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Designing a Treadmill Ramp Protocol to Evaluate Aerobic Capacity of Ambulatory Hemiparetic Post-Stroke Patients: 2482 Board #5 June 3, 9: 30 AM - 11: 00 AM.

Patients who have had stroke often exhibit neurological and motor sequels associated to functional impairments that compromise the activities of daily living. Walking difficulties associated with hemiparesis are major obstacles to a correct evaluation of aerobic capacity in stroke patients. Because of these limitations, standardized procedures for assessing the VO2max of hemiparetic ambulatory post-stroke patients should be developed. PURPOSE: To compare the cardio-respiratory and perceptual responses elicited by two ramp cardiopulmonary exercise tests (CPET) specifically developed for chronic hemiparetic patients. METHODS: Eleven patients (52 ± 14 years, 10 men) performed the CPET protocol proposed by Ovando et al. (2011) and an adapted protocol proposed by the present study designed to increase its specificity for hemiparetic stroke population. The oxygen uptake (VO2), systolic blood pressure and heart rate (HR), maximum speed, time to exhaustion and rating of perceived exertion (RPE), as well as the speed, HR and the VO2 at the first ventilatory threshold (VT) were measured. To compare the relationship between VO2 vs. workload, HR vs. workload and VO2 vs. HR between both CPETs, individual linear regressions were calculated for each patient, and then, the slopes, intercepts and standard error of estimate were compared by Student t test. RESULTS: In comparison with Ovando’s protocol, the current CPET protocol was able to induce higher VO2 peak (20.3 ± 6.1 vs. 18.6 ± 5.0 ml.kg.min -1 ; P= 0.04), VO2 at VT (11.5 ± 2.9 vs. 9.8 ± 2.0 ml.kg.min -1 ; P= 0.04) and time to exhaustion (10 ± 3 vs. 6 ± 2 min; P0.05), the current protocol produced lower standard errors of estimate for HR vs. workload (2.95 ± 1.3 vs. 3.82 ± 1.0; P= 0.004) and HR vs. VO2 (6.0 ± 2.1 vs. 4.8 ± 2.4; P= 0.05) compared with Ovando ́s protocol. CONCLUSION: The smoother rate of increment proposed by the current CPET protocol seems to be more appropriate than other available test, to assess the maximal aerobic capacity of hemiparetic post-stroke patients.