M-A. Brehm, PhD, Department of Rehabilitation Medicine and MOVE Research Institute, VU University Medical Center, and Department of Rehabilitation, Academic Medical Center, University of Amsterdam, PO Box 2260, 1100 DD, Amsterdam, the Netherlands.
Phys Ther. 2014 Jan;94(1):121-8. doi: 10.2522/ptj.20130197. Epub 2013 Sep 12.
Rehabilitation research in children with cerebral palsy (CP) is increasingly addressing cardiorespiratory fitness testing. However, evidence on the reliability of peak oxygen uptake (Vo2peak) measurements, considered the best indicator of aerobic fitness, is not available in this population.
The objective of this study was to establish the reliability of a progressive maximal cycle ergometer test when assessing Vo2peak in children with mild to moderate CP.
Repeated measures were used to assess test-retest reliability.
Eligible participants were ambulant, 6 to 14 years of age, and classified as level I, II, or III according to the Gross Motor Function Classification System (GMFCS). Two progressive maximal cycle ergometer tests were conducted (separated by 3 weeks), with the workload increasing every minute in steps of 3 to 11 W, dependent on height and GMFCS level. Reliability was determined by means of the intraclass correlation coefficient (ICC [2,1]) and smallest detectable change (SDC).
Twenty-one children participated (GMFCS I: n=4; GMFCS II: n=12; and GMFCS III: n=5). Sixteen of them (9 boys, 7 girls; GMFCS I: n=3; GMFCS II: n=11; and GMFCS III: n=2) performed 2 successful tests, separated by 9.5 days on average. Reliability for Vo2peak was excellent (ICC=.94, 95% confidence interval=.83-.98). The SDC was 5.72 mL/kg/min, reflecting 14.6% of the mean.
The small sample size did not allow separate analysis of reliability per GMFCS level.
In children with CP of GMFCS levels I and II, a progressive maximal cycle ergometer test to assess Vo2peak is reliable and has the potential to detect change in cardiorespiratory fitness over time. Further study is needed to establish the reliability of Vo2peak in children of GMFCS level III.
脑瘫（CP）儿童的康复研究越来越关注心肺适能测试。然而，在该人群中，作为有氧适能最佳指标的最大摄氧量（Vo2peak）测量的可靠性证据尚不可用。
本研究的目的是确定在轻度至中度 CP 儿童中使用递增式最大功率自行车测试评估 Vo2peak 的可靠性。
重复测量用于评估测试-再测试可靠性。
符合条件的参与者为可步行者，年龄在 6 至 14 岁之间，并根据粗大运动功能分类系统（GMFCS）分为 I 级、II 级或 III 级。进行了两次递增式最大功率自行车测试（间隔 3 周），每 1 分钟增加 3 至 11 W 的工作量，取决于身高和 GMFCS 水平。可靠性通过组内相关系数（ICC [2,1]）和最小可检测变化量（SDC）确定。
共有 21 名儿童参加（GMFCS I：n=4；GMFCS II：n=12；GMFCS III：n=5）。其中 16 名儿童（9 名男孩，7 名女孩；GMFCS I：n=3；GMFCS II：n=11；GMFCS III：n=2）完成了 2 次成功的测试，平均间隔 9.5 天。Vo2peak 的可靠性非常好（ICC=.94，95%置信区间=.83-.98）。SDC 为 5.72 mL/kg/min，反映了平均值的 14.6%。
样本量小，无法按 GMFCS 级别分别进行可靠性分析。
在 GMFCS 水平 I 和 II 的 CP 儿童中，递增式最大功率自行车测试评估 Vo2peak 是可靠的，并且有可能随时间检测心肺适能的变化。需要进一步研究来确定 GMFCS 水平 III 儿童的 Vo2peak 可靠性。
