2025/12/16 by KEVIN MONCION, Kevin Moncion, LYNDEN RODRIGUES +17
Medicine · #Cardiovascular and exercise physiology #Stroke Rehabilitation and Recovery #Cardiac Health and Mental Health
paper · doi:10.1249/mss.0000000000003927
BACKGROUND: Accurate assessment of cardiorespiratory fitness is a critical component of cardiopulmonary exercise testing (CPET) and prescription for people with stroke. However, post-stroke disability and neuromuscular impairments are common and may disproportionately affect females throughout the continuum of recovery. There is a need to evaluate alternative whole-body CPET protocols and to characterize the sex-specific CPET responses throughout the continuum of stroke recovery. PURPOSE: To characterize the sex-specific CPET responses on a whole-body recumbent stepper CPET using American College of Sports Medicine (ACSM) criteria in people with subacute (7-90 d) and chronic (≥6-60 months) stroke. METHODS: Participants underwent a whole-body recumbent stepper symptom-limited CPET. Each CPET was assessed for ventilatory threshold (VT), peak oxygen uptake ( ) and ACSM maximal oxygen uptake criteria, including respiratory exchange ratio ≥1.10; plateau, heart rate (HR) within 10 beats of HRmax, and ratings of perceived exertion (RPE) ≥17/20 or ≥7/10. Sex differences by stroke chronicity were evaluated via t tests, rank-sum tests, χ 2 , or Fisher exact tests. RESULTS: In total, 145 participants underwent a symptom-limited CPET. In subacute stroke ( n = 69), no sex differences were found for VT or ( P > 0.05), but females were more likely to achieve a plateau ( P = 0.002). In chronic stroke ( n = 76), no sex differences were observed for VT or criteria ( P > 0.05), but females had lower ( P = 0.002). Irrespective of sex, achieving the RPE ( n = 41 subacute [61%], n = 38 chronic [54%]) or respiratory exchange ratio criteria ( n = 28 subacute [41%], n = 39 [51%]) was the most commonly met ACSM criteria. CONCLUSIONS: This whole-body CPET protocol is appropriate for eliciting peak and maximal efforts in people post-stroke; however, clinicians should consider biological sex and stroke chronicity.