心肺运动测试评估神经肌肉疾病患者有氧能力的有效性。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2024-10-01 DOI:10.1016/j.apmr.2024.07.006

Tim Veneman MSc , Fieke S. Koopman MD, PhD , Sander Oorschot MSc , Jos J. de Koning PhD , Bart C. Bongers PhD , Frans Nollet MD, PhD , Eric L. Voorn PhD

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引用次数: 0

摘要

目的确定心肺运动测试（CPET）在评估神经肌肉疾病（NMD）患者摄氧量峰值（VO2peak）方面的内容有效性：设计：随机对照试验的基线评估：参与者86名患有Charcot-Marie-Tooth病（35人）、脊髓灰质炎后综合征（26人）或其他NMD（25人）的成年人（年龄：58.0 ± 13.9岁）：主要结果测量：在一名经验丰富的训练有素的评估员的监督下，在自行车测力计上测量 CPET 期间的工作量、气体交换变量、心率和感知用力等级。使用固定式测力计对膝关节伸肌的肌力进行等强度评估。CPET 期间最大心肺努力的确认标准是在与专家组举行的 3 次共识会议上确定的。对符合这些标准的参与者比例进行了评估，以量化内容效度：最大心肺努力的标准如下：摄氧量高原（VO2plateau）作为主要标准，或 3 个次要标准中的 2 个；1）呼吸交换比峰值（RERpeak）≥1.10；2）心率峰值（HRpeak）≥预测最大心率的 85%；3）在 6-20 级博格量表中，感知用力峰值（RPEpeak）≥17。71 名参与者（83%）达到了这些标准。分别有 31%、73%、69% 和 72% 的参与者达到了 VO2plateau、RERpeak ≥1.10、HRpeak ≥85% 和 RPEpeak ≥17。峰值工作量、VO2 峰值和伸膝肌力显著提高，体重指数降低（均为 p 结论：大多数 NMD 患者在 CPET 中都达到了最大心肺努力。因此，本研究提供了高质量的证据，证明作为最大有氧能力测量指标的 VO2peak 具有充分的内容效度。对于体能较差的严重患者，其内容有效性可能较低。

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Validity of Cardiopulmonary Exercise Testing for Assessing Aerobic Capacity in Neuromuscular Diseases

Objectives

To determine the content validity of cardiopulmonary exercise testing (CPET) for assessing peak oxygen uptake (VO_2peak) in neuromuscular diseases (NMD).

Design

Baseline assessment of a randomized controlled trial.

Setting

Academic hospital.

Participants

Eighty-six adults (age: 58.0±13.9 y) with Charcot-Marie-Tooth disease (n=35), postpolio syndrome (n=26), or other NMD (n=25).

Intervention

Not applicable.

Main Outcome Measures

Workload, gas exchange variables, heart rate, and ratings of perceived exertion were measured during CPET on a cycle ergometer, supervised by an experienced trained assessor. Muscle strength of the knee extensors was assessed isometrically with a fixed dynamometer. Criteria for confirming maximal cardiorespiratory effort during CPET were established during 3 consensus meetings of an expert group. The percentage of participants meeting these criteria was assessed to quantify content validity.

Results

The following criteria were established for maximal cardiorespiratory effort: a plateau in oxygen uptake (VO_2plateau) as the primary criterion, or 2 of 3 secondary criteria: (1) peak respiratory exchange ratio (RER_peak) ≥1.10 (2), peak heart rate ≥85% of predicted maximal heart rate; and (3) peak rating of perceived exertion (RPE_peak) ≥17 on the 6-20 Borg scale. These criteria were attained by 71 participants (83%). VO_2plateau, RER_peak ≥1.10, peak heart rate ≥85%, and RPE_peak ≥17 were attained by 31%, 73%, 69%, and 72% of the participants, respectively. Peak workload, VO_2peak, and knee extension muscle strength were significantly higher, and body mass index was lower (all P<.05), in participants with maximal cardiorespiratory effort than other participants.

Conclusions

Most people with NMD achieved maximal cardiorespiratory effort during CPET. This study provides high quality evidence of sufficient content validity of VO_2peak as a maximal aerobic capacity measure. Content validity may be lower in more severely affected people with lower physical fitness.

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.