PTPilotPM & R : the journal of injury, function, and rehabilitation2023

A 3-minute recumbent stepper test in chronic stroke.

Daniel L Carl, Dustyn Whitesel, Colleen Meyrose and 6 others

PMID 36580538

WHAT IT FOUND

In 15 people with chronic stroke, a 3-minute all-out recumbent stepper test after a graded exercise test raised peak heart rate more than the recumbent stepper graded test alone.

It did not outperform treadmill testing, and its screening value is not proven.

Key findings

01Peak heart rate was significantly higher during the RS 3Min test than during the recumbent stepper graded exercise test, but not higher than the treadmill graded exercise test.

02Fourteen of 15 participants completed the RS 3Min test on the first attempt, and end-test power was significantly closer to minimum power than peak power.

03No serious adverse events occurred, but one participant had atrial fibrillation, one reported moderate knee pain, one reported mild transient lightheadedness, and one diastolic blood pressure reached 120 mmHg.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Fifteen participants is a small sample, and one participant's heart-rate data were excluded from heart-rate analyses because of atrial fibrillation. The three tests were always done in the same order, which could influence results. The recumbent stepper graded test and the 3-minute test were done on the same day, separated by only 15 minutes of rest. The 3-minute test did not include ischemia testing, so its ability to screen for silent myocardial ischemia was not shown. Reliability of the 3-minute test was not measured. Power output was measured continuously for only 12 participants. Participants had chronic stroke with residual gait impairment but could walk with assistive devices as needed and no physical assistance; severe spasticity, significant arrhythmia, recent cardiopulmonary hospitalization, and other conditions were excluded.

Declared interests

The authors declared no conflicts of interest. The article is tagged as receiving NIH extramural and non-U.S. government research support.

The easy way to misread this

Do not read this as proof that the 3-minute recumbent stepper test can replace treadmill stress testing or detect silent ischemia. It did not significantly raise peak heart rate above treadmill testing, and ischemia was not tested during the 3-minute test.

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