Pub Date : 2022-03-16DOI: 10.1097/CPT.0000000000000201
Bini Thomas, J. Tabisz, Kelly Collins, O. Kim, Sharmila Gupte
Introduction and Purpose: The 2019 emergence of the coronavirus disease (COVID-19), and associated medical complications of pneumonia and acute respiratory distress syndrome, necessitated the development of safe and effective physical therapy (PT) interventions to treat this new patient population. The acuity of patients with COVID-19 resulted in intensive care unit (ICU)–acquired weakness and deconditioning. The purpose of this case study was to discuss the physical therapy contributions in treating a complex patient with COVID-19 who required venovenous extracorporeal membrane oxygenation (ECMO) support. Case Presentation: This case report discusses a patient who was 34 years old with morbid obesity, in her third trimester of pregnancy, who tested positive for SARS-CoV-2. The deteriorating respiratory status required the patient to have an emergent caesarean section, intubation, and ventilatory support. Methods: Worsening hypoxic respiratory failure and medical deterioration resulted in the initiation of ECMO. After 18 days, the patient was weaned off ECMO and medically cleared to initiate PT. Physical therapy interventions included positioning for airway clearance, bed mobility, transfer training, strengthening, mechanically assisted gait training, and patient education. Results: After 30 days, the patient was transferred back to the referring community hospital where she was subsequently weaned off oxygen support and discharged directly home. Conclusion: This case study outlines how initiating physical therapy interventions in the ICU in collaboration with other disciplines may have contributed to the functional recovery of a medically complex patient with COVID-19. Further research is recommended regarding early and collaborative interventions in the ICU for medically complex patients with COVID-19.
{"title":"Importance of Physical Therapy Interventions for Medically Complex Patient With Severe COVID-19: A Case Report","authors":"Bini Thomas, J. Tabisz, Kelly Collins, O. Kim, Sharmila Gupte","doi":"10.1097/CPT.0000000000000201","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000201","url":null,"abstract":"Introduction and Purpose: The 2019 emergence of the coronavirus disease (COVID-19), and associated medical complications of pneumonia and acute respiratory distress syndrome, necessitated the development of safe and effective physical therapy (PT) interventions to treat this new patient population. The acuity of patients with COVID-19 resulted in intensive care unit (ICU)–acquired weakness and deconditioning. The purpose of this case study was to discuss the physical therapy contributions in treating a complex patient with COVID-19 who required venovenous extracorporeal membrane oxygenation (ECMO) support. Case Presentation: This case report discusses a patient who was 34 years old with morbid obesity, in her third trimester of pregnancy, who tested positive for SARS-CoV-2. The deteriorating respiratory status required the patient to have an emergent caesarean section, intubation, and ventilatory support. Methods: Worsening hypoxic respiratory failure and medical deterioration resulted in the initiation of ECMO. After 18 days, the patient was weaned off ECMO and medically cleared to initiate PT. Physical therapy interventions included positioning for airway clearance, bed mobility, transfer training, strengthening, mechanically assisted gait training, and patient education. Results: After 30 days, the patient was transferred back to the referring community hospital where she was subsequently weaned off oxygen support and discharged directly home. Conclusion: This case study outlines how initiating physical therapy interventions in the ICU in collaboration with other disciplines may have contributed to the functional recovery of a medically complex patient with COVID-19. Further research is recommended regarding early and collaborative interventions in the ICU for medically complex patients with COVID-19.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"151 - 156"},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41838143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-19DOI: 10.1097/CPT.0000000000000190
A. Garcia-Araujo, R. Trimer, Cássia da Luz Goulart, F. Caruso, P. A. Ricci, A. Borghi-Silva
Purpose: To evaluate interrater and intrarater reliability of chest wall mobility using cirtometry in individuals with asthma and controls. Methods: Twenty-six controlled individuals with asthma group (AG) and 12 healthy individuals control group (CG) underwent chest wall mobility assessed by cirtometry. The measurements were performed manually by 2 independent evaluators at 3 levels: axillary, xiphoid and abdominal using a tape, in 2 different days. For the analyses, the average of 3 measurements and the highest value were considered. Results: Interrater reliability in AG showed acceptable intraclass correlation coefficient (ICC) for the axillary (0.76 and 0.75), good for the xiphoid (0.91 and 0.93), and abdominal level (0.91 and 0.91) for the average and highest value. In CG, ICC values were acceptable for the 3 levels: axillary (0.64 and 0.71), xiphoid (0.66 and 0.93), and abdominal level (0.61 and 0.91) also for the average and highest value. The analysis with the mean and the highest values found it acceptable for the axillary and good for the xiphoid and abdominal levels. Intrarater ICC was good for all levels in AG, axillary (0.86), xiphoid (0.93), and abdominal (0.96), for both evaluators. In CG, for evaluator 1, it was acceptable for the axillary and good for the xiphoid and abdominal levels. Regarding evaluator 2, it was good for the axillary and xiphoid and acceptable at the abdominal level. Conclusion: Cirtometry is a reliable tool to measure the chest wall mobility in controlled asthma individuals and in healthy individuals. The average of the 3 measurements or the highest value of the evaluations may be considered in clinical assessments. Axillary mobility was lower in the asthma group.
{"title":"Interevaluator and Intraevaluator Reliability of Chest Wall Mobility Assessment in Young Asthmatics Subjects","authors":"A. Garcia-Araujo, R. Trimer, Cássia da Luz Goulart, F. Caruso, P. A. Ricci, A. Borghi-Silva","doi":"10.1097/CPT.0000000000000190","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000190","url":null,"abstract":"Purpose: To evaluate interrater and intrarater reliability of chest wall mobility using cirtometry in individuals with asthma and controls. Methods: Twenty-six controlled individuals with asthma group (AG) and 12 healthy individuals control group (CG) underwent chest wall mobility assessed by cirtometry. The measurements were performed manually by 2 independent evaluators at 3 levels: axillary, xiphoid and abdominal using a tape, in 2 different days. For the analyses, the average of 3 measurements and the highest value were considered. Results: Interrater reliability in AG showed acceptable intraclass correlation coefficient (ICC) for the axillary (0.76 and 0.75), good for the xiphoid (0.91 and 0.93), and abdominal level (0.91 and 0.91) for the average and highest value. In CG, ICC values were acceptable for the 3 levels: axillary (0.64 and 0.71), xiphoid (0.66 and 0.93), and abdominal level (0.61 and 0.91) also for the average and highest value. The analysis with the mean and the highest values found it acceptable for the axillary and good for the xiphoid and abdominal levels. Intrarater ICC was good for all levels in AG, axillary (0.86), xiphoid (0.93), and abdominal (0.96), for both evaluators. In CG, for evaluator 1, it was acceptable for the axillary and good for the xiphoid and abdominal levels. Regarding evaluator 2, it was good for the axillary and xiphoid and acceptable at the abdominal level. Conclusion: Cirtometry is a reliable tool to measure the chest wall mobility in controlled asthma individuals and in healthy individuals. The average of the 3 measurements or the highest value of the evaluations may be considered in clinical assessments. Axillary mobility was lower in the asthma group.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"70 - 76"},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45177615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/cpt.0000000000000174
Rebecca Byrd, Patrick J Smith, Hannah F McHugh, Laurie D Snyder, Amy M Pastva
Purpose: The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation.
Methods: Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression.
Results: Participants (N = 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1-3) after hospital discharge. The mean 6MWD of 324 m (SD = 107) improved after rehabilitation to 488 m (SD = 105). Factors associated with improvement were younger age (P = .003), higher baseline forced expiratory volume in 1 second (FEV1) (P < .001), and lower baseline 6MWD (P < .001). Participants averaged 22 sessions in 41 days (IQR 35-50); with lower baseline FEV1 (P = .002) and 6MWD (P < .001) associated with longer completion time.
Conclusions: A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management. (Cardiopulm Phys Ther J. 2022;33:24-30).
{"title":"Condensed Outpatient Rehabilitation Early After Lung Transplantation: A Retrospective Analysis of 6-Minute Walk Distance and Its Predictors.","authors":"Rebecca Byrd, Patrick J Smith, Hannah F McHugh, Laurie D Snyder, Amy M Pastva","doi":"10.1097/cpt.0000000000000174","DOIUrl":"10.1097/cpt.0000000000000174","url":null,"abstract":"<p><strong>Purpose: </strong>The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation.</p><p><strong>Methods: </strong>Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression.</p><p><strong>Results: </strong>Participants (N = 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1-3) after hospital discharge. The mean 6MWD of 324 m (SD = 107) improved after rehabilitation to 488 m (SD = 105). Factors associated with improvement were younger age (<i>P</i> = .003), higher baseline forced expiratory volume in 1 second (FEV<sub>1</sub>) (<i>P</i> < .001), and lower baseline 6MWD (<i>P</i> < .001). Participants averaged 22 sessions in 41 days (IQR 35-50); with lower baseline FEV<sub>1</sub> (<i>P</i> = .002) and 6MWD (<i>P</i> < .001) associated with longer completion time.</p><p><strong>Conclusions: </strong>A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management. (<b>Cardiopulm Phys Ther J. 2022;33:24-30</b>).</p>","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"24-30"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43832971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-06DOI: 10.1097/CPT.0000000000000191
MarySue Ingman, J. Bezner, B. Black, Phillip W. Vaughan
Supplemental Digital Content is Available in the Text. Purpose: Physical therapists are well positioned to encourage their patients to live a healthy lifestyle. Physical therapists report barriers that limit their ability to practice health promotion counseling with their patients including the availability of a brief tool to gather information about their patient's current level of activity related to specific health behaviors. The purpose of this study was to describe the development and testing of the Physical Therapy Healthy Lifestyle Appraisal (PTHLA). Methods: The PTHLA is a patient self-report questionnaire that assesses stage of change, importance of changing, and confidence in engaging in 6 health behaviors. Physical Therapy Healthy Lifestyle Appraisal version 1 (106 items) was designed to compare different constructs for measuring stage of change and confidence in engaging in health behaviors. After pilot testing, 3 versions were tested to arrive at the 18 item PTHLA-version 3. Physical therapy patients in outpatient clinics in Michigan, Minnesota, and Texas were recruited for this multiphase study (version 1 n = 60, version 2 n = 65, and version 3 n = 28). Results: Physical Therapy Healthy Lifestyle Appraisal version 3 consists of 3 questions for each of 6 health behavior domains; a 3-option ordinal question for assessing stage of change and 11-point rulers for assessing importance of engaging in the behavior and confidence in engaging in the behavior. Unique items from version 1 and version 2 were retained in PTHLA-version 3, whereas those items that were somewhat redundant were excluded. Behavioral definitions for the “sleep” and “stress” domains were the only changes made from the first to the second versions. Across samples and behavioral domains, scores for the 18 items generally displayed satisfactory-to-high test–retest reliabilities (Cohen κw = 0.56–1.00, mean = 0.76; Spearman ρ = 0.53–1.00, mean = 0.77; intraclass correlation coefficient = 0.39–1.00, mean = 0.74). Confidence in behavior ruler scores displayed satisfactory-to-high convergent correlations with scores from lengthier multiple-item confidence in behavior measures (Pearson r validity coefficients = 0.33–0.90, mean = 0.63). The three-option stage of change items demonstrated satisfactory convergent validity with scores on the stage of change ruler (Pearson r validity coefficients = 0.16–0.86, mean = 0.61). Conclusions: The PTHLA-version 3 is a reliable and efficient tool for PT practice developed by physical therapists with expertise in prevention, health promotion, and wellness. Physical therapists can use the information provided from the PTHLA to initiate conversations about behavior change with their patients. Understanding the patient's current stage of change, level of interest in changing the behavior, and confidence for changing the behavior is important information for the PT to ensure a productive and respectful conversation about behavior change.
补充数字内容可在文本中获得。目的:物理治疗师有能力鼓励他们的病人过健康的生活方式。物理治疗师报告了一些障碍，这些障碍限制了他们对患者进行健康促进咨询的能力，包括收集患者当前与特定健康行为相关的活动水平信息的简短工具的可用性。本研究的目的是描述物理治疗健康生活方式评估(PTHLA)的发展和测试。方法:PTHLA是一份患者自我报告问卷，评估患者参与6种健康行为的改变阶段、改变的重要性和信心。物理治疗健康生活方式评估第1版(106项)旨在比较不同构式对参与健康行为的改变阶段和信心的测量。经过试点测试，测试了3个版本，得到了18个项目的pthla -版本3。在密歇根州、明尼苏达州和德克萨斯州的门诊诊所接受物理治疗的患者被招募参加这项多期研究(版本1 n = 60，版本2 n = 65，版本3 n = 28)。结果:物理治疗健康生活方式评估第3版由6个健康行为领域各3个问题组成;一个3选项顺序问题用于评估变化阶段和11分标尺用于评估参与行为的重要性和参与行为的信心。版本1和版本2中的独特项目保留在pthla -版本3中，而那些有些冗余的项目被排除在外。“睡眠”和“压力”领域的行为定义是从第一个版本到第二个版本的唯一变化。在样本和行为领域中，18个项目的得分普遍表现出满意到高的重测信度(Cohen κw = 0.56-1.00，平均值= 0.76;Spearman ρ = 0.53-1.00，均值= 0.77;类内相关系数= 0.39-1.00，平均值= 0.74)。行为标尺得分的置信度与行为测量中更长的多项置信度得分表现出满意到高的收敛相关性(Pearson r效度系数= 0.33-0.90，平均值= 0.63)。三选项阶段的变化项目与变化阶段标尺上的分数具有满意的收敛效度(Pearson r效度系数= 0.16-0.86，平均值= 0.61)。结论:PTHLA-version 3是一种可靠和有效的PT实践工具，由具有预防，健康促进和健康专业知识的物理治疗师开发。物理治疗师可以利用PTHLA提供的信息，与患者就行为改变展开对话。了解患者当前的变化阶段，改变行为的兴趣程度，以及改变行为的信心，对于PT来说是重要的信息，以确保关于行为改变的富有成效和尊重的谈话。
{"title":"Development and Reliability of the Physical Therapy Healthy Lifestyle Appraisal: A New Assessment Tool to Guide Behavior Change","authors":"MarySue Ingman, J. Bezner, B. Black, Phillip W. Vaughan","doi":"10.1097/CPT.0000000000000191","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000191","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Physical therapists are well positioned to encourage their patients to live a healthy lifestyle. Physical therapists report barriers that limit their ability to practice health promotion counseling with their patients including the availability of a brief tool to gather information about their patient's current level of activity related to specific health behaviors. The purpose of this study was to describe the development and testing of the Physical Therapy Healthy Lifestyle Appraisal (PTHLA). Methods: The PTHLA is a patient self-report questionnaire that assesses stage of change, importance of changing, and confidence in engaging in 6 health behaviors. Physical Therapy Healthy Lifestyle Appraisal version 1 (106 items) was designed to compare different constructs for measuring stage of change and confidence in engaging in health behaviors. After pilot testing, 3 versions were tested to arrive at the 18 item PTHLA-version 3. Physical therapy patients in outpatient clinics in Michigan, Minnesota, and Texas were recruited for this multiphase study (version 1 n = 60, version 2 n = 65, and version 3 n = 28). Results: Physical Therapy Healthy Lifestyle Appraisal version 3 consists of 3 questions for each of 6 health behavior domains; a 3-option ordinal question for assessing stage of change and 11-point rulers for assessing importance of engaging in the behavior and confidence in engaging in the behavior. Unique items from version 1 and version 2 were retained in PTHLA-version 3, whereas those items that were somewhat redundant were excluded. Behavioral definitions for the “sleep” and “stress” domains were the only changes made from the first to the second versions. Across samples and behavioral domains, scores for the 18 items generally displayed satisfactory-to-high test–retest reliabilities (Cohen κw = 0.56–1.00, mean = 0.76; Spearman ρ = 0.53–1.00, mean = 0.77; intraclass correlation coefficient = 0.39–1.00, mean = 0.74). Confidence in behavior ruler scores displayed satisfactory-to-high convergent correlations with scores from lengthier multiple-item confidence in behavior measures (Pearson r validity coefficients = 0.33–0.90, mean = 0.63). The three-option stage of change items demonstrated satisfactory convergent validity with scores on the stage of change ruler (Pearson r validity coefficients = 0.16–0.86, mean = 0.61). Conclusions: The PTHLA-version 3 is a reliable and efficient tool for PT practice developed by physical therapists with expertise in prevention, health promotion, and wellness. Physical therapists can use the information provided from the PTHLA to initiate conversations about behavior change with their patients. Understanding the patient's current stage of change, level of interest in changing the behavior, and confidence for changing the behavior is important information for the PT to ensure a productive and respectful conversation about behavior change.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"77 - 86"},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61664749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.1097/CPT.0000000000000188
Catherine Stolboushkin, Rajashree Mondkar, Terrence Schwing, Bobby Belarmino
Purpose: To describe physical therapist (PT) practice for patients with COVID-19 in the intensive care unit (ICU) at a tertiary hospital and to describe a novel clinical decision-making algorithm (nCDM) and its use in enhancing clinical practice for this patient population. Methods: This is a single-center, retrospective chart review. An nCDM was formulated to assist with best practice. The Activity Measure for Post-Acute Care “6 clicks” (AM-PAC) score, highest level of mobility, discharge destination, and observed clinical complications at hospital discharge were collected. Results: Seventy-seven patients received ICU PT services. Of these, twenty-six patients were outside previously established parameters for initiating PT intervention and forty-four patients were on mechanical ventilation during the initial PT evaluation. All groups showed a statistically significant improvement in their respective AM-PAC scores from initial PT evaluation to ICU discharge. Conclusion: The authors have described our PT practice for this patient population in our setting. Patients who were outside previously established parameters for initiating PT intervention were able to participate with PT and showed functional improvement. This nCDM shows a promising use in enhancing clinical decision-making for PT practice while treating patients with COVID-19 in the ICU.
{"title":"Physical Therapy Practice for Critically Ill Patients With COVID-19 in the Intensive Care Unit","authors":"Catherine Stolboushkin, Rajashree Mondkar, Terrence Schwing, Bobby Belarmino","doi":"10.1097/CPT.0000000000000188","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000188","url":null,"abstract":"Purpose: To describe physical therapist (PT) practice for patients with COVID-19 in the intensive care unit (ICU) at a tertiary hospital and to describe a novel clinical decision-making algorithm (nCDM) and its use in enhancing clinical practice for this patient population. Methods: This is a single-center, retrospective chart review. An nCDM was formulated to assist with best practice. The Activity Measure for Post-Acute Care “6 clicks” (AM-PAC) score, highest level of mobility, discharge destination, and observed clinical complications at hospital discharge were collected. Results: Seventy-seven patients received ICU PT services. Of these, twenty-six patients were outside previously established parameters for initiating PT intervention and forty-four patients were on mechanical ventilation during the initial PT evaluation. All groups showed a statistically significant improvement in their respective AM-PAC scores from initial PT evaluation to ICU discharge. Conclusion: The authors have described our PT practice for this patient population in our setting. Patients who were outside previously established parameters for initiating PT intervention were able to participate with PT and showed functional improvement. This nCDM shows a promising use in enhancing clinical decision-making for PT practice while treating patients with COVID-19 in the ICU.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"60 - 69"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43419815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-30DOI: 10.1097/CPT.0000000000000181
K. Dias, Ethan DuClos, James Heath, Shelbi Nelson, Bethany Coffey, Steven Schahl, Nicholas Giacalone, S. Collins
Purpose: Blood pressure (BP) during arm (AE) and leg ergometry (LE) have traditionally been compared at submaximal intensities of the peak oxygen uptake, which is often challenging to interpret in clinical practice. The purpose of this investigation was to evaluate the relationship of the heart rate with systolic blood pressure (SBP), diastolic blood pressure (DBP), and workload (WL) during AE and LE exercise. Methods: A prospective, observational, cross-sectional design with 35 healthy subjects compared BP and WL during AE and LE at specific submaximal target heart rates (HRs) of 110, 120, 130, 140, and 150 beats per minute. A linear mixed model tested for differences in SBP, DBP, and WL between AE and LE. Results: There was a larger increase in SBP {0.55 mm Hg (95% CI [0.38, 0.73])} per heart beat during LE. There was a larger increase in WL {0.62 watts (95% CI [0.38, 0.85])} and WL relative to body mass {0.01 watts/kg (95% CI [0.006, 0.011])} per heart beat during LE. Statistical models were developed that estimated SBP, DBP, and WL based on the submaximal heart rate. Conclusion: The findings from this investigation informs physical therapists that lower SBP, higher DBP, and lower WL is achieved at any given submaximal HR during AE compared with LE. Furthermore, prediction equations derived from the statistical models can be used to compare actual against predicted SBP and DBP responses to determine tolerance to exercise. Finally, differences in WL per beat increase in HR are valuable in dosing exercise on the AE or LE.
{"title":"Differences in Blood Pressure and Workload Intensity During Arm and Leg Ergometry at Submaximal Target Heart Rates in College-Aged Individuals","authors":"K. Dias, Ethan DuClos, James Heath, Shelbi Nelson, Bethany Coffey, Steven Schahl, Nicholas Giacalone, S. Collins","doi":"10.1097/CPT.0000000000000181","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000181","url":null,"abstract":"Purpose: Blood pressure (BP) during arm (AE) and leg ergometry (LE) have traditionally been compared at submaximal intensities of the peak oxygen uptake, which is often challenging to interpret in clinical practice. The purpose of this investigation was to evaluate the relationship of the heart rate with systolic blood pressure (SBP), diastolic blood pressure (DBP), and workload (WL) during AE and LE exercise. Methods: A prospective, observational, cross-sectional design with 35 healthy subjects compared BP and WL during AE and LE at specific submaximal target heart rates (HRs) of 110, 120, 130, 140, and 150 beats per minute. A linear mixed model tested for differences in SBP, DBP, and WL between AE and LE. Results: There was a larger increase in SBP {0.55 mm Hg (95% CI [0.38, 0.73])} per heart beat during LE. There was a larger increase in WL {0.62 watts (95% CI [0.38, 0.85])} and WL relative to body mass {0.01 watts/kg (95% CI [0.006, 0.011])} per heart beat during LE. Statistical models were developed that estimated SBP, DBP, and WL based on the submaximal heart rate. Conclusion: The findings from this investigation informs physical therapists that lower SBP, higher DBP, and lower WL is achieved at any given submaximal HR during AE compared with LE. Furthermore, prediction equations derived from the statistical models can be used to compare actual against predicted SBP and DBP responses to determine tolerance to exercise. Finally, differences in WL per beat increase in HR are valuable in dosing exercise on the AE or LE.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"33 1","pages":"31 - 39"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48363108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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