Rollator Use Does Not Consistently Change the Metabolic Cost of Walking in People With Chronic Obstructive Pulmonary Disease

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• 作者：Kylie Hill ; PhD^a ; ^c ; ^d ; ^e ; Thomas E. Dolmage ; MSc^a ; ^b ; Lynda J. Woon ; BSc^a ; Dina Brooks ; PhD^a ; ^c ; ^{dina.brooks@utoronto.ca" class="auth_mail" title="E-mail the corresponding author} ; Roger S. Goldstein ; MD^a ; ^c
• 关键词：Lung diseases ; obstructive ; Mobility limitation ; Rehabilitation ; Walking
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2012
• 出版时间：June 2012
• 年：2012
• 卷：93
• 期：6
• 页码：1077-1080
• 全文大小：208 K

文摘

Hill K, Dolmage TE, Woon LJ, Brooks D, Goldstein RS. Rollator use does not consistently change the metabolic cost of walking in people with chronic obstructive pulmonary disease.

Objectives

To (1) evaluate whether the use of a rollator changed metabolic cost during a controlled walking task, and (2) explore relationships between the difference in dyspnea and metabolic cost associated with rollator use.

Design

Single-group interventional study in which patients completed 2 corridor walks: 1 without and 1 with a rollator, at the same individualized constant speed.

Setting

Rehabilitation hospital.

Participants

Patients with chronic obstructive pulmonary disease (N=15; 10 men; median age [interquartile range; IQR]=69 [12]y; forced expiratory volume in 1 second=42 [20]% predicted).

Intervention

Rollator use.

Main Outcome Measures

Oxygen uptake, converted to metabolic equivalent units (METs), and minute ventilation were measured throughout both tasks using a portable gas analysis system; dyspnea and arterial oxygen saturation (SpO₂) were collected on completion.

Results

Median [IQR] walk speed [IQR] was 48 (10)m/min. Walking with a rollator, compared with walking without, reduced dyspnea (median [IQR]=1.0 [1.5] vs 2.0 [2.0]; P=.01) without changing energy expenditure (median [IQR]=2.8 [1.2] vs 3.2 [0.9] METs; P=.65), minute ventilation (median [IQR]=30.3 [9.6] vs 27.7 [9.9]L/min; P=.50), or SpO₂ (median [IQR]=92 [8]% vs 94 [10]%; P=.41). The association between the reduction in dyspnea and any difference in energy expenditure related to rollator use was of borderline significance (r_s=.50; P=.06). Six of the 8 participants who experienced a reduction in dyspnea also demonstrated a reduction in the metabolic cost of walking.

Conclusions

The mechanism responsible for the amelioration in dyspnea during rollator-assisted walking is multifactorial. A reduction in the metabolic cost of walking may play a part in some, but not all, patients.