Prestroke VO₂max by the Jurca prediction index as a predictor of functional outcomes in stroke patients

Prestroke cardiopulmonary fitness (CPF) levels can affect post-stroke respiratory function and functional status, including gait and activities of daily living (ADL).

To investigate the prestroke CPF level measured by the Jurca prediction index as a predictor of functional outcomes after stroke and to evaluate the association between estimated prestroke CPF and respiratory function after stroke.

This was a prospective observational study involving 71 inpatients with first-time subacute stroke between June 2017 and July 2019. The prestroke VO₂max was assessed using the Jurca prediction index, which was calculated from age, sex, resting heart rate, body mass index, and physical activity level. Linear regression analysis was performed to determine the relationship between the Jurca prediction index, functional outcomes, pulmonary functions, and cough strength variables.

The estimated prestroke VO₂max was significantly associated with the post-stroke Berg Balance Scale (β=1.199, P<0.001), Trunk Impairment Scale (β=0.308, P=0.006), and Functional Independence Measure score (β=1.102, P=0.004) at admission, and these relationships remained significant at the follow-up evaluation after 1 month of conventional rehabilitation (P<0.001). Among the respiratory function variables, only peak cough flow (PCF) (β=0.696, P=0.037) was significantly associated with the estimated prestroke VO₂max.

Prestroke CPF likely affects the stability of core muscles that are related to PCF and the functional status, including balance function and ADL after stroke. Regular exercise to increase the CPF level should be encouraged in patients with risk factors for stroke, not only for primary prevention but also for functional improvement after stroke.