Peak Cardiorespiratory Responses of Patients with Subacute Stroke During Land and Aquatic Treadmill Exercise

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The aim of this work was to investigate the cardiorespiratory responses of patients with subacute stroke to exercise stress tests with aquatic and land treadmills.


Twenty-one consecutive patients who presented with first-ever subacute stroke in 2013–2015. All subjects underwent symptom-limited incremental exercise testing with aquatic and land treadmills. Land treadmill speed started at 1.5 km/h and increased 0.5 km/h every 1 to 2 minutes until maximal tolerable speed was achieved. Thereafter, the grade was elevated by 2% every 2 minutes. In the aquatic treadmill test, subjects were submerged to the xiphoid in 28°C water. Treadmill speed started at 1.5 km/h and was increased 0.5 km/h every 2 minutes thereafter. Cardiorespiratory responses were recorded with aquatic and land treadmills.


Compared to land treadmill exercise, aquatic treadmill exercise achieved significantly better peak VO2 (22.0 vs 20.0; P = 0.02), peak metabolic equivalents (6.3 vs 5.8; P = 0.02), and peak rating of perceived exertion (17.6 vs 18.4, P = 0.01). Heart rate and VO2 correlated significantly during both tests (land treadmill: r = 0.96, P < 0.001; aquatic treadmill: r = 0.99, P < 0.001).


Aquatic treadmill exercise elicited significantly better peak cardiorespiratory responses than land treadmill exercise and may be as effective for early intensive aerobic training in subacute stroke patients.

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