Department for Spinal Cord Injuries, Neuroscience Center, Hornbæk, Denmark.
Department of Nursing and Nutrition, University College Copenhagen, Copenhagen, Denmark.
Spinal Cord. 2021 Jan;59(1):82-91. doi: 10.1038/s41393-020-00540-1. Epub 2020 Sep 4.
Test-retest study.
To describe the test-retest reliability of an individualized approach for peak oxygen uptake (VOpeak) testing in a clinical context, accommodating inpatients with heterogeneous levels of physical functioning.
Inpatient rehabilitation.
Test-retest on two types of devices (recumbent stepper and arm-crank ergometer) with two predefined protocols of varying load increments on each device. No participants performed all four test modalities. VOpeak, respiratory exchange ratio (RER), peak workload, and the reason for termination were reported. Of 23 participants included, 21 completed the test-retest procedure. Participants were inpatients, ≥18 years, who sustained a spinal cord injury (SCI) within the last 12 months at the time of admission. The median age was 52 years and 74% were male. Median time since injury at the time of the first test (T1) was 5.5 months. Seventeen were classified as American Spinal Injury Association Impairment Scale D. Intraclass correlation coefficients (ICC) and Bland-Altman plots for VOpeak was calculated to determine intra- and intertester reliability of VOpeak.
Mean VOpeak obtained at T1 was 1.91 L/min (95%CI: 1.31-2.51); 1.26 L/min and 2.69 L/min for the recumbent stepper protocols; 0.61 L/min and 1.39 L/min for the arm-crank ergometer protocols. ICC for intra- and intertester reliability was 0.997 (95%CI: 0.986-0.999) and 0.994 (95%CI: 0.978-0.998) respectively. Bland-Altman plots showed a mean difference of -0.005 (SD 0,12) for overall test-retest.
Test-retest reliability was high. Mean VOpeak at discharge from rehabilitation was higher than previously reported and individualized test modalities seemed to yield more optimal results in a heterogenous and representative sample during rehabilitation.
测试-再测试研究。
描述在临床环境中，针对不同身体功能水平的住院患者，采用个体化峰值摄氧量（VOpeak）测试方法的测试-再测试可靠性。
住院康复。
在两种设备（卧式踏步机和臂曲柄测功计）上进行测试-再测试，每种设备都有两种预定义的负荷增量方案。没有参与者完成所有四种测试模式。报告了 VOpeak、呼吸交换比（RER）、峰值工作量和终止原因。23 名参与者中，21 名完成了测试-再测试程序。参与者为住院患者，年龄≥18 岁，在入院时患有脊髓损伤（SCI），且时间不超过 12 个月。中位年龄为 52 岁，74%为男性。第一次测试（T1）时距损伤的中位时间为 5.5 个月。17 名参与者被归类为美国脊髓损伤协会损伤量表 D 级。计算了 VOpeak 的组内相关系数（ICC）和 Bland-Altman 图，以确定 VOpeak 的内部和外部测试者可靠性。
T1 时获得的平均 VOpeak 为 1.91L/min（95%置信区间：1.31-2.51）；卧式踏步机方案分别为 1.26L/min 和 2.69L/min；臂曲柄测功计方案分别为 0.61L/min 和 1.39L/min。内部和外部测试者可靠性的 ICC 分别为 0.997（95%置信区间：0.986-0.999）和 0.994（95%置信区间：0.978-0.998）。Bland-Altman 图显示总体测试-再测试的平均差值为-0.005（SD0.12）。
测试-再测试可靠性高。康复出院时的平均 VOpeak 高于之前的报告，在康复期间，针对不同身体功能水平的个体化测试模式似乎为异质且具有代表性的样本产生了更优的结果。
