Original article
Validity of Submaximal Exercise Testing in Adults With Athetospastic Cerebral Palsy

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Abstract

Satonaka A, Suzuki N, Kawamura M. Validity of submaximal exercise testing in adults with athetospastic cerebral palsy.

Objective

To examine the validity of the multistage submaximal cycle ergometer test for adults with athetospastic cerebral palsy.

Design

Cross-sectional and correlative study. Oxygen uptake and heart rates were recorded while the participants underwent the maximal cycle ergometer test and the multistage submaximal cycle ergometer test. Peak oxygen consumption (Vo2peak) was achieved by the maximal cycle test. Maximum oxygen consumption (V̇o2max) was predicted by the multistage submaximal cycle ergometer test.

Setting

Research laboratory setting.

Participants

Adults with athetospastic cerebral palsy (N=16; 10 women and 6 men; mean age ± SD, 43.7±14.5y).

Interventions

Not applicable.

Main Outcome Measure

Peak Vo2 was compared with the predicted V̇o2max.

Results

Mean Vo2peak and the predicted V̇o2max ± SD were 866.9±202.9mL/min−1 and 857.4±248.4mL/min−1, respectively. There was not a significant difference between Vo2peak values and the predicted V̇o2max values (r=.28). And there was a significant correlation between Vo2peak values and the predicted V̇o2max values (r=.94, P<.001). SE of the estimate (or SE for X to Y) was 71.2mL/min−1, equivalent to 7.4%.

Conclusions

The multistage submaximal cycle ergometer test may provide a valid V̇o2max estimate of adults with athetospastic cerebral palsy.

Section snippets

Participants

Twenty-five adults with athetospastic cerebral palsy were recruited from local care and rehabilitation facilities. The inclusion criteria were: (1) individuals over 20 years of age, (2) individuals who did not participate in sports or any special exercise programs, (3) individuals who had no cardiorespiratory diseases that would affect the results of this study, (4) individuals who did not take medication that could affect the results of this study (eg, β-blockers), and (5) individuals who had

Results

Sixteen out of 25 volunteers completed both the maximal cycle ergometer test and the multistage submaximal cycle ergometer test. The other 9 participants could not reach maximal effort during the maximal cycle ergometer test. Although the sample size was smaller as a result, we were unable to recruit additional volunteers at the time. Therefore, only data from 16 participants (10 women and 6 men) aged 43.7±14.5 years (range, 22–67y) were analyzed in this study. Nine of these 16 participants

Discussion

Most submaximal tests provide an accurate estimate of cardiorespiratory fitness in healthy individuals,8 and most do not require meticulous measurements of V̇o2. Furthermore, each test has been validated for specific populations (eg, men and women of different age groups).8, 9, 10 In contrast, there is no convenient submaximal test that has been validated for individuals with cerebral palsy, and many of these patients (9/25 in our study) may not be fit enough for maximum tests. In these

Conclusions

There have been no validated submaximal exercise tests to examine the cardiorespiratory fitness of adults with cerebral palsy. This study demonstrated that the multistage submaximal cycle ergometer test may provide a valid V̇o2max estimate of adults with athetospastic cerebral palsy. This test could be used for the evaluation and monitoring of rehabilitation outcomes in many more adults living with athetospastic cerebral palsy. Future studies should confirm that the multistage submaximal cycle

Acknowledgments

We thank Reisuke Natsume, MD, PhD, for introducing us to the people who attend the local care and rehabilitation facilities where he directs as a medical doctor, and for helping us to conduct this study. We also thank Pieter Mioch for his valuable advice in translation.

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