Bridging activity as a mode of stress testing for persons with hemiplegia

Objective: To establish a stress testing protocol for hemiplegic persons using graded bridging activity at the rates of 3 to 24 repetitions per minute. Design: Paired comparisons of exercise parameters and admission and discharge data between hemiplegic and control groups. Setting: Inpatient rehabilitation program of a tertiary rehabilitation center in Japan. Patients: (1) Preliminary study: five hemiplegic patients. (2) Comparison with normal subjects. 39 hemiplegic patients and 10 age-matched controls. (3) Study of reproducibility five hemiplegic patients and five controls. (4) Longitudinal changes 30 hemiplegic patients. Main Outcome Measures: Oxygen consumption (Vo₂), heart rate (HR), and HR oxygen coefficient (regression coefficient between HR and Vo₂). Results: The testing protocol was applicable to 88.6% of hemiplegic patients. The relationship between HR and Vo₂ was linear, and HR oxygen coefficient was significantly lower in hemiplegic patients than the controls. The intraclass correlation coefficients were greater than 0.7 for Vo₂, HR, and HR oxygen coefficient, indicating satisfactory reproducibility HR decreased longitudinally for the same stress levels and the HR oxygen coefficient increased, indicating improved fitness level. Conclusions: The bridging activity protocol is a useful mode for stress-testing hemiplegic persons. The linearity between HR and VO₂ with this protocol allows us to use the indices of fitness obtainable from this relationship.