Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan.
Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
Exp Gerontol. 2022 Jul;164:111810. doi: 10.1016/j.exger.2022.111810. Epub 2022 Apr 19.
Usual gait speed is a prognostic factor in cardiovascular disease (CVD) patients; however, given the aging population, there has been an increase in patients with CVD with slow usual gait speed. Even among patients with slow usual gait speed, some can walk with sufficient speed during maximal gait, while others cannot. This study aimed to investigate the relationship between maximal gait speed and prognosis, and the utility of evaluating maximal gait speed in conjunction with usual gait speed in risk stratification of prognosis in patients with CVD.
We included 2951 CVD patients who underwent evaluation of both usual and maximal gait speeds. They were classified into the usual (+) group [usual gait speed ≥1.0 m/s], usual (-) and maximal (+) group [usual gait speed <1.0 m/s and maximal gait speed ≥1.0 m/s], and usual (-) and maximal (-) group [usual gait speed <1.0 m/s and maximal gait speed <1.0 m/s].
Slower maximal gait speed was significantly associated with higher mortality in CVD patients. This association was consistent across various subgroups. Maximal gait speed provided additional prognostic information to that of pre-existing prognostic factors and usual gait speed (P = 0.048). The usual (-) and maximal (-) group showed higher mortality (hazard ratio: 1.63; 95% confidence interval: 1.18-2.27; P = 0.003) than the usual (-) and maximal (+) group. There was no significant difference in mortality between the usual (+) group and the usual (-) and maximal (+) group.
Maximal gait speed was an independent prognostic predictor for CVD patients. Evaluating maximal gait speed in conjunction with usual gait speed was useful for further risk stratification of prognosis in CVD patients.
通常的步行速度是心血管疾病 (CVD) 患者的预后因素；然而，由于人口老龄化，患有 CVD 且通常步行速度较慢的患者有所增加。即使在通常步行速度较慢的患者中，一些人在最大步行速度时也可以以足够的速度行走，而另一些人则不能。本研究旨在探讨最大步行速度与预后的关系，以及评估最大步行速度与通常步行速度结合在 CVD 患者预后风险分层中的作用。
我们纳入了 2951 名接受通常和最大步行速度评估的 CVD 患者。他们被分为通常 (+) 组[通常步行速度≥1.0 m/s]、通常 (-) 和最大 (+) 组[通常步行速度<1.0 m/s 且最大步行速度≥1.0 m/s]以及通常 (-) 和最大 (-) 组[通常步行速度<1.0 m/s 且最大步行速度<1.0 m/s]。
较慢的最大步行速度与 CVD 患者的死亡率显著相关。这种关联在各种亚组中是一致的。最大步行速度提供了比现有预后因素和通常步行速度更多的预后信息 (P=0.048)。与通常 (-) 和最大 (+) 组相比，通常 (-) 和最大 (-) 组的死亡率更高(危险比：1.63；95%置信区间：1.18-2.27；P=0.003)。通常 (+) 组与通常 (-) 和最大 (+) 组之间的死亡率无显著差异。
最大步行速度是 CVD 患者的独立预后预测指标。评估最大步行速度与通常步行速度结合有助于进一步对 CVD 患者的预后进行风险分层。
