Cardiovascular stress during a contemporary stroke rehabilitation program: is the intensity adequate to induce a training effect?

OBJECTIVES: To investigate the level of cardiovascular stress of physical therapy (PT) and occupational therapy (OT) sessions of a contemporary stroke rehabilitation program and to identify therapeutic activities that elicit heart rate responses adequate to induce a training effect.
DESIGN: A descriptive, longitudinal study with heart rate and activity monitoring of PT and OT sessions at biweekly intervals, 2 to 14 weeks poststroke.
SETTING: An acute inpatient stroke unit and inpatient and outpatient stroke rehabilitation units. PARTICIPANTS: A consecutive sample of 20 patients with ischemic stroke who participated in inpatient and outpatient stroke rehabilitation. INTERVENTION: Observation of routine PT and OT sessions for patients poststroke without influencing the extent and content of the sessions. MAIN OUTCOME MEASURE: Time per session in which heart rate was within the calculated target heart rate zone.
RESULTS: Time per PT session spent in target heart rate zone was low (2.8+/-0.9 min), and per OT session was negligible (0.7+/-0.2 min) over the course of rehabilitation.
CONCLUSIONS: The PT and OT sessions between 2 and 14 weeks poststroke did not elicit adequate cardiovascular stress to induce a training effect. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation