间质性肺疾病的功能表现测试：损伤与测量特性
Functional performance tests in interstitial lung disease: Impairment and measurement properties.
作者信息
Zamboti Camile Ludovico, Gonçalves Aline Ferreira Lima, Garcia Thatielle, Krinski Gabriela Garcia, Bertin Larissa Dragonetti, Almeida Heloiza Dos Santos, Pimpão Heloise Angélico, Fujisawa Dirce Shizuko, Ribeiro Marcos, Pitta Fabio, Camillo Carlos Augusto
机构信息
Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.
Post-graduation Program in Rehabilitation Sciences, Centre of Research and Post-graduation, State University of Londrina, Londrina, Brazil.
出版信息
Respir Med. 2021 Aug;184:106413. doi: 10.1016/j.rmed.2021.106413. Epub 2021 Apr 28.
BACKGROUND
There is limited information regarding impairment in functional performance tests and their measurement properties in ILD. The present study aimed to verify the impairment and measurement properties of functional performance tests in ILD.
METHODS
ILD and healthy individuals underwent assessments of pulmonary function, peripheral muscle strength (handgrip force and maximum isometric contraction of quadriceps femoris - MIVCq) and exercise capacity (6-min walk test - 6MWT). Functional performance was assessed by timed-up-and-go with usual (TUGu) and fast (TUGf) gait speeds, 4-m gait speed (4MGS), sit-to-stand in 30 s (30sec-STS), 1 min (1min-STS) and with 5 repetition (5rep-STS) and Short Physical Performance Battery (SPPB). Functional performance was compared between groups, validity (correlation with 6MWT and MIVCq) and reliability of tests were checked in subjects with ILD (intra- and inter-rater agreement analysis).
RESULTS
Seventy-six participants (40 ILD [25 women, 61 ± 11 years, FVC 75 ± 17 %pred] and 36 healthy [22 women, 61 ± 9 years, FVC 97 ± 11 %pred]) were included. Functional performance in ILD was worse than in healthy individuals in all tests, except for the 30sec-STS (p = 0.13). Pre-specified validity criteria were reached for TUGu, TUGf, 4MGS and 5rep-STS (-0.69 < r < 0.55; p < 0.05 for all). Except for 4MGS and SPPB, all tests showed good to excellent inter-rater (0.85 < ICC<0.93; p < 0.05 for all) and all tests showed good to excellent intra-rater (0.83 < ICC< 0.94; p < 0.05 for all) reliability.
CONCLUSIONS
Subjects with ILD present worse functional performance than healthy individuals. According to reliability and validity results, TUGu, TUGf and 5rep-STS seem to be the most appropriate tests to evaluate functional performance in ILD.
背景
关于间质性肺疾病（ILD）功能表现测试中的损伤及其测量特性的信息有限。本研究旨在验证ILD功能表现测试的损伤情况及其测量特性。
方法
ILD患者和健康个体接受了肺功能、外周肌肉力量（握力和股四头肌最大等长收缩——股四头肌最大等长收缩力）和运动能力（6分钟步行试验——6MWT）评估。通过以通常（TUGu）和快速（TUGf）步态速度进行的计时起立行走测试、4米步态速度（4MGS）、30秒（30sec - STS）、1分钟（1min - STS）和5次重复（5rep - STS）的坐立测试以及简短体能状况量表（SPPB）来评估功能表现。对两组之间的功能表现进行比较，在ILD患者中检查测试的有效性（与6MWT和股四头肌最大等长收缩力的相关性）和可靠性（评分者内和评分者间一致性分析）。
结果
纳入了76名参与者（40名ILD患者[25名女性，61±11岁，用力肺活量（FVC）为预计值的75±17%]和36名健康个体[22名女性，61±9岁，FVC为预计值的97±11%]）。除30秒坐立测试（p = 0.13）外，ILD患者在所有测试中的功能表现均比健康个体差。TUGu、TUGf、4MGS和5次重复坐立测试达到了预先设定的有效性标准（-0.69 < r < 0.55；所有p < 0.05）。除4MGS和SPPB外，所有测试均显示出良好到优秀的评分者间可靠性（0.85 <组内相关系数（ICC）< 0.93；所有p < 0.05），并且所有测试均显示出良好到优秀的评分者内可靠性（0.83 < ICC < 0.94；所有p < 0.05）。
结论
ILD患者的功能表现比健康个体差。根据可靠性和有效性结果，TUGu、TUGf和5次重复坐立测试似乎是评估ILD功能表现的最合适测试。
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