Open AccessCan functional walk tests add value to the prediction of cardiorespiratory fitness after stroke? A prospective cohort study
Author(s) -
Mari Gunnes,
IngerLise Aamot Aksetøy,
Turid Follestad,
Bent Indredavik,
Torunn Askim
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0255308
Subject(s) - cardiorespiratory fitness , medicine , physical therapy , stroke (engine) , metabolic equivalent , prospective cohort study , vo2 max , cohort , treadmill , physical medicine and rehabilitation , heart rate , physical activity , blood pressure , mechanical engineering , engineering
Background Cardiorespiratory fitness is often impaired following stroke, and peak oxygen consumption (VO 2peak ) is an important prognostic value of all-cause mortality. The primary objective was to investigate whether functional walk tests assessed in the subacute phase after stroke added value in predicting VO 2peak in chronic stroke, in addition to age, sex and functional dependency. Secondary objectives were to investigate associations between daily physical activity and functional walk tests, and with VO 2peak in chronic stroke. Methods This prospective cohort study included eligible participants originally included in the randomized controlled trial Life After Stroke. Functional walk tests, i.e., six-minute walk test (6MWT) and maximal gait speed, were assessed at inclusion and 18 months later. VO 2peak [ml/kg/min] was assessed by a cardiopulmonary exercise test on a treadmill 20 months after inclusion. Daily physical activity was measured by a uniaxial accelerometer (activPAL) at 18-month follow-up. Results Ninety-two community-dwelling individuals, with a mean (SD) age of 69.2 (10.6) years and 33 (35.9%) women, were included 3 months after stroke onset. Eighty-three (90.2%) participants had a modified Rankin Scale (mRS) score of 1 or 2, indicating functional independence. An overall assessment of four prediction models indicated the combination of age, sex, mRS and 6MWT as predictors to be the best fitted model in predicting VO 2peak (adjusted R 2 = 0.612). Secondary results showed statistically significant, but not clinically significant, associations between daily physical activity and functional walk tests, and with VO 2peak.Conclusions 6MWT add significant value to the prediction of mean VO 2peak in the chronic phase in mild strokes, in combination with age, sex and functional dependency. This prediction model may facilitate clinical decisions and rehabilitation strategies for mildly affected stroke survivors in risk of low levels of VO 2peak . Future studies should validate the model in various stages after stroke and in patients moderately and severely affected.