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

Background Assessment of peak oxygen consumption (V̇o2peak) 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 V̇o2peak 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 V̇o2peak and peak HR (r=.91 and .89, respectively). Mean V̇o2peak was significantly higher for the mTBRS-XT (16.6 mL×kg−1×min−1[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mL×kg−1×min−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 V̇o2peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on V̇o2peak values for individuals with mild to severe deficits after stroke.