Cardiovascular stress during inpatient spinal cord injury rehabilitation

Publication date: Available online 13 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Dominik Zbogar, Janice J. Eng, William C. Miller, Andrei V. Krassioukov, Mary C. Verrier
Objectives1) To measure the amount of a) cardiovascular stress, b) self-reported physical activity and c) accelerometry-measured physical activity by individuals with SCI during physical therapy (PT) and occupational therapy (OT) and, 2) to investigate the relationship between these measures.DesignObservational study.SettingTwo inpatient SCI rehabilitation centres.ParticipantsSCI patients (n=87) were recruited from consecutive admissions to rehabilitation.Main Outcome MeasuresHeart rate (HR) was recorded by a Holter monitor, while physical activity was captured by self-report (PARA-SCI questionnaire) and real-time wrist accelerometry during a total 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 relationship between measurements of physical activity and HR.ResultsTime spent at a HR within a cardiovascular training zone (≥ 40% heart rate reserve) was low and did not exceed a median 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.ConclusionThe 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 neurological, cardiovascular, or musculoskeletal health; this represents a lost opportunity to maximize rehabilitation. Self-reported minutes of higher intensity PA do not reflect actual time spent at higher intensity measured objectively via a HR monitor.



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