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脑瘫粗大运动功能分级系统 I 级和 II 级儿童的 6 分钟步行试验:可重复性、有效性和训练效果。

Six-minute walk test in children with cerebral palsy gross motor function classification system levels I and II: reproducibility, validity, and training effects.

机构信息

EA 3300, Adaptations Physiologiques à l'Exercice et Réadaptation à l'Effort, Université de Picardie Jules Verne, Amiens, France.

出版信息

Arch Phys Med Rehabil. 2012 Dec;93(12):2333-9. doi: 10.1016/j.apmr.2012.06.005. Epub 2012 Jun 18.

Abstract

OBJECTIVES

To assess the reproducibility and validity of the 6-minute walk test (6MWT) with gas collection, and to evaluate effectiveness of a walking program in children with cerebral palsy (CP).

DESIGN

Assessment and controlled training study.

SETTING

Rehabilitation service.

PARTICIPANTS

Children/adolescents with CP (N=24; 12 boys, 12 girls; mean age, 14.2±2.0 y, Gross Motor Function Classification System levels I and II).

INTERVENTION

After a cycle-ergometer stress test and the 6MWT, subjects were assigned to training (n=12, 40 min of moderate walking exercise 3 times per week for 8 wk) or a matched control group (n=12).

MAIN OUTCOME MEASURES

Peak oxygen consumption (VO(2)peak), peak ventilation, peak heart rate, and 6MWT distance.

RESULTS

Test-retest correlations for the 6MWT were good (VO(2)peak: r=.90, P<.001, intraclass correlation coefficient [ICC]=.85; peak ventilation: r=.88, P<.001, ICC=.83; peak heart rate: r=.86, P<.001, ICC=.82; distance walked: r=.87, P=.007, ICC=.80). Mean scores for the 6MWT also closely matched corresponding cycle-ergometer data. Significant improvements in 6MWT VO(2)peak, peak ventilation, and peak heart rate were found after 8 weeks of training (P<.05).

CONCLUSIONS

The 6MWT appears reproducible and valid relative to cycle-ergometer assessments of cardiorespiratory responses, and offers a simple method of clinical assessment. An 8-week moderate walking program improves the cardiopulmonary fitness of children with CP, as measured by 6MWT.

摘要

目的

评估带气体采集的 6 分钟步行测试(6MWT)的可重复性和有效性,并评价步行方案对脑瘫(CP)患儿的疗效。

设计

评估和对照训练研究。

地点

康复服务机构。

参与者

CP 患儿/青少年(24 例;男 12 例,女 12 例;平均年龄 14.2±2.0 岁,粗大运动功能分级系统Ⅰ级和Ⅱ级)。

干预

在测功计运动试验和 6MWT 后,将患儿分为训练组(12 例,每周 3 次、每次 40min 中等强度步行运动,共 8 周)和匹配的对照组(12 例)。

主要观察指标

峰值摄氧量(VO2peak)、峰值通气量、峰值心率和 6MWT 距离。

结果

6MWT 的重测信度良好(VO2peak:r=.90,P<.001,组内相关系数[ICC]=.85;峰值通气量:r=.88,P<.001,ICC=.83;峰值心率:r=.86,P<.001,ICC=.82;步行距离:r=.87,P=.007,ICC=.80)。6MWT 的平均得分也与相应的测功计数据非常匹配。经过 8 周的训练,6MWT 的 VO2peak、峰值通气量和峰值心率均显著提高(P<.05)。

结论

6MWT 与测功计评估心肺反应的方法相比,具有可重复性和有效性,并且提供了一种简单的临床评估方法。8 周的中等强度步行方案可提高 CP 患儿的心肺功能,这可通过 6MWT 测量得出。

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