Elías Hernández M T, Ortega Ruiz F, Fernández Guerra J, Toral Marín J, Sánchez Riera H, Montemayor Rubio T
Servicio de Neumología, Hospital Universitario Virgen del Rocío, Sevilla.
Arch Bronconeumol. 1997 Nov;33(10):498-502.
To validate a shuttle walking test in a group of patients with COPD, comparing responses to those produced by a conventional stress test limited by symptoms on the cycle ergometer, and to analyze the relation between the shuttle walking test and maximal effort parameters. We enrolled 20 patients with COPD, mean age 60 years (SD 7), FEV1/46.6% (SD 19.2) of theoretical value and FEV1/FVC% 47.3% (SD 11.2). All the patients underwent a maximal effort test on the cycle ergometer, determination of initial dyspnea by applying Mahler's baseline dyspnea index, and a quality of life questionnaire specific to COPD the Chronic Respiratory Disease Questionnaire). To compare the responses of patients to the two tests, we analyzed heart rate, dyspnea and lactic acid at the end of each test. To see the relations between the two tests, we examined distance walked and maximal effort parameters. The relation between the walking test and lung function parameters at rest, initial dyspnea and quality of life were also analyzed. No statistically significant differences were found for heart rate [128.2 (SD 19.8) versus 131.6 (SD 12.9)], dyspnea 17.1 (SD 1.78) versus 7.24 (SD 2.64)] or lactic acid [5.24 (SD 2.34) versus 6.19 (SD 2.12)] at the end of the tests. Distance covered on the shuttle walking test correlated significantly with V'O2ml/min/Kgmax (r = 0.71), as well as with the remaining parameters of maximal effort. There was only a slight relation between lung function at rest and quality of life. The COPD patient's cardiovascular, metabolic and subjective responses to the shuttle walking test are similar to those of the cycle ergometer test, and oxygen consumption is significantly correlated. The shuttle walking test gives a valid estimate of the functional capacity of COPD patients.
为验证穿梭步行试验在一组慢性阻塞性肺疾病（COPD）患者中的效果，将其反应与受症状限制的传统蹬车测力计压力测试的反应进行比较，并分析穿梭步行试验与最大用力参数之间的关系。我们纳入了20例COPD患者，平均年龄60岁（标准差7岁），第一秒用力呼气容积（FEV1）为理论值的46.6%（标准差19.2），FEV1/用力肺活量（FVC）百分比为47.3%（标准差11.2）。所有患者均接受了蹬车测力计最大用力测试，应用马勒基线呼吸困难指数测定初始呼吸困难，并完成了一份针对COPD的生活质量问卷（慢性呼吸系统疾病问卷）。为比较患者对两种测试的反应，我们分析了每次测试结束时的心率、呼吸困难和乳酸水平。为观察两种测试之间的关系，我们检查了行走距离和最大用力参数。还分析了步行测试与静息肺功能参数、初始呼吸困难和生活质量之间的关系。测试结束时，心率[128.2（标准差19.8）对131.6（标准差12.9）]、呼吸困难[17.1（标准差1.78）对7.24（标准差2.64）]或乳酸[5.24（标准差2.34）对6.19（标准差2.12）]均未发现统计学上的显著差异。穿梭步行试验所覆盖的距离与最大摄氧量（V'O2）毫升/分钟/千克最大值（r = 0.71）以及最大用力的其余参数显著相关。静息肺功能与生活质量之间仅有微弱关系。COPD患者对穿梭步行试验的心血管、代谢和主观反应与蹬车测力计测试相似，且耗氧量显著相关。穿梭步行试验能有效评估COPD患者的功能能力。
