Boyne Pierce, Reisman Darcy, Brian Michael, Barney Brian, Franke Ava, Carl Daniel, Khoury Jane, Dunning Kari
a Department of Rehabilitation Sciences , College of Allied Health Sciences, University of Cincinnati , Cincinnati , OH , USA.
b Department of Environmental Health , College of Medicine, University of Cincinnati , Cincinnati , OH , USA.
Top Stroke Rehabil. 2017 Mar;24(2):149-157. doi: 10.1080/10749357.2016.1209831. Epub 2016 Jul 25.
After stroke, aerobic deconditioning can have a profound impact on daily activities. This is usually measured by the peak oxygen consumption rate achieved during exercise testing (VO2-peak). However, VO2-peak may be distorted by motor function. The oxygen uptake efficiency slope (OUES) and VO2 at the ventilatory threshold (VO2-VT) could more specifically assess aerobic capacity after stroke, but this has not been tested.
To assess the differential influence of motor function on three measures of aerobic capacity (VO2-peak, OUES, and VO2-VT) and to evaluate the inter-rater reliability of VO2-VT determination post-stroke.
Among 59 persons with chronic stroke, cross-sectional correlations with motor function (comfortable gait speed [CGS] and lower extremity Fugl-Meyer [LEFM]) were compared between the different aerobic capacity measures, after adjustment for covariates, in order to isolate any distorting effect of motor function. Reliability of VO2-VT determination between three raters was assessed with intra-class correlation (ICC).
CGS was moderately correlated with VO2-peak (r = 0.52, p < 0.0001) and weakly correlated with OUES (r = 0.41, p = 0.002) and VO2-VT (r = 0.37, p = 0.01). LEFM was weakly correlated with VO2-peak (r = 0.26, p = 0.055) and very weakly correlated with OUES (r = 0.19, p = 0.17) and VO2-VT (r = 0.14, p = 0.31). Compared to VO2-peak, VO2-VT was significantly less correlated with CGS (r difference = -0.16, p = 0.02). Inter-rater reliability of VO2-VT determination was high (ICC: 0.93, 95% CI: 0.89-0.96).
Motor dysfunction appears to artificially lower measured aerobic capacity. VO2-VT seemed to be less distorted than VO2-peak and had good inter-rater reliability, so it may provide more specific assessment of aerobic capacity post-stroke.
中风后，有氧体能下降会对日常活动产生深远影响。这通常通过运动测试中达到的峰值耗氧率（VO2峰值）来衡量。然而，VO2峰值可能会受到运动功能的影响而出现偏差。摄氧效率斜率（OUES）和通气阈值时的VO2（VO2-VT）可能能更具体地评估中风后的有氧能力，但尚未得到验证。
评估运动功能对三种有氧能力指标（VO2峰值、OUES和VO2-VT）的不同影响，并评估中风后VO2-VT测定的评分者间信度。
在59例慢性中风患者中，在调整协变量后，比较不同有氧能力指标与运动功能（舒适步态速度[CGS]和下肢Fugl-Meyer[LEFM]）之间的横断面相关性，以分离运动功能的任何干扰效应。采用组内相关系数（ICC）评估三位评分者之间VO2-VT测定的信度。
CGS与VO2峰值中度相关（r = 0.52，p < 0.0001），与OUES弱相关（r = 0.41，p = 0.002），与VO2-VT弱相关（r = 0.37，p = 0.01）。LEFM与VO2峰值弱相关（r = 0.26，p = 0.055），与OUES极弱相关（r = 0.19，p = 0.17），与VO2-VT极弱相关（r = 0.14，p = 0.31）。与VO2峰值相比，VO2-VT与CGS的相关性显著更低（r差异 = -0.16，p = 0.02）。VO2-VT测定的评分者间信度较高（ICC：0.93，95%CI：0.89-0.96）。
运动功能障碍似乎会人为降低所测得的有氧能力。VO2-VT似乎比VO2峰值受影响更小，且评分者间信度良好，因此它可能为中风后的有氧能力提供更具体的评估。
