Merske lastnosti 6-minutnega testa hoje, meritev srčne frekvence in Borgove lestvice ter povezanost s testi pljučnih funkcij pri pacientih po možganski kapi : magistrsko delo

Žnidar, Tina (author), Puh, Urška (mentor), Žen Jurančič, Marijana (comentor), Kacin, Alan (reviewer)

Uvod: Klinične smernice za fizioterapijo odraslih nevroloških pacientov za ocenjevanje prehojene razdalje priporočajo 6-minutni test hoje. Primarni izid je prehojena razdalja v šestih minutah, smiselno pa je spremljati tudi nasičenost krvi s kisikom, srčno frekvenco ter občutenje napora po Borgovi lestvici. Namen: Namen magistrske naloge je bil ugotoviti zanesljivost 6-minutnega testa hoje in hkratnega merjenja srčne frekvence ter ocenjevanja z Borgovo lestvico. Izračunali smo tudi minimalno klinično pomembno razliko in minimalno zaznavno spremembo prehojene razdalje pri 6-minutnem testu hoje. Ugotavljali smo še povezanost prehojene razdalje pri tem testu s testi pljučnih funkcij. Metode dela: V raziskavi je sodelovalo 30 preiskovancev po možganski kapi, starih od 22 do 78 let, od 3 do 26,7 tednov po možganski kapi. Na začetku in na koncu rehabilitacije smo izvedli 6-minutni test hoje, obremenitveno testiranje s cikloergometrom in spirometrijo. Med 6-minutnim testom hoje smo z merilcem srčnega utripa beležili srčno frekvenco, občuteni napor pa s 15- stopenjsko Borgovo lestvico. Med obremenitvenim testiranjem smo srčno frekvenco spremljali preko EKG, občuteni napor pa so preiskovanci ocenili tudi po koncu cikloergometrije. Rezultati: Zanesljivost med preiskovalci pri 6-minutnem testu hoje je bila odlična (ICC = 0,97). Minimalna klinična pomembna razlika pri 6-minutnem testu hoje je bila 60,2 m, minimalna zaznavna sprememba pa 60,9 m ob sprejemu in 54,3 m ob odpustu. Zanesljivost merjenja srčne frekvence med 6-minutnim testom hoje je bila zmerna (ICC = 0,59), prav tako zanesljivost ocenjevanja po Borgovi lestvici (ICC = 0,44). Povezanost prehojene razdalje pri 6-minutnem testu hoje in ^˙^2maks pri obremenitvenim testiranjem je bila zmerna (r = 0,44). Povezanosti prehojene razdalje pri 6-minutnem testu hoje z Borgovo lestvico ni bilo, povezanost s forsiranim ekspiratornim volumnom v prvi sekundi pa je bila zmerna ob sprejemu (r = 0,46), ob odpustu je ni bilo. Zaključek: Ugotovitve naše raziskave so skladne s predhodnimi, v katerih so prav tako ugotovili visoko zanesljivost med preiskovalci pri 6-minutnem testu hoje. Nadaljnje raziskovanje bi morali usmeriti v razjasnitev razlogov za zmerno zanesljivost merjenja srčne frekvence in Borgove lestvice ter razjasnitev veljavnosti 6-minutnega testa hoje.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, 6-minutni test hoje, obremenitveno testiranje, srčna frekvenca, Borgova lestvica, pljučna funkcija
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [T. Žnidar]
• Year: 2022
• Number of pages: 52 str., [3] str. pril.
• PID: 20.500.12556/RUL-142675
• UDC: 615.8
• COBISS.SI-ID: 130190595
• Publication date in RUL: 19.11.2022

Secondary language

• Language: English
• Title: Metric properties of 6-minute walk test, measuring heart rate and rating of percieved scale - Borg scale and impact of respiratory function in patients after stroke : master thesis

Abstract

Introduction: Neurophysiotherapy clinical guidelines recommend the 6-minute walk test for assessing walking distance. The primary outcome is the distance walked in 6 minutes, but it is also reasonable to monitor blood oxygen saturation, heart rate and the subjective dyspnea using the Borg scale. Purpose: The purpose of the master's thesis was to determine the reliability of the 6-minute walk test and the measurement of heart rate and evaluation of percieved exertion with the Borg scale. We also calculated the minimal clinically important difference and the minimal detectable change in distance walked in the 6-minute walk test. We also determined the correlation of the distance walked in this test with lung function tests. Methods: 30 stroke subjects aged 22 to 78 years, 3 to 26.7 weeks after stroke participated in the study. At the beginning and at the end of the rehabilitation, we assessed a 6-minute walking test, exercise test with a cycle ergometer and spirometry. During the 6- minute walk test, heart rate was recorded with a heart rate monitor (Polar RS800CX), and perceived exertion was assessed with a 15-point Borg scale. During the exercise test, the heart rate was monitored via ECG, and the subjects also assessed the perceived effort in the end of the cycle ergometry. Results: Inter-rater reliability of the 6-minute walk test was excellent (ICC = 0.97). The minimum clinically important difference of the 6-minute walk test was 60.2 m and the minimum detectable change was 60.9 m at admission and 54.3 m at discharge. The reliability of the heart rate measurement during the 6-minute walk test was moderate (ICC = 0.59), as was the reliability of the Borg scale assessment (ICC = 0.44). The correlation between distance walked in the 6-minute walk test and V ̇O2max in exercise test was moderate (r = 0.44). There was no correlation between the distance walked in the 6- minute walk test and the Borg scale, and the correlation with forced expiratory volume in the first second was moderate at admission (r = 0.46) and absent at discharge. Conclusion: The findings of our study are consistent with previous studies, which also found high interrater reliability of the 6-minute walk test. Further research should be directed at elucidating the reasons for the moderate reliability of heart rate and the Borg scale and clarifying the validity of the 6-minute walk test.

• Keywords: master's theses, physiotherapy, 6-minute walk test, exercise test, heart rate, Borg scale, pulmonary function