Robot-Assisted End-Effector-Based Stair Climbing for Cardiopulmonary Exercise Testing: Feasibility, Reliability, and...

Area of Science:

• Exercise Physiology
• Rehabilitation Engineering
• Clinical Biomechanics

Background:

• Conventional cardiopulmonary exercise testing (CPET) is challenging for individuals with neurological impairments.
• Robot-assisted end-effector-based stair climbing (RASC) offers a promising alternative for cardiovascular stress and task-specific exercise.
• Augmented RASC integrates feedback control for enhanced exercise provocation.

Purpose of the Study:

• To evaluate the feasibility, reliability, and repeatability of augmented RASC-based CPET in able-bodied subjects.
• To establish the potential of RASC-CPET for future applications in neurologically impaired populations.
• To assess the accuracy of work rate tracking during RASC-CPET.

Main Methods:

• Twenty able-bodied subjects underwent familiarization and two incremental RASC-based CPETs.
• Outcome measures included standard cardiopulmonary parameters and work rate tracking accuracy (RMSEP).
• Reliability was assessed using ICC, SEM, and MDC; repeatability by CoV, mean differences, and limits of agreement.

Main Results:

• Feasibility criteria were met, with peak oxygen uptake (V'O2peak) at 106±9% and peak heart rate (HRpeak) at 99±3% of predicted values.
• Sub-maximal ventilatory thresholds (VAT and RCP) were successfully detected in most subjects.
• Excellent test-retest reliability (ICC ≥ 0.890) and good repeatability (CoV ≤ 0.12) were observed for primary outcomes.

Conclusions:

• Augmented RASC-based CPET is feasible, reliable, and repeatable in able-bodied individuals.
• It achieves high peak cardiopulmonary responses and allows determination of ventilatory thresholds.
• RASC holds significant potential for exercise testing and prescription in neurologically impaired populations requiring task-specific training.