Author/Editor		Ščavničar, Ana; Grabljevec, Klemen; Erjavec, Tatjana; Vipavec, Branka; Vidmar, Gaj
Title		Aerobna zmogljivost oseb po hudi nezgodni možganski poškodbi
Translated title		Aerobic capacity of persons after severe traumatic brain injury
Type		članek
Vol. and No.		Letnik 14, št. 1
Publication year		2015
Volume		str. 19-25
ISSN		1580-9315 - Rehabilitacija
Language		slv
Abstract		Izhodišča: Osebe po nezgodni možganski poškodbi (NMP) imajo pogosto težave pri izvedbi telesnih dejavnosti. Poleg tega osebe po NMP pogosto navajajo povečano utrudljivost, ki bi tudi lahko vplivala na zmanjšano aerobno zmogljivost. Želeli smo oceniti aerobno zmogljivost oseb po hudi NMP in jih primerjati s skupino zdravih preiskovancev. Poleg tega smo želeli ugotoviti vpliv utrudljivosti na zmanjšano aerobno zmogljivost ter oceniti varnost obremenitve oseb po NMP po prilagojenem protokolu Balke - Ware. Metode: V študijo smo vključili 18 oseb, od tega 9 oseb po hudi NMP in 9 zdravih prostovoljcev. Pri preiskovancih po hudi NMP smo utrudljivost ocenili z lestvico izražene utrudljivosti (angl. Fatigability severity scale, v nadaljevanju FSS). Preiskovance smo po priporočenih merilih za maksimalni test obremenili na tekočem traku po prilagojenem protokolu Balke - Ware (osem stopenj, pri čemer je hitrost traku stalna (5,3 km/h), naklon pa zlagoma narašča za 2% vsaki 2 minuti do končnih 1% naklona). Med obremenitvijo smo osebe spremljali z elektrokardiogramom (EKG), merili srčno frekvenco (p), porabo kisika (VO2), ekspiracijski volumen (VE) in dihalni količnik izmenjave plinov (RER). Iz rezultatov smo izračunali kisikov pulz (O2/p), ventilatorni ekvivalent za kisik (VE/VO2) in ventilatorni ekvivalent za ogljikov dioksid (VE/CO2). Rezultati: Vsi preiskovanci so na FSS dosegli več kot 36 točk, med testiranjem pa so zmogli doseči sedmo ali osmo stopnjo obremenitve. Med testiranjem niso navajali težav, traku ni bilo potrebno ustavljati zaradi ogrožene varnosti preiskovancev. Zdravstvenih zapletov med testiranjem nismo opazili. V testni skupini so preiskovanci testiranje končali s povprečno 83% frekvence srca, predvidene za starost, povprečnim RER 1,1 ter povprečno VO2 30,4 ml/kg/min. V kontrolni skupini so preiskovanci testiranje končali s povprečno 89% frekvence srca, predvidene za starost, povprečnim RER 1,0 ter povprečno VO2 33,3 ml/kg/min. Med skupinama nismo ugotovili statistično pomembnih razlik. Zaključki: Naši preiskovanci po NMP so kljub navajanju utrudljivosti telesno dobro zmogljivi. Prilagojeni protokol Balke - Ware je varna metoda testiranja aerobne zmogljivosti oseb po nezgodni možganski poškodbi.Background After traumatic brain injury (TBI), people often show low tolerance to sustained physical activity. The degree of aerobic capacity limitation in recovering TBI patients is not well documented. Additionally, people with TBI often report fatigability, which could also have an impact on reduced aerobic capacity. The aim of our study was to compare the aerobic capacity of subjects after TBI with the aerobic capacity of healthy individuals, to determine the influence of fatigue on reduced aerobic capacity and to evaluate the suitability of the modified Balke-Ware protocol for testing persons after TBI. Subjects and methods We included 18 participants, 9 patients after severe traumatic brain injury and 9 healthy volunteers (matched by sex and age). Patients after TBI were evaluated with the Fatigue Severity Scale (FSS) prior to testing. The participants were tested on a treadmill. We followed the criteria advised for maximal testing. The test was conducted according to a modified Balke-Ware protocol. The protocol consists of 8 levels: during testing the treadmill speed remains constant (5.3 km/h) and the slope gradually increases by 2% every 2 minutes until it reaches 14% at the eight level. During the test, ECG, heart rate (HR), oxygen consumption (VO2), minute ventilation (VE), and the respiratory exchange ratio (RER) were continuously observed and measured. Based on the data collected, oxygen pulse (O2/p) and the ventilatory equivalents for oxygen (VE/VO2) and carbon dioxide (VE/CO2) were calculated. Results All the participants achieved more than 36 points on the FSS. All the participants except one reached one of the final two exercise test levels. There were no complaints during the testing. We did not observe any safety risks or medical problems. The participants in the test group completed the test with a heart rate averaging 83% of the age-predicted heart rate, an average RER of 1.1 and an average VO2 of 30.4 ml/kg/min. The healthy volunteers completed the test with a heart rate averaging 89% of the age-predicted heart rate, an average RER of 1.0 and an average VO2 of 33.3 ml/kg/min. No statistically significant differences between the two groups were found. Conclusions Reduced aerobic capacity is not linked to the fatigability reported after traumatic brain injury. The modified Balke- Ware protocol is a safe method for testing the aerobic capacity of persons after traumatic brain injury.
Descriptors		Brain Injuries
Keywords		traumatic brain injury aerobic capacity fatigability nezgodna možganska poškodba aerobna zmogljivost utrudljivost