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Stroke Research and Treatment
Volume 2013 (2013), Article ID 612458, 7 pages
http://dx.doi.org/10.1155/2013/612458
Clinical Study

Cardiovascular Responses Associated with Daily Walking in Subacute Stroke

1Graduate Department of Rehabilitation Science, University of Toronto, 500 University Avenue, Toronto, ON, Canada M5G 1V7
2Toronto Rehabilitation Institute, UHN, 550 University Avenue, Toronto, ON, Canada M5G 2A2
3Heart & Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5
4Department of Physical Therapy, University of Toronto, 500 University Avenue, Toronto, ON, Canada M5G 1V7
5Faculty of Health, School of Kinesiology & Health Science, York University, 4700 Keele St., Toronto, ON, Canada M3J 1P3
6Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1

Received 4 December 2012; Accepted 11 January 2013

Academic Editor: Stefan Schwab

Copyright © 2013 Sanjay K. Prajapati et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Despite the importance of regaining independent ambulation after stroke, the amount of daily walking completed during in-patient rehabilitation is low. The purpose of this study is to determine if (1) walking-related heart rate responses reached the minimum intensity necessary for therapeutic aerobic exercise (40%–60% heart rate reserve) or (2) heart rate responses during bouts of walking revealed excessive workload that may limit walking (>80% heart rate reserve). Eight individuals with subacute stroke attending in-patient rehabilitation were recruited. Participants wore heart rate monitors and accelerometers during a typical rehabilitation day. Walking-related changes in heart rate and walking bout duration were determined. Patients did not meet the minimum cumulative requirements of walking intensity (>40% heart rate reserve) and duration (>10 minutes continuously) necessary for cardiorespiratory benefit. Only one patient exceeded 80% heart rate reserve. The absence of significant increases in heart rate associated with walking reveals that patients chose to walk at speeds well below a level that has meaningful cardiorespiratory health benefits. Additionally, cardiorespiratory workload is unlikely to limit participation in walking. Measurement of heart rate and walking during in-patient rehabilitation may be a useful approach to encourage patients to increase the overall physical activity and to help facilitate recovery.