Peak Cardiorespiratory Responses of Patients with Subacute Stroke During Land and Aquatic Treadmill Exercise

The aim of this work was to investigate the cardiorespiratory responses of patients with subacute stroke to exercise stress tests with aquatic and land treadmills.

Twenty-one consecutive patients who presented with first-ever subacute stroke in 2013-2015. All subjects underwent symptom-limited incremental exercise testing with aquatic and land treadmills. Land treadmill speed started at 1.5 km/h and increased 0.5 km/h every 1 to 2 minutes until maximal tolerable speed was achieved. Thereafter, the grade was elevated by 2% every 2 minutes. In the aquatic treadmill test, subjects were submerged to the xiphoid in 28°C water. Treadmill speed started at 1.5 km/h and was increased 0.5 km/h every 2 minutes thereafter. Cardiorespiratory responses were recorded with aquatic and land treadmills.

Compared to land treadmill exercise, aquatic treadmill exercise achieved significantly better peak VO2 (22.0 vs 20.0; P = 0.02), peak metabolic equivalents (6.3 vs 5.8; P = 0.02), and peak rating of perceived exertion (17.6 vs 18.4, P = 0.01). Heart rate and VO2 correlated significantly during both tests (land treadmill: r = 0.96, P < 0.001; aquatic treadmill: r = 0.99, P < 0.001).

Aquatic treadmill exercise elicited significantly better peak cardiorespiratory responses than land treadmill exercise and may be as effective for early intensive aerobic training in subacute stroke patients.