Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos, SP, Brasil.
Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil.
Braz J Med Biol Res. 2019;52(9):e8402. doi: 10.1590/1414-431X20198402. Epub 2019 Aug 29.
Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS - (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.
心肺适能评估是获取个体身体机能的量化指标的有价值资源。心肺运动测试（CPX）被认为是该评估的金标准测试，但费用高昂，且一般人群难以获得。为了使这种评估更易获得，并更好地反映日常生活活动的表现，提出了替代测试。病态肥胖患者存在限制身体机能评估的限制因素，因此需要一种更短时间的测试，只要它经过验证即可。本观察性研究旨在验证 2 分钟台阶测试（2MST）作为评估肥胖合并症和病态肥胖患者的功能能力（FC）的工具，比较 2MST 与 CPX 作为身体机能的衡量标准，并开发预测 2MST 中峰值摄氧量（VO2）的方程式。对 31 名肥胖患者（BMI>35 kg/m2）进行了 CPX 和 2MST，并记录了代谢和通气参数。进行了 Pearson 相关性和多元线性回归分析，以评估最佳的峰值 VO2 预测因子。进行了 Bland-Altman 分析以评估两种方法之间的一致性。CPX 和 2MST 测量的峰值 VO2 显示出很强的相关性（r=0.70，P<0.001），2MST 的峰值 VO2 与上下台阶循环次数（UDS）（r=0.55；P=0.01）之间存在中度相关性。获得的参考方程为：VO2（mL·kg-1·min-1）=13.341+0.138×总 UDS-（0.183×BMI），估计标准误差为 1.3 mL·kg-1·min-1。2MST 是一种可行、实用且易于获得的 FC 测试。UDS 和 BMI 可以很好地预测峰值 VO2。
