Relative Aerobic Load of Daily Activities after Stroke 2023 Blokland et al

Abstract

Objective
Individuals after stroke are less active, experience more fatigue, and perform activities at a slower pace than peers with no impairments. These problems might be caused by an increased aerobic energy expenditure during daily tasks and a decreased aerobic capacity after stroke. The aim of this study was to quantify relative aerobic load (ie, the ratio between aerobic energy expenditure and aerobic capacity) during daily-life activities after stroke.

Methods
Seventy-nine individuals [after stroke (14 in Functional Ambulation Category [FAC] 3, 25 in FAC 4, and 40 in FAC 5) and 22 peers matched for age, sex, and body mass index performed a maximal exercise test and 5 daily-life activities at a preferred pace for 5 minutes. Aerobic energy expenditure (mL of O2/kg/min) and economy (mL of O2/kg/unit of distance) were derived from oxygen uptake (⁠Vo2⁠). Relative aerobic load was defined as aerobic energy expenditure divided by peak aerobic capacity (%Vo2peak) and by Vo2 at the ventilatory threshold (%Vo2-VT) and compared in individuals after stroke and individuals with no impairments.

Results
Individuals after stroke performed activities at a significantly higher relative aerobic load (39%–82%Vo2peak) than peers with no impairments (38%–66% Vo2peak), despite moving at a significantly slower pace. Aerobic capacity in individuals after stroke was significantly lower than that in peers with no impairments. Movement was less economical in individuals after stroke than in peers with no impairments.

Conclusion
Individuals after stroke experience a high relative aerobic load during cyclic daily-life activities, despite adopting a slower movement pace than peers with no impairments. Perhaps individuals after stroke limit their movement pace to operate at sustainable relative aerobic load levels at the expense of pace and economy.

Impact
Improving aerobic capacity through structured aerobic training in a rehabilitation program should be further investigated as a potential intervention to improve mobility and functioning after stroke.

Open access, https://academic.oup.com/ptj/advance-article/doi/10.1093/ptj/pzad005/6989697

 

Yeah, definitely the problems are not limited to us at all. It's a failure of basic reasoning and common sense and it's all downhill from there. It's as if problem-solving is entirely missing from the profession, it just follows the path of least resistance.

We don't have a health profession, we have a some-diseases profession. It's terrible outside of some specific scenarios. This entire profession needs to be rebuilt from the ground up without all the baggage.