Myers J, Do D, Herbert W, Ribisl P, Froelicher V F
Cardiology Division, Palo Alto Veterans Affairs Medical Center, California 94304.
Am J Cardiol. 1994 Mar 15;73(8):591-6. doi: 10.1016/0002-9149(94)90340-9.
Recent investigations suggested that clinical exercise testing can be optimized by individualizing the protocol, depending on the purpose of the test and the subject tested. This requires some knowledge of a patient's exercise capacity before beginning the test. The accuracy of a simple physical activity questionnaire and readily available clinical data in predicting subsequent treadmill performance was examined. A brief, self-administered questionnaire (VSAQ) was developed for veterans who were referred to exercise testing for clinical reasons. The VSAQ was designed to determine which specific daily activities were associated with symptoms of cardiovascular disease (fatigue, chest pain and shortness of breath). Two hundred twelve consecutive patients (mean age 62 +/- 8 years) referred for maximal exercise testing were studied. Clinical and demographic variables were added to VSAQ responses in a stepwise regression model to determine their ability to predict treadmill performance. Only metabolic equivalents by VSAQ, and age were significant predictors of treadmill performance; these 2 variables yielded R = 0.82 (SEE 1.43; p < 0.001), and explained 67% of the variance in exercise capacity. The regression equation reflecting the relation between age, VSAQ and exercise capacity was: achieved metabolic equivalents = 4.7 + 0.97 (VSAQ) - 0.06 (age). Using this equation, a nomogram was developed. Incorporating the VSAQ with the nomogram requires only a few minutes, and yields a reasonably accurate estimate of a patient's exercise capacity. Although the present equation is population-specific, a similar approach in different populations may be useful for individualizing protocols for clinical exercise testing.
最近的研究表明，根据测试目的和受测对象，通过个性化方案可优化临床运动测试。这需要在开始测试前了解患者的运动能力。我们检验了一份简单的体力活动问卷及现成临床数据在预测后续跑步机运动表现方面的准确性。针对因临床原因被转介进行运动测试的退伍军人，我们开发了一份简短的自填式问卷（VSAQ）。VSAQ旨在确定哪些特定日常活动与心血管疾病症状（疲劳、胸痛和呼吸急促）相关。我们研究了连续212名被转介进行最大运动测试的患者（平均年龄62±8岁）。在逐步回归模型中，将临床和人口统计学变量添加到VSAQ回答中，以确定它们预测跑步机运动表现的能力。只有VSAQ得出的代谢当量和年龄是跑步机运动表现的显著预测因素；这两个变量的R值为0.82（标准误1.43；p<0.001），解释了运动能力差异的67%。反映年龄、VSAQ与运动能力之间关系的回归方程为：达到的代谢当量=4.7+0.97（VSAQ）-0.06（年龄）。利用这个方程，我们绘制了一张列线图。将VSAQ与列线图结合只需几分钟，就能对患者的运动能力做出相当准确的估计。尽管目前的方程是针对特定人群的，但在不同人群中采用类似方法可能有助于临床运动测试方案的个性化。
