Article

The majority of post-stroke individuals suffer from low exercise
capacity as a secondary reaction to immobility. The aim of this study was to
prove the concept of feedback-controlled robotics-assisted treadmill exercise
(RATE) to assess aerobic capacity and guide cardiovascular exercise in severely
impaired individuals early after stroke. METHOD: Subjects underwent constant load
and incremental exercise testing using a human-in-the-loop feedback system within
a robotics-assisted exoskeleton (Lokomat, Hocoma AG, CH). Inclusion criteria
were: stroke onset </=8 weeks, stable medical condition, non-ambulatory status,
moderate motor control of the lower limbs and appropriate cognitive function.
Outcome measures included oxygen uptake kinetics, peak oxygen uptake (VO2peak),
gas exchange threshold (GET), peak heart rate (HRpeak), peak work rate (Ppeak)
and accuracy of reaching target work rate (P-RMSE). RESULTS: Three subjects
(18-42 d post-stroke) were included. Oxygen uptake kinetics during constant load
ranged from 42.0 to 60.2 s. Incremental exercise testing showed: VO2peak range
19.7-28.8 ml/min/kg, GET range 11.6-12.7 ml/min/kg, and HRpeak range 115-161 bpm.
Ppeak range was 55.2-110.9 W and P-RMSE range was 3.8-7.5 W. CONCLUSIONS:
The concept of feedback-controlled RATE for assessment of aerobic capacity and
guidance of cardiovascular exercise is feasible. Further research is warranted to
validate the method on a larger scale. IMPLICATIONS FOR REHABILITATION: Aerobic
capacity is seriously reduced in post-stroke individuals as a secondary reaction
to immobility. Robotics-assisted walking devices may have substantial clinical
relevance regarding assessment and improvement of aerobic capacity early after
stroke. Feedback-controlled robotics-assisted treadmill exercise represents a new
concept for cardiovascular assessment and intervention protocols for severely
impaired individuals.

Langue : ANGLAIS