title: Exercise stress testing after stroke or transient ischemic attack: a scoping review.
abstract: OBJECTIVE
  To provide insight into exercise stress testing after stroke or transient ischemic attack (TIA) in terms of feasibility, safety, and protocols used.
  
  
  METHODS
  PubMed, Embase, CINAHL, and Web of Science were searched for relevant studies published from inception to March 2014, and reference lists were hand searched.
  
  
  METHODS
  To be included in the review, the articles needed to include participants diagnosed with stroke or TIA and have any form of test to assess exercise capacity.
  
  
  METHODS
  The scoping review methodology does not include critical appraisal of the literature but was chosen to reflect all aspects of exercise stress testing after stroke or TIA. Two reviewers performed screening for eligible studies independently, and 1 reviewer extracted the data.
  
  
  RESULTS
  We found a total of 112 studies involving 5008 participants describing symptom-limited (n=103), submaximal (n=9), and field (n=6) exercise stress test protocols. Some of the studies reported on data from >1 protocol. Metabolic analysis was included in 87% of the studies involving symptom-limited tests, 40% of submaximal studies, and 29% of field tests. Monitoring of blood pressure, perceived exertion, and electrocardiographic responses was done in 54%, 42%, and 95% of all studies, respectively. A mere 10% of all studies reported on electrocardiographic abnormalities detected during testing. No serious adverse events were reported.
  
  
  CONCLUSIONS
  Symptom-limited exercise stress testing appears to be safe in patients with stroke or TIA and provides a more valid measure of exercise capacity than submaximal and field tests. The level of disability may compromise feasibility, and test modality should be chosen carefully to optimize test results.
authors: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden. Electronic address: johan.gaverth@karolinska.se.
authors: Johan
authors: J
authors: Gäverth
authors: W.K. Kellogg Health Sciences Library, Dalhousie University, Halifax, NS, Canada.
authors: Robin
authors: R
authors: Parker
authors: Faculty of Health Professions, School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.
authors: Marilyn
authors: M
authors: MacKay-Lyons
mesh_terms: D000367:Age Factors; D004185:Disability Evaluation; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000503:physiopathology / Q000534:rehabilitation*; D061214:Patient Safety; D012737:Sex Factors; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors
keywords: Exercise test; Ischemic attack, transient; Rehabilitation; Stroke