Feasibility, reproducibility and validity of the 10 meter Shuttle Test in mild to moderately impaired people with stroke.

BACKGROUND: There currently is no field test available for measuring maximal exercise capacity in people with stroke. OBJECTIVE: To determine the feasibility, reproducibility and validity of the Shuttle Test (ST) to measure exercise capacity in people with stroke. DESIGN: Longitudinal study design. SETTING: Rehabilitation department, day care centres from a nursing home and private practices specialized in neuro rehabilitation. SUBJECTS: People with subacute or chronic stroke. INTERVENTIONS: A standardized protocol was used to determine feasibility, reproducibility and validity of the 10-meter Shuttle Test (10mST). MAIN MEASURES: Number of shuttles completed, 1stVentilatory Threshold (1stVT). RESULTS: The associations of the number of shuttles completed and cardiopulmonary capacity as measured with a portable gas analyser were r > 0.7, confirming good convergent validity in subacute and chronic people with stroke. Criterion validity, however, indicates it is not a valid test for measuring maximal cardiopulmonary capacity (VO2max). Only 60% of participants were able to reach the 1stVT. Higher cardiopulmonary capacity and a higher total score of the lower extremity Motricity Index contributed significantly to a higher number of shuttles walked (p = 0.001). CONCLUSIONS: The Shuttle Test may be a safe and useful exercise test for people after stroke, but may not be appropriate for use with people who walk slower than 2 km/h or 0.56 m/s.

Reproducibility of Different Methodologies to Calculate Oxygen Consumption and Oxygen Cost During Walking in Chronic Stroke Survivors.

OBJECTIVE: The most common methods to calculate energy costs are based on measured oxygen uptake during walking a standardized distance or time. Unfortunately, it is unclear which method is most reliable to determine energy cost of walking in stroke survivors. The objective of this study was to evaluate the 3 most commonly used methods for calculating oxygen consumption and -cost by assessing test-retest reliability and measurement error in community dwelling chronic stroke survivors during a 6 Minute Walk Test. METHODS: In this secondary analysis of a longitudinal study, reproducibility of the outcome of walking distance, walking speed, oxygen consumption and oxygen cost from 3 methods (Kendall's tau, assumed steady-state and total walking time oxygen consumption) were determined using Intraclass Correlation Coefficient, Standard Error of Measurement and Smallest Detectable Change. RESULTS: 20 from the 31 participants successfully performed the 6 minute walk test-retest within a timeframe of 1 month. Within the 2 tests the reproducibility of walking distance and walking speed was high. The 3 methods to determine reproducibility for oxygen cost and oxygen consumption were considered good (Kendall's tau), good (assumed steady-state) and excellent (total walking time). CONCLUSIONS: The method using oxygen consumption and -cost over the total walking time resulted in the highest reproducibility considering the Intraclass Correlation Coefficient, its 95% Confidence Interval, and smaller absolute differences.