Stair climbing test post-stroke: feasibility, convergent validity and metabolic, cardiac, and respiratory responses

Background: The 6-minute walk test (6MWT) and treadmill walk tests (TMW) are commonly used to assess post-stroke patients (PSP) aerobic capacity. However, these tests are not without their limitations (e.g. limited sensitivity to change and the use of external pacing). Therefore, there is a need for additional tools to assess PSP aerobic capacity. Objective: To establish the feasibility, convergent validity, and metabolic, cardiac, and respiratory responses of a stair climbing test (SC), among chronic PSP. Methods: Nineteen chronic PSP conducted SC, TMW, and 6MWT. Metabolic (oxygen consumption VO2), cardiac (heart rate), and respiratory (ventilation volume, breathing frequency, and tidal volume) measures were established. Adverse events were documented. Correlations established the convergent validity of the SC test. A repeated measures analysis of variance was performed to compare the participant's physiological responses at the end of the various tests. Results: SC is feasible and safe, as all participants completed the test with no adverse events. The SC demonstrated convergent validity as numerous associations were found between SC and TMW, and 6MWT. Metabolic, cardiac, and respiratory responses to the SC were significantly higher than these of the TMW and 6MWT (e.g. VO2=13.43+/- 2.19, 11.01+/- 2.0, and 11.26+/- 1.87 ml/kg/min, respectively) (P<0.05). Conclusions: SC is a feasible and valid test within chronic PSP. SC is more metabolically demanding than TMW and 6MW and therefore, may enable appropriate endurance capacity measurement, especially for high functioning PSP. Negotiating stairs is a common community ambulation requirement. Therefore, it is appropriate to incorporate SC test in PSP testing battery.