title: "Graded Cycling Test with Talk Test" Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke.
abstract: BACKGROUND
  Physical exercise is generally recommended as part of life style changes post stroke. Monitoring cardiovascular effects may help motivate patients for further exercise, and can be an instrument to assess intervention effects in clinical trials. In 1 of 4 stroke patients, the heart rate variability may challenge currently used cardiovascular monitoring. The Graded Cycling Test with Talk Test is a submaximal exercise test independent of heart rate variability, shown reliable for patients with cardiac disease.
  
  
  METHODS
  Patients diagnosed with lacunar stroke according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria performed an incremental exercise test on a stationary bicycle with a 15 W (watt) increase in workload every minute. Toward the end of each incremental step, the patients recited a standardized text passage and subsequently were asked: "Are you still able to speak comfortably?" The test was stopped when the patients were no longer able to speak comfortably. Two consecutive tests were performed separated by 1 hour rest.
  
  
  RESULTS
  Sixty patients completed the study. The intraclass correlation coefficient (ICC2.1) was as follows: .97 [95% CI: .95-.98] with only a minor measurement error: 12.9 W for groups of patients (standard error of measurement, SEM95) and 18.3 W for individual patients (smallest real difference).
  
  
  CONCLUSIONS
  The "Graded Cycling Test with Talk Test" is feasible and reliable for monitoring exercise effects in patients with lacunar stroke. The high ICC2.1and small measurement error suggest it to be a valuable outcome measurement in clinical practice.
authors.affiliation: Department of Rehabilitation, Herlev Gentofte Hospital, University of Copenhagen, Herlev, Denmark; Department of Neurology, Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Steen Krawcyk
authors.affiliation: Department of Rehabilitation, Herlev Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Vinther
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Caesar Petersen
authors.affiliation: Department of Neurology, Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Herlev, Denmark. Electronic address: ckruuse@dadlnet.dk.
authors.forename: Christina
authors.initials: C
authors.lastname: Kruuse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D015898:Tomography Scanners, X-Ray Computed
keywords: Graded Cycling Test; Talk Test; lacunar stroke; outcome assessment; reproducibility of results