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慢性阻塞性肺疾病患者在进行Glittre日常生活活动测试期间的心脏、通气和代谢调整。

Cardiac, ventilatory, and metabolic adjustments in chronic obstructive pulmonary disease patients during the performance of Glittre activities of daily living test.

作者信息

Tufanin Andréa, Souza Gerson Fonseca, Tisi Guilherme Rocha, Tufik Sergio, de Mello Marco Túlio, Nascimento Oliver A, Jardim José R

机构信息

Pulmonary Rehabilitation Center of Escola Paulista de Medicina (EPM/Unifesp), Federal University of São Paulo, São Paulo, Brazil.

Pulmonary Rehabilitation Center (EPM/Unifesp), Nove de Julho University, São Paulo, Brazil.

出版信息

Chron Respir Dis. 2014 Nov;11(4):247-55. doi: 10.1177/1479972314552805. Epub 2014 Oct 14.

Abstract

Functional status and quality of life are measures of the chronic obstructive pulmonary disease (COPD) patient's health status and can demonstrate the impact of the disease on the patient's ability to perform activities of daily living (ADLs). The Glittre-ADL test was developed to evaluate the functional status of COPD patients and their ability to perform activities of daily life. The objective of this study was to evaluate the cardiac, respiratory, and metabolic adjustments and reproducibility of the Glittre ADL test performed by COPD patients. Twenty-two mild to severe COPD patients (forced expiratory volume in 1 second (FEV1): 56.6 ± 19.9% predicted; mean age: 66.3 ± 9.18 years old) were enrolled in this study. Metabolic (oxygen uptake (VO2), carbon dioxide production (VCO2), pulmonary ventilation (VE)/VCO2, and VE/VO2), ventilatory (tidal volume, respiratory rate, and VE), and cardiovascular (pulse oxygen saturation, VO2/heart rate (HR), and HR) variables, lower limbs fatigue, and dyspnea (Borg score) after each lap of two Glittre ADL test were analyzed. All metabolic, ventilatory, and cardiac variables increased their values up to the third lap and remained stable (plateau) until the end of the test (five laps; multivariate analysis); there was no difference among the time spent to complete each of the five laps in each test and between tests (total time of second test: 4 minutes and 3 seconds); the second test was 17.8 seconds (6.6%) shorter than the first one (NS). All variables were highly reproducible in the two tests (NS). At the end of the test, patients reached 87.7% of the VO2 max, 81% of VE peak, and 88.5% of the HR peak obtained from an incremental maximal test on a treadmill. The Glittre ADL test is easy for COPD patients to perform and is a highly reproducible test in COPD patients with mild to severe stages of the disease. In addition, our results suggest that it is possible to demonstrate the patient's functional capacity with a single test of only three laps, making it faster and easier to apply and less stressful for some patients.

摘要

功能状态和生活质量是慢性阻塞性肺疾病(COPD)患者健康状况的衡量指标,能够显示该疾病对患者进行日常生活活动(ADL)能力的影响。Glittre-ADL测试旨在评估COPD患者的功能状态及其进行日常生活活动的能力。本研究的目的是评估COPD患者进行Glittre ADL测试时的心脏、呼吸和代谢调节情况以及该测试的可重复性。22例轻度至重度COPD患者(一秒用力呼气量(FEV1):预测值的56.6±19.9%;平均年龄:66.3±9.18岁)纳入本研究。分析了两次Glittre ADL测试每一圈后的代谢指标(摄氧量(VO2)、二氧化碳产生量(VCO2)、肺通气量(VE)/VCO2和VE/VO2)、通气指标(潮气量、呼吸频率和VE)、心血管指标(脉搏血氧饱和度、VO2/心率(HR)和HR)、下肢疲劳程度以及呼吸困难程度(Borg评分)。所有代谢、通气和心脏指标的值在第三圈前均升高,并在测试结束(五圈;多变量分析)前保持稳定(平台期);每次测试完成五圈中每一圈所花费的时间以及两次测试之间没有差异(第二次测试总时间:4分03秒);第二次测试比第一次测试短17.8秒(6.6%)(无显著性差异)。所有指标在两次测试中均具有高度可重复性(无显著性差异)。测试结束时,患者达到了在跑步机上进行递增式最大测试所获得的最大摄氧量(VO2 max)的87.7%、最大通气量(VE peak)的81%和心率峰值(HR peak)的88.5%。Glittre ADL测试对COPD患者来说易于进行,并且在轻度至重度COPD患者中是一项高度可重复的测试。此外,我们的结果表明,仅通过三圈的单次测试就有可能展示患者的功能能力,这使得该测试应用起来更快、更容易,并且对一些患者来说压力更小。

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