心肺耐力的科学测评:心肺运动试验与6 min二级台阶试验的比较
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摘要
背景:心肺运动试验在心肺功能评价方面具有重要意义,但其测试需要严格实验室环境、昂贵的仪器设备和专业测试人员等,且试验中要求达到受试者最大耐受水平,风险较大。目的:通过比较心肺功能试验与6min二级台阶试验的最大摄氧量,探讨2种不同试验方法评价心肺耐力的一致性。方法:试验经北京体育大学运动科学实验伦理委员会批准。随机招募67名志愿者,能够理解试验并自愿配合测试全过程,并签署知情同意书。受试者进行6 min二级台阶试验,并使用公式间接推算其最大摄氧量。相隔1周后,同一批受试者按照BRUCE方案进行心肺运动试验直接测得最大摄氧量。将2种试验方法获得最大摄氧量进行比较分析。结果与结论:①6 min二级台阶试验推算最大摄氧量小于心肺运动试验所测得的最大摄氧量;②6 min二级台阶试验推算最大摄氧量与心肺运动试验测得最大摄氧量呈正相关关系(r=0.861,P <0.01);③2种测试方法获得最大摄氧量有较高相关关系且一致性较高(r=0.868,P <0.01);④结果说明,6 min二级台阶试验可能作为一种亚极量负荷方案,有效估算心肺耐力水平。
BACKGROUND: Cardiopulmonary exercise test plays an important role in the evaluation of cardiopulmonary function, but it needs strict laboratory environment, expensive equipment and professional testers. The test requires a maximum tolerance level of the subject, which is more risky.OBJECTIVE: To evaluate the consistency of cardiopulmonary endurance by comparing the maximum oxygen uptake of the cardiopulmonary exercise test with the 6-minute two-step test.METHODS: The study was approved by the Ethics Committee of Beijing Sport University. Sixty-seven volunteers were randomly enrolled and signed the informed consents. The maximal oxygen uptake was measured directly in the cardiopulmonary exercise test according to the BRUCE protocol. A week later, the same group of subjects underwent a 6-minute two-step test and indirectly estimated their maximum oxygen uptake using the reckoning equation. The maximum oxygen uptake of the two test methods was compared and analyzed.RESULTS AND CONCLUSION:(1) The maximum oxygen uptake calculated by 6-minute two-step test was less than that calculated by cardiopulmonary exercise test.(2) There was a positive correlation between the maximum oxygen uptake of by 6-minute two-step test and the cardiopulmonary exercise test(r=0.861, P < 0.01).(3) There was a high correlation and consistency between the two methods(r=0.868, P <0.01).(4) Therefore, 6-minute two-step test may be used as a sub-maximal load to estimate the level of cardiopulmonary endurance effectively.
BACKGROUND: Cardiopulmonary exercise test plays an important role in the evaluation of cardiopulmonary function, but it needs strict laboratory environment, expensive equipment and professional testers. The test requires a maximum tolerance level of the subject, which is more risky.OBJECTIVE: To evaluate the consistency of cardiopulmonary endurance by comparing the maximum oxygen uptake of the cardiopulmonary exercise test with the 6-minute two-step test.METHODS: The study was approved by the Ethics Committee of Beijing Sport University. Sixty-seven volunteers were randomly enrolled and signed the informed consents. The maximal oxygen uptake was measured directly in the cardiopulmonary exercise test according to the BRUCE protocol. A week later, the same group of subjects underwent a 6-minute two-step test and indirectly estimated their maximum oxygen uptake using the reckoning equation. The maximum oxygen uptake of the two test methods was compared and analyzed.RESULTS AND CONCLUSION:(1) The maximum oxygen uptake calculated by 6-minute two-step test was less than that calculated by cardiopulmonary exercise test.(2) There was a positive correlation between the maximum oxygen uptake of by 6-minute two-step test and the cardiopulmonary exercise test(r=0.861, P < 0.01).(3) There was a high correlation and consistency between the two methods(r=0.868, P <0.01).(4) Therefore, 6-minute two-step test may be used as a sub-maximal load to estimate the level of cardiopulmonary endurance effectively.
引文
[1]AMERICAN COLLEGA OF SPORTS MEDICINE. ACSM’s guidelines for exercise testing and prescription.Tenth Edition.Wolters Kluwer. 2016:45-49.
[2]Laukkanen JA, Kurl S, Salonen R,et al. The predictive value of cardiorespiratory fitness for cardiovascular events in men with various risk profiles:a prospective population-based cohort study.Eur Heart J. 2004;25:1428–1437.
[3]America Heart Association. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice:A Case for Fitness as a Clinical Vital Sign:A Scientific statement from the American Heart Association.Circulation. 2016:e1-e48.
[4]宁亮,孙兴国.心肺运动试验在医学领域的临床应用[J].中国全科医学,2013,16(33):3898-3902.
[5]AMERICAN COLLEGA OF SPORTS MEDICINE. ACSM’s Health-Related Physical Fitness Assessment Manual Fourth Edition. Baltimore:Wolters Kluwer. 2014:111.
[6]刘爱华.运动心肺功能试验的应用进展[J].医学综述, 2013,19(22):4125-4128.
[7]杨甜.20-MST评价20-39岁成年人心肺耐力方法及速查表的研究[D].北京:北京体育大学,2016.
[8]李萍. 12分钟跑推测大学生最大有氧工作能力方法的研究[D].北京:北京体育大学,2012.
[9]郭辉,孙景权,张一民.六分钟上下楼梯试验与摄氧量的相关性研究[J].成都体育学院学报,2016,42(3):14-18..
[10]Brouha L, Health CW, Graybiel A, Step test simple method of measuring physical fitness for hard muscular work in adult men.Rev Canadian Biol. 1943;(2):86-89
[11]王健,邓树勋.台阶试验质疑[J].中国体育科技, 2003,39(2):62-65.
[12]蔡广,陆大江,沈勋章,等.两种台阶实验间接推算和直接测试最大摄氧量的比较[J].中国组织工程研究与临床康复,2008,12(15):2918-2921
[13]JettéM, Campbell J, Mongeon J, et al.The Canadian Home Fitness Test as a predictor for aerobic capacity. Can Med Assoc J.1976; 114(8):680-682.
[14]Bland J, Pfeiffer K, Eisenmann JC. The PWC170:comparison of different stage lengths in 11–16. Eur J Appl Physiol. 2012;112(5):1955-1961.
[15]邱少霖,敖运忠,向宗明.Pwc(170)台阶实验、15min跑和12min跑与间接推算VO2max的研究[J].北京体育大学学报, 2001,24(1):52-53.
[16]AMERICAN COLLEGA OF SPORTS MEDICINE. ACSM’S Guidelines for Exercise Testing and Prescription. Eighth Edition.Wolters Kluwer.2010:65-66.
[17]中华人民共和国建设部.《住宅建筑规范》GB 50368—2005[B].北京:中国建筑工业出版社2006.
[18]杨文兰.运动心肺试验的安全性及注意事项[J].中国实用内科杂志,2014,34(S1):27-29.
[19]Astrand PO, Ryhming I. A Nomogram for Calculation of Aerobic Capacity(Physical Fitness)From Pulse Rate During Submaximal Work. J Appl Physiol. 1954;7(2):218-221.
[20]郭辉.成年人心肺耐力自评价方法的研制与参考等级的建立[D].北京:北京体育大学,2016.
[21]王正珍.ACSM运动测试与运动处方指南[M].9版.北京:北京体育大学出版社, 2014.
[22]周誉,王正珍,黄守清,等.不同BMI和心肺耐力水平的中年男性心血管疾病风险因素的特征研究[J].中国体育科技,2017,53(1):56-62.
[23]田野.运动生理学高级教程[M].高等教育出版社, 2003:234-235.
[24]Vainshelboim B, Lima RM, Edvardsen E, et al. Cardiorespiratory fitness, incidence and mortality of lung cancer in men:A prospective cohort study. J Sci Med Sport. 2019;22(4):403-407.
[25]金钟一,皮林,韩海英,胡大一.家庭运动康复对于冠状动脉介入术后患者心肺功能的影响[J].慢性病学杂志, 2018,19(7):838-840+843
[26]刘晓丽,刘超能,王人卫,等.心肺功能在健康风险预测中的应用[J].中国运动医学杂志,2018,37(2):158-165.
[27]Pandey A, Patel M, Gao A, et al. Changes in mid-life fitness predicts heart failure risk at a later age independent of interval development of cardiac and noncardiac risk factors:The Cooper Center Longitudinal Study. Am Heart J. 2015;169(2):290-297.e1.
[28]DeFina LF, Radford NB, Leonard D, et al. The association of cardiorespiratory fitness, body mass index, and age with testosterone levels at screening of healthy men undergoing preventive medical examinations:The Cooper Center Longitudinal Study. Maturitas. 2018;118:1-6.
[29]石秀廷,尹小俭.20m往返跑用于青少年心肺耐力评价的研究进展[J].中国学校卫生,2017,38(12):1916-1920.
[30]Berntsen KS, Tollisen A, Schwartz T,et al.Submaximal Exercise Capacity in Juvenile Dermatomyositis after Longterm Disease:The Contribution of Muscle, Lung, and Heart Involvement. J Rheumatol. 2017;44(6):827-834.
[31]张茹斌.基于智能功率车的心肺耐力测试与训练方法研究[D].合肥:中国科学技术大学,2018
[32]荆志成.六分钟步行距离试验的临床应用[J].中华心血管病杂志,2006, 34(4):381-384.
[33]陈嵘,王健,杨红春.四种运动负荷试验评价运动心肺功能比较研究[J].中国运动医学杂志,2014,(9):917-920.
[34]郭辉,孙景权,张一民.心肺运动试验与6 min上下楼梯试验评价心肺功能的比较[J].中国组织工程研究,2016,20(2):292-296.
[35]Brouha L, Health CW, Graybiel A, Step test simple method of measuring physical fitness for hard muscular work in adult men.Rev Canadian Biol.1943;2:86.
[36]郭辉,孙景权,张一民.74例健康青年志愿者心肺运动试验、六分钟上下楼梯试验结果对比观察[J].山东医药,2016,56(23):52-54.
[37]Leone M, DuvergeS, KalinovaE, et al. Comtois Comparison of bioenergetics of walking during a multistage incremental shuttle walk test and a 6-min walk test in active older adults. Aging Clin Exp Res. 2017;29(2):239-246.
[38]张劭夫.六分钟行走试验:运动耐力评价的方法及临床意义[J].中国组织工程研究与临床康复,2011,15(5):894-897.
[39]闫金辉,张丽华.大学生体力劳动能力和最大摄氧量的关系[J].现代预防医学,2008,35(21):4191-4192.
[40]袁林,宋应华,刘心伟,等.不同体重人群爬楼梯过程中能量消耗的测定[J].中国体育科技, 2012, 48(3):104-107.
[41]刘建华,丸山仁司,胜平纯司.上下台阶方法的生物力学研究[J].中国康复理论与实践,2003,9(10):32-33.
[2]Laukkanen JA, Kurl S, Salonen R,et al. The predictive value of cardiorespiratory fitness for cardiovascular events in men with various risk profiles:a prospective population-based cohort study.Eur Heart J. 2004;25:1428–1437.
[3]America Heart Association. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice:A Case for Fitness as a Clinical Vital Sign:A Scientific statement from the American Heart Association.Circulation. 2016:e1-e48.
[4]宁亮,孙兴国.心肺运动试验在医学领域的临床应用[J].中国全科医学,2013,16(33):3898-3902.
[5]AMERICAN COLLEGA OF SPORTS MEDICINE. ACSM’s Health-Related Physical Fitness Assessment Manual Fourth Edition. Baltimore:Wolters Kluwer. 2014:111.
[6]刘爱华.运动心肺功能试验的应用进展[J].医学综述, 2013,19(22):4125-4128.
[7]杨甜.20-MST评价20-39岁成年人心肺耐力方法及速查表的研究[D].北京:北京体育大学,2016.
[8]李萍. 12分钟跑推测大学生最大有氧工作能力方法的研究[D].北京:北京体育大学,2012.
[9]郭辉,孙景权,张一民.六分钟上下楼梯试验与摄氧量的相关性研究[J].成都体育学院学报,2016,42(3):14-18..
[10]Brouha L, Health CW, Graybiel A, Step test simple method of measuring physical fitness for hard muscular work in adult men.Rev Canadian Biol. 1943;(2):86-89
[11]王健,邓树勋.台阶试验质疑[J].中国体育科技, 2003,39(2):62-65.
[12]蔡广,陆大江,沈勋章,等.两种台阶实验间接推算和直接测试最大摄氧量的比较[J].中国组织工程研究与临床康复,2008,12(15):2918-2921
[13]JettéM, Campbell J, Mongeon J, et al.The Canadian Home Fitness Test as a predictor for aerobic capacity. Can Med Assoc J.1976; 114(8):680-682.
[14]Bland J, Pfeiffer K, Eisenmann JC. The PWC170:comparison of different stage lengths in 11–16. Eur J Appl Physiol. 2012;112(5):1955-1961.
[15]邱少霖,敖运忠,向宗明.Pwc(170)台阶实验、15min跑和12min跑与间接推算VO2max的研究[J].北京体育大学学报, 2001,24(1):52-53.
[16]AMERICAN COLLEGA OF SPORTS MEDICINE. ACSM’S Guidelines for Exercise Testing and Prescription. Eighth Edition.Wolters Kluwer.2010:65-66.
[17]中华人民共和国建设部.《住宅建筑规范》GB 50368—2005[B].北京:中国建筑工业出版社2006.
[18]杨文兰.运动心肺试验的安全性及注意事项[J].中国实用内科杂志,2014,34(S1):27-29.
[19]Astrand PO, Ryhming I. A Nomogram for Calculation of Aerobic Capacity(Physical Fitness)From Pulse Rate During Submaximal Work. J Appl Physiol. 1954;7(2):218-221.
[20]郭辉.成年人心肺耐力自评价方法的研制与参考等级的建立[D].北京:北京体育大学,2016.
[21]王正珍.ACSM运动测试与运动处方指南[M].9版.北京:北京体育大学出版社, 2014.
[22]周誉,王正珍,黄守清,等.不同BMI和心肺耐力水平的中年男性心血管疾病风险因素的特征研究[J].中国体育科技,2017,53(1):56-62.
[23]田野.运动生理学高级教程[M].高等教育出版社, 2003:234-235.
[24]Vainshelboim B, Lima RM, Edvardsen E, et al. Cardiorespiratory fitness, incidence and mortality of lung cancer in men:A prospective cohort study. J Sci Med Sport. 2019;22(4):403-407.
[25]金钟一,皮林,韩海英,胡大一.家庭运动康复对于冠状动脉介入术后患者心肺功能的影响[J].慢性病学杂志, 2018,19(7):838-840+843
[26]刘晓丽,刘超能,王人卫,等.心肺功能在健康风险预测中的应用[J].中国运动医学杂志,2018,37(2):158-165.
[27]Pandey A, Patel M, Gao A, et al. Changes in mid-life fitness predicts heart failure risk at a later age independent of interval development of cardiac and noncardiac risk factors:The Cooper Center Longitudinal Study. Am Heart J. 2015;169(2):290-297.e1.
[28]DeFina LF, Radford NB, Leonard D, et al. The association of cardiorespiratory fitness, body mass index, and age with testosterone levels at screening of healthy men undergoing preventive medical examinations:The Cooper Center Longitudinal Study. Maturitas. 2018;118:1-6.
[29]石秀廷,尹小俭.20m往返跑用于青少年心肺耐力评价的研究进展[J].中国学校卫生,2017,38(12):1916-1920.
[30]Berntsen KS, Tollisen A, Schwartz T,et al.Submaximal Exercise Capacity in Juvenile Dermatomyositis after Longterm Disease:The Contribution of Muscle, Lung, and Heart Involvement. J Rheumatol. 2017;44(6):827-834.
[31]张茹斌.基于智能功率车的心肺耐力测试与训练方法研究[D].合肥:中国科学技术大学,2018
[32]荆志成.六分钟步行距离试验的临床应用[J].中华心血管病杂志,2006, 34(4):381-384.
[33]陈嵘,王健,杨红春.四种运动负荷试验评价运动心肺功能比较研究[J].中国运动医学杂志,2014,(9):917-920.
[34]郭辉,孙景权,张一民.心肺运动试验与6 min上下楼梯试验评价心肺功能的比较[J].中国组织工程研究,2016,20(2):292-296.
[35]Brouha L, Health CW, Graybiel A, Step test simple method of measuring physical fitness for hard muscular work in adult men.Rev Canadian Biol.1943;2:86.
[36]郭辉,孙景权,张一民.74例健康青年志愿者心肺运动试验、六分钟上下楼梯试验结果对比观察[J].山东医药,2016,56(23):52-54.
[37]Leone M, DuvergeS, KalinovaE, et al. Comtois Comparison of bioenergetics of walking during a multistage incremental shuttle walk test and a 6-min walk test in active older adults. Aging Clin Exp Res. 2017;29(2):239-246.
[38]张劭夫.六分钟行走试验:运动耐力评价的方法及临床意义[J].中国组织工程研究与临床康复,2011,15(5):894-897.
[39]闫金辉,张丽华.大学生体力劳动能力和最大摄氧量的关系[J].现代预防医学,2008,35(21):4191-4192.
[40]袁林,宋应华,刘心伟,等.不同体重人群爬楼梯过程中能量消耗的测定[J].中国体育科技, 2012, 48(3):104-107.
[41]刘建华,丸山仁司,胜平纯司.上下台阶方法的生物力学研究[J].中国康复理论与实践,2003,9(10):32-33.
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