Cardiopulmonary Exercise Testing Using the Modified Balke Protocol in Fully Ambulatory People With Multiple Sclerosis.
Cardiopulmonary Exercise Testing Using the Modified Balke Protocol in Fully Ambulatory People With Multiple Sclerosis.
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DOI：
10.1097/cpt.0000000000000141
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发表时间：
2021-04
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本研究使用改进的 Balke 方案在电机驱动的跑步机上对完全行走的多发性硬化症 (MS) 患者进行了心肺运动测试 (CPET) 结果的应用、结果和有效性。能够完全行走的多发性硬化症患者 (N = 20) 接受了残疾（扩展残疾状态量表，EDSS）、步行耐力（6 分钟步行距离，6MWD）和认知（符号数字模态测试，SDMT）的评估，并在电机驱动跑步机上完成了最大 CPET（改进的 Balke 方案），同时通过间接量热法收集呼出气体。记录了美国国立卫生研究院指南定义的严重不良事件 (AE) 和 AE，以及使用最大努力标准标准提供的“最大”努力测试。 CPET 得出的生理结果包括摄氧量 (V̇o2)、二氧化碳产生量、通气量 (VE)、呼吸交换率和心率 (HR)。其他结果使用标准指南计算，包括 V̇o2/HR 斜率和摄氧效率斜率 (V̇o2/log10VE)。描述性统计数据以平均值±标准差进行总结，并使用类似的 CPET 方案与表面健康个体的规范数据进行描述性比较。在峰值 V̇o2 和 SDMT、6MWD 和 EDSS 评分之间进行 Spearman 的 rho 排序相关性 (ρ)。没有出现 AE，20 项测试中有 17 项被描述为产生最大努力，因此可以解释。可以预见的是，根据修改后的 Balke 方案得出的 V̇o2 峰值在 MS 中与健康样本男性 (43.4 ± 9.3) 和女性 (35.0 ± 7.2) 的正常值不同。 V̇o2 峰值与 SDMT (ρ = 0.53，P = .01) 和 6MWD (ρ = 0.73，P = .0003) 呈正相关，与残疾呈负相关 (ρ = -0.51，P = .02)。在电动跑步机上使用改进的 Balke 方案进行心肺运动测试对于测量完全走动的多发性硬化症患者的有氧功率来说是安全、可行且有效的。
This study examined the application, outcomes, and validity of cardiopulmonary exercise test (CPET) outcomes using a modified Balke protocol on a motor-driven treadmill in fully ambulatory people with multiple sclerosis (MS). Fully ambulatory people with MS (N = 20) underwent assessments of disability (Expanded Disability Status Scale, EDSS), walking endurance (6-minute walk distance, 6MWD), and cognition (Symbol Digit Modalities Test, SDMT), and completed a maximal CPET (modified Balke protocol) on a motor-driven treadmill while expired gases were collected with indirect calorimetry. Serious adverse events (AEs) and AEs, defined by National Institutes of Health guidelines, and provision of a “maximal” effort test using standard criteria for a maximal effort were documented. The physiological outcomes derived from the CPET included oxygen uptake (V̇o2), carbon dioxide production, ventilation (VE), respiratory exchange ratio, and heart rate (HR). Other outcomes were calculated using standard guidelines, including V̇o2/HR slope and oxygen uptake efficiency slope (V̇o2/log10VE). Descriptive statistics were summarized with mean ± SD and descriptively compared with normative data from apparently healthy individuals using a similar CPET protocol. Spearman’s rho rank-order correlations (ρ) were performed among peak V̇o2 and SDMT, 6MWD, and EDSS scores. There were no AEs, and 17 of 20 tests were characterized as yielding a maximal effort and therefore interpretable. V̇o2 peak derived from the modified Balke protocol was predictably different in MS (25.8 ± 6.3) than normative values for healthy samples men (43.4 ± 9.3) and women (35.0 ± 7.2). V̇o2 peak positively correlated with SDMT (ρ = 0.53, P = .01) and 6MWD (ρ = 0.73, P = .0003), and negatively correlated with disability (ρ = −0.51, P = .02). Cardiopulmonary exercise test using a modified Balke protocol on a motorized treadmill is safe, feasible, and valid for the measurement of aerobic power in fully ambulatory people with MS.