Saynor Zoe L, Barker Alan R, Oades Patrick J, Williams Craig A
Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, UK; Royal Devon and Exeter NHS Foundation Trust Hospital, UK.
J Sci Med Sport. 2013 Nov;16(6):539-44. doi: 10.1016/j.jsams.2013.01.010. Epub 2013 Mar 17.
Measuring aerobic fitness (V˙O2max) via a maximal cardiopulmonary exercise test is an important clinical tool in cystic fibrosis. This study sought to establish: (1) the validity of traditional criteria to verify maximal efforts during a ramp cardiopulmonary exercise test; and (2) whether V˙O2 measured during an exhaustive cardiopulmonary exercise test represents a valid V˙O2max in paediatric patients, using a subsequent exhaustive supramaximal (Smax) exercise test.
Cross-sectional.
Fourteen patients (7-18 years; 10 males) completed an exhaustive ramp test to determine V˙O2max. Following 15-min recovery, Smax (110% ramp peak power output) was performed.
Ramp test V˙O2peak was significantly higher than V˙O2 documented at traditional endpoint criteria, including a RER of 1.00 (0.99±0.47 L min(-1) vs. 1.83±0.78 L min(-1), p<0.001) and 1.10 (1.36±0.59 L min(-1) vs. 1.83±0.78 L min(-1), p<0.001), despite 100% of patients satisfying these two criteria. Only 23% and 75% of patients satisfied the 95% age-predicted heart rate (HR) maximum and 180 b min(-1) criteria. Whilst mean ramp and Smax V˙O2peak were not significantly different (1.83±0.78 L min(-1) vs. 1.82±0.67 L min(-1); p=0.88), at the individual level Smax elicited a 'meaningful' (>9%) increase in V˙O2peak (range 9.9-38.3%) compared with V˙O2peak from the ramp test in 3 of 14 cases (21.4%).
Traditional criteria significantly underestimate V˙O2max in young cystic fibrosis patients. Conversely, Smax can confirm when 'true' V˙O2max is achieved. The use of Smax following cardiopulmonary exercise test represents an appropriate method to measure V˙O2max in young cystic fibrosis patients.
通过最大心肺运动试验测量有氧适能（最大摄氧量）是囊性纤维化的一项重要临床工具。本研究旨在确定：（1）传统标准在递增式心肺运动试验中验证最大努力程度的有效性；（2）在力竭性心肺运动试验中测得的最大摄氧量是否代表儿科患者的有效最大摄氧量，采用后续的力竭性超最大（Smax）运动试验进行评估。
横断面研究。
14名患者（7 - 18岁；10名男性）完成递增式力竭试验以确定最大摄氧量。恢复15分钟后，进行Smax（递增试验峰值功率输出的110%）试验。
递增试验中的最大摄氧量峰值显著高于传统终点标准记录的最大摄氧量，包括呼吸交换率为1.00时（0.99±0.47升/分钟对1.83±0.78升/分钟，p<0.001）以及呼吸交换率为1.10时（1.36±0.59升/分钟对1.83±0.78升/分钟，p<0.001），尽管100%的患者满足这两个标准。仅23%和75%的患者满足95%年龄预测心率最大值和180次/分钟的标准。虽然递增试验和Smax试验的平均最大摄氧量峰值无显著差异（1.83±0.78升/分钟对1.82±0.67升/分钟；p = 0.88），但在个体水平上，与递增试验的最大摄氧量峰值相比，14例中有3例（21.4%）的Smax试验使最大摄氧量峰值有“显著”（>9%）增加（范围为9.9 - 38.3%）。
传统标准显著低估了年轻囊性纤维化患者的最大摄氧量。相反，Smax试验可确认何时达到“真正的”最大摄氧量。在心肺运动试验后使用Smax试验是测量年轻囊性纤维化患者最大摄氧量的合适方法。
