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预测慢性阻塞性肺疾病患者在3分钟恒定速率登楼梯和穿梭试验期间的耗氧率。

Predicting the rate of oxygen consumption during the 3-minute constant-rate stair stepping and shuttle tests in people with chronic obstructive pulmonary disease.

作者信息

Lewthwaite Hayley, Koch Emily M, Ekström Magnus, Hamilton Alan, Bourbeau Jean, Maltais François, Borel Benoit, Jensen Dennis

机构信息

Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, Canada.

Innovation, Implementation and Clinical Translation in Health (IIMPACT), School of Health Sciences, University of South Australia, Adelaide, Australia.

出版信息

J Thorac Dis. 2020 May;12(5):2489-2498. doi: 10.21037/jtd.2020.03.13.

Abstract

BACKGROUND

The 3-minute constant-rate stair stepping (3-min CRSST) and constant-speed shuttle tests (3-min CSST) were developed to assess breathlessness in response to a standardized exercise stimulus. Estimating the rate of oxygen consumption (V'O) during these tests would assist clinicians to relate the stepping/shuttle speeds that elicit breathlessness to daily physical activities with a similar metabolic demand. This study: (I) developed equations to estimate the V'O of these tests in people with chronic obstructive pulmonary disease (COPD); and (II) compared the newly developed and American College of Sports Medicine (ACSM) metabolic equations for estimating the V'O of these tests.

METHODS

This study was a retrospective analysis of people with COPD who completed a 3-min CRSST (n=98) or 3-min CSST (n=69). Multivariate linear regression estimated predictors (alpha <0.05) of V'O to construct COPD-specific metabolic equations. The mean squared error (MSE) of the COPD-specific and ACSM equations was calculated and compared. Bland-Altman analyses evaluated level of agreement between measured and predicted V'O using each equation; limits of agreement (LoA) and patterns of bias were compared.

RESULTS

Stepping rate/shuttle speed and body mass were identified as significant predictors of V'O. The MSE of the COPD-specific equations was 0.05 L·min for both tests. Mean difference between measured and predicted V'O was 0.00 L·min (95% LoA -0.46, 0.46) and 0.00 L·min (95% LoA -0.44, 0.44) for the 3-min CRSST and 3-min CSST, respectively. For the ACSM metabolic equations, the MSE was 0.10 L·min and 0.18 L·min for the 3-min CRSST and 3-min CSST, respectively. The ACSM metabolic equations underestimated V'O of the 3-min CRSST by -0.18 L·min (95% LoA -0.68, 0.32), and overestimated V'O of the 3-min CSST by 0.35 L·min (95% LoA -0.14, 0.84).

CONCLUSIONS

This study presents metabolic equations to predict V'O2 of the 3-min CRSST and 3-min CSST for people with COPD that are more accurate than the ACSM metabolic equations.

摘要

背景

3分钟恒定速率登楼梯试验(3-min CRSST)和恒定速度往返跑试验(3-min CSST)旨在评估对标准化运动刺激的呼吸困难情况。在这些试验中估算耗氧率(V'O)将有助于临床医生将引发呼吸困难的登楼梯/往返跑速度与具有相似代谢需求的日常体力活动联系起来。本研究:(I)建立方程以估算慢性阻塞性肺疾病(COPD)患者这些试验的V'O;(II)比较新建立的和美国运动医学学院(ACSM)的代谢方程对这些试验V'O的估算情况。

方法

本研究是对完成3分钟CRSST(n = 98)或3分钟CSST(n = 69)的COPD患者进行的回顾性分析。多变量线性回归估算V'O的预测因子(α<0.05)以构建COPD特异性代谢方程。计算并比较COPD特异性方程和ACSM方程的均方误差(MSE)。Bland-Altman分析评估使用每个方程测量和预测的V'O之间的一致性水平;比较一致性界限(LoA)和偏差模式。

结果

登楼梯速率/往返跑速度和体重被确定为V'O的重要预测因子。两种试验中COPD特异性方程的MSE均为0.05 L·min。3分钟CRSST和3分钟CSST测量和预测的V'O之间的平均差异分别为0.00 L·min(95% LoA -0.46, 0.46)和0.00 L·min(95% LoA -0.44, 0.44)。对于ACSM代谢方程,3分钟CRSST和3分钟CSST的MSE分别为0.10 L·min和0.18 L·min。ACSM代谢方程低估了3分钟CRSST的V'O为 -0.18 L·min(95% LoA -0.68, 0.32),高估了3分钟CSST的V'O为0.35 L·min(95% LoA -0.14, 0.84)。

结论

本研究提出了用于预测COPD患者3分钟CRSST和3分钟CSST的V'O2的代谢方程,其比ACSM代谢方程更准确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b91/7330369/df061368c69b/jtd-12-05-2489-f1.jpg

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