M. Heine, MSc, Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands.
E.L.J. Hoogervorst, MD, PhD, Multiple Sclerosis Center, St Antonius Hospital, Nieuwegein, the Netherlands.
Phys Ther. 2014 Aug;94(8):1168-75. doi: 10.2522/ptj.20130418. Epub 2014 Mar 27.
Cardiopulmonary exercise testing can be considered the gold standard for assessing cardiorespiratory fitness. Little is known about the criteria for maximal exercise testing in people with multiple sclerosis (MS) and how these criteria behave across different levels of neurological disability.
The study objectives were to determine the criteria for maximal exercise testing across various levels of disability and to assess concomitant subgroup differences in measures related to the participant, disease, and function.
This was a cross-sectional study.
Cardiopulmonary exercise testing was conducted with a sample of 56 participants with MS. Analysis of variance was used to assess the criteria in participants with MS and low, mild, and moderate levels of disability.
Mean peak oxygen consumption (V̇o2peak) was 21.4 (SD=7.1) mL·kg(-1)·min(-1). An oxygen consumption (V̇o2) plateau was seen in 37.5% of participants. A respiratory exchange ratio of 1.10 or greater was achieved by 69.6% of the participants, a maximal heart rate within 90% of their age-predicted maximal heart rate was achieved by 48.2% of the participants, and 23.2% of the participants perceived their exertion to be 18 or greater on the Borg Scale of Perceived Exertion (scores of 6-20). The values for achieved heart rate and incidence of a V̇o2 plateau were significantly lower in participants with moderate levels of disability than in those with mild levels of disability.
The primary limitations of this study were its cross-sectional nature and relatively small sample of participants with moderate levels of disability.
The findings suggest that the outcome of cardiopulmonary exercise testing in people with MS and low to mild levels of disability (Expanded Disability Status Scale scores of ≤4.0) is a valid measure of cardiorespiratory fitness, whereas the outcome in people with moderate levels of disability (Expanded Disability Status Scale scores of >4.0) is most likely symptom limited.
心肺运动测试可被视为评估心肺适应性的金标准。目前对于多发性硬化症（MS）患者最大运动测试的标准知之甚少，也不清楚这些标准在不同程度的神经功能障碍患者中是如何表现的。
本研究旨在确定不同残疾程度下最大运动测试的标准，并评估与患者、疾病和功能相关的各项指标在不同亚组间的差异。
这是一项横断面研究。
对 56 名 MS 患者进行心肺运动测试。采用方差分析评估轻度、中度残疾患者的标准。
平均峰值摄氧量（V̇o2peak）为 21.4（SD=7.1）mL·kg(-1)·min(-1)。37.5%的患者出现摄氧量（V̇o2）平台。69.6%的患者呼吸交换比达到 1.10 或更高，48.2%的患者达到 90%预计最大心率，23.2%的患者感觉自己的用力程度为 Borg 量表的 18 或更高（得分 6-20）。中度残疾患者的达到心率和出现 V̇o2平台的发生率明显低于轻度残疾患者。
本研究的主要局限性是其横断面性质和中度残疾患者样本相对较小。
研究结果表明，低至轻度残疾（扩展残疾状态量表评分≤4.0）的 MS 患者心肺运动测试的结果是心肺适应性的有效衡量标准，而中度残疾患者（扩展残疾状态量表评分>4.0）的结果很可能受到症状限制。
