Dominik Zbogar1, Janice J Eng2, Jeremy W Noble3, William C Miller4, Andrei V Krassioukov5, Mary C Verrier6. 1. Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, Vancouver, BC, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 2. Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, Vancouver, BC, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: Janice.Eng@ubc.ca. 3. Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada. 4. Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, Vancouver, BC, Canada; Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 5. International Collaboration on Repair Discoveries, Vancouver, BC, Canada; Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 6. University Health Network - Toronto Rehabilitation Institute, Toronto, ON, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Abstract
OBJECTIVES: (1) To measure the amount of cardiovascular stress, self-reported physical activity, and accelerometry-measured physical activity by individuals with spinal cord injury (SCI) during physical therapy (PT) and occupational therapy (OT); and (2) to investigate the relations between these measures. DESIGN: Observational study. SETTING: Two inpatient SCI rehabilitation centers. PARTICIPANTS: Patients with SCI (N=87) were recruited from consecutive admissions to rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Heart rate was recorded by a Holter monitor, whereas physical activity was captured by self-report (Physical Activity Recall Assessment for People with SCI questionnaire) and real-time wrist accelerometry during a total of 334 PT and OT inpatient sessions. Differences between individuals with paraplegia and tetraplegia were assessed via Mann-Whitney U tests. Spearman correlations were used to explore the relation between measurements of physical activity and heart rate. RESULTS: Time spent at a heart rate within a cardiovascular training zone (≥40% heart rate reserve) was low and did not exceed a median of 5 minutes. In contrast, individuals reported at least 60 minutes of higher-intensity time during therapy. There was a low but statistically significant correlation between all measures. CONCLUSIONS: The cardiovascular stress incurred by individuals with SCI during inpatient PT and OT sessions is low and not sufficient to obtain a cardiovascular training effect to optimize their neurologic, cardiovascular, or musculoskeletal health; this represents a lost opportunity to maximize rehabilitation. Self-reported minutes of higher-intensity physical activity do not reflect actual time spent at a higher intensity measured objectively via a heart rate monitor.
OBJECTIVES: (1) To measure the amount of cardiovascular stress, self-reported physical activity, and accelerometry-measured physical activity by individuals with spinal cord injury (SCI) during physical therapy (PT) and occupational therapy (OT); and (2) to investigate the relations between these measures. DESIGN: Observational study. SETTING: Two inpatient SCI rehabilitation centers. PARTICIPANTS: Patients with SCI (N=87) were recruited from consecutive admissions to rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Heart rate was recorded by a Holter monitor, whereas physical activity was captured by self-report (Physical Activity Recall Assessment for People with SCI questionnaire) and real-time wrist accelerometry during a total of 334 PT and OT inpatient sessions. Differences between individuals with paraplegia and tetraplegia were assessed via Mann-Whitney U tests. Spearman correlations were used to explore the relation between measurements of physical activity and heart rate. RESULTS: Time spent at a heart rate within a cardiovascular training zone (≥40% heart rate reserve) was low and did not exceed a median of 5 minutes. In contrast, individuals reported at least 60 minutes of higher-intensity time during therapy. There was a low but statistically significant correlation between all measures. CONCLUSIONS: The cardiovascular stress incurred by individuals with SCI during inpatient PT and OT sessions is low and not sufficient to obtain a cardiovascular training effect to optimize their neurologic, cardiovascular, or musculoskeletal health; this represents a lost opportunity to maximize rehabilitation. Self-reported minutes of higher-intensity physical activity do not reflect actual time spent at a higher intensity measured objectively via a heart rate monitor.
Authors: Carol Ewing Garber; Bryan Blissmer; Michael R Deschenes; Barry A Franklin; Michael J Lamonte; I-Min Lee; David C Nieman; David P Swain Journal: Med Sci Sports Exerc Date: 2011-07 Impact factor: 5.411
Authors: J A Haisma; J B J Bussmann; H J Stam; T A R Sluis; M P Bergen; M W M Post; A J Dallmeijer; L H V van der Woude Journal: Clin Rehabil Date: 2007-10 Impact factor: 3.477
Authors: Shane J T Balthazaar; Tom E Nightingale; Katharine D Currie; Christopher R West; Teresa S M Tsang; Matthias Walter; Andrei V Krassioukov Journal: Front Cardiovasc Med Date: 2022-06-15
Authors: Marzieh M Ardestani; Christopher E Henderson; Seyed H Salehi; Gordhan B Mahtani; Brian D Schmit; T George Hornby Journal: J Neurotrauma Date: 2019-02-01 Impact factor: 5.269
Authors: B Catharine Craven; Louise Brisbois; Chelsea Pelletier; Julia Rybkina; Ann Heesters; Mary Caroline Verrier Journal: J Spinal Cord Med Date: 2021 Impact factor: 1.985