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Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)

Hitting the Target? Achieving optimal cardiovascular intensity for persons with spinal cord injury and stroke

Thursday, November 10, 2022

3:24 PM – 3:29 PM

Location: Station 3

Presenting Author(s)

Zachary C. Crump, PT, DPT

Locomotor Specialist
Sheltering Arms Institute
Richmond, Virginia, United States

Non-presenting Author(s)

Amol M. Karmarkar, PhD

Professor and Director of Research
Virginia Commonwealth University (VCU) & Sheltering Arms Institute (SAI)
Richmond, Virginia, United States

Research Objectives: To investigate the feasibility of achieving the American Physical Therapy Association Locomotor Clinical Practice Guideline’s cardiovascular intensity recommendations for persons with acute or sub-acute spinal cord injury (SCI) and acute or sub-acute cerebrovascular accident (CVA).

Design: A retrospective data-analysis from June 2020-June 2022

Setting: 114 bed inpatient rehabilitation hospital

Participants: 78 persons with acute/sub-acute spinal cord injury who participated in 253 locomotor sessions and 81 persons with acute/sub-acute stroke who participated in 222 locomotor sessions.

Interventions: Locomotor sessions were 30-60 minutes in duration and aimed to utilize advanced rehabilitation technology in order to achieve target heart rate recommendations within 60-80% heart rate reserve per the American Physical Therapy Association Locomotor Clinical Practice Guideline.

Main Outcome Measures: Average heart rate with activity, average maximum heart rate with activity, average target heart rate, average gait distance (feet), and rating of perceived exertion (RPE).

Results: 22.2% of persons with acute/sub-acute cerebrovascular accident achieved average target heart rate via average maximum heart rate, while 17.9% of persons with SCI achieved average target heart rate via average maximum heart rate. Average RPE was 15 for both SCI and CVA cohorts. Average session walking distance for persons with SCI and CVA were 1,250.95 feet and 1,313.45 feet, respectively.

Conclusions: Achievement of Locomotor Clinical Practice Guideline target heart rate values appear to be more feasible for persons with acute/sub-acute CVA than for SCI, although attainment of target heart rates were low for both groups. Gait distance and perceived exertion levels were similar between groups, although heart rate responses appeared to be different.

Author(s) Disclosures: None

Learning Objectives:

1. Describe the differences in cardiovascular response to intensive locomotor training between persons with acute/sub-acute SCI and stroke.
Define the American Physical Therapy Association Locomotor Clinical Practice Guideline's optimal cardiovascular intensity recommendations for persons with non-progressive upper motor neuron injury.
Describe how to utilize at least 1 piece of advanced rehabilitation technology during an intensive locomotor training session.
Describe at least 1 barrier and 1 facilitator that contributes to achieving optimal cardiovascular intensity for persons with acute/sub-acute CVA and SCI.