Relationship Between Ambulatory Capacity and Cardiorespiratory Fitness in Chronic Stroke

Abstract

Study Objectives-To identify in individuals with chronic stroke (1) the relationship between the maximal oxygen uptake (VO 2 max) during cycle ergometry and the distance covered in the Six Minute Walk Test (6MWT), and (2) the stroke-specific impairments which are important determinants for the 6MWT distance.Design-Cross-sectional study using a convenience sample. Setting-Exercise testing laboratory in a tertiary rehabilitation center.Participants-Sixty-three older adults (mean age ± standard deviation, 65.3 ± 8.7) with an average post-stroke interval of 5.5 ± 4.9 years. Intervention-Not applicableMain Outcome Measures-Each subject underwent a maximal cycle ergometer test and a 6MWT. Oxygen consumption (VO 2 ) was measured during both tests. Subjects were also evaluated for Berg Balance Scale, Modified Ashworth Scale of Spasticity, isometric knee extension strength and percent body fat.Results-The 6MW distance had a low correlation with the VO 2 max (r=0.402). Balance, knee extension strength and spasticity were all significant determinants for the 6MWT distance, with balance being the major contributor for the 6MWT distance, accounting for 66.5% of its variance.Conclusions-Factors other than the cardiorespiratory status considerably influenced the ambulatory capacity as measured by the 6MWT. The 6MWT distance alone should not be used to indicate cardiorespiratory fitness in individuals with chronic stroke.

Walking ability and predictors of performance on the 6‐minute walk test in adults with spastic cerebral palsy

“…12 For elderly and stroke populations, the 6MWT is considered a general measure of overall functional walking capacity, involving the integrated response of multiple body systems. 9,13,14 The TUG was originally developed as a balance test for the elderly. 15 By measuring, in time, the ability to stand up, walk, turn around, and sit down, the TUG captures the complex interaction between balance and movement, including planning, initiating, executing, and completing a series of linked movements that are common in daily activities.…”

“…The 6MWT has demonstrated test-retest reliability for adults with CP (ICC=0.97). 19 Perceived exertion was graded immediately after 6 minutes using the Borg Scale (rating of perceived exertion, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], a measure of exercise intensity with reported correlations of ratings and heart rates of r>0.80 and test-retest reliability of ICC=0.72. 19,20 The TUG was used to measure functional mobility.…”

Reliability and Validity of the Six-Minute Arm Test for the Evaluation of Cardiovascular Fitness in People With Spinal Cord Injury

“…Similarly, the popular submaximal endurance assessment using the 6 Minute Walk Test has been shown to have moderate association with VO 2 peak in a number of populations. 43,44 The use of HR reserve, rather than % of age-predicted maximal HR or RPE to determine submaximal PO was considered, but to do this, subjects would have had to have a VO 2 max test first to determine their maximal HR. As the 6-MAT test is designed for clinical use where maximal testing may not be possible, the use of RPE and % of age-predicted maximal HR would be more clinically feasible.…”

A 19-week exercise program for people with chronic stroke enhances bone geometry at the tibia: a peripheral quantitative computed tomography study

“…Impaired balance, muscle weakness and spasticity that occur after a stroke can lead to reduced mobility [3,4] with a risk of disuse of the paretic leg during functional activities [5,6,7]. These impairments can result in muscle atrophy and may compromise bone health [8,9,10] and can contribute to the increased risk for fragility fracture observed in this population [1,2,11].…”