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An Equation With Clinical Applicability and Adequate Validity to Predict the Maximum Oxygen Consumption of Individuals Post-stroke

Published:December 06, 2022DOI:https://doi.org/10.1016/j.apmr.2022.11.005

      Highlights

      • Equation to predict the oxygen consumption of individuals post-stroke is necessary.
      • An equation with clinical applicability and adequate validity was provided.
      • o2max=22.239+0.020 × distance in the 6MWT+4.039 × sex-0.157 × age-0.265 × BMI.
      • Studies with larger sample must investigate the external validity of this equation.

      Abstract

      Objective

      To develop an equation with clinical applicability and adequate validity to predict the maximum oxygen consumption (V̇o2max) of individuals post-stroke.

      Design

      A cross-sectional study.

      Setting

      A university laboratory.

      Participants

      Individuals post-stroke in the chronic phase (at least 6 months post-stroke). Step-1 (equation development): n=50, aged 55±12 years; Step-2 (validity investigation): n=20, aged 58±8 years (N=50 [step 1], N=20 [step 2]).

      Interventions

      Not applicable.

      Main Outcome Measure(s)

      Step-1 (equation development): multiple linear regression analysis was performed. Dependent variable: V̇o2max (mL/kg/min) in the cardiopulmonary exercise test. Independent variables: age (years), sex (1-women, 2-men), body mass index (BMI) (kg/m2), and distance (meters) in the Six-Minute Walk Test (6MWT) (6MWT-Equation) or in the Incremental Shuttle Walk Test (ISWT) (ISWT-Equation). Step-2 (validity investigation): agreement between the V̇o2max measured and predicted was evaluated with the intraclass correlation coefficient (ICC) with 95% confidence interval (CI) and the Bland-Altman method (α=5%).

      Results

      In step-1 (equation development), the 4 independent variables for each equation were retained (6MWT-Equation: R2=0.68, P<.001; ISWT-Equation: R2=0.58, P<.001). In step-2 (validity investigation), the 6MWT-Equation showed an ICC of 0.73 (95% CI=0.30, 0.89; P=.004) and a mean bias of 0.003 mL/kg/min; and the ISWT-Equation showed an imprecise ICC of 0.55 (95% CI=-0.12, 0.82; P=.045) and a mean bias of 0.971 mL/kg/min. 6MWT-Equation (V̇o2max=22.239+0.02 × distance in the 6MWT+4.039 × sex-0.157 × age-0.265 × BMI) showed adequate validity.

      Conclusions

      An equation with clinical applicability and adequate validity in the investigated sample was developed to predict the V̇o2max of individuals post-stroke in the chronic phase (6MWT-Equation). Future studies with larger sample should investigate its external validity.

      Keywords

      List of abbreviations:

      BMI (body mass index), CI (confidence interval), CPET (cardiopulmonary exercise test), ICC (intraclass correlation coefficient), ISWT (Incremental Shuttle Walk Test), V̇o2max (maximum oxygen consumption), 6MWT (Six-Minute Walk Test), 10mWT (10-meter walk test)
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