Document Detail


Low-velocity graded treadmill stress testing in hemiparetic stroke patients.
MedLine Citation:
PMID:  9158639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Coronary artery disease is prevalent in stroke patients and is an important factor affecting rehabilitation and health outcomes. However, the presence of neurological deficits in gait and balance has discouraged systematic application of exercise testing and prescription in the stroke population. We evaluated a novel graded treadmill stress test in paretic stroke patients and tested floor walking as a predictor of adequate neurological function to perform the treadmill test. METHODS: Patients (n = 31) with residual paretic gait deficits after ischemic stroke were evaluated with graded treadmill at gait velocities individualized to functional mobility observed during an initial zero-incline treadmill tolerance test. RESULTS: Most patients (30/31) tolerated testing, achieving mean heart rates of 129 +/- 14 beats per minute (mean +/- SD), representing 84 +/- 10% of maximal age-predicted heart rate. Evidence for asymptomatic myocardial ischemia was found in 29% of those without known coronary artery disease. Exercise termination was more often due to generalized fatigue than cardiopulmonary intolerance (23/31 versus 4/31; P < .0001) or hemiparetic leg fatigue (1/31; P < .0001). Floor walking across a wide range of velocities (0.25 to 2.5 mph) demonstrated a strong linear relation with treadmill velocities (n = 24; r = 80; P < .0001); all patients floor walking at > or = 0.5 mph had adequate neuromotor function to perform the exercise test. CONCLUSIONS: These findings suggest that graded treadmill exercise testing, with proper safety precautions, can be used to assess cardiopulmonary function in paretic stroke patients. A simple floor-walking test predicts adequate neurological function to perform the exercise test. Exercise capacity is most limited by generalized fatigue and not by the paretic limb, supporting a rationale for endurance training in this population.
Authors:
R F Macko; L I Katzel; A Yataco; L D Tretter; C A DeSouza; D R Dengel; G V Smith; K H Silver
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  28     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-23     Completed Date:  1997-06-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  988-92     Citation Subset:  IM    
Affiliation:
Geriatrics Service, Baltimore Department of Veterans Affairs Medical Center, Md, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cerebrovascular Disorders / diagnosis*,  physiopathology
Exercise Test*
Female
Gait
Hemiplegia / diagnosis*,  physiopathology
Humans
Male
Middle Aged
Physical Endurance
Grant Support
ID/Acronym/Agency:
P60-AG12583/AG/NIA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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