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Editorial
. 2021 Spring;73(2):110-117.
doi: 10.3138/ptc-2019-0070.

Cardiopulmonary Exercise Testing in Stroke Rehabilitation: Benefits and Clinical Utility Perceived by Physiotherapists and Individuals with Stroke

Allison Sharpe  1 , Valerie Boyes  1 , Calvin Lee  1 , Christopher Murtha  1 , Justin Mah  1 , Karen Yoshida  1 , Susan Marzolini  1   2   3 , Elizabeth L Inness  1   4   3
Affiliations
Editorial

Cardiopulmonary Exercise Testing in Stroke Rehabilitation: Benefits and Clinical Utility Perceived by Physiotherapists and Individuals with Stroke

Allison Sharpe et al. Physiother Can. 2021 Spring.

Abstract
in English, French

Purpose: The purpose of this study was to understand the perceived benefits and clinical utility of cardiopulmonary exercise testing (CPET) from the perspectives of physiotherapists and patients and to explore the factors that influence adopting CPET in a stroke rehabilitation setting. Method: A qualitative descriptive study was conducted. Physiotherapists (n = 6) participated in a focus group to discuss the use of CPET in practice. Patients (n = 8) who had completed CPET during stroke rehabilitation participated in a semi-structured interview to explore their experiences. Thematic analysis was performed. Results: CPET increased the physiotherapists' confidence in prescribing exercise, especially for medically complex patients. Ongoing medical management early post-stroke was a barrier to referral. Physiotherapists expressed decreased confidence in interpreting test results. Consultation with local experts facilitated the use of CPET. Patients described how CPET increased their confidence to participate in exercise. They desired more information before and after CPET to better understand the purpose and results and their relation to their rehabilitation goals. Conclusions: Both physiotherapists and patients described the benefit of having CPET available to support them as they participated in exercise in a stroke rehabilitation setting. Physiotherapists would benefit from having educational tools to support their interpretation and application of test results, and patients would benefit from improved communication and education to support their understanding of the relevance of CPET to their rehabilitation goals. Future research should explore these findings in other stroke rehabilitation settings.

Objectif : comprendre les avantages perçus et l’utilité clinique de l’épreuve d’effort cardiorespiratoire (ÉECR) du point de vue des physiothérapeutes et des patients et explorer les facteurs qui influent sur l’adoption de l’ÉECR dans un milieu de réadaptation après un accident vasculaire cérébral (AVC). Méthodologie : étude descriptive qualitative. Les physiothérapeutes (n = 6) ont participé à un groupe de travail pour discuter de l’utilisation de l’ÉECR dans la pratique. Les patients (n = 8) qui ont effectué une ÉECR pendant la réadaptation après un AVC ont participé à une entrevue semi-structurée pour explorer leurs expériences. Une analyse thématique a suivi. Résultats : l’ÉECR donne confiance aux physiothérapeutes qui prescrivent de l’exercice, particulièrement pour les patients qui éprouvent des problèmes de santé complexes. La prise en charge médicale continue peu après un AVC était un obstacle à une demande de consultation. Les physiothérapeutes exprimaient leur manque de confiance à interpréter les résultats de l’ÉECR. La consultation d’experts locaux les incitait à utiliser l’ÉECR. Les patients ont expliqué que l’ÉECR leur donnait confiance à participer aux exercices. Ils souhaitaient recevoir plus d’information avant et après l’ÉECR, afin de mieux comprendre la raison d’être, les résultats et leur lien avec les objectifs de réadaptation. Conclusion : les physiothérapeutes et les patients ont décrit les avantages de disposer de l’ÉECR pour les aider dans le cadre des exercices effectués en réadaptation après un AVC. Les physiothérapeutes profiteraient d’outils de formation pour les aider à interpréter et appliquer les résultats, et les patients profiteraient de meilleures communications et d’une meilleure éducation pour mieux comprendre la pertinence de l’ÉECR dans l’atteinte de leurs objectifs de réadaptation. Les prochaines recherches devraient explorer ces résultats dans d’autres milieux de réadaptation après un AVC.

Keywords: exercise; focus groups; interview; stroke.

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Figures

Figure 1
Figure 1
Summary of physiotherapist and patient perspectives of in stroke rehabilitation.
See this image and copyright information in PMC

References

    1. Billinger SA, Arena R, Bernhardt J, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association. Stroke. 2014;45(8):2532–53. 10.1161/str.0000000000000022. Medline:24846875 - DOI - PubMed
    1. Billinger SA, Coughenour E, MacKay-Lyons MJ, et al. Reduced cardiorespiratory fitness after stroke: biological consequences and exercise-induced adaptations. Stroke Res Treat. 2012:1–11. 10.1155/2012/959120. Medline:21876848 - DOI - PMC - PubMed
    1. Ploughman M, Kelly LP. Four birds with one stone? Reparative, neuroplastic, cardiorespiratory, and metabolic benefits of aerobic exercise poststroke. Curr Opin Neurol. 2016;29(6):684–92. 10.1097/wco.0000000000000383. Medline:27661010 - DOI - PubMed
    1. Stoller O, de Bruin ED, Knols RH, et al. Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis. BMC Neurol. 2012;12(1):45. 10.1186/1471-2377-12-45. Medline:22727172 - DOI - PMC - PubMed
    1. Mackay-Lyons M, Macko R, Eng J, et al. AEROBICS 2019 update: aerobic exercise recommendations to optimize best practices in care after stroke. 2019. [cited 24 May 2019]. Available from: 10.1093/ptj/pzz153. - DOI - PMC - PubMed

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