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Cognition and motor impairment correlates with exercise test performance after stroke.
Ada Tang1, Janice J Eng, Teresa S M Tsang
1Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
Medicine and Science in Sports and Exercise
|November 9, 2012
Summary
Exercise intensity in older adults with stroke is often estimated using age-predicted maximal heart rate (HR). However, leg motor and cognitive impairments significantly impact achieving this maximal HR during exercise testing.
Area of Science:
- Gerontology
- Neurology
- Exercise Physiology
Background:
- Exercise offers significant benefits for physical, cardiovascular, and cognitive health in older adults with multiple chronic conditions.
- Peak heart rate (HR) is a key indicator of maximal effort and exercise intensity, often estimated using age-predicted maximal HR in the absence of graded maximal exercise test (GXT) data.
Purpose of the Study:
- To investigate the factors influencing the achievement of age-predicted maximal HR during GXT in individuals with stroke.
- To examine the relationship between neurological, cognitive, and lower limb function and maximal HR attainment in this population.
Main Methods:
- Forty-seven participants with stroke underwent a GXT, with peak gas exchange, HR, and rating of perceived exertion (RPE) recorded.
- Logistic regression analysis identified determinants associated with achieving age-predicted maximal HR, including neurological impairment, leg motor impairment, cognitive function (Montreal Cognitive Assessment score), and walking ability.
Main Results:
- Only 30% of participants achieved ≥100% of their age-predicted maximal HR.
- Less severe leg motor impairment (P = 0.02, OR = 2.3) and higher cognitive scores (P = 0.048, OR = 1.3) were significantly associated with achieving the age-predicted maximal HR threshold.
Conclusions:
- Noncardiopulmonary factors, specifically leg motor and cognitive function, play a crucial role in determining maximal effort during exercise tests.
- Exercise prescription for individuals post-stroke may underestimate training intensities if solely based on peak HR from GXT, highlighting the need to consider physical and cognitive impairments.
