常规节奏400米长距离走廊步行评估老年人的心肺适能：肌肉、活动能力与衰老研究（SOMMA）

Usual-Paced 400m Long Distance Corridor Walk Estimates Cardiorespiratory Fitness among Older Adults: The Study of Muscle, Mobility and Aging (SOMMA).

作者信息

Moffit Reagan E, Cawthon Peggy M, Nicklas Barbara J, Goodpaster Bret H, Coen Paul M, Forman Daniel E, Cummings Steven R, Newman Anne B, Glynn Nancy W

出版信息

medRxiv. 2023 Nov 6:2023.11.05.23298103. doi: 10.1101/2023.11.05.23298103.

DOI:10.1101/2023.11.05.23298103

PMID:37986795

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10659523/

Abstract

BACKGROUND

Cardiopulmonary exercise testing (CPET), the gold-standard method to quantify cardiorespiratory fitness (CRF), is not always feasible due to cost, access, and burden. The usual-paced 400m long-distance corridor walk (LDCW), a measure of mobility among older adults, may provide an alternate method to assess CRF among populations unable to complete maximal intensity testing. The purpose of this study was to develop and validate an estimating equation to estimate VO peak from average 400m walking speed (WS) among participants in the Study of Muscle, Mobility and Aging (SOMMA).

METHODS

At baseline, participants (N=820, 76.2±4.9 years, 58% Women, 86% Non-Hispanic White) completed a 400m LDCW (400m WS=400m/completion time in seconds) and symptom-limited maximal CPET (Modified Balke Protocol). VO peak (mL/kg/min) was considered the highest 30-second average oxygen consumption during CPET. Other covariates included: age, sex, race, physical activity (7-day wrist-worn accelerometer), physical function (Short Physical Performance Battery, range 0-12), perceived physical fatigability (Pittsburgh Fatigability Scale, range 0-50), and Borg Rating of Perceived Exertion (RPE, range 6-20) at completion of the 400m LDCW. Stepwise linear regression was used. Internal validation was completed using data-splitting method (70%; 30%).

RESULTS

Mean VO peak was 20.2±4.8 mL/kg/min and mean 400m WS was 1.06±0.2 m/s. Each 0.05 m/s increment in 400m WS was associated with a 0.40 mL/kg/min higher VO peak after adjustment for covariates. An estimating equation including 400m WS, age, sex, race, and RPE was developed. Internal validation showed low overall bias (-0.26) and strong correlation (r = 0.71) between predicted and measured VO peak values. Bland-Altman plot and regression analyses indicated predicted VO peak was an acceptable alternative, despite mean underestimation of 4.53 mL/kg/min among those with CPET VO peak ≥25 mL/kg/min.

CONCLUSIONS

Usual-paced 400m LDCW strongly correlates with direct measures of cardiorespiratory fitness during CPET in older adults with lower fitness and can be used to test both fitness and function.

摘要

背景

心肺运动试验（CPET）是量化心肺适能（CRF）的金标准方法，但由于成本、可及性和负担等因素，该方法并不总是可行。常规步速400米长距离走廊行走（LDCW）是评估老年人活动能力的一项指标，对于无法完成最大强度测试的人群，它可能提供一种评估CRF的替代方法。本研究的目的是开发并验证一个估算方程，该方程可根据肌肉、活动能力与衰老研究（SOMMA）参与者的平均400米行走速度（WS）估算最大摄氧量（VO₂）峰值。

方法

在基线时，参与者（N = 820，年龄76.2±4.9岁，女性占58%，非西班牙裔白人占86%）完成了400米LDCW（400米WS = 400米/完成时间（秒））以及症状限制的最大CPET（改良Balke方案）。VO₂峰值（毫升/千克/分钟）被视为CPET期间最高的30秒平均耗氧量。其他协变量包括：年龄、性别、种族、身体活动（佩戴7天的腕式加速度计）、身体功能（简短身体性能量表，范围0 - 12）、400米LDCW完成时的主观身体疲劳感（匹兹堡疲劳量表，范围0 - 50）以及博格主观用力程度评分（RPE，范围6 - 20）。采用逐步线性回归分析。使用数据拆分法（70%；30%）完成内部验证。

结果

平均VO₂峰值为20.2±4.8毫升/千克/分钟，平均400米WS为1.06±0.2米/秒。在对协变量进行调整后，400米WS每增加0.05米/秒，VO₂峰值就会升高0.40毫升/千克/分钟。开发了一个包含400米WS、年龄、性别、种族和RPE的估算方程。内部验证显示，预测的VO₂峰值与实测值之间总体偏差较低（-0.26），且具有较强的相关性（r = 0.71）。布兰德-奥特曼图和回归分析表明，尽管在CPET VO₂峰值≥25毫升/千克/分钟的人群中，预测的VO₂峰值平均低估了4.53毫升/千克/分钟，但预测的VO₂峰值仍是一种可接受的替代方法。