van den Akker Lizanne Eva, Heine Martin, van der Veldt Nikki, Dekker Joost, de Groot Vincent, Beckerman Heleen
Department of Rehabilitation Medicine, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands.
Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands.
Arch Phys Med Rehabil. 2015 Nov;96(11):2055-66. doi: 10.1016/j.apmr.2015.04.021. Epub 2015 May 10.
To investigate the feasibility and safety of cardiopulmonary exercise testing (CPET) in patients with multiple sclerosis (MS).
PubMed, EMBASE, CINAHL, SPORTDiscus, PsycINFO, ERIC, and the Psychology and Behavioral Sciences Collection were searched up to October 2014. References from retrieved articles were examined to identify additional relevant studies.
Inclusion of original studies was on the basis of performance of maximal CPET, description of the protocol, and participants with definite MS aged ≥18 years. No language restrictions were applied.
The quality of CPET reporting in included studies was scored according to a structured checklist considering 10 feasibility (eg, test abnormalities) and 12 safety quality criteria (eg, adverse events). Structured data extraction was performed for these feasibility and safety features of CPET.
Forty-six studies were included, comprising 1483 patients with MS, with a mean age ± SD of 42.0±5.8 years and a median Expanded Disability Status Scale (EDSS) score of 2.8 (first quartile=2.1; third quartile=3.9; range of average EDSS scores, .75-5.8). Quality of reporting on CPET varied from 3 to 13 out of a possible 22 quality points. The percentage of test abnormalities (feasibility) was 10.0%, primarily because of an inability to maintain pedaling at a specific resistance. The percentage of adverse events (safety) was 2.1%. All adverse events were temporary.
Based on the available data, we conclude that CPET is feasible provided that the CPET modality is tailored to the physical abilities of the patient. Furthermore, CPET is safe when recommended precautions and safety measures are implemented. However, future optimization of CPET will require protocolized testing and the implementation of standard reporting procedures.
探讨心肺运动试验（CPET）在多发性硬化症（MS）患者中的可行性和安全性。
检索了截至2014年10月的PubMed、EMBASE、CINAHL、SPORTDiscus、PsycINFO、ERIC以及心理学与行为科学文集。对检索到的文章的参考文献进行检查，以识别其他相关研究。
纳入的原始研究基于最大CPET的实施情况、方案描述以及年龄≥18岁的明确MS患者。不设语言限制。
根据一份结构化清单对纳入研究中CPET报告的质量进行评分，该清单考虑了10项可行性标准（如测试异常）和12项安全质量标准（如不良事件）。对CPET的这些可行性和安全特征进行结构化数据提取。
纳入了46项研究，包括1483例MS患者，平均年龄±标准差为42.0±5.8岁，扩展残疾状态量表（EDSS）中位数评分为2.8（第一四分位数=2.1；第三四分位数=3.9；平均EDSS评分范围为0.75 - 5.8）。CPET报告质量在可能的22分中从3分到13分不等。测试异常（可行性）的百分比为10.0%，主要原因是无法在特定阻力下保持蹬踏。不良事件（安全性）的百分比为2.1%。所有不良事件均为暂时性的。
基于现有数据，我们得出结论，只要CPET模式根据患者的身体能力进行调整，CPET就是可行的。此外，当实施推荐的预防措施和安全措施时，CPET是安全的。然而，CPET未来的优化将需要标准化测试和标准报告程序的实施。
