EXERCISE PRESCRIPTION FOR STROKE PATIENT ON THE BASIS OF ANAEROBIC THRESHOLD :Examination of double-product-break-point
Taka-aki Kawasaki, Hideyuki Nagaoki, Shigenobu Ishigami (National Defense Medical College, Saitama, Japan), Youichi Kondou (Yamano College of Aesthetics)
The exercise at Anaerobic threshold (AT) level is adequate to endurance exercise for stroke patient. It is said that AT is equal to double-product (heart rate x systolic blood pressure) break point (DPBP) in healthy person. We examined the correlation between AT and DPBP in stroke patients.
Method: Five stroke outpatients and five healthy persons participated in this study. Equipments were cycle ergometer (Load), CM-4001 DPBP (Kyokko), K2 expired gas analysis system, and blood lactate analysis system (Boehringer). Work load (w), oxygen consumption (Vo2), ventilation volume (VE), heart rate (HR), and blood lactate (LA) were measured. The exercise test according to ramp protocol was performed on cycle ergometer after five minutes resting. Exercise was started at OW work load for two minutes. The rate of increase was 10 to 15w per minute. End points were determined from symptom or recommendation of medical doctor.
Results: DPBPs were obtained at 26 to 60 W. It is nearly equal to AT decided by ventilation thresholds. LA were 1.0 to 1.3 mmol/l at starting points, 2.4 to 3.1 mmol/l at DPBP, and 3.9 to 5.7 mmol/l at end points. DPBP and AT of patients were lower than those of healthy persons. Any subjects have no complication during these exercise.
Conclusion: DPBP could be utilized to prescribe exercise for stroke patients to keep their physical condition up.
PHYSICAL ASSESSMENT WITH GAS ANALYSIS IN HEMIPLEGIA STROKE PATIENTS
J. KATOH, M. IWAHASHI, J. MIYAJI,
Department of Internal Medicine, Hyogo Rehabilitation Center, Kobe, Japan
[Aim] The purpose of this study was to assess tile physical fitness using a graded cycling exercise test in hemiplegia stroke patients.
[Materials and Methods] Subjects were 39 stroke patients (19 patients with cerebral bleeding and 20 cerebral infarction) who had been admitted to our hospital. All patients were classified on the Brunnstrom (Br) stage from grade I to 5 in lower extremity and divided into the two groups, the severe hemi-paralytic group (Br stage 1〜3) and the mild hemi-paralytic group (Br stage 4〜5). To evaluate physical strength, all patients were tested on a graded cycle ergometer with a load (20W/min); we then measured, monitoring gas exchange with a resporomonitor.
[Results] (I)The ratio of the real maximum oxygen uptake per the expected oxygen uptake (%VO2), the oxygen uptake per body weight (VO2/W), maximum load and METS in severe hemi-paralytic group were decreased significantly to compared with those in mild hemi-paralytic group. (2) The ratio of the real maximum heart rate per the expected heart rate (%HR) was not significantly different in the both groups. (3) The percentage ventilatory capacity (%VC) and the percentage forced expiratory volume at one second (FEV 1.0%) at resting were not significantly different in the both groups.
[Conclusions] These results suggest that the cardiorespiratory physical fitness in severe hemi-paralytic stroke patients would be diminished compared to that in mild hemi-paralytic stroke patients.