Adverse Events During Submaximal Aerobic Exercise Testing in People With Subacute Stroke: A Scoping Review.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurologic Physical Therapy Pub Date : 2024-01-01 Epub Date: 2023-05-15 DOI:10.1097/NPT.0000000000000445

Jean Michelle Legasto-Mulvale, Elizabeth L Inness, Alexandra N Thompson, Nivetha Chandran, Sunita Mathur, Nancy M Salbach

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引用次数: 0

Abstract

Background and purpose: Concern for adverse cardiovascular events and limited guidance regarding how to conduct aerobic exercise (AEx) testing for individuals poststroke are key barriers to implementation by physical therapists in stroke rehabilitation. This study aimed to describe the nature and safety of submaximal AEx testing protocols for people with subacute stroke (PwSS) and the nature of comorbidity of PwSS who underwent submaximal AEx testing.

Methods: We conducted a scoping review and searched MEDLINE, EMBASE, PsycINFO, CINAHL, and SPORTDiscus from inception to October 29, 2020. Studies involving submaximal AEx testing with PwSS, reporting on participant comorbidity and on adverse events during testing, were eligible. Two reviewers independently conducted title and abstract and full-text screening. One reviewer extracted data; a second reviewer verified data.

Results: Thirteen studies involving 452 participants and 19 submaximal AEx testing protocols (10 field test, 7 incremental, and 2 constant load) were included. Hypertension (41%), diabetes (31%), and dyslipidemia (27%) were the most common comorbidities reported. No protocols resulted in a serious adverse event. The most common test termination criterion was a heart rate (HR) limit (9 protocols); a limit of 85% age-predicted maximal HR (APM-HR) most frequently reported. Average APM-HR achieved, computed using mean age and mean peak HR, ranged from 59% to 88% across 13 protocols.

Discussion and conclusion: Diverse submaximal AEx testing protocols with conservative test termination criteria can be safely implemented with PwSS. Results can inform clinical practice guidelines and address physical therapists' concerns with the occurrence of serious adverse events during submaximal AEx testing.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A430 ).

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亚急性脑卒中患者进行亚最大限度有氧运动测试期间的不良事件：范围综述。

背景和目的：对心血管不良事件的担忧以及有关如何对脑卒中后患者进行有氧运动（AEx）测试的指导有限，是物理治疗师在脑卒中康复中实施测试的主要障碍。本研究旨在描述亚急性卒中患者（PwSS）亚极限有氧运动测试方案的性质和安全性，以及接受亚极限有氧运动测试的 PwSS 的合并症性质：我们进行了范围界定审查，并检索了从开始到 2020 年 10 月 29 日的 MEDLINE、EMBASE、PsycINFO、CINAHL 和 SPORTDiscus。符合条件的研究涉及对 PwSS 进行的亚极限 AEx 测试，并报告了参与者的合并症和测试期间的不良事件。两名审稿人独立进行标题、摘要和全文筛选。一位审稿人提取数据，另一位审稿人核实数据：结果：共纳入 13 项研究，涉及 452 名参与者和 19 个亚最大 AEx 测试方案（10 个现场测试、7 个增量测试和 2 个恒定负荷测试）。高血压（41%）、糖尿病（31%）和血脂异常（27%）是最常见的合并症。所有方案均未导致严重不良事件。最常见的测试终止标准是心率（HR）限制（9 项方案）；最常报告的限制是年龄预测最大心率（APM-HR）的 85%。使用平均年龄和平均峰值心率计算出的平均 APM-HR 在 13 个方案中从 59% 到 88% 不等：讨论和结论：可以安全地对 PwSS 实施不同的亚极限 AEx 测试方案，并采用保守的测试终止标准。结果可为临床实践指南提供参考，并解决物理治疗师对在亚极限 AEx 测试中发生严重不良事件的担忧。视频摘要可获得作者的更多见解（请参阅视频，补充数字内容 1，网址：http://links.lww.com/JNPT/A430 ）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION

CiteScore

5.70

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.