Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK.
Eur Respir J. 2013 Aug;42(2):333-40. doi: 10.1183/09031936.00162712. Epub 2012 Dec 6.
In community-dwelling older adults, usual gait speed over 4 m (4MGS) consistently predicts greater risk of adverse health outcomes. The aims of the present study were to assess the reliability of the 4MGS and the relationship with established health outcome measures in chronic obstructive pulmonary disease (COPD). Test-retest and interobserver reliability of the 4MGS were measured in 80 and 58 COPD patients, respectively. In 586 COPD patients, the 4MGS, as well as forced expiratory volume in 1 s (FEV1), the incremental shuttle walk (ISW), Medical Research Council (MRC) dyspnoea scale and St George's Respiratory Questionnaire (SGRQ) were measured. Participants were stratified according to "slow" (<0.8 m·s(-1)) or "normal" 4MGS (≥0.8 m·s(-1)). Intra-class correlation coefficients for test-retest and interobserver reliability were 0.97 and 0.99, respectively. There was a significant positive correlation between 4MGS with ISW (ρ = 0.78; p<0.001) and a negative correlation with MRC dyspnoea scale and SGRQ (ρ = -0.55 and -0.44; p<0.001 for both). COPD patients with slow 4MGS had significantly reduced ISW and higher MRC dyspnoea scale and SGRQ than those with preserved walking speed, despite similar FEV1 % predicted. The 4MGS is reliable in COPD, correlates with exercise capacity, dyspnoea and health-related quality of life, and has potential as a simple assessment tool in COPD.
在社区居住的老年人中，通常的步行速度超过 4 米（4MGS）始终预示着更大的不良健康结果风险。本研究的目的是评估 4MGS 的可靠性以及与慢性阻塞性肺疾病（COPD）中既定健康结果测量的关系。分别在 80 名和 58 名 COPD 患者中测量了 4MGS 的测试 - 重测和观察者间可靠性。在 586 名 COPD 患者中，测量了 4MGS 以及 1 秒用力呼气量（FEV1）、递增穿梭步行（ISW）、医学研究委员会（MRC）呼吸困难量表和圣乔治呼吸问卷（SGRQ）。根据“慢”（<0.8 m·s(-1))或“正常”4MGS（≥0.8 m·s(-1)))将参与者分层。测试 - 重测和观察者间可靠性的组内相关系数分别为 0.97 和 0.99。4MGS 与 ISW 呈显著正相关（ρ=0.78;p<0.001），与 MRC 呼吸困难量表和 SGRQ 呈负相关（ρ=-0.55 和 -0.44;p<0.001）。4MGS 缓慢的 COPD 患者的 ISW 明显降低，MRC 呼吸困难量表和 SGRQ 较高，尽管 FEV1%预测值相似。4MGS 在 COPD 中具有可靠性，与运动能力、呼吸困难和健康相关的生活质量相关，并且具有作为 COPD 简单评估工具的潜力。
