慢性阻塞性肺病患者的实际行走速度

Laura Delgado-Ortiz, Saverio Ranciati, A. Arbillaga-Etxarri, Eva Balcells, J. Buekers, H. Demeyer, Anja Frei, E. Gimeno-Santos, N. Hopkinson, Corina de Jong, Niklas Karlsson, Z. Louvaris, L. Palmerini, M. I. Polkey, M. Puhan, Roberto A. Rabinovich, Diego A. Rodríguez Chiaradia, Robert Rodriguez-Roisin, Pere Torán-Montserrat, Ioannis Vogiatzis, Henrik Watz, Thierry Troosters, J. Garcia-Aymerich
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摘要

慢性阻塞性肺病(COPD)患者真实世界行走步频的临床有效性尚无定论。我们从五个欧洲国家的 593 名慢性阻塞性肺病患者的 7 天加速度计数据中评估了他们的步行步频(步行时间大于 10 秒时的每分钟步数),并从经过验证的调查问卷和标准化测试中评估了他们的临床和功能特征。在12个月的随访期间,严重病情恶化的记录来自患者报告和医疗登记。参与者大多为男性(80%),平均(sd)年龄为68(8)岁,支气管扩张剂后FEV157(19)%,每天步行6880(3926)步。平均行走步频为 88 步/分钟,呈正态分布(sd=9),人际间高度稳定(ICC 0.92 (95%CI 0.90-0.93))。通过分数多项式或线性回归对年龄、性别、身高和步行次数进行调整后,步行节奏与 FEV1、6 分钟步行距离、体力活动(步数/天、中强度体力活动时间、矢量大小单位、步行时间、运动强度)、体力活动经验和健康相关生活质量呈正相关;与呼吸困难和抑郁呈负相关(均 p<0.05)。在对每日步数进行进一步调整后,这些相关性依然存在。在对多种混杂因素进行调整后的负二项回归中,行走步频与随访期间较低的严重恶化次数有关(每步/分钟IRR为0.94,95%CI为0.91-0.99,p=0.009)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Real-world walking cadence in people with COPD
The clinical validity of real-world walking cadence in people with chronic obstructive pulmonary disease (COPD) is unsettled. Objective: to assess the levels, variability and association with clinically relevant COPD characteristics and outcomes of real-world walking cadence.We assessed walking cadence (steps per minute during walking bouts >10 s) from 7-days accelerometer data in 593 individuals with COPD from five European countries, and clinical and functional characteristics from validated questionnaires and standardised tests. Severe exacerbations during 12-months follow-up were recorded from patient reports and medical registries.Participants were mostly male (80%) and had mean (sd) age 68 (8) years, post-bronchodilator FEV157 (19)%, and 6880 (3926) steps/day. Mean walking cadence was 88 steps/min, followed a normal distribution (sd=9), and was highly stable within-person (ICC 0.92 (95%CI 0.90–0.93)). After adjusting for age, sex, height and number of walking bouts in fractional polynomial or linear regressions, walking cadence was positively associated with FEV1,6-min walk distance, physical activity (steps/day, time in moderate-to-vigorous physical activity, vector magnitude units, walking time, intensity during locomotion), physical activity experience and health-related quality of life; and negatively associated with breathlessness and depression (all p<0.05). These associations remained after further adjustment for daily steps. In negative binomial regression adjusted for multiple confounders, walking cadence related to lower number of severe exacerbations during follow-up (IRR 0.94 per step/min, 95%CI 0.91–0.99, p=0.009).Higher real-world walking cadence is associated with better COPD status and lower severe exacerbations risk, which makes it attractive as future prognostic marker and clinical outcome.
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