Abstract
Understanding the physiological limitations to exercise after stroke will assist the development of targeted therapies to improve everyday function. This study defines (1) whether exercise capacity is limited by the cardiovascular system (oxygen supply) or skeletal muscles (oxygen utilization); and (2) cardiac function and pumping capability in people with stroke. Twenty-eight male participants with mild ischemic stroke (70 ± 6 years of age, 18 ± 20 months poststroke) and 25 male, age-matched healthy control subjects performed a graded cardiopulmonary exercise test with gas exchange and noninvasive hemodynamic measurements. Maximal oxygen extraction was calculated as the ratio between peak oxygen consumption and peak cardiac output. Cardiac function and pumping capability were assessed by peak exercise cardiac power output (expressed in watts) and cardiac output. Peak oxygen consumption (18.4 ± 4.6 versus 26.8 ± 5.5 mL/kg/min, P<0.01) and arterial-venous O(2) difference (9.3 ± 2.5 versus 12.6 ± 1.9 mlO(2)/100 mL of blood, P<0.01) were both reduced in stroke participants compared with healthy control subjects. In contrast, peak exercise cardiac power output (4.79 ± 0.79 versus 4.51 ± 0.96 W, P=0.49), cardiac output (16.4 ± 3.1 v...Continue Reading
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