Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, the Netherlands.
University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands.
Spinal Cord. 2019 Aug;57(8):669-678. doi: 10.1038/s41393-019-0262-8. Epub 2019 Feb 28.
Cross-sectional.
Individualized training regimes are often based on ventilatory thresholds (VTs). The objectives were to study: (1) whether VTs during arm ergometry could be determined in individuals with spinal cord injury (SCI), (2) the intrarater and interrater reliability of VT determination.
University research laboratory.
Thirty graded arm crank ergometry exercise tests with 1-min increments of recreationally active individuals (tetraplegia (N = 11), paraplegia (N = 19)) were assessed. Two sports physicians assessed all tests blinded, randomly, in two sessions, for VT1 and VT2, resulting in 240 possible VTs. Power output (PO), heart rate (HR), and oxygen uptake (VO) at each VT were compared between sessions or raters using paired samples t-tests, Wilcoxon signed-rank tests, intraclass correlation coefficients (ICC, relative agreement), and Bland-Altman plots (random error, absolute agreement).
Of the 240 VTs, 217 (90%) could be determined. Of the 23 undetermined VTs, 2 (9%) were VT1 and 21 (91%) were VT2; 7 (30%) among individuals with paraplegia, and 16 (70%) among individuals with tetraplegia. For the successfully determined VTs, there were no systematic differences between sessions or raters. Intrarater and interrater ICCs for PO, HR, and VO at each VT were high to very high (0.82-1.00). Random error was small to large within raters, and large between raters.
For VTs that could be determined, relative agreement was high to very high, absolute agreement varied. For some individuals, often with tetraplegia, VT determination was not possible, thus other methods should be considered to prescribe exercise intensity.
横断面研究。
个体化训练方案通常基于通气阈值（VT）。本研究旨在：（1）确定脊髓损伤（SCI）个体在手臂测功运动中能否确定 VT；（2）VT 确定的内部和外部测试者可靠性。
大学研究实验室。
30 次分级手臂曲柄测功运动测试，每个测试增加 1 分钟，参与者为休闲活跃个体（四肢瘫痪（n=11），截瘫（n=19））。两名运动医生在两次会议中以盲法、随机的方式评估所有测试，以确定 VT1 和 VT2，共产生 240 个可能的 VT。使用配对样本 t 检验、Wilcoxon 符号秩检验、组内相关系数（ICC，相对一致性）和 Bland-Altman 图（随机误差，绝对一致性）比较两次会议或测试者之间的每个 VT 的功率输出（PO）、心率（HR）和摄氧量（VO）。
在 240 个 VT 中，有 217 个（90%）可以确定。在未确定的 23 个 VT 中，2 个（9%）为 VT1，21 个（91%）为 VT2；截瘫者中有 7 个（30%），四肢瘫痪者中有 16 个（70%）。对于成功确定的 VT，两次会议或测试者之间没有系统差异。在每个 VT 时，PO、HR 和 VO 的内部和外部测试者 ICC 均为高至非常高（0.82-1.00）。测试者内的随机误差较小到较大，测试者间的随机误差较大。
对于可以确定的 VT，相对一致性较高至非常高，绝对一致性存在差异。对于一些个体，尤其是四肢瘫痪者，无法确定 VT，因此应考虑其他方法来规定运动强度。
