Šestminutni test hoje pri stabilnih srčnih bolnikih : magistrsko delo

Novak, Ana (avtor), Karpljuk, Damir (mentor), Dervišević, Edvin (komentor)

Vseživljenjska rehabilitacija koronarnih bolnikov je v Sloveniji organizirana preko koronarnih klubov in društev. 6-minutni test hoje (6MTH) se enotno in pogosto uporablja v koronarnih klubih z namenom ocenjevanja kardiorespiratorne zmogljivosti pri včlanjenih bolnikih, saj prehojena razdalja 6-minutnega testa (6MTHR) napoveduje kardiovaskularne dogodke pri bolnikih s stabilno koronarno boleznijo srca. Cilj naše raziskave je bil oceniti vpliv spola, starosti in telesne mase ter nekaterih drugih dejavnikov na prehojeno razdaljo 6-minutnega testa hoje (6MTHR) pri koronarnih bolnikih. Testiranje je potekalo v štirih enotah Koronarnega kluba Ljubljana, v študiji pa je sodelovalo 95 bolnikov (33 moških in 62 žensk), starih 74,5 ± 7,9 let. 6MTH smo izvajali po standardiziranem protokolu. Pri prehojeni 6-minutni razdalji ni bilo statistično značilne razlike (F = 0,98; p = 0,755) med moškimi (498 m) in ženskami (492 m). Predvidena 6MTHR (441 m za moške in 434 m za ženske) se je statistično značilno razlikovala (p < 0,001) od izmerjenih 6MTHR (498 m za moške in 492 m za ženske), kar kaže, da bi bila lahko telesna zmogljivost bolnikov s stabilno koronarno boleznijo z uporabo napovednih formul podcenjena, zato je potrebno redno – letno ali dvakrat letno – testiranje. Ker se referenčne vrednosti za 6MTHR poročajo v 5-letnih starostnih intervalih, smo v naši študiji uporabili enak pristop in pokazali, da obstaja velika razlika v 6MTHR med različnimi starostnimi skupinami (F = 10,178; p < 0,001) – najbolj očitne razlike so na desetletnem starostnem intervalu (npr. 60–69 so boljši od 70–79-letnikov). V našem vzorcu starost bolnika pojasnjuje 41 % (p < 0,001) 6MTHR, 6MTHR pa se lahko izračuna kot 1041 m – 7,33 x starost. Učinek telesne teže je bil opazen le preko razmerja med pasom in višino (WHtR; p = 0,005), ni pa bil značilen za indeks telesne mase (p = 0,559). Bolniki z normalno WHtR so imeli statistično daljšo 6MTHR (521 m) kot bolniki z nenormalnim WHtR (469 m). Naši rezultati poudarjajo pomen rednega testiranja bolnikov s stabilno koronarno boleznijo, da bi dobili njihove dejanske ravni telesne zmogljivosti, potrebne za predpisovanje primerne intenzivnosti. Raziskava je pokazala tudi na pomemben vpliv starosti in telesne teže na 6MTHR, kar je potrebno upoštevati pri načrtovanju in izvajanju vadbe.

• Jezik: Slovenski jezik
• Ključne besede: 6-minutni test hoje, kardiorespiratorna zmogljivost, srčno-žilne bolezni, koronarna bolezen, koronarni klub
• Vrsta gradiva: Magistrsko delo/naloga
• Tipologija: 2.09 - Magistrsko delo
• Organizacija: FŠ - Fakulteta za šport
• Leto izida: 2018
• PID: 20.500.12556/RUL-103975
• COBISS.SI-ID: 5426865
• Datum objave v RUL: 30.09.2018

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: SIX MINUTE WALK DISTANCE IN PATIENTS WITH STABLE CORONARY HEART DISEASE

Izvleček

Life-long outpatient rehabilitation of coronary patients in Slovenia is organized through coronary clubs. The 6-minute walk test (6MWT) is a common outcome measurement used in those clubs to evaluate the cardio-respiratory fitness of patients, as distance walked on the test (6MWD) predicts cardiovascular events in patients with stable coronary heart disease (CHD). The aim of our study was to evaluate the influence of gender, age and weight on the 6MWD in coronary patients. Testing was performed in 4 clubs in Ljubljana region and 95 patients (33 males and 62 females), age 74.5 ± 7.9, participated in the study. 6MWT was performed according to standardized protocol. There was no significant difference (F = 0,98; p = 0,755) in 6MWD among males (498 m) and females (492 m). The predicted 6MWD (441 m and 434 m for males and females, respectively) differed significantly (p < 0,001) from measured 6MWD (498 m and 492 m for males and females, respectively). This clearly highlights that physical ability of patients with stable CHD may be underestimated using prediction formulas, hence there is a need for regular annual/biannual testing. Furthermore, as reference values for 6MWD are reported for 5-years intervals we have used same approach in our study, and we have shown that there is a significant difference in 6MWD among different age groups (F = 10,178; p < 0,001), where most prominent differences are rather on a 10-years interval (eg. 60–69y are better than 70–79y). The age of patient explains 41 % (p < 0,001) of the 6MWD in our sample and 6MWD can be calculated as 1041 m – 7.33 x age. Finally, the influence of weight was noticed only through waist to height (WHtR; p = 0,005) ratio rather than among different body mass index grades (p = 0,559). The patients with normal WHtR had statistically bigger 6MWD (521 m) than patients with abnormal WHtR (469 m). Our results are stressing the importance of regular fitness testing in patients with stable CHD to obtain their actual fitness levels needed to prescribe exercise of proper intensity. Furthermore, there is important influence of age and weight on 6MWD that should also be accounted for in exercise prescription.

• Ključne besede: Six-minute walk test (6-minute walk test), cardiorespiratory fitness, heart disease, coronary heart disease, coronary club