六分鐘行走測試應用於慢性阻塞性肺病患者運動耐力評估

The 6-minute Walk Test to Assess Exercise Capacity of Patients with Chronic Obstructive Pulmonary Disease

黃良慧(Liang-Hui Huang) ； 李靜怡(Chun-Yi Lee) ； 蔣立琦(Li-Chi Chiang) ； 陳玉如(Yu-Ju Chen)

《源遠護理》 9卷3期 (2015/09) Pp. 63-71

https://doi.org/10.6530/YYN/2015.4.05

摘要

六分鐘行走測試（6-minute walking test）於臨床上運用，已被證明為有效及可靠的評估心、肺等疾病病人運動耐力之方法。同時，臨床上重複測量六分鐘行走測試之變化，可做為監測病人疾病嚴重度，及判斷介入措施後改變之成效。因此，為使六分鐘行走測試成為評估運動耐力與介入措施成效的客觀指標，其量化數值的界定為目前各科專家所努力研究的方向。但直至目前為止，六分鐘行走測試於各專科用的臨床最小重要差異值（minimal clinicallyimportant difference, MCID），仍存在爭議。因有鑑於六分鐘行走測試對於慢性阻塞性肺病病人臨床使用的重要，故本文將近年來所發表實證文獻，做綜整性的討論。冀望此探討結果，得以提供臨床醫護人員或研究者進行以六分鐘行走測試作為疾病嚴重度及介入成效評值的參考依據。

關鍵字

最小臨床重要差異值 ； 運動耐力 ； 六分鐘行走測試 ； 慢性阻塞性肺病

並列摘要

This article critically reviews evidence based on the value of 6MWT and it’s MCID used in patients diagnosed with chronic obstructive pulmonary disease (COPD). Measurements of the 6MWT can be used to detect clinical relevant disease progression and the effectiveness of interventions. Health care experts recommended the 6MWT as an objective tool and worthy of investment to examine its cut-point value for clinical guidance. However, the minimal clinically important difference (MCID) of 6MWT used to monitor the disease progression or to evaluate the outcomes is still under discussion. The goal is to provide recommendations on clinical application and research for the use of 6MWT in patients with COPD to monitor disease progression and effectiveness of interventions. The 6-minute walk test (6MWT) is considered to be a valid and reliable assessment tool for exercise tolerance in patients with cardiac or pulmonary diseases.

並列關鍵字

minimal clinically important difference ； exercise tolerance ； 6-minute walk test ； chronic obstructive pulmonary disease

參考文獻

Andersson, M., Moberg, L., Svantesson, U., Sundbom, A., Johansson, H., & Emtner, M. (2011). Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test. Primary Care Respiratory Journal, 20(4), 434-440. doi: 10.4104/pcrj.2011.00082

American Thoracic Society statement: guidelines for the six-minute walk test. American Journal of Respiratory and Critical Care Medicine, 166(1), 111-117. doi:10.1164/ajrccm.166.1.at1102

Casanova, C., Cote, C., Marin, J. M., Pinto-Plata, V., de Torres, J. P., Aguirre-Jaime, A., ... Celli, B. R. (2008). Distance and oxygen desaturation during the 6-min walk test as predictors of longterm mortality in patients with COPD. Chest, 134(4), 746-752. doi:10.1378/chest.08-0520

Casanova, C., Cote, C. G., Marin, J. M., de Torres, J. P., Aguirre-Jaime, A., Mendez, R., ... Celli, B. R. (2007). The 6-min walking distance: Longterm follow up in patients with COPD. European Respiratory Journal, 29(3), 535-540. doi: 10.1183/09031936.00071506

Celli, B. R., Cote, C. G., Marin, J. M., Casanova, C., Montes de Oca, M., Mendez, R. A., ... Cabral, H. J. (2004). The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. The New England Journal of Medicine, 350(10), 1005-1012. doi:10.1056/NEJMoa021322