Comparison of Peak Cardiopulmonary Performance Parameters on a Robotics-Assisted Tilt Table, a Cycle and a Treadmill

Abstract

Robotics-assisted tilt table (RATT) technology provides body support, cyclical stepping movement and physiological loading. This technology can potentially be used to facilitate the estimation of peak cardiopulmonary performance parameters in patients who have neurological or other problems that may preclude testing on a treadmill or cycle ergometer. The aim of the study was to compare the magnitude of peak cardiopulmonary performance parameters including peak oxygen uptake (VO2peak) and peak heart rate (HRpeak) obtained from a robotics-assisted tilt table (RATT), a cycle ergometer and a treadmill. The strength of correlations between the three devices, test-retest reliability and repeatability were also assessed. Eighteen healthy subjects performed six maximal exercise tests, with two tests on each of the three exercise modalities. Data from the second tests were used for the comparative and correlation analyses. For nine subjects, test-retest reliability and repeatability of VO2peak and HRpeak were assessed. Absolute VO2peak from the RATT, the cycle ergometer and the treadmill was (mean (SD)) 2.2 (0.56), 2.8 (0.80) and 3.2 (0.87) L/min, respectively (p < 0.001). HRpeak from the RATT, the cycle ergometer and the treadmill was 168 (9.5), 179 (7.9) and 184 (6.9) beats/min, respectively (p < 0.001). VO2peak and HRpeak from the RATT vs the cycle ergometer and the RATT vs the treadmill showed strong correlations. Test-retest reliability and repeatability were high for VO2peak and HRpeak for all devices. The results demonstrate that the RATT is a valid and reliable device for exercise testing. There is potential for the RATT to be used in severely impaired subjects who cannot use the standard modalities.

Distinctive Steady-State Heart Rate and Blood Pressure Responses to Passive Robotic Leg Exercise and Functional Electrical Stimulation during Head-Up Tilt

“…This is because PE is consisted of passive robotic leg movements and cyclic leg loadings (provided by the springs beneath the subject's legs, see Figure 1), which result in improved muscle pump function and venous return, and thus, improved cardiovascular stability (Luther et al, 2008). The PE mechanism has also been used to develop biofeedback systems for early rehabilitation (Giggins et al, 2013), ranging from systems assuming complete passive inclusion of the subject in the biofeedback loop (Wieser et al, 2014; Sarabadani Tafreshi et al, 2015) to systems supposing active participation of the patient in the loop (Laubacher et al, 2015; Saengsuwan et al, 2015a,b). …”

Feasibility of cardiopulmonary exercise testing and training using a robotics-assisted tilt table in dependent-ambulatory stroke patients

“…The V'O 2peak reported in this study (11.9 ± 4.0 mL/kg/min) is lower than values previously reported in ambulatory stroke patients using: cycle ergometry, 17.2 ± 3.0 mL/kg/min [ 26 ]; recumbent cycle ergometry, 16.0 ± 1.2 mL/kg/min [ 27 ]; or a treadmill with body weight support, 14.4 ± 5.1 mL/kg/min [ 24 ]. This low value may be attributable in part to the more profound disability in the patients in the present study and in part to the observation that, in normal subjects, the RATT V'O 2peak is approximately 20 % lower than with a cycle ergometer and 30 % lower than for a treadmill [ 28 ].…”

“…The RATT V'O 2peak was previously observed to be approximately 20 % lower than the cycle ergometer and 30 % lower than the treadmill in normal subjects [ 28 ], but it is not certain whether these differences would be the same in stroke patients. Further study is needed to address the comparability of the RATT and the standard exercise testing devices (e.g.…”

A method for predicting peak work rate for cycle ergometer and treadmill ramp tests

“…(). We divided METpred by 1·1 for the prediction of maximal on the cycle ergometer because maximal achieved by the cycle ergometer is generally approximately 10% lower than the treadmill (Saengsuwan et al ., ) and this factor was used by Wasserman et al . () for the translation of maximal from the treadmill to the cycle ergometer.…”