Objective: To establish a stress testing protocol for hemiplegic persons using graded bridging activity at the rates of 3 to 24 repetitions per minute. Design: Paired comparisons of exercise parameters and admission and discharge data between hemiplegic and control groups. Setting: Inpatient rehabilitation program of a tertiary rehabilitation center in Japan. Patients: (1) Preliminary study: five hemiplegic patients. (2) Comparison with normal subjects. 39 hemiplegic patients and 10 age-matched controls. (3) Study of reproducibility five hemiplegic patients and five controls. (4) Longitudinal changes 30 hemiplegic patients. Main Outcome Measures: Oxygen consumption (Vo2), heart rate (HR), and HR oxygen coefficient (regression coefficient between HR and Vo2). Results: The testing protocol was applicable to 88.6% of hemiplegic patients. The relationship between HR and Vo2 was linear, and HR oxygen coefficient was significantly lower in hemiplegic patients than the controls. The intraclass correlation coefficients were greater than 0.7 for Vo2, HR, and HR oxygen coefficient, indicating satisfactory reproducibility HR decreased longitudinally for the same stress levels and the HR oxygen coefficient increased, indicating improved fitness level. Conclusions: The bridging activity protocol is a useful mode for stress-testing hemiplegic persons. The linearity between HR and VO2 with this protocol allows us to use the indices of fitness obtainable from this relationship.
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