关键词:
Cardiopulmonary fitness
Exercise testing
Exercise training
Peak oxygen uptake
Robotics
Robotics-assisted tilt table
Stroke
摘要:
Background: We evaluated the feasibility of an augmented robotics-assisted tilt table (RATT) for incremental cardiopulmonary exercise testing (CPET) and exercise training in dependent-ambulatory stroke patients. Methods: Stroke patients (Functional Ambulation Category <= 3) underwent familiarization, an incremental exercise test (IET) and a constant load test (CLT) on separate days. A RATT equipped with force sensors in the thigh cuffs, a work rate estimation algorithm and real-time visual feedback to guide the exercise work rate was used. Feasibility assessment considered technical feasibility, patient tolerability, and cardiopulmonary responsiveness. Results: Eight patients (4 female) aged 58.3 +/- 9.2 years (mean +/- SD) were recruited and all completed the study. For IETs, peak oxygen uptake (V'O-2peak), peak heart rate (HRpeak) and peak work rate (WRpeak) were 11.9 +/- 4.0 ml/kg/min (45 % of predicted V'O-2max), 117 +/- 32 beats/min (72 % of predicted HRmax) and 22.5 +/- 13.0 W, respectively. Peak ratings of perceived exertion (RPE) were on the range "hard" to "very hard". All 8 patients reached their limit of functional capacity in terms of either their cardiopulmonary or neuromuscular performance. A ventilatory threshold (VT) was identified in 7 patients and a respiratory compensation point (RCP) in 6 patients: mean V'O-2 at VT and RCP was 8.9 and 10.7 ml/kg/min, respectively, which represent 75 % (VT) and 85 % (RCP) of mean V'O-2peak. Incremental CPET provided sufficient information to satisfy the responsiveness criteria and identification of key outcomes in all 8 patients. For CLTs, mean steady-state V'O-2 was 6.9 ml/kg/min (49 % of V'O-2 reserve), mean HR was 90 beats/min (56 % of HRmax), RPEs were > 2, and all patients maintained the active work rate for 10 min: these values meet recommended intensity levels for bouts of training. Conclusions: The augmented RATT is deemed feasible for incremental cardiopulmonary exercise testing and exercise training in d