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与心力衰竭保留射血分数的老年人 6 分钟步行试验期间功能能力、疲劳和呼吸困难相关的运动学参数。

Kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test in older adults with heart failure with preserved ejection fraction.

机构信息

Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, 29071, Málaga, España.

Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29010 Málaga, España.

出版信息

Eur J Cardiovasc Nurs. 2024 Jan 12;23(1):69-80. doi: 10.1093/eurjcn/zvad027.

Abstract

AIMS

This paper aims to assess kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test (6MWT) in patients with heart failure with preserved ejection fraction (HFpEF).

METHODS AND RESULTS

A cross-sectional study was conducted in which adults 70 years or older with HFpEF were voluntarily recruited between April 2019 and March 2020. An inertial sensor was placed at the L3-L4 level and another on the sternum to assess kinematic parameters. The 6MWT was divided into two 3-min phases. Leg fatigue and breathlessness, assessed by the Borg scale, the heart rate (HR), and the oxygen saturation (SpO2), were measured at the beginning and the end of the 6MWT. The difference in kinematic parameters between the 6MWT two 3-min phases was also calculated. Bivariate Pearson correlations and subsequent multivariate linear regression analysis were performed. Seventy older adults with HFpEF (mean = 80.74 years old) were included. Kinematic parameters explained 81.00% of the functional capacity, 45.50% of the leg fatigue and 66.10% of the breathlessness variance. Moreover, kinematic parameters could explain 30.90% of the SpO2 variance at the end of the 6MWT. Kinematic parameters also explained 33.10% of the SpO2 difference between the beginning and end of 6MWT. Kinematic parameters explained neither the HR variance at the end of 6MWT nor the HR difference between the beginning and end.

CONCLUSION

Gait kinematics from L3-L4 and sternum explain a part of the variance in subjective outcomes, assessed by the Borg scale, and objective outcomes such as functional capacity and SpO2. The kinematic assessment allows clinicians to quantify fatigue and breathlessness through objective parameters related to the patient's functional capacity.

REGISTRATION

ClinicalTrials.gov NCT03909919.

摘要

目的

本研究旨在评估射血分数保留心力衰竭(HFpEF)患者 6 分钟步行试验(6MWT)中与功能能力、疲劳和呼吸困难相关的运动学参数。

方法和结果

本研究为横断面研究,于 2019 年 4 月至 2020 年 3 月期间自愿招募 70 岁及以上的 HFpEF 成年人。在 L3-L4 水平和胸骨处放置惯性传感器以评估运动学参数。6MWT 分为两个 3 分钟阶段。在 6MWT 开始和结束时,使用 Borg 量表、心率(HR)和血氧饱和度(SpO2)评估腿部疲劳和呼吸困难。还计算了 6MWT 两个 3 分钟阶段之间运动学参数的差异。进行了双变量 Pearson 相关性和随后的多元线性回归分析。共纳入 70 名 HFpEF 老年人(平均年龄=80.74 岁)。运动学参数解释了功能能力的 81.00%、腿部疲劳的 45.50%和呼吸困难的 66.10%的变异性。此外,运动学参数可以解释 6MWT 结束时 SpO2 变异性的 30.90%。运动学参数还解释了 6MWT 开始和结束时 SpO2 差异的 33.10%。运动学参数既不能解释 6MWT 结束时 HR 的变异性,也不能解释 6MWT 开始和结束时 HR 的差异。

结论

L3-L4 和胸骨的步态运动学解释了主观结局(Borg 量表评估)和客观结局(如功能能力和 SpO2)的部分变异性。运动学评估允许临床医生通过与患者功能能力相关的客观参数来量化疲劳和呼吸困难。

注册

ClinicalTrials.gov NCT03909919。

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