A 3‐minute recumbent stepper test in chronic stroke

Abstract Background Persons with stroke often have difficulty achieving target heart rate (HR) during graded exercise testing (GXT), which is known to limit test sensitivity for detecting clinically relevant cardiac conditions. A novel Recumbent Stepper 3‐minute (RS 3Min) “all out” test may increase sensitivity of stress testing after stroke. Objective To determine the feasibility of adding the RS 3Min test after GXT among persons after stroke. Design A within‐participant, nonrandomized, repeated measures design. Setting Rehabilitation research laboratory and cardiovascular stress laboratory Participants Fifteen participants with chronic stroke (56.7 ± 9.6 years; 6.4 ± 4.3 years post stroke; 8 male). Interventions All participants randomly completed (1) a symptom‐limited treadmill GXT and (2) a symptom‐limited RS GXT followed by RS 3Min critical power test. Main Outcome Measures HR, ratings of perceived exertion, oxygen consumption, respiratory exchange ratio, and power output measured continuously during each test. Blood pressure measured every 2 minutes and or immediately post exercise. P value set at p < .05 from omnibus test for a significant difference among protocols. Results The RS 3Min test had a significantly higher rate of achieving target HR compared to the RS GXT (9/14 vs 4/14, p = .02) and was not significantly different from the treadmill GXT (9/14 vs 5/14, p = .09). Minimum power output during the RS 3Min was significantly higher than peak power output during the RS GXT (110 ± 41 W vs. 84 ± 22 W, p = .02) with 12/15 participants reaching a VO 2 plateau. Conclusions Although additional studies with randomized designs are needed, a novel RS 3Min “all out” test appears to be a promising method for enhancing test sensitivity in cardiovascular screening after stroke, while providing a potentially valid measure of critical power.