Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Division of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
Chest. 2014 Jul;146(1):104-110. doi: 10.1378/chest.13-2017.
Measures of physical function, daily physical activity, and exercise capacity have been proposed for the care of patients with COPD but are not used routinely in daily office care. Gait speed is a powerful and simple measure of physical function in elderly patients and seems to be a promising measure for the daily care of patients with COPD. The objective of this study was to comprehensively evaluate the determinants and factors influencing gait speed in COPD, particularly the association of gait speed with objectively measured physical activity and the most used exercise capacity field test in cardiopulmonary disease: the 6-min walk test (6MWT).
One hundred thirty patients with stable COPD performed two different 4-m gait speed protocols (usual and maximal pace). We modeled gait speed using demographics, lung function, dyspnea, quality of life, physical activity monitoring, exercise capacity, mood, cognitive function, and health-care use.
Gait speed was independently associated with 6MWT but not with daily physical activity. The correlation between gait speed and 6MWT was high regardless of protocol used (r = 0.77-0.80). Both 6MWT and gait speed shared similar constructs. Gait speed had an excellent ability to predict poor (≤ 350 m) or very poor (≤ 200 m) 6MWT distances (areas under the curve, 0.87 and 0.98, respectively). Gait speed was not independently associated with quality of life, mood, or cognitive function.
Gait speed is more indicative of exercise capacity (6MWT) than daily physical activity in COPD. Despite its simplicity, gait speed has outstanding screening properties for detecting poor and very poor 6MWT performance, making it a useful and informative tool for the clinical care of patients with COPD.
身体机能、日常体力活动和运动能力的测量方法已经被提出用于 COPD 患者的治疗，但在日常临床护理中并未常规使用。步速是一种评估老年患者身体机能的简单而有力的方法，似乎是 COPD 患者日常护理中很有前途的评估方法。本研究的目的是全面评估 COPD 患者步速的决定因素和影响因素，特别是步速与客观测量的体力活动以及在心肺疾病中最常用的运动能力测试（6 分钟步行试验，6MWT）的相关性。
130 例稳定期 COPD 患者进行了两种不同的 4 米步速测试方案（通常速度和最大速度）。我们采用人口统计学资料、肺功能、呼吸困难、生活质量、体力活动监测、运动能力、情绪、认知功能和医疗保健使用情况来建立步速模型。
步速与 6MWT 独立相关，但与日常体力活动无关。无论使用哪种方案，步速与 6MWT 的相关性都很高（r = 0.77-0.80）。6MWT 和步速有相似的结构。步速能很好地预测较差（≤350 米）或非常差（≤200 米）的 6MWT 距离（曲线下面积分别为 0.87 和 0.98）。步速与生活质量、情绪或认知功能无关。
在 COPD 患者中，步速比日常体力活动更能反映运动能力（6MWT）。尽管简单，但步速对检测较差和非常差的 6MWT 表现具有出色的筛查特性，使其成为 COPD 患者临床护理的有用且信息丰富的工具。
