Physical and perceived effort of patients with stroke during hospital-based rehabilitation when performing sit to stand: a pilot study

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background/Information Rehabilitation of patients with stroke includes optimisation of function and increasing individuals’ physical activity levels as a means of improving independence and preventing recurrence of cardiovascular events. Physical effort evaluation and monitoring is important to highlight exercise intensity level during rehabilitation. Sit to stand (STS) is a mechanically demanding functional task. Little is known about the physical effort experienced by patients with stroke when performing this activity during hospital-based rehabilitation. Purpose The study assessed the perceived effort, energy expenditure and metabolic equivalent of task (MET) levels of patients with stroke when performing STS as a means of outlining their physical effort. Methods A descriptive cross-sectional pilot study took place at two hospitals in Johannesburg, South Africa, between November 2018 to February 2020 and March to September 2021. Participants reported their perceived effort using the Modified Borg Scale (MBS) and their energy expenditure and MET level were assessed with a triaxial accelerometer. The Shapiro-Wilk Test was used to test for normality of data and descriptive and inferential statistics were used to determine findings (p-value set at ≤ 0.05). Results The team screened four hundred and twenty eight individuals for potential inclusion in the study. The pilot study consisted of nine participants (n=5 female, 55.5%), with a mean age of 52.77 (SD ± 11.33) years and mean body mass index of 24.31 (±5.36) kg/m2. Most had a haemorrhagic stroke (n=6, 66.6%), left hemiplegia (n=6, 66.6%), ‘mild’ stroke (n=7, 77.8%) as per the National Institutes of Health Stroke Scale and were assessed 9.11 (SD ±6.57) days post stroke. The mean time it took participants to complete STS was 6.04 (±4.03) seconds. Most participants (n=7, 77.8%) perceived STS at a ‘moderate’ or stronger effort level on the MBS. The calculated mean physical energy expenditure during STS was 2.82 (±1.9) kCal/min and the mean MET level 2.99 (±1.89). The correlation coefficient between the subjective perceived effort and physical effort as per energy expenditure was r = 0.61 (p = 0.08) and subjective perceived effort and MET level r = 0.34 (p = 0.38). Conclusion The ability to come from STS is one of the most frequent functional tasks used daily and a prerequisite to walking. Study participants’ exercise intensity during STS was much higher when compared to published literature in healthy individuals. This study found a fair to moderate positive correlation between physical effort parameters and MBS for patients with stroke during STS. The results did not meet statistical significance due to the small sample size, indicating further research is warranted.