在心脏手术术前筛查患者时，利用5米步行试验评估自我选择的步态速度。
Utilization of a 5-Meter Walk Test in Evaluating Self-selected Gait Speed during Preoperative Screening of Patients Scheduled for Cardiac Surgery.
作者信息
Wilson Christopher M, Kostsuca Stephanie R, Boura Judith A
机构信息
Coordinator of Clinical Education, Beaumont Hospital, Troy, MI; Clinical Assistant Professor, Oakland University, Rochester, MI; Adjunct Faculty, Wayne State University, Detroit, MI.
出版信息
Cardiopulm Phys Ther J. 2013 Sep;24(3):36-43.
PURPOSE
The 5-Meter Walk Test (5MWT) has been recommended for use by the Society of Thoracic Surgeons as an outcome measure in the Adult Cardiac Surgery Database to predict frailty in individuals who are candidates for cardiac surgery. However, there are no published reports of performance on this test in the literature. Therefore, the purpose of this study was to provide descriptive analysis of the 5MWT for individuals who were candidates for cardiac surgery.
METHODS
Retrospective analysis of 113 preoperative cardiac surgery candidates who underwent a 5MWT. Gait speed calculated from the test was completed as part of preoperative testing administered by physical therapists. Three trials were performed with up to a one minute rest between trials. Differences by trial, gender, use of assistive device, and gait or postural deviations were determined using t-tests.
RESULTS
Mean gait speed was 1.05 (SD 0.26) m/s for the subjects. There was a statistically significant increase in gait speed from trial 1 to trial 3 by 0.05 (0.08) m/s (p < 0.0001). There were no significant differences in gait speed between males and females. Participants using assistive devices displayed a significantly slower mean gait speed of 0.70 (0.27) than those who walked unaided, with a mean gait speed of 1.08 (0.24) m/s (p < 0.0001). Participants with noted gait or postural deviations also walked significantly slower (mean 0.84, SD 0.22) than those without deviations (mean 1.15, SD 0.21) (p < 0.0001).
CONCLUSIONS
Subjects displayed a slight increase in speed from trial 1 to trial 3, reinforcing a cited benefit of the shorter distance of the 5MWT that may limit fatigue. Although statistically significant, the increase in speed from trial 1 to 3 may not be clinically significant in relation to the intent of the test. Significantly slower gait speeds were noted when a subject had an observable gait or postural deviation or used an assistive device.
目的
胸外科医师协会推荐将5米步行试验（5MWT）作为成人心脏手术数据库中的一项预后指标，用于预测心脏手术候选者的虚弱程度。然而，文献中尚无关于该试验表现的公开报告。因此，本研究的目的是对心脏手术候选者的5MWT进行描述性分析。
方法
对113名接受5MWT的术前心脏手术候选者进行回顾性分析。由物理治疗师进行的术前测试中，根据该试验计算出的步速作为测试的一部分完成。进行三次试验，试验之间最多休息一分钟。使用t检验确定试验、性别、辅助设备使用情况以及步态或姿势偏差的差异。
结果
受试者的平均步速为1.05（标准差0.26）米/秒。从试验1到试验3，步速有统计学意义的增加，增加了0.05（0.08）米/秒（p < 0.0001）。男性和女性之间的步速没有显著差异。使用辅助设备的参与者平均步速明显较慢，为0.70（0.27）米/秒，而未使用辅助设备自行行走的参与者平均步速为1.08（0.24）米/秒（p < 0.0001）。有明显步态或姿势偏差的参与者行走速度也明显较慢（平均0.84，标准差0.22），低于无偏差的参与者（平均1.15，标准差0.21）（p < 0.0001）。
结论
从试验1到试验3，受试者的速度略有增加，这强化了5MWT距离较短可能限制疲劳的益处。虽然具有统计学意义，但从试验1到试验3的速度增加相对于该试验的目的可能在临床上并无显著意义。当受试者有明显的步态或姿势偏差或使用辅助设备时，步速明显较慢。
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