Department of Respiratory Medicine, Toronto, ON, Canada; Departments of Physical Therapy and Medicine, University of Toronto, Toronto, ON, Canada; School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia; Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Crawley, WA, Australia.
Department of Respiratory Medicine, Toronto, ON, Canada; Respiratory Diagnostic and Evaluations Services, West Park Healthcare Centre, Toronto, ON, Canada.
Chest. 2012 Feb;141(2):406-412. doi: 10.1378/chest.11-0298. Epub 2011 Aug 11.
The aims of this study were to determine which tests of exercise capacity relate to average daily energy expenditure (DEE) and to quantify aerobic reserve during daily life in people with COPD.
A cross-sectional study was undertaken in 26 people with COPD (16 men; FEV(1), 50% ± 16%). Six-min walk distance (6MWD) and incremental shuttle walk distance (ISWD) measures were collected, and peak oxygen uptake (VO(2) peak) was measured during a symptom-limited ramp cycle ergometry test. The SenseWear Armband was worn during the waking hours for 4.4 ± 1.1 days to measure DEE. The intensity at which activities of daily living were undertaken was expressed as a percentage of VO(2) peak.
DEE was associated with 6MWD (r = 0.40, P = .046) and ISWD (r = 0.52, P = .007) but not VO(2) peak (mL/kg per min) (r = 0.07, P = .74). Stronger associations were observed between DEE and the body weight-walking distance product for the 6MWD (r = 0.73, P < .001) and ISWD (r = 0.75, P < .001). The average intensity of daily activity was equivalent to 58% ± 11% of VO(2) peak, leaving an average aerobic reserve of 42%.
Both 6MWD and ISWD, but not VO(2) peak, were related to DEE. Because activities of daily living were performed at a high percentage of VO(2) peak, it may be more realistic to optimize habitual DEE in COPD by increasing the frequency or duration rather than the intensity of physical activity.
本研究旨在确定哪些运动能力测试与慢性阻塞性肺疾病（COPD）患者的日常能量消耗（DEE）相关，并量化日常生活中的有氧储备。
在 26 名 COPD 患者（16 名男性；FEV(1)，50%±16%）中进行了一项横断面研究。收集了 6 分钟步行距离（6MWD）和递增穿梭步行距离（ISWD）测量值，并在症状限制斜坡式功率自行车测试中测量了峰值摄氧量（VO(2)峰值）。在清醒时间内佩戴 SenseWear 臂带 4.4±1.1 天以测量 DEE。日常生活活动的强度表示为 VO(2)峰值的百分比。
DEE 与 6MWD（r=0.40，P=0.046）和 ISWD（r=0.52，P=0.007）相关，但与 VO(2)峰值（mL/kg/min）（r=0.07，P=0.74）不相关。在 6MWD（r=0.73，P<0.001）和 ISWD（r=0.75，P<0.001）中，DEE 与体重-步行距离乘积之间存在更强的相关性。日常活动的平均强度相当于 VO(2)峰值的 58%±11%，留下 42%的平均有氧储备。
6MWD 和 ISWD 都与 DEE 相关，但 VO(2)峰值与 DEE 不相关。由于日常生活活动是在 VO(2)峰值的高百分比下进行的，因此通过增加体力活动的频率或持续时间而不是强度来优化 COPD 患者的习惯性 DEE 可能更为现实。
