Johnson-Warrington Vicki, Harrison Samantha, Mitchell Katy, Steiner Mick, Morgan Mike, Singh Sally
NIHR CLAHRC-LNR, Pulmonary Rehabilitation Research Group, Glenfield Hospital, University Hospitals Leicester NHS Trust, Leicester, the United Kingdom (Mss Johnson-Warrington and Harrison and Drs Mitchell, Steiner, Morgan, and Singh); and Faculty of Health and Life Sciences, Coventry University, Coventry, the United Kingdom (Dr Singh).
J Cardiopulm Rehabil Prev. 2014 Mar-Apr;34(2):150-4. doi: 10.1097/HCR.0000000000000038.
Patients with chronic obstructive pulmonary disease (COPD) are often classified by Medical Research Council (MRC) dyspnea grade and comparisons thus made to healthy individuals. The MRC grade of a healthy population is assumed to be grade 1, although this may be inaccurate. Physical activity and exercise capacity are not well-defined for those with MRC grade 2. This study was undertaken to establish whether there are differences in physical activity and exercise capacity between individuals with COPD and healthy controls, who have all assessed themselves as MRC grade 2.
Patients with COPD (n = 83) and 19 healthy controls, with a self-selected MRC grade of 2, completed the Incremental Shuttle Walk Test (ISWT) and wore a SenseWear (BodyMedia, Pittsburgh, PA) activity monitor for 12 hours for 2 weekdays.
Adjusting for age, step count and ISWT were significantly reduced for those with COPD, compared with healthy controls (P < .05). Patients with COPD achieved mean (SD) 425.5 (131.3) m on ISWT and took 6022 (3276) steps per day compared with 647.8 (146.3) m and 9462 (4141) steps per day for healthy controls. For subjects achieving 10 000 steps per day, 8 (42.11%) healthy controls achieved this level compared with 7 (8.43%) patients with COPD (P < .01).
Healthy individuals may report functional limitations and categorize themselves as MRC grade 2. However, despite both groups subjectively considering themselves similarly functionally limited, exercise capacity and physical activity were significantly reduced in patients with COPD compared with healthy participants. This highlights the importance of early interventions to increase physical performance and prevent functional decline for patients with COPD.
慢性阻塞性肺疾病（COPD）患者常根据医学研究委员会（MRC）呼吸困难分级进行分类，并与健康个体进行比较。尽管这可能不准确，但健康人群的MRC分级被假定为1级。对于MRC 2级的患者，体力活动和运动能力尚无明确界定。本研究旨在确定自我评估为MRC 2级的COPD患者与健康对照者在体力活动和运动能力方面是否存在差异。
83例COPD患者和19例自我选择MRC分级为2级的健康对照者完成了递增往返步行试验（ISWT），并在两个工作日佩戴SenseWear（BodyMedia，匹兹堡，宾夕法尼亚州）活动监测仪12小时。
在调整年龄后，与健康对照者相比，COPD患者的步数和ISWT显著降低（P < 0.05）。COPD患者在ISWT上平均（标准差）达到425.5（131.3）米，每天走6022（3276）步，而健康对照者分别为647.8（146.3）米和9462（4141）步。对于每天达到10000步的受试者，8名（42.11%）健康对照者达到了这一水平，而COPD患者只有7名（8.43%）（P < 0.01）。
健康个体可能报告功能受限并将自己归类为MRC 2级。然而，尽管两组主观上都认为自己功能受限程度相似，但与健康参与者相比，COPD患者的运动能力和体力活动显著降低。这突出了早期干预对提高COPD患者身体表现和预防功能衰退的重要性。
