Document Detail


Reproducibility of maximal and submaximal exercise testing in "normal ambulatory" and "community ambulatory" children and adolescents with spina bifida: which is best for the evaluation and application of exercise training?
MedLine Citation:
PMID:  21212378     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
METHODS: /b> Twenty-three children and adolescents with spina bifida (10 normal ambulatory and 13 community ambulatory) participated in the study. Maximal exercise outcomes were measured using a graded treadmill test. Peak measures (peak oxygen uptake [Vo(2)peak], peak heart rate [HRpeak], heart rate response [HRR], and oxygen pulse) were recorded. For submaximal measures, heart rate (HR) and oxygen uptake (Vo(2)) at the ventilatory threshold and oxygen uptake efficiency slope (OUES) were derived from the maximal measures. Functional performance was measured as the 6-minute walking distance and the maximal speed during the treadmill test. After checking for normality and heteroscedasticity, paired t tests, intraclass correlation coefficients (ICCs), and the smallest detectable difference (SDD) or the coefficient of variation (CV) were calculated.
RESULTS: /b> Performance measures showed good reliability and agreement. For maximal measures, acceptable ICCs were found for all measures. For submaximal measures, only HR at the ventilatory threshold showed an ICC of less than .80. Agreement showed a CV of less than 10% for all measures, except for Vo(2) at the ventilatory threshold, HRR, and OUES. Limitations Limitations of the study include missing data due to equipment failure. Furthermore, the outcomes were limited to normal ambulatory and community ambulatory children and adolescents with spina bifida.
CONCLUSIONS: /b> Both maximal and submaximal measures of exercise testing can be used for discriminative purposes in ambulatory children and adolescents with spina bifida. For evaluative purposes, HR measures are superior to Vo(2) measures, while taking into account the individual variation of 5% to 8%. The SDD was 0.5 km/h for peak speed and 36.3 m for 6-minute walking distance. Heart rate response, oxygen pulse, and OUES are not recommended in the evaluation of exercise testing in this population.
Authors:
Janke Frederike de Groot; Tim Takken; Rob H J M Gooskens; Marja A G C Schoenmakers; Manon Wubbels; Luc Vanhees; Paul J M Helders
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Publication Detail:
Type:  Journal Article     Date:  2011-01-06
Journal Detail:
Title:  Physical therapy     Volume:  91     ISSN:  1538-6724     ISO Abbreviation:  Phys Ther     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  267-76     Citation Subset:  AIM; IM    
Affiliation:
Research Group Lifestyle and Health, University of Applied Sciences, Utrecht, the Netherlands, and Department of Pediatric Physical Therapy and Exercise Physiology, Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Room kb.02.056.0. PO Box 85090, 3508 AB Utrecht, the Netherlands.
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