De Brandt Jana, Jakobsson Johan, Hedlund Mattias, Sandström Thomas, Nyberg André
Department of Community Medicine and Rehabilitation, Faculty of Medicine, Umeå University, Umeå, Sweden.
Lung and Allergy Clinic, Norrlands Universitetssjukhus, Umeå, Sweden.
Exp Physiol. 2025 Jul 10. doi: 10.1113/EP092151.
Accurate prescription of supramaximal exercise requires exercise tests covering the intensity domain between maximal aerobic and peak power output. All-out tests are commonly used for this objective but are considered challenging for people with chronic obstructive pulmonary disease (COPD) due to the extreme physiological demand. The modified Borg cycle strength test (mBCST), previously used in older adults to achieve supramaximal intensities, might be a suitable alternative in people with COPD. We aimed to determine the feasibility of the mBCST in people with COPD and to compare the physiological response with that of healthy older adults. Eighteen people with COPD and 16 age-, sex- and physical activity-matched healthy adults performed a cardiopulmonary exercise test and a mBCST. The mBCST is an incremental test [30 s:30 s cycling:rest; with individualized starting load and step size (15-50 W)] with end-of-test criteria of a rating of perceived exertion of ≥17 or cadence of <75 RPM for >5 s. Feasibility was assessed using a framework covering the aim, interpretability, familiarity, duration, scoring/completion complexity, costs and safety. Measurements of external exercise intensity, rating of perceived exertion, symptoms and cardiorespiratory demand were obtained. The mBCST was deemed feasible according to the feasibility framework. Expressed relative to the cardiopulmonary exercise test, all participants reached supramaximal external exercise intensities during the mBCST [COPD, 145 (125-168)%; healthy, 154 (148-163)%], without differences in intensity or physiological response between groups (p > 0.05). The mBCST is feasible in people with COPD and enables supramaximal external exercise intensities, with similar physiological response to healthy older adults. The mBCST could be considered when selecting an exercise test to prescribe supramaximal exercise.
准确开具超最大运动处方需要进行运动测试，测试强度范围涵盖最大有氧功率和峰值功率输出之间的区间。全力测试通常用于此目的，但由于其对生理需求极高，对于慢性阻塞性肺疾病（COPD）患者而言被认为具有挑战性。改良的博格循环力量测试（mBCST），此前用于老年人以达到超最大强度，可能是COPD患者的合适替代方案。我们旨在确定mBCST在COPD患者中的可行性，并将其生理反应与健康老年人进行比较。18名COPD患者和16名年龄、性别及身体活动相匹配的健康成年人进行了心肺运动测试和mBCST。mBCST是一种递增测试[30秒：30秒骑行：休息；起始负荷和步长个体化（15 - 50瓦）]，测试结束标准为自感用力度≥17或踏频<75转/分钟持续>5秒。使用涵盖目的、可解释性、熟悉度、持续时间、评分/完成复杂性、成本和安全性的框架评估可行性。获取了外部运动强度、自感用力度、症状和心肺需求的测量值。根据可行性框架，mBCST被认为是可行的。相对于心肺运动测试，所有参与者在mBCST期间均达到了超最大外部运动强度[COPD患者，145（125 - 168）%；健康成年人，154（148 - 163）%]，两组之间在强度或生理反应上无差异（p>0.05）。mBCST在COPD患者中是可行的，能够实现超最大外部运动强度，且生理反应与健康老年人相似。在选择用于开具超最大运动处方的运动测试时，可以考虑mBCST。
