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运动能力保留患者步行试验与运动峰值耗氧量的长期可重复性比较。

Comparison of the long-term reproducibility of the walk test and of exercise peak oxygen consumption in patients with preserved exercise capacity.

作者信息

Raissuni Zainab, Roul Gerald

机构信息

a Faculté de Médecine et de Pharmacie TANGER , Université Abdelmalek Essaidi, Université Mohammed V Rabat , Tétouan , Morocco.

b Pôle d'Activité Médico-Chirurgicale Cardio-vasculaire, Unité de Soins Intensifs de Cardiologie , Hôpitaux Universitaires de Strasbourg , Strasbourg Cedex , France.

出版信息

Acta Cardiol. 2018 Apr;73(2):155-162. doi: 10.1080/00015385.2017.1351250. Epub 2017 Jul 26.

Abstract

UNLABELLED

Short-term and long-term reproducibility of the cardiopulmonary (CPX) exercise test have been established. Though short and mid-term reproducibility of the walk test has been ascertained, this was not extensively done for the long-term reproducibility. The aim of the study was to examine the long-term reproducibility of distance walked in an allotted time and to check the stability of the relationship between walked distance and exercise peak VO (pVO).

METHODS

Forty six subjects (33 men; 57 ± 14 years), referred for functional capacity assessment, were studied twice by CPX and walking test. On the same day, CPX was performed on a bicycle or a treadmill and walk test in a corridor as required by specific guidelines. We performed a 12-minute walk test and the distance covered in six minutes was systematically taken down. A free time interval of 1.5 hours was observed between the exercise tests. Distance walked in the allotted time and pVO were analysed. Reproducibility was assessed according to Bland and Altman plots and intra-class coefficient correlation (ICC). The relationship between distance ambulated and pVO was analysed by the Spearman coefficient correlation.

RESULTS

The time interval between the two evaluations was 290 ± 10 days. During this meantime, for those subjects having drug treatment, no change was recorded in their regimen. BMI remained stable for the entire studied population (28 ± 5 kg/m). Minute walked distance was respectively 522 ± 83 and 527 ± 76 m in six minutes, 1033 ± 182 and 1041 ± 153 m in 12 minutes. pVO was 21 ± 7 and 22 ± 7 ml/kg/min (all p = NS). The walk test was reproducible in the long-term, regardless of the modality (6 or 12-minute walk) as shown by the Bland-Altman plots and the high ICC of .89. Spearman's rho coefficient between distance ambulated and pVO was modest and remained stable over time whatever the allotted time: Spearman's r = .54; p = .0011 (1st evaluation) and Spearman's r = .51; p = .0019 (2nd evaluation) between 6-minute distance walked and pVO.

CONCLUSIONS

The walking distance in an allotted time seems highly reproducible in the long-term. Its relationship with pVO remains stable over time. It could be of value for repeated assessment of patients' exercise capacity in a first step. Further evaluation in a larger population is needed to confirm our result and its usefulness in clinical practice.

摘要

未标注

心肺运动试验(CPX)的短期和长期可重复性已得到证实。虽然步行试验的短期和中期可重复性已得到确定,但长期可重复性方面尚未进行广泛研究。本研究的目的是检验在规定时间内步行距离的长期可重复性,并检查步行距离与运动峰值VO₂(pVO₂)之间关系的稳定性。

方法

46名受试者(33名男性;年龄57±14岁)因功能能力评估前来就诊,接受了两次CPX和步行试验。在同一天,根据具体指南要求,在自行车或跑步机上进行CPX,在走廊进行步行试验。我们进行了12分钟步行试验,并系统记录了6分钟内所走的距离。两次运动试验之间观察到1.5小时的自由时间间隔。分析规定时间内的步行距离和pVO₂。根据Bland-Altman图和组内相关系数(ICC)评估可重复性。通过Spearman相关系数分析步行距离与pVO₂之间的关系。

结果

两次评估之间的时间间隔为290±10天。在此期间,对于那些接受药物治疗的受试者,其治疗方案没有变化。整个研究人群的BMI保持稳定(28±5kg/m²)。6分钟内步行的分钟距离分别为522±83米和527±76米,12分钟内为1033±182米和1041±153米。pVO₂为21±7和22±7ml/kg/min(所有p值均无统计学意义)。如Bland-Altman图和高达0.89的ICC所示,无论采用何种方式(6分钟或12分钟步行),步行试验在长期内都是可重复的。步行距离与pVO₂之间的Spearman相关系数适中,并且无论规定时间如何,随着时间推移保持稳定:6分钟步行距离与pVO₂之间,第一次评估时Spearman's r = 0.54;p = 0.0011,第二次评估时Spearman's r = 0.51;p = 0.0019。

结论

规定时间内的步行距离在长期内似乎具有高度可重复性。其与pVO₂的关系随时间保持稳定。在第一步中,它对于重复评估患者的运动能力可能具有价值。需要在更大规模人群中进行进一步评估,以证实我们的结果及其在临床实践中的实用性。

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