Upper limb energy demand during unilateral arm crank submaximal exercise testing in individuals with chronic stroke

ABSTRACT Objective To investigate (i) upper limb (UL) energy demand during unilateral arm crank submaximal exercise testing in individuals with stroke compared with healthy controls, and (ii) the relationship between UL energy demand and UL activity in individuals with stroke. Design Cross-sectional, observational study. Setting Research laboratory. Participants Individuals with chronic stroke (n=14) and controls (n=12), matched for age, sex, and body mass index. Main Outcome Measures UL energy demand was measured as peak VO2/peak load during unilateral arm crank submaximal exercise testing. UL activity was measured using the Box and Block Test (BBT) and Grooved Pegboard Test (GPT). Results The energy demand of the paretic side compared with the non-paretic side of the stroke group was 0.43 mL.kg−1.min−1.W−1 (95% CI 0.03 to 0.83, p=0.005) greater than the dominant compared with the non-dominant side of the control group. The median difference between sides in peak VO2/peak load was 52% for the stroke compared with 11% for the control group. Positive correlations between the median percentage difference between the paretic and the non-paretic side of peak VO2/peak load and BBT were 0.72 (p=0.004) and of VO2/peak load and GPT was 0.77 (p=0.002). Conclusions The higher energy demand of the paretic UL during unilateral arm crank submaximal exercise testing than the non-paretic and both UL of the controls together with the strong relationship between energy demand and UL activity suggest that the energy demand of the paretic UL has the potential to impact real life UL activity after stroke.