Modified total-body recumbent stepper exercise test for assessing peak oxygen consumption in people with chronic stroke

Abstract

Background: Assessment of peak oxygen consumption (Vo(2)peak) using traditional modes of testing such as treadmill or cycle ergometer can be difficult in individuals with stroke due to balance deficits, gait impairments, or decreased coordination.

Objective: The purpose of this study was to quantitatively assess the validity and feasibility of a modified exercise test using a total-body recumbent stepper (mTBRS-XT) in individuals after stroke.

Design: A within-subject design, with a sample of convenience, was used.

Participants: Eleven participants (7 male, 4 female) with a mean of 40.1 months (SD=32.7) after stroke, a mean age of 60.9 years (SD=12.0), and mild to severe lower-extremity Fugl-Myer test scores (range=13-34) completed the study.

Methods: Participants performed 2 maximal-effort graded exercise tests on separate days using the mTBRS-XT and a cycle ergometer exercise protocol to assess cardiorespiratory fitness. Measurements of Vo(2)peak and peak heart rate (peak HR) were obtained during both tests.

Results: A strong relationship existed between the mTBRS-XT and the cycle ergometer exercise test for Vo(2)peak and peak HR (r=.91 and .89, respectively). Mean Vo(2)peak was significantly higher for the mTBRS-XT (16.6 mL x kg(-1) x min(-1)[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mL x kg(-1) x min(-1) [SD=4.5]). All participants performed the mTBRS-XT. One individual with severe stroke was unable to pedal the cycle ergometer. No significant adverse events occurred.

Conclusion: The mTBRS-XT may be a safe, feasible, and valid exercise test to obtain measurements of Vo(2)peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on Vo(2)peak values for individuals with mild to severe deficits after stroke.

Figure 1.

Participant performing a maximal-effort exercise test using the Modified Total-Body Recumbent Stepper Exercise Test.

Figure 2.

Relationship between the Modified Total-Body Recumbent Stepper Exercise Test (mTBRS-XT) and the cycle ergometer exercise test for assessing peak oxygen uptake (V̇o₂peak) (mL×kg⁻¹×min⁻¹), expressed as a solid line. Dashed line represents identity line.