Respiratory Medicine, West Park Healthcare Centre, University of Toronto, Toronto, Canada.
Respirology. 2012 Feb;17(2):278-84. doi: 10.1111/j.1440-1843.2011.02089.x.
Field and laboratory-based tests are used to measure exercise capacity in people with COPD. A comparison of the cardiorespiratory responses to field tests, referenced to a laboratory test, is needed to appreciate the relative physiological demands. We sought to compare peak and submaximal cardiorespiratory responses to the 6-min walk test, incremental shuttle walk test and endurance shuttle walk test with a ramp cycle ergometer test (CET) in patients with COPD.
Twenty-four participants (FEV(1) 50 ± 14%; 66.5 ± 7.7 years; 15 men) completed four sessions, separated by ≥24 h. During an individual session, participants completed either two 6-min walk tests, incremental shuttle walk tests, endurance shuttle walk tests using standardized protocols, or a single CET, wearing a portable gas analysis unit (Cosmed K4b(2)) which included measures of heart rate and arterial oxygen saturation (SpO(2)).
Between tests, no difference was observed in the peak rate of oxygen uptake (F(3,69) = 1.2; P = 0.31), end-test heart rate (F(2,50) = 0.6; P = 0.58) or tidal volume (F(3,69) = 1.5; P = 0.21). Compared with all walking tests, the CET elicited a higher peak rate of carbon dioxide output (1173 ± 350 mL/min; F(3,62) = 4.8; P = 0.006), minute ventilation (48 ± 17 L/min; F(3,69) = 10.2; P < 0.001) and a higher end-test SpO(2) (95 ± 4%; F(3,63) = 24.9; P < 0.001).
In patients with moderate COPD, field walking tests elicited a similar peak rate of oxygen uptake and heart rate as a CET, demonstrating that both self- and externally paced walking tests progress to high intensities.
在 COPD 患者中,使用现场和实验室测试来测量运动能力。需要将现场测试的心肺反应与实验室测试进行比较,以了解相对的生理需求。我们试图比较 6 分钟步行测试、递增穿梭步行测试和耐力穿梭步行测试与斜坡式踏车测试(CET)在 COPD 患者中的峰值和亚最大心肺反应。
24 名参与者(FEV1 50 ± 14%;66.5 ± 7.7 岁;15 名男性)完成了 4 次测试,每次测试之间间隔至少 24 小时。在一次个体测试中,参与者按照标准方案完成了两次 6 分钟步行测试、递增穿梭步行测试、耐力穿梭步行测试,或者穿着便携式气体分析单元(Cosmed K4b2)完成了一次 CET,该单元包括心率和动脉血氧饱和度(SpO2)的测量。
在测试之间,没有观察到峰值摄氧量(F(3,69)= 1.2;P = 0.31)、终末心率(F(2,50)= 0.6;P = 0.58)或潮气量(F(3,69)= 1.5;P = 0.21)的差异。与所有步行测试相比,CET 引起的峰值二氧化碳输出量(1173 ± 350 mL/min;F(3,62)= 4.8;P = 0.006)、分钟通气量(48 ± 17 L/min;F(3,69)= 10.2;P < 0.001)和终末 SpO2(95 ± 4%;F(3,63)= 24.9;P < 0.001)更高。
在中度 COPD 患者中,现场步行测试引起的峰值摄氧量和心率与 CET 相似,表明自我和外部 paced 步行测试都进展到高强度。