The Selection of Exercise Stress Test in Hemiplegic Patients

Objective: To suggest the standard tool for the selection of exercise stress tests (EST) by analysis of the initial evaluation factors affecting EST. Method: Twenty-two hemiplegic patients carried out treadmill, arm and bicycle ergometer ESTs. Treadmill EST using modified Harbor protocol was performed without taking off AFO. The velocity of the arm and bicycle ergometer was set in 50 rpm, and the resistance was increased up to 5 W at each stage. Each EST was completed at 80% of maximal heart rate. Results: Brunnstrom stage of lower extrimity, Medical Research Council (MRC) scores [hip flexor, knee extensor, finger flexor] and standing balance of twelve patients completing treadmill EST were superior to those of failed group (p＜0.05). Twelve patients completing bicycle ergometer EST showed significant differences in MRC scores [hip flexor, knee extensor] and sitting balance (p＜0.05). Brunnstrom stage of lower extremity hip flexor and knee extensor power contributed mostly to the completion of treadmill EST (p＜0.01). The completion of bicycle ergometer EST was mostly dependent on hip flexor and knee extensor power (p＜0.01). Conclusion: For bicycle ergometer EST, hip flexor and knee extensor power should be higher than 3 and 4, respectively. Treadmill EST can be suggested when Brunnstrom stage of lower extremity, hip flexor and knee extensor power are above 4, 4 and 3, respectively. The completion rate of treadmill EST can be increased when standing balance ability and Brunnstrom hand score higher than 4 and 2, respectively. (J Korean Acad Rehab Med 2008; 32: 26- 31)