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Oxygen uptake during functional activities after stroke - Reliability and validity of a portable ergospirometry system
Journal article, Peer reviewed
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Original versionPLoS ONE. 2017, 12 (10): e0186894. 10.1371/journal.pone.0186894
Background People with stroke have a low peak aerobic capacity and experience increased effort during performance of daily activities. The purpose of this study was to examine test-retest reliability of a portable ergospirometry system in people with stroke during performance of functional activities in a field-test. Secondary aims were to examine the proportion of oxygen consumed during the field-test in relation to the peak-test and to analyse the correlation between the oxygen uptake during the field-test and peak-test in order to support the validity of the field-test. Methods With simultaneous measurement of oxygen consumption, participants performed a standardized field-test consisting of five activities; walking over ground, stair walking, stepping over obstacles, walking slalom between cones and from a standing position lifting objects from one height to another. All activities were performed in self-selected speed. Prior to the field-test, a peak aerobic capacity test was performed. The field-test was repeated minimum 2 and maximum 14 days between the tests. ICC2,1 and Bland Altman tests (Limits of Agreement, LoA) were used to analyse test-retest reliability. Results In total 31 participants (39% women, mean (SD) age 54.5 (12.7) years and 21.1 (14.3) months’ post-stroke) were included. The ICC2,1 was ≥ 0.80 for absolute V̇O2, relative V̇O2, minute ventilation, CO2, respiratory exchange ratio, heart rate and Borgs rating of perceived exertion. ICC2,1 for total time to complete the field-test was 0.99. Mean difference in steady state V̇O2 during Test 1 and Test 2 was -0.40 (2.12) The LoAs were -3.75 and 4.51. Participants spent 60.7% of their V̇O2peak performing functional activities. Correlation between field-test and peak-test was 0.689, p = 0.001 for absolute and 0.733, p = 0.001 for relative V̇O2. Conclusions This study presents first evidence on reliability of oxygen uptake during performance of functional activities after stroke, showing very good test-retest reliability. The secondary analysis showed that the amount of energy spent during the field-test relative to the peak-test was high and the correlation between the two test was good, supporting the validity of this method.