Does clinical rehabilitation impose sufficient cardiorespiratory strain to improve aerobic fitness?

A.D. Koopman, M.M. Eken, T. van Bezeij, L. Valent, J.H.P. Houdijk

    Research output: Contribution to JournalArticleAcademicpeer-review

    Abstract

    Objective: To investigate the cardiorespiratory strain experienced by patients over a day and during different types of rehabilitation therapies during a clinical rehabilitation programme. In addition, to investigate the use of the Borg scale as an instrument to monitor exercise intensity. Design: An observational, cross-sectional study. Setting: Rehabilitation centre in the Netherlands. Participants: Eleven people after stroke (age range 20-71 years), 9 people with a lower limb amputation (age range 21-66 years) and 11 people with a spinal cord injury (age range 28-65 years). All participants were inpatients undergoing clinical rehabilitation. Main outcome measures: Frequency distribution of percentage heart rate reserve (%HRR) and length of time heart rate (HR) > 40%HRR over one day, and mean %HRR, length of time HR > 40%HRR and HR > 70%HRR during different types of rehabilitation therapies were compared with the American College of Sports Medicine guidelines for achieving an aerobic training effect. The correlation coefficient between the Borg scale score and %HRR was assessed. Results: Patients' mean HR was 114 min/day (standard deviation 92) > 40%HRR, of which 1 h was spent in therapy. In 5 out of 10 rehabilitation therapies (fitness, hydrotherapy, walking group, wheelchair group and cycling/handbike group) a mean HR > 40%HRR was reached and more than half of the time was spent > 40%HRR. A moderate correlation (R = 0.56) was found between Borg scale score and %HRR. All outcome measures showed large variation between and within patients. Conclusion: In general, patients in a clinical rehabilitation programme experience adequate cardiorespiratory strain to potentially induce an aerobic training effect. The large variation in cardiorespiratory strain, however, necessitates individual monitoring to ensure proper exercise intensity. The Borg scale was shown to be of limited value for this monitoring, and therefore the use of HR monitors during rehabilitation should be considered. © 2013 The Authors.
    Original languageEnglish
    Pages (from-to)92-8
    JournalJournal of Rehabilitation Medicine
    Volume45
    Issue number1
    Early online date25 Oct 2012
    DOIs
    Publication statusPublished - 2013

    Fingerprint

    Rehabilitation
    Heart Rate
    Hydrotherapy
    Outcome Assessment (Health Care)
    Exercise
    Rehabilitation Centers
    Wheelchairs
    Therapeutics
    Spinal Cord Injuries
    Amputation
    Netherlands
    Walking
    Inpatients
    Lower Extremity
    Cross-Sectional Studies
    Stroke
    Guidelines

    Cite this

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    title = "Does clinical rehabilitation impose sufficient cardiorespiratory strain to improve aerobic fitness?",
    abstract = "Objective: To investigate the cardiorespiratory strain experienced by patients over a day and during different types of rehabilitation therapies during a clinical rehabilitation programme. In addition, to investigate the use of the Borg scale as an instrument to monitor exercise intensity. Design: An observational, cross-sectional study. Setting: Rehabilitation centre in the Netherlands. Participants: Eleven people after stroke (age range 20-71 years), 9 people with a lower limb amputation (age range 21-66 years) and 11 people with a spinal cord injury (age range 28-65 years). All participants were inpatients undergoing clinical rehabilitation. Main outcome measures: Frequency distribution of percentage heart rate reserve ({\%}HRR) and length of time heart rate (HR) > 40{\%}HRR over one day, and mean {\%}HRR, length of time HR > 40{\%}HRR and HR > 70{\%}HRR during different types of rehabilitation therapies were compared with the American College of Sports Medicine guidelines for achieving an aerobic training effect. The correlation coefficient between the Borg scale score and {\%}HRR was assessed. Results: Patients' mean HR was 114 min/day (standard deviation 92) > 40{\%}HRR, of which 1 h was spent in therapy. In 5 out of 10 rehabilitation therapies (fitness, hydrotherapy, walking group, wheelchair group and cycling/handbike group) a mean HR > 40{\%}HRR was reached and more than half of the time was spent > 40{\%}HRR. A moderate correlation (R = 0.56) was found between Borg scale score and {\%}HRR. All outcome measures showed large variation between and within patients. Conclusion: In general, patients in a clinical rehabilitation programme experience adequate cardiorespiratory strain to potentially induce an aerobic training effect. The large variation in cardiorespiratory strain, however, necessitates individual monitoring to ensure proper exercise intensity. The Borg scale was shown to be of limited value for this monitoring, and therefore the use of HR monitors during rehabilitation should be considered. {\circledC} 2013 The Authors.",
    author = "A.D. Koopman and M.M. Eken and {van Bezeij}, T. and L. Valent and J.H.P. Houdijk",
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    Does clinical rehabilitation impose sufficient cardiorespiratory strain to improve aerobic fitness? / Koopman, A.D.; Eken, M.M.; van Bezeij, T.; Valent, L.; Houdijk, J.H.P.

    In: Journal of Rehabilitation Medicine, Vol. 45, No. 1, 2013, p. 92-8.

    Research output: Contribution to JournalArticleAcademicpeer-review

    TY - JOUR

    T1 - Does clinical rehabilitation impose sufficient cardiorespiratory strain to improve aerobic fitness?

    AU - Koopman, A.D.

    AU - Eken, M.M.

    AU - van Bezeij, T.

    AU - Valent, L.

    AU - Houdijk, J.H.P.

    PY - 2013

    Y1 - 2013

    N2 - Objective: To investigate the cardiorespiratory strain experienced by patients over a day and during different types of rehabilitation therapies during a clinical rehabilitation programme. In addition, to investigate the use of the Borg scale as an instrument to monitor exercise intensity. Design: An observational, cross-sectional study. Setting: Rehabilitation centre in the Netherlands. Participants: Eleven people after stroke (age range 20-71 years), 9 people with a lower limb amputation (age range 21-66 years) and 11 people with a spinal cord injury (age range 28-65 years). All participants were inpatients undergoing clinical rehabilitation. Main outcome measures: Frequency distribution of percentage heart rate reserve (%HRR) and length of time heart rate (HR) > 40%HRR over one day, and mean %HRR, length of time HR > 40%HRR and HR > 70%HRR during different types of rehabilitation therapies were compared with the American College of Sports Medicine guidelines for achieving an aerobic training effect. The correlation coefficient between the Borg scale score and %HRR was assessed. Results: Patients' mean HR was 114 min/day (standard deviation 92) > 40%HRR, of which 1 h was spent in therapy. In 5 out of 10 rehabilitation therapies (fitness, hydrotherapy, walking group, wheelchair group and cycling/handbike group) a mean HR > 40%HRR was reached and more than half of the time was spent > 40%HRR. A moderate correlation (R = 0.56) was found between Borg scale score and %HRR. All outcome measures showed large variation between and within patients. Conclusion: In general, patients in a clinical rehabilitation programme experience adequate cardiorespiratory strain to potentially induce an aerobic training effect. The large variation in cardiorespiratory strain, however, necessitates individual monitoring to ensure proper exercise intensity. The Borg scale was shown to be of limited value for this monitoring, and therefore the use of HR monitors during rehabilitation should be considered. © 2013 The Authors.

    AB - Objective: To investigate the cardiorespiratory strain experienced by patients over a day and during different types of rehabilitation therapies during a clinical rehabilitation programme. In addition, to investigate the use of the Borg scale as an instrument to monitor exercise intensity. Design: An observational, cross-sectional study. Setting: Rehabilitation centre in the Netherlands. Participants: Eleven people after stroke (age range 20-71 years), 9 people with a lower limb amputation (age range 21-66 years) and 11 people with a spinal cord injury (age range 28-65 years). All participants were inpatients undergoing clinical rehabilitation. Main outcome measures: Frequency distribution of percentage heart rate reserve (%HRR) and length of time heart rate (HR) > 40%HRR over one day, and mean %HRR, length of time HR > 40%HRR and HR > 70%HRR during different types of rehabilitation therapies were compared with the American College of Sports Medicine guidelines for achieving an aerobic training effect. The correlation coefficient between the Borg scale score and %HRR was assessed. Results: Patients' mean HR was 114 min/day (standard deviation 92) > 40%HRR, of which 1 h was spent in therapy. In 5 out of 10 rehabilitation therapies (fitness, hydrotherapy, walking group, wheelchair group and cycling/handbike group) a mean HR > 40%HRR was reached and more than half of the time was spent > 40%HRR. A moderate correlation (R = 0.56) was found between Borg scale score and %HRR. All outcome measures showed large variation between and within patients. Conclusion: In general, patients in a clinical rehabilitation programme experience adequate cardiorespiratory strain to potentially induce an aerobic training effect. The large variation in cardiorespiratory strain, however, necessitates individual monitoring to ensure proper exercise intensity. The Borg scale was shown to be of limited value for this monitoring, and therefore the use of HR monitors during rehabilitation should be considered. © 2013 The Authors.

    U2 - 10.2340/16501977-1072

    DO - 10.2340/16501977-1072

    M3 - Article

    VL - 45

    SP - 92

    EP - 98

    JO - Journal of Rehabilitation Medicine

    JF - Journal of Rehabilitation Medicine

    SN - 1650-1977

    IS - 1

    ER -