Maximal Cardiorespiratory Fitness Testing in Individuals With Chronic Stroke With Cognitive Impairment: Practice Test Effects and Test-Retest Reliability

Objectives: To evaluate, for individuals with chronic stroke with cognitive impairment, (1) the effects of a practice test on peak cardiorespiratory fitness test results; (2) cardiorespiratory fitness test-retest reliability; and (3) the relationship between individual practice test effects and cognitive impairment. Design: Cross-sectional. Setting: Rehabilitation center. Participants: A convenience sample of 21 persons (men [n=12] and women [n=9]; age range, 48-81y; 44.9 +/- 36.2mo poststroke) with cognitive impairments who had sufficient lower limb function to perform the test. Interventions: Not applicable. Main Outcome Measure: Peak oxygen consumption (Vo(2)peak, ml.kg(-1).min(-1)). Results: Test-retest reliability of Vo(2)peak was excellent (intraclass correlation coefficient model 2,1 [ICC2,1]=.94; 95% confidence interval [CI], .86-.98). A paired t test showed that there was no significant difference for the group for Vo(2)peak obtained from 2 symptom-limited cardiorespiratory fitness tests performed 1 week apart on a semirecumbent cycle ergometer (test 2 test 1 difference, -.32ml.kg(-1).min(-1); 95% CI, -.69 to 1.33ml.kg(-1).min(-1); P=.512). Individual test-retest differences in Vo(2)peak were, however, positively related to general cognitive function as measured by the Mini-Mental State Examination (rho=.485; P<.026). Conclusions: Vo(2)peak can be reliably measured in this group without a practice test. General cognitive function, however, may influence the effect of a practice test in that those with lower general cognitive function appear to respond differently to a practice test than those with higher cognitive function. (C) 2013 by the American Congress of Rehabilitation Medicine