Monitoring Work Intensity during Occupational Therapy

Abstract

Patients with physical disability due to leg amputation, stroke, or low back pain performed a graded exercise test on a bicycle or armcrank ergometer. Their voluntary maximum and pre-exercise heart rates were determined and used to calculate their heart rate or cardiac reserve. Patients were subsequently monitored by ambulatory electrocardiography during the occupational therapy activities which made up their respective treatment programs. The peak heart rates for each activity were determined and expressed as a percentage of the patient's cardiac reserve. The means and ranges of working intensity were calculated for patients grouped by disability. The mean values of 24% and 27% of cardiac reserve for the older amputees and hemiplegic patients respectively were low compared to the mean values of 55% found for both the traumatic amputees and patients with low back pain. Wide ranges in values were found, particularly for hemiplegic patients, and may reflect the disimilar degree of disability among patients with the same diagnosis as well as the presence of factors affecting heart rate via the sympathetic nervous system.