Oral Presentation Smart Strokes Annual Scientific Meeting 2024

Cardiorespiratory Intensity During Home-Based Physiotherapy In Post-Stroke Rehabilitation (106574)

Stephanie Mock 1 2 , Dr Julie Pryor 1 , Dr Chris Barr 2 , Dr Maayken van den Berg 2
  1. Royal Rehab, Ryde, NSW, Australia
  2. Clinical Rehabilitation, Flinders University, Bedford Park, SA, Australia

Introduction: Cardiorespiratory deconditioning, lowered functional capacity and higher sedentary behaviours are well-known effects following stroke. Physiotherapy sessions and home programs can facilitate daily exercise to improve these factors. However, it is not known if home-based rehabilitation physiotherapy sessions are provided at an intensity that evokes cardiorespiratory stress (defined as 40% of heart rate reserve for 10 minutes) or whether physiotherapy sessions improve overall activity levels.

Methods: A cross-sectional observational study of usual care with repeat measures was completed. Heart rate of 24 people in the sub-acute stroke phase was recorded during and for one week post a home physiotherapy session (incorporating 29 physiotherapy sessions). Total number of minutes reached above 40% heart rate reserve were calculated and an activity diary captured daily activities.

Results:  Twenty-four participants were recruited, of whom 20 were male, mean age was 69 (SD 16) years and mean time since stroke onset was 93 (SD 36) days. A total of 29 physiotherapy sessions were recorded, of which three achieved the required cardiorespiratory stress intensity and minimum duration for cardiorespiratory benefits. Nine of the 29 sessions reached the intensity but not the minimum duration. The addition of physiotherapy did not increase the participant’s daily physical activity.

Conclusion: The majority of physiotherapy sessions do not evoke cardiorespiratory stress nor increase the activity intensity levels of sub-acute stroke patients.

Relevance to clinical practice or patient experience:

  • Cardiorespiratory benefits could be safely evoked in home-based physiotherapy sessions without specialist equipment.
  • Heart rate monitors can be used independently by people living in the community post-stroke to measure activity levels.
  • Home-based physiotherapy sessions should focus on increasing heart rate intensity for a longer duration to evoke cardiorespiratory stress. This ultimately promotes increased functional capacity, neuroplasticity and secondary stroke prevention.