Bonnevie Tristan, Gravier Francis-Edouard, Leboullenger Marie, Médrinal Clément, Viacroze Catherine, Cuvelier Antoine, Muir Jean-François, Tardif Catherine, Debeaumont David
a ADIR Association , Bois-Guillaume , France.
b Departement of Haute Normandie Research and Biomedical Innovation , Normandie University, UNIROUEN, Rouen University Hospital , Rouen , France.
COPD. 2017 Jun;14(3):293-297. doi: 10.1080/15412555.2017.1303040. Epub 2017 Apr 7.
Pulmonary rehabilitation (PR) improves outcomes in patients with chronic obstructive pulmonary disease (COPD). Optimal assessment includes cardiopulmonary exercise testing (CPET), but consultations are limited. Field tests could be used to individualize PR instead of CPET. The six-minute stepper test (6MST) is easy to set up and its sensitivity and reproducibility have previously been reported in patients with COPD. The aim of this study was to develop a prediction equation to set intensity in patients attending PR, based on the 6MST. The following relationships were analyzed: mean heart rate (HR) during the first (HR) and last (HR) 3 minutes of the 6MST and HR at the ventilatory threshold (HRvt) from CPET; step count at the end of the 6MST and workload at the Ventilatory threshold (VT) (Wvt); and forced expiratory volume in 1 second and step count during the 6MST. This retrospective study included patients with COPD referred for PR who underwent CPET, pulmonary function evaluations and the 6MST. Twenty-four patients were included. Prediction equations were HRvt = 0.7887 × HR + 20.83 and HRvt = 0.6180 × HR + 30.77. There was a strong correlation between HR and HR and HRvt (r = 0.69, p < 0.001 and r = 0.57, p < 0.01 respectively). A significant correlation was also found between step count and LogWvt (r = 0.63, p < 0.01). The prediction equation was LogWvt = 0.001722 × step count + 1.248. The 6MST could be used to individualize aerobic training in patients with COPD. Further prospective studies are needed to confirm these results.
肺康复（PR）可改善慢性阻塞性肺疾病（COPD）患者的预后。最佳评估包括心肺运动试验（CPET），但会诊有限。现场测试可用于替代CPET对PR进行个体化。六分钟踏阶试验（6MST）易于设置，其敏感性和可重复性此前已在COPD患者中得到报道。本研究的目的是基于6MST建立一个预测方程，以设定接受PR治疗患者的运动强度。分析了以下关系：6MST前3分钟（HR）和最后3分钟（HR）的平均心率与CPET通气阈值时的心率（HRvt）；6MST结束时的步数与通气阈值（VT）时的工作量（Wvt）；以及1秒用力呼气量与6MST期间的步数。这项回顾性研究纳入了因PR而接受CPET、肺功能评估和6MST的COPD患者。共纳入24例患者。预测方程为HRvt = 0.7887×HR + 20.83和HRvt = 0.6180×HR + 30.77。HR与HR以及HRvt之间存在强相关性（r分别为0.69，p < 0.001和r = 0.57，p < 0.01）。步数与LogWvt之间也存在显著相关性（r = 0.63，p < 0.01）。预测方程为LogWvt = 0.001722×步数 + 1.248。6MST可用于对COPD患者的有氧运动训练进行个体化。需要进一步的前瞻性研究来证实这些结果。
