H Myrthe Boss1, Inger A Deijle2, Sander M Van Schaik3, Edwin C de Melker4, Bob T J van den Berg5, Henry C Weinstein3, Mirjam I Geerlings6, L Jaap Kappelle7, Renske M Van den Berg-Vos8. 1. Department of Neurology, OLVG West, Amsterdam, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. 2. Department of Physical Therapy, OLVG West, Amsterdam, The Netherlands. 3. Department of Neurology, OLVG West, Amsterdam, The Netherlands. 4. Department of Cardiology, OLVG West, Amsterdam, The Netherlands. 5. Department of Respiratory Medicine, OLVG West, Amsterdam, The Netherlands. 6. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 7. Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. 8. Department of Neurology, OLVG West, Amsterdam, The Netherlands. Electronic address: r.vandenberg-vos@olvg.nl.
Abstract
BACKGROUND:Cardiorespiratory fitness (CRF) is reduced in patients with stroke. It is unclear whether it is also reduced in patients with a transient ischemic attack (TIA) or minor stroke. We investigated the CRF in patients with a recent TIA or minor stroke and explored which determinants are associated with a lower fitness. METHODS: In 113 patients with a recent TIA or minor ischemic stroke (64 (SD = 10) years of age; 49 (IQR 27-86) days post TIA or stroke), the peak oxygen consumption (VO2peak) was determined in a symptom-limited ramp exercise test. Physical activity level, vascular risk factors, history of vascular or pulmonary disease, and stroke characteristics were recorded at inclusion and related to the VO2peak. RESULTS:Mean VO2peak was 22 mL/kg/min (SD = 6), which is the fifth percentile of age- and sex-related normative values. Increasing age and female sex were associated with a lower VO2peak (B (95% CI): per 10 years -2.57 mL/kg/min (-3.75; -1.40) and female sex -5.84 mL/kg/min (-8.06; -3.62)). Age- and sex-adjusted linear regression analyses showed that a history of cardiovascular disease and pulmonary disease was associated with a lower VO2peak. In addition, a lower level of physical activity, hypertension, smoking, and overweight were associated with a lower VO2peak. History of stroke and stroke characteristics were not related to VO2peak. CONCLUSION: The majority of patients with a recent TIA or minor ischemic stroke have a poor CRF. Our findings suggest that premorbid cardiovascular and pulmonary disease and vascular risk factors, but not TIA- or stroke-related factors, contribute to a reduced CRF.
RCT Entities:
BACKGROUND:Cardiorespiratory fitness (CRF) is reduced in patients with stroke. It is unclear whether it is also reduced in patients with a transient ischemic attack (TIA) or minor stroke. We investigated the CRF in patients with a recent TIA or minor stroke and explored which determinants are associated with a lower fitness. METHODS: In 113 patients with a recent TIA or minor ischemic stroke (64 (SD = 10) years of age; 49 (IQR 27-86) days post TIA or stroke), the peak oxygen consumption (VO2peak) was determined in a symptom-limited ramp exercise test. Physical activity level, vascular risk factors, history of vascular or pulmonary disease, and stroke characteristics were recorded at inclusion and related to the VO2peak. RESULTS: Mean VO2peak was 22 mL/kg/min (SD = 6), which is the fifth percentile of age- and sex-related normative values. Increasing age and female sex were associated with a lower VO2peak (B (95% CI): per 10 years -2.57 mL/kg/min (-3.75; -1.40) and female sex -5.84 mL/kg/min (-8.06; -3.62)). Age- and sex-adjusted linear regression analyses showed that a history of cardiovascular disease and pulmonary disease was associated with a lower VO2peak. In addition, a lower level of physical activity, hypertension, smoking, and overweight were associated with a lower VO2peak. History of stroke and stroke characteristics were not related to VO2peak. CONCLUSION: The majority of patients with a recent TIA or minor ischemic stroke have a poor CRF. Our findings suggest that premorbid cardiovascular and pulmonary disease and vascular risk factors, but not TIA- or stroke-related factors, contribute to a reduced CRF.
Authors: Wouter J Harmsen; Ladbon Khajeh; Gerard M Ribbers; Majanka H Heijenbrok-Kal; Emiel Sneekes; Fop van Kooten; Sebastian Neggers; Rita J van den Berg-Emons Journal: Phys Ther Date: 2019-07-01
Authors: Inger A Deijle; Roelofjan Hemmes; H Myrthe Boss; Edwin C de Melker; Bob T J van den Berg; Gert Kwakkel; Erwin van Wegen; Wendy M Bosboom; Henry C Weinstein; Sander M van Schaik; Renske M Van den Berg-Vos Journal: BMC Neurol Date: 2022-08-04 Impact factor: 2.903