Comparing self-reported levels of activity against gold standard fitness tests among people living with neurological disability

Research Objectives: To investigate whether simple self-report measures of physical activity could estimate the gold-standard test of cardiorespiratory fitness in people with stroke and multiple sclerosis.

Design: Cross-sectional descriptive.

Setting: A rehabilitation research laboratory.

Participants: A total of thirty-two community dwelling individuals with chronic stroke (mean age ± SD [y]: 65.97±9.9) and eighteen individuals with multiple sclerosis (50.39±12.2).

Interventions: Participants performed a physical activity profile questionnaire listing activities and their subjective intensity in relation to feelings of breathlessness or fatigue, a maximal exercise test, and self-selected walking along an instrumented walkway. Level of disability was determined using the National Institutes of Health Stroke Scale and Expanded Disability Status Scale.

Main Outcome Measures: Self-reported physical activity was quantified as metabolic equivalents of task (METs) and further categorized into METs of activities of daily living (ADL) and exercise. A maximal exercise test determined cardiorespiratory fitness indexed by peak oxygen uptake (V̇O2 peak). Self-selected walking was recorded as cm/s.

Results: There was no association between total METs and V̇O2 peak in either group. In the stroke patients, who had moderate disability and slow walking speed (67.0 cm/s), METs of ADLs and walking speed were correlated with fitness (R=0.45, p=0.011, R=0.64, p= <.001). However, in MS patients, who displayed mild disability and faster walking speed (92.6 cm/s), only METs of exercise were predictive (R=0.64, p=0.005).

Conclusions: Self-reports of physical activity levels can provide insight into levels of fitness for this sample of individuals with stroke and MS when they are separated into categories of ADLs and exercise. There is a need for more education on measurable, accessible markers of cardiorespiratory fitness to improve physical activity prescription for people with neurological diseases in community-based settings. Physical activity counselling should consider baseline disability and fitness and should deliver clear messages on forms of physical activity (ADLs versus exercise).

Author(s) Disclosures: All authors have nothing to disclose.