Safety of performing a graded exercise test early after stroke and transient ischaemic attack.

Abstract

Low cardiorespiratory fitness is a predictor of stroke risk and poor outcome post-stroke. Fitness levels are rarely assessed in the acute-phase and it is unclear if it is safe for stroke survivors and people with transient ischaemic attack (TIA) to perform a graded exercise test to assess fitness. To determine if people within 14 days post-stroke can safely perform a graded exercise test. Observational study. Research institute PARTICIPANTS: People with stroke or TIA admitted to an acute stroke unit INTERVENTION: Not applicable MAIN OUTCOME MEASURES: Safety of performing a graded exercise test early post-stroke. Safety outcomes were: 1) occurrence of an adverse event or 2) <85% blood oxygen saturation (SpO2 ). Participants performed a graded exercise test on a recumbent stepper at a research institute <2 weeks post-event. Cardiorespiratory fitness was determined by measuring peak volume of oxygen-uptake (VO2peak ) using a metabolic cart. Twenty-nine participants were enrolled in the study (median age 69 years; interquartile range 58-75). Sixteen were diagnosed with TIA and 13 suffered a mild stroke. Twenty-eight participants completed the test; one participant was unable to perform the test due to back pain. The test was terminated due to standardised stopping criteria in 26 cases (5=volitional fatigue, 6=unable to keep required cadence, 15=reaching 85%HRmax ), one due to safety (i.e. SpO2 <85%), and one was inadvertently terminated before stopping criteria were reached. Average cardiorespiratory fitness determined by the exercise test was low; mean VO2peak of 16.2±4.5 ml.kg.min-1 for men (n=20) and 12.4±3.6 ml.kg.min-1 for women (n=8). Determining exercise capacity early post-stroke and TIA using a graded exercise test appears to be safe in patients with mild deficits. This information should be useful to plan tailored exercise programs. Further research should focus on determining safety of exercise testing in more severely affected stroke survivors. This article is protected by copyright. All rights reserved.