Maximal Exercise Test Results in Subacute Stroke.

Abstract: Tang A, Sibley KM, Thomas SG, McIlroy WE, Brooks D. Maximal exercise test results in subacute stroke. Objectives: To establish the feasibility and reliability of graded maximal exercise testing, suitability of standard indexes of maximum oxygen consumption (V̇o ₂max), and evidence of trial-to-trial practice effects in subacute stroke. Design: Descriptive, cross-sectional study. Setting: Rehabilitation hospital. Participants: Consecutive sample of 35 participants (mean age, 65.7±2.6y; mean days poststroke, 17.6±2.2d). Interventions: Not applicable. Main Outcome Measures: Graded maximal exercise test using semirecumbent cycle ergometry. A subset (n=20) performed repeated tests to determine test-retest reliability and presence of practice effects. Results: Thirty-one (89%) participants completed the exercise test without symptomatic responses (mean peak level of oxygen consumed [Vo ₂peak], 10.7mL·kg⁻¹·min⁻¹; peak work rate, 39W). Twelve (34%), 15 (44%), and 3 (9%) participants achieved oxygen consumption per unit time (V̇o ₂) plateau, respiratory exchange ratio, and heart rate criteria, respectively. Although test-retest correlations were high (intraclass correlation coefficient range, .67–.87), higher Vo ₂peak (1.0mL·kg⁻¹·min⁻¹, P=.04) and work rate (7.3W, P=.01) were observed with repeated testing, with no associated increase in reaching standard criteria for V̇o ₂max. Conclusions: This work has important implications for developing guidelines for measuring aerobic capacity early after stroke. Although maximal exercise testing using semirecumbent cycle ergometry is feasible, standard V̇o ₂max criteria are not consistently appropriate. At least 1 practice trial is recommended before the actual evaluation is performed. [Copyright &y& Elsevier]