成人脑瘫患者6分钟步行试验步行距离的影响因素

关键词：脑瘫  6分钟步行试验  步行功能  影响因素

Keywords:cerebral palsy  six-minute walking test  walking function  influential factor

摘要：

      摘要 目的：探究在成人脑瘫患者中不同生理因素及粗大运动功能对6min步行试验步行距离（6MWD）的影响。 方法：将符合脑瘫诊断标准的55例患者纳入研究，分别测定身高（height）、体重（weight）、静息状态下的心率（RHR）和血压（BP），并使用粗大运动功能测定量表（GMFM）评定患者粗大运动功能总分（GMFM总），以及D和E功能区的分数（分别记为GMFM-D、GMFM-E），然后进行6min步行试验（6MWT），测定患者步行试验过程中的摄氧量（VO2总）、心率（HR步）以及6MWD，并计算出步行5m的速度（speed 5m）、每公斤体重摄氧量（VO2/kg）和步行每米摄氧量（VO2/m）。 结果：成人脑瘫患者6MWD相关的因素主要包括RHR（r=-0.531, P＜0.05），VO2/m（r=-0.542, P＜0.05），VO2/kg（r=0.682, P＜0.001）、GMFM总（r=0.614, P＜0.01）、GMFM-D（r=0.538, P＜0.05）、GMFM-E（r=0.679, P＜0.001）和speed 5m（r=0.680, P＜0.001），其中GMFM-E（r=0.679, P＜0.001）、VO2/kg（r=0.682, P＜0.001）和speed 5m（r=0.680, P＜0.001）对6MWD具有显著影响，而height（r=0.01, P=0.81）、6MWT的HR（r=0.04, P=0.68）及BP（r=0.16, P=0.50）与6MWD结果无显著关联。 结论：步行相关的粗大运动功能以及步行过程中有氧代谢水平是影响成人脑瘫患6MWD的主要因素。

Abstract:

      Abstract Objective: To investigate the effects of selected physiologic factor and gross motor function measures(GMFM) on 6minute walking distance (6MWD) in adults with cerebral palsy（CP）. Method: Fifty-five adults with CP were included in research. Height, weight, heart rate (HR), blood pressure(BP) and oxygen consumption (VO2) at rest, GMFM, and the walking speed over 5m were measured. The VO2 and HR during the 6MWT parameters were also evaluated. The level of association between 6MWD and each of the independent variables were examined with Pearson's correlation coefficients. Result: The variables correlated to 6MWD were resting HR(RHR) (r=-0.531, P＜0.05), VO2 per meter(VO2/m) walked (r=-0.542, P＜0.05), VO2 per kg body mass(VO2/kg)(r=0.682, P＜0.001), the GMFM total score (r=0.614, P＜0.01), the GMFM-D score (r=0.538, P＜0.05), the GMFM-E score (r=0.679, P＜0.001), and walking speed over 5m(speed 5m)(r=0.680, P＜0.001). The research showed that the GMFM-E score (r=0.679, P＜0.001), VO2/kg(r=0.682, P＜0.001), and the speed 5m(r=0.680, P＜0.001) could used to explain most of the variance in the 6MWD, however 6MWD was not correlated with height (r=0.01, P=0.81), HR of 6MWT (r=0.04, P=0.68) and BP(r=0.16, P=0.50). Conclusion: For adults with CP, the gross motor function skills associated with walking and aerobic capacity during the 6min walking test are the main factors which affect the 6MWD.