TY - JOUR

T1 - "Graded Cycling Test with Talk Test" Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke

AU - Steen Krawcyk, Rikke

AU - Vinther, Anders

AU - Caesar Petersen, Nicolas

AU - Kruuse, Christina

N1 - Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

PY - 2017/3

Y1 - 2017/3

N2 - BACKGROUND: Physical exercise is generally recommended as part of life style changes post stroke. Monitoring cardiovascular effects may help motivate patients for further exercise, and can be an instrument to assess intervention effects in clinical trials. In 1 of 4 stroke patients, the heart rate variability may challenge currently used cardiovascular monitoring. The Graded Cycling Test with Talk Test is a submaximal exercise test independent of heart rate variability, shown reliable for patients with cardiac disease.METHODS: Patients diagnosed with lacunar stroke according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria performed an incremental exercise test on a stationary bicycle with a 15 W (watt) increase in workload every minute. Toward the end of each incremental step, the patients recited a standardized text passage and subsequently were asked: "Are you still able to speak comfortably?" The test was stopped when the patients were no longer able to speak comfortably. Two consecutive tests were performed separated by 1 hour rest.RESULTS: Sixty patients completed the study. The intraclass correlation coefficient (ICC2.1) was as follows: .97 [95% CI: .95-.98] with only a minor measurement error: 12.9 W for groups of patients (standard error of measurement, SEM95) and 18.3 W for individual patients (smallest real difference).CONCLUSION: The "Graded Cycling Test with Talk Test" is feasible and reliable for monitoring exercise effects in patients with lacunar stroke. The high ICC2.1and small measurement error suggest it to be a valuable outcome measurement in clinical practice.

AB - BACKGROUND: Physical exercise is generally recommended as part of life style changes post stroke. Monitoring cardiovascular effects may help motivate patients for further exercise, and can be an instrument to assess intervention effects in clinical trials. In 1 of 4 stroke patients, the heart rate variability may challenge currently used cardiovascular monitoring. The Graded Cycling Test with Talk Test is a submaximal exercise test independent of heart rate variability, shown reliable for patients with cardiac disease.METHODS: Patients diagnosed with lacunar stroke according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria performed an incremental exercise test on a stationary bicycle with a 15 W (watt) increase in workload every minute. Toward the end of each incremental step, the patients recited a standardized text passage and subsequently were asked: "Are you still able to speak comfortably?" The test was stopped when the patients were no longer able to speak comfortably. Two consecutive tests were performed separated by 1 hour rest.RESULTS: Sixty patients completed the study. The intraclass correlation coefficient (ICC2.1) was as follows: .97 [95% CI: .95-.98] with only a minor measurement error: 12.9 W for groups of patients (standard error of measurement, SEM95) and 18.3 W for individual patients (smallest real difference).CONCLUSION: The "Graded Cycling Test with Talk Test" is feasible and reliable for monitoring exercise effects in patients with lacunar stroke. The high ICC2.1and small measurement error suggest it to be a valuable outcome measurement in clinical practice.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Analysis of Variance

KW - Exercise Therapy/methods

KW - Female

KW - Heart Rate/physiology

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Monitoring, Physiologic

KW - Outcome Assessment (Health Care)

KW - Retrospective Studies

KW - Stroke/diagnostic imaging

KW - Stroke Rehabilitation

KW - Tomography Scanners, X-Ray Computed

U2 - 10.1016/j.jstrokecerebrovasdis.2016.12.004

DO - 10.1016/j.jstrokecerebrovasdis.2016.12.004

M3 - Journal article

C2 - 28041898

VL - 26

SP - 494

EP - 499

JO - Journal of Stroke & Cerebrovascular Diseases

JF - Journal of Stroke & Cerebrovascular Diseases

SN - 1052-3057

IS - 3

ER -