Physiological response to the Glittre-ADL test in elderly COPD patients

Abstract Introduction: The Glittre-ADL (TGlittre) test was developed to assess functional capacity in a group of activities of daily living, but little is known about the physiological responses expected during its implementation. Objective: To evaluate the physiological responses induced by TGlittre in COPD patients and compare them with those induced by the 6-minute walk test (6MWT). Method: This is a cross-sectional study involving 15 elderly patients with COPD (70±6 years and predicted FEV1 of 47±16%). The TGlittre and 6MWT were performed on two different days, evaluating heart rate, peripheral oxygen saturation and perceived exertion in the 1st, 4th and 6th minutes of the 6MWT and at the start, after each lap and the end of TGlittre. After the normality test (Shapiro-Wilk), the Wilcoxon test was applied to compare the functional tests, and Spearman’s correlation coefficient to assess the association between variables. Results: At the end of TGlittre, heart rate was faster than in the 6MWT (106.7±21.9 vs 96.4±16.2bpm, p = 0.02). The other physiological variables were similar at the end of both tests. Heart rate at the end of TGlittre correlated with the final heart rate in the 6MWT (r = 0.69; p = 0.002). Conclusion: TGlittre induced a faster heart rate than in the 6MWT, with increased metabolic demand, but with similar ventilatory responses.

摘要：Glittre-ADL（TGlittre）测试旨在评估日常生活活动中的功能能力，但目前对其实施过程中预期的生理反应尚缺乏了解。研究目的：评估TGlittre测试对慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease, COPD）患者诱导的生理反应，并与6分钟步行试验（6-minute walk test, 6MWT）的结果进行对比。研究方法：本研究为横断面研究，纳入15名老年慢性阻塞性肺疾病患者（年龄70±6岁，预计第1秒用力呼气容积（forced expiratory volume in one second, FEV1）为47±16%）。研究对象于两天内分别完成TGlittre测试与6MWT，在6MWT的第1、4、6分钟时评估心率、外周血氧饱和度以及自觉劳累程度；在TGlittre测试开始时、每完成一圈后以及测试结束时采集上述指标。经夏皮罗-威尔克（Shapiro-Wilk）正态性检验后，采用威尔科克森（Wilcoxon）符号秩检验比较两项功能测试结果，采用斯皮尔曼（Spearman）相关系数分析变量间的关联。研究结果：TGlittre测试结束时，受试者心率快于6MWT结束时（106.7±21.9 vs 96.4±16.2次/分钟，p=0.02）。两项测试结束时的其余生理指标均无显著差异。TGlittre测试结束时的心率与6MWT结束时的心率呈显著正相关（r=0.69；p=0.002）。研究结论：TGlittre测试可诱导受试者产生较6MWT更快的心率，提示代谢需求升高，但二者的通气反应相似。