“Graded Cycling Test with Talk Test” Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke

Krawcyk, Rikke Steen; Vinther, Anders; Petersen, N.; Kruuse, Christina

doi:10.1016/j.jstrokecerebrovasdis.2016.12.004

Cited by 9 publications

(14 citation statements)

References 21 publications

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“…In addition, the supervision of all patients by a physiotherapist during the baseline assessment of the GCT-TT may have decreased the fear of doing aerobic exercise following stroke also in the usual care group. Despite encouragements and a subtle increase in physical activity, a change exceeding the previously established SEM 95 of 12.9W (34) was not observed either within the groups or between the groups in GCT-TT power output.…”

Section: Discussioncontrasting

confidence: 57%

“…When the patient was no longer able to speak comfortably the test terminated. A detailed test protocol has previously been published (34) establishing the feasibility and measurement error for groups [12.9W; standard error of measurement (SEM 95 )] and for individuals with lacunar stroke [18.3W; smallest real difference (SRD)] (34). The SRD corresponded to two steps (30W) in the GCT protocol, which represents a change for an individual patient (34).…”

Section: Methodsmentioning

confidence: 99%

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Effect of Home-Based High-Intensity Interval Training in Patients With Lacunar Stroke: A Randomized Controlled Trial

et al. 2019

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Background: High-intensity interval training (HIIT) is superior to moderate-intensity continuous training in improving cardiorespiratory fitness in patients with cardiovascular disease, but is it safe, feasible and effective in patients with stroke? We investigated feasibility and effect of early, home-based HIIT in patients with lacunar stroke combined with usual care vs. usual care, only. Methods: Patients with minor stroke (severity: 55/58 point on the Scandinavian Stroke Scale) were randomized to HIIT or usual care in a randomized, controlled trial. We measured the following outcomes at baseline and post-intervention: cardiorespiratory fitness monitored as power output from the Graded Cycling Test with Talk Test (GCT-TT; primary outcome), physical activity, fatigue, depression, well-being, stress, cognition, endothelial function, blood pressure, body mass index, and biomarkers. Results: We included 71 patients (mean age 63.7 ± 9.2), 49 men, 31 in intervention group. Home-based HIIT was feasible with no reported adverse events in relation to the intervention. No significant change between the groups in GCT-TT power output was detected ( p = 0.90). The change in time spent on vigorous-intensity activity was 2 h/week and 0.6 h/week, intervention and usual care, respectively ( p = 0.045). There were no significant differences between groups in the remaining secondary outcomes. Conclusion: HIIT was feasible and safe in patients with lacunar stroke. Patients can engage early in home-based HIIT when involved in choosing exercise modality and guided by weekly motivational phone calls. Within 3 months, HIIT did, however, not yield effect on cardiorespiratory fitness. We await further evaluation of long-term effects of this intervention on continued regular physical exercise and cardiovascular event. Clinical Trial Registration: https://clinicaltrials.gov , identifier NCT02731235

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Section: Discussioncontrasting

confidence: 57%

Section: Methodsmentioning

confidence: 99%

Effect of Home-Based High-Intensity Interval Training in Patients With Lacunar Stroke: A Randomized Controlled Trial

et al. 2019

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“…This point, identifies the highest possible exercise intensity where the patient can speak comfortably without feeling disturbed by increased breathing. A detailed test-protocol has previously been described [ 34 ].…”

Section: Methods and Analysismentioning

confidence: 99%

“…These qualities of the GCT-TT make it an attractive outcome measure in various rehabilitation settings. The GCT-TT has shown good reliability and minor measurement error in both patients with ischemic heart disease [ 35 ] and in patients with lacunar stroke [ 34 ]. The Standard Error of Measurement with 95% certainty (SEM 95 ) in patients with lacunar stroke is: 12.9 Watt.…”

Section: Methods and Analysismentioning

confidence: 99%

Home-based aerobic exercise in patients with lacunar stroke: Design of the HITPALS randomized controlled trial

Krawcyk

Vinther

Petersen

et al. 2019

Contemporary Clinical Trials Communications

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Background The effects of physical exercise in patients with lacunar stroke, seem promising in secondary prevention and only few studies have investigated the effect of high-intensity interval training in patients with lacunar stroke. This study will be investigating whether high-intensity interval training improves cardiovascular fitness as well as cognitive- and endothelial function and potentially attenuating the risk of recurrent stroke. Methods A randomized controlled trial evaluating 12 weeks of home-based, high-intensity interval training compared with usual care. The intervention group will be exercising 15 min a day, 5 days a week, for 12 weeks. Outcomes will be evaluated at baseline, three, six and twelve months post-stroke with ‘The Graded Cycling Test with Talk Test’ as the primary outcome registered as power output in Watts. Additionally, an annually register-based follow-up will be performed for 5 years from date of inclusion with a composite endpoint of cardiovascular disease or death. Secondary outcomes will be: physical activity, endothelial response, mental well-being, cognition, mood, fatigue, stress, and MRI scan. Discussion This study is going to show if early initiated home-based high-intensity interval training is feasible and effective in patients with lacunar stroke. A self-chosen aerobic exercise modality allows a realistic implementation of practice, together with greater chance of long-term adherence. A limitation of the study is that recruitment bias cannot be ruled out, as there may be a preferential enrolment of patients who are self-motivated to engage in exercise.

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“…Although an acceptable ICC value was found, Petersen et al [33] observed low reliability among evaluators when the TT was assessed only by physiotherapists and not by participants. The reliability values were classified as adequate [33] in only one study, two studies presented doubtful [29,31] reliability, and one was classified as inadequate [35] (Supplementary Table 3).…”

Section: Measurement Propertiesmentioning

confidence: 99%

Application and Measurement Properties of the Talk Test in Cardiopulmonary Patients: A Systematic Review

Vieira¹,

Martins²,

Althoff³

et al. 2022

Rev. Cardiovasc. Med.

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Background:The talk test (TT) evaluates the exercise intensity by measuring speech comfort level during aerobic exercise. There are several application protocols available to assess individuals with cardiopulmonary diseases. However, the measurement properties of the TT were not systematically reviewed yet. Methods: A systematic review was developed, registered (CRD420181068930), and reported according to PRISMA Statement. Randomized clinical trials, cross-sectional studies, or series cases were identified through multiple databases and were selected if they presented concomitant speech provocation and an exercise test. Included studies were evaluated based on methodological quality (adapted New Castle-Ottawa Scale), descriptive quality (STROBE Statement), and risk of bias (COSMIN bias risk scale). Results: Ten studies were included. Seven studies presented moderate to high quality and the majority presented good scores according to the STROBE statement. Four hundred and fourteen subjects performed the TT, the majority being patients with coronary artery disease. The test validity was supported by the included studies. Talk Test reliability was considered satisfactory, although only one study presented an adequate reliability analysis. The studies found a correlation between the last positive stage of the TT with the first ventilatory threshold. Workload, oxygen uptake, and heart rate in the last positive stage of the TT were not different from the same parameters related to the first ventilatory threshold. Conclusions: The evidence indicates that the TT is suitable as an alternative tool for the assessment and prescription of exercise in individuals with cardiovascular diseases. The stage when the individual is still able to speak comfortably is suggested as the intensity for aerobic exercise prescription. As there is still no well-defined and fully explored TT protocol, caution is required when interpreting the TT results.

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“Graded Cycling Test with Talk Test” Is a Reliable Test to Monitor Cardiovascular Fitness in Patients with Minor Stroke

Cited by 9 publications

References 21 publications

Effect of Home-Based High-Intensity Interval Training in Patients With Lacunar Stroke: A Randomized Controlled Trial

Effect of Home-Based High-Intensity Interval Training in Patients With Lacunar Stroke: A Randomized Controlled Trial

Home-based aerobic exercise in patients with lacunar stroke: Design of the HITPALS randomized controlled trial

Application and Measurement Properties of the Talk Test in Cardiopulmonary Patients: A Systematic Review

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