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六分钟步行试验在心力衰竭患者中的可靠性和有效性。

Reliability and validity of six-minute step test in patients with heart failure.

机构信息

Programa de Pós-Graduação Interunidades de Bioengenharia, Universidade de São Paulo, São Carlos, SP, Brasil.

Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.

出版信息

Braz J Med Biol Res. 2021 Jul 16;54(10):e10514. doi: 10.1590/1414-431X2020e10514. eCollection 2021.

Abstract

Exercise intolerance is the hallmark consequence of advanced chronic heart failure (HF). The six-minute step test (6MST) has been considered an option for the six-minute walk test because it is safe, inexpensive, and can be applied in small places. However, its reliability and concurrent validity has still not been investigated in participants with HF with reduced ejection fraction (HFrEF). Clinically stable HFrEF participants were included. Reliability and error measurement were calculated by comparing the first with the second 6MST result. Forty-eight hours after participants underwent the 6MST, they were invited to perform a cardiopulmonary exercise test (CPET) on a cycle ergometer. Concurrent validity was assessed by correlation between number of steps and peak oxygen uptake (V̇O2 peak) at CPET. Twenty-seven participants with HFrEF (60±8 years old and left ventricle ejection fraction of 41±6%) undertook a mean of 94±30 steps in the 6MST. Intra-rater reliability was excellent for 6MST (ICC=0.9), with mean error of 4.85 steps and superior and inferior limits of agreement of 30.6 and -20.9 steps, respectively. In addition, strong correlations between number of steps and CPET workload (r=0.76, P<0.01) and peak V̇O2 (r=0.71, P<0.01) were observed. From simple linear regression the following predictive equations were obtained with 6MST results: V̇O2 peak (mL/min) = 350.22 + (7.333 × number of steps), with R2=0.51, and peak workload (W) = 4.044 + (0.772 × number of steps), with R2=0.58. The 6MST was a reliable and valid tool to assess functional capacity in HFrEF participants and may moderately predict peak workload and oxygen uptake of a CPET.

摘要

运动不耐受是晚期慢性心力衰竭(HF)的主要后果。六分钟步梯测试(6MST)已被认为是六分钟步行测试的一种选择,因为它安全、廉价且可在小场所进行。然而,其在射血分数降低的心力衰竭(HFrEF)患者中的可靠性和同时效度仍未得到研究。本研究纳入了临床稳定的 HFrEF 患者。可靠性和误差测量通过比较第一次和第二次 6MST 结果来计算。在参与者进行 6MST 后 48 小时,邀请他们在功率自行车上进行心肺运动测试(CPET)。同时效度通过 CPET 时的步数与峰值摄氧量(V̇O2 峰值)之间的相关性进行评估。27 名 HFrEF 患者(60±8 岁,左心室射血分数 41±6%)在 6MST 中平均完成 94±30 步。6MST 的内部一致性非常好(ICC=0.9),平均误差为 4.85 步,上下限分别为 30.6 和-20.9 步。此外,还观察到步数与 CPET 工作量(r=0.76,P<0.01)和峰值 V̇O2(r=0.71,P<0.01)之间存在很强的相关性。通过简单线性回归,从 6MST 结果中得到以下预测方程:V̇O2 峰值(mL/min)=350.22+(7.333×步数),R2=0.51,峰值工作量(W)=4.044+(0.772×步数),R2=0.58。6MST 是一种可靠且有效的工具,可用于评估 HFrEF 患者的功能能力,并且可以适度预测 CPET 的峰值工作量和摄氧量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11f9/8289340/0bd17ea4fb5e/1414-431X-bjmbr-54-10-e10514-gf001.jpg

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