Systematic review of cardiopulmonary exercise testing post stroke: Are we adhering to practice recommendations?

A systematic review of studies of cardiopulmonary exercise testing in stroke survivors has been published on the Journal of Rehabilitation Medicine.

The aim of the present study was to systematically review the use of CPET in people who have survived a stroke, whether used for diagnostic purposes or to assess functional capacity. The following questions were addressed:

• What testing procedures are being used, with respect to equipment, testing protocol and criteria for test termination?
• What are the patient, safety and outcomes characteristics in CPET procedures described in the literature?
• Which criteria are being used to determine maximum oxygen uptake (VO2peak/max) in the CPET procedures described in the literature?

Sixty studies were scrutinized, including 2,104 stroke survivors. The conclusions are that "the protocols described in the studies included in our review were very heterogeneous. Insufficient reporting of relevant outcome measures other than VO2peak, such as RER and VT, raises the question as to whether the results do indeed reflect maximum effort. Although authors referred to established guidelines, these were not adhered to, or were incorrectly adhered to. This means that the results of cardiopulmonary exercise testing protocols in stroke survivors cannot be compared, and raises the question as to whether stroke-specific testing and reporting guidelines are needed. ".

The study is available for download at the following link: click here