Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan.
Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan.
Respir Investig. 2021 Jul;59(4):505-512. doi: 10.1016/j.resinv.2021.03.008. Epub 2021 Apr 23.
Measuring daily physical activity and exercise capacity is recommended in the routine care of patients with chronic obstructive pulmonary disease (COPD). The 4-m gait speed (4mGS) is simple and effective in stratifying patients according to exercise performance, dyspnea, health status, and prognosis. We assessed the reliability of the 4mGS as a clinical marker by examining its association with established clinical indicators among hospitalized patients with COPD.
This retrospective study included 78 patients hospitalized with COPD (mean age: 76.3 ± 0.9 years; males, n = 69) between January 2016 and June 2018 who were assessed using the 4mGS and divided into slow (<0.8 m/s) and normal (≥0.8 m/s) 4mGS groups. Clinical characteristics were compared, including death during the observation period, time to first exacerbation, and long-term oxygen therapy requirement.
There were strong relationships between 4mGS performance, the 6-min walk test (R = 0.70; p < 0.0001), and the modified Medical Research Council dyspnea scale (R = 0.68; p < 0.0001) among the 78 patients. The slow 4mGS group had a higher frequency of death during the observation period (p = 0.0095) and a greater requirement for long-term oxygen therapy (p = 0.0063). The 4mGS correlated with inspiratory capacity (IC) and IC/total lung capacity ratios, which are respiratory failure indicators.
The 4mGS is a simple and easy method of assessing the physical condition as well as estimating the prognosis of patients with COPD, and may serve as a useful marker in home medical treatment or clinical settings.
在慢性阻塞性肺疾病（COPD）患者的常规护理中，建议测量日常体力活动和运动能力。4 米步行速度（4mGS）可根据运动表现、呼吸困难、健康状况和预后对患者进行简单有效的分层。我们通过检查其与 COPD 住院患者的既定临床指标的相关性，评估了 4mGS 作为临床标志物的可靠性。
这项回顾性研究纳入了 2016 年 1 月至 2018 年 6 月期间因 COPD 住院的 78 例患者（平均年龄：76.3±0.9 岁；男性，n=69），评估了 4mGS，并将其分为步行速度较慢（<0.8 m/s）和正常（≥0.8 m/s）4mGS 组。比较了临床特征，包括观察期间的死亡、首次加重时间和长期氧疗需求。
78 例患者中，4mGS 表现与 6 分钟步行试验（R=0.70；p<0.0001）和改良医学研究委员会呼吸困难量表（R=0.68；p<0.0001）之间存在较强的关系。4mGS 较慢的患者在观察期间的死亡率更高（p=0.0095），长期氧疗需求更大（p=0.0063）。4mGS 与吸气量（IC）和 IC/总肺容量比相关，这些是呼吸衰竭的指标。
4mGS 是一种简单易用的评估 COPD 患者身体状况和估计预后的方法，可能成为家庭医疗或临床环境中的有用标志物。
