Exercise stress testing in subacute stroke patients using a combined upper- and lower-limb ergometer.

Objective: To assess functional cardiopulmonary exercise tolerance in a subset of patients with residual neurologic deficits after stroke by exercise stress testing using the Power Trainer, a combined upper- and lower-limb ergometer.

Design: Prospective, observational study using a convenience sample.

Setting: Clinical locomotor laboratory in a tertiary rehabilitation hospital.

Participants: Thirty subjects undergoing rehabilitation an average of 7.3 weeks after stroke.

Interventions: Not applicable.

Main Outcome Measures: Percentage of age-predicted maximal heart rate (APMHR) achieved and rate-pressure product (RPP).

Results: Thirty subjects completed stress tests. Twelve of the 30 subjects were taking beta-blocker medications. Mean maximum heart rate +/- standard deviation achieved was 119+/-21 beats/min, equal to 75%+/-11% of APMHR. Ten subjects achieved 85% of APMHR or greater. Those not taking a beta-blocker attained 80%+/-10% of APMHR. The percentage increase in RPP from rest to maximal exercise for the whole group was 117%+/-44%. Four subjects developed cardiopulmonary signs or symptoms. Exercise prescriptions were provided to patients using the Karvonen formula. Overall subject satisfaction with the Power Trainer was high.

Conclusion: The Power Trainer can be used safely to assess cardiopulmonary exercise tolerance in a select subset of patients with neurologic impairments secondary to stroke. This information can be extrapolated for proper exercise prescription and may contribute to the investigation of coronary artery disease in this high-risk population.