion, two SPWs and one 6MWT were performed. The repeatability, responsiveness, and validity of the SPW were assessed.
Two SPWs were completed by 50 and 37 patients before and after rehabilitation, respectively. The speed (r = -0.54, P < .001) but not the time (r = -0.23, P = .19) of the SPW correlated with Medical Research Council dyspnea grade. The mean SPW time increased on the second day of testing from 15.1 ± 8.4 min to 17.9 ± 7.7 min (P = .004), and the effect of test day was unaltered by PR (P = .80). The coefficient of repeatability for SPW time was 16.1 min. Both the mean SPW time (10.6 min; 95% CI, 6.6-14.5 min; P < .001) and the mean speed (3.5 m/min; 95% CI, 1.3-5.7 m/min; P < .01) increased after rehabilitation.
The SPW time is an easily understandable, patient goal-oriented assessment with construct validity that is highly responsive to the effects of PR. The variability in SPW time makes it better suited to interpreting group rather than individual changes.
ClinicalTrials.gov; No.: NCT00781183; URL: www.clinicaltrials.gov.
慢性呼吸系统疾病患者通常只有一个简单的目标，就是想要走得更远。我们评估了一种以患者目标为导向、症状限制、自我调节速度的步行（SPW）的特性。
筛选出患有症状性慢性呼吸系统疾病并接受为期 6 周的肺康复（PR）治疗的患者，评估其合格性。基线评估包括两次测量时间和速度的 SPW、两次 6 分钟步行测试（6MWT）和呼吸困难量表。在计划完成时，进行了两次 SPW 和一次 6MWT。评估了 SPW 的重复性、反应性和有效性。
分别有 50 名和 37 名患者在康复前后完成了两次 SPW。SPW 的速度（r = -0.54，P <.001）而不是时间（r = -0.23，P =.19）与呼吸困难量表的等级相关。SPW 的平均时间在测试的第二天从 15.1 ± 8.4 分钟增加到 17.9 ± 7.7 分钟（P =.004），并且 PR 并没有改变测试日的影响（P =.80）。SPW 时间的重复性系数为 16.1 分钟。SPW 的平均时间（10.6 分钟；95%CI，6.6-14.5 分钟；P <.001）和平均速度（3.5 m/min；95%CI，1.3-5.7 m/min；P <.01）在康复后均增加。
SPW 时间是一种易于理解、以患者目标为导向的评估方法，具有结构有效性，对 PR 的效果具有高度反应性。SPW 时间的可变性使其更适合解释群体变化，而不是个体变化。
ClinicalTrials.gov；编号：NCT00781183；网址：www.clinicaltrials.gov。
