Mall Maurice Pablo, Wander Johanna, Lentz Anne, Jakob André, Oberhoffer Felix Sebastian, Mandilaras Guido, Haas Nikolaus Alexander, Dold Simone Katrin
Department of Pediatric Cardiology and Pediatric Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany.
Children (Basel). 2024 Feb 12;11(2):236. doi: 10.3390/children11020236.
(1) Background: Cardiorespiratory fitness (CRF) is known to be a prognostic factor regarding long-term morbidity and mortality. This study aimed to develop a standardized Stair Climbing Test (SCT) with a reliable correlation to spiroergometry and the 6MWT which can be used in healthy children as well as patients with congenital heart disease (CHD) and a restricted exercise capacity. (2) Methods: A total of 28 healthy participants aged 10-18 years were included. We tested the individuals' CRF by cardiopulmonary exercise testing (CPET) on a treadmill, the 6MWT, and a newly developed Stair Climbing Test (SCT). For the SCT, we defined a standardized SCT protocol with a total height of 13.14 m to achieve maximal exercise effects while recording time and vital parameters. To compare the SCT, the 6 Min Walking Test, and CPET, we introduced an SCT-Index that included patient data (weight, height) and time. To assess the SCT's feasibility for clinical practice, we also tested our protocol with five adolescents with complex congenital heart disease (i.e., Fontan circulation). (3) Results: A strong correlation was observed between SCT-Index and O pulse (r = 0.921; < 0.001). In addition, when comparing the time achieved during SCT (tSCT) with VOmax (mL/min/kg) and VOmax (mL/min), strong correlations were found (r = -0.672; < 0.001 and r = -0.764; < 0.001). Finally, we determined a very strong correlation between SCT-Index and VOmax (mL/min) (r = 0.927; = <0.001). When comparing the 6MWD to tSCT, there was a moderate correlation (r = -0.544; = 0.003). It appears to be feasible in patients with Fontan circulation. (4) Conclusions: We were able to demonstrate that there is a significant correlation between our standardized SCT and treadmill CPET. Therefore, we can say that the SCT can be used as an easy supplement to CPET and in certain contexts, it can also be used as a screening tool when CPET is not available. The advantages would be that the SCT is a simple, quick, cost-effective, and reliable standardized (sub)maximal exercise test to evaluate CRF in healthy children on a routine basis. We can even assume that it can be used in patients with congenital heart disease.
(1) 背景：已知心肺适能（CRF）是长期发病率和死亡率的一个预后因素。本研究旨在开发一种标准化的爬楼梯测试（SCT），使其与运动心肺功能测试及6分钟步行试验（6MWT）具有可靠的相关性，该测试可用于健康儿童以及先天性心脏病（CHD）和运动能力受限的患者。(2) 方法：共纳入28名年龄在10至18岁的健康参与者。我们通过在跑步机上进行心肺运动测试（CPET）、6MWT和新开发的爬楼梯测试（SCT）来测试个体的CRF。对于SCT，我们定义了一个总高度为13.14米的标准化SCT方案，以在记录时间和生命参数的同时实现最大运动效果。为了比较SCT、6分钟步行试验和CPET，我们引入了一个包含患者数据（体重、身高）和时间的SCT指数。为了评估SCT在临床实践中的可行性，我们还对五名患有复杂先天性心脏病（即Fontan循环）的青少年进行了该方案测试。(3) 结果：观察到SCT指数与氧脉搏之间存在强相关性（r = 0.921；P < 0.001）。此外，当比较SCT期间达到的时间（tSCT）与最大摄氧量（VOmax，mL/min/kg）和最大摄氧量（VOmax，mL/min）时，发现存在强相关性（r = -0.672；P < 0.001和r = -0.764；P < 0.001）。最后，我们确定SCT指数与最大摄氧量（VOmax，mL/min）之间存在非常强的相关性（r = 0.927；P < 0.001）。当比较6分钟步行距离（6MWD）与tSCT时，存在中度相关性（r = -0.544；P = 0.003）。在Fontan循环患者中似乎可行。(4) 结论：我们能够证明我们的标准化SCT与跑步机CPET之间存在显著相关性。因此，我们可以说SCT可以作为CPET的一种简便补充，在某些情况下，当无法进行CPET时，它也可以用作筛查工具。其优点是SCT是一种简单、快速、经济高效且可靠的标准化（次）最大运动测试，可用于常规评估健康儿童的CRF。我们甚至可以假设它可用于先天性心脏病患者。
