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Modified Total-Body Recumbent Stepper Exercise Test for Assessing Peak Oxygen Consumption in People With Chronic Stroke

SA Billinger, PT, MSPT, FAHA, is a PhD candidate and Clinical Instructor, Metabolic, Strength, and Energy Lab, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 2002; Kansas City, KS 66160 (USA)
BY Tseng, MS, is a PhD candidate and Graduate Research Assistant, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center
PM Kluding, PT, PhD, is Assistant Professor, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center

Address all correspondence to Ms Billinger at: sbillinger{at}kumc.edu

Background: Assessment of peak oxygen consumption (O₂peak) 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 O₂peak 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 O₂peak and peak HR (r=.91 and .89, respectively). Mean O₂peak was significantly higher for the mTBRS-XT (16.6 mLxkg^–1xmin^–1[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mLxkg^–1xmin^–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 O₂peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on O₂peak values for individuals with mild to severe deficits after stroke.

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