title: Exercise stress testing in subacute stroke patients using a combined upper- and lower-limb ergometer.
abstract: OBJECTIVE
  To assess functional cardiopulmonary exercise tolerance in a subset of patients with residual neurologic deficits after stroke by exercise stress testing using the Power Trainer, a combined upper- and lower-limb ergometer.
  
  
  METHODS
  Prospective, observational study using a convenience sample.
  
  
  METHODS
  Clinical locomotor laboratory in a tertiary rehabilitation hospital.
  
  
  METHODS
  Thirty subjects undergoing rehabilitation an average of 7.3 weeks after stroke.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Percentage of age-predicted maximal heart rate (APMHR) achieved and rate-pressure product (RPP).
  
  
  RESULTS
  Thirty subjects completed stress tests. Twelve of the 30 subjects were taking beta-blocker medications. Mean maximum heart rate +/- standard deviation achieved was 119+/-21 beats/min, equal to 75%+/-11% of APMHR. Ten subjects achieved 85% of APMHR or greater. Those not taking a beta-blocker attained 80%+/-10% of APMHR. The percentage increase in RPP from rest to maximal exercise for the whole group was 117%+/-44%. Four subjects developed cardiopulmonary signs or symptoms. Exercise prescriptions were provided to patients using the Karvonen formula. Overall subject satisfaction with the Power Trainer was high.
  
  
  CONCLUSIONS
  The Power Trainer can be used safely to assess cardiopulmonary exercise tolerance in a select subset of patients with neurologic impairments secondary to stroke. This information can be extrapolated for proper exercise prescription and may contribute to the investigation of coronary artery disease in this high-risk population.
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of Calgary, Calgary, AB.
authors.forename: Denise C
authors.initials: DC
authors.lastname: Hill
authors.forename: Karen D
authors.initials: KD
authors.lastname: Ethans
authors.forename: Don A
authors.initials: DA
authors.lastname: MacLeod
authors.forename: Edmund R
authors.initials: ER
authors.lastname: Harrison
authors.forename: Jane E
authors.initials: JE
authors.lastname: Matheson
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D016552:Ergometry / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010807:Physical Endurance / Q000502:physiology*; D005082:Physical Exertion / Q000502:physiology; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis*; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000502:physiology