Transdisciplinary Implementation of Heart Rate Monitors During Inpatient Rehabilitation

Abstract

<h3>Research Objectives</h3> Clinical practice guidelines demonstrate clear benefits of cardiovascular intensity on movement recovery after a neurologic injury, particularly walking recovery. However, research shows a lack of sufficient intensity during inpatient rehabilitation for both physical and occupational therapy sessions. Knowledge translation efforts and implementation of wearable heart rate monitors have been shown to support increased intensity during physical therapy directed interventions. Through a year-long effort, we have investigated the feasibility of implementing transdisciplinary heart rate monitoring informed by the knowledge to action cycle. <h3>Design</h3> 1 year transdisciplinary feasibility study. <h3>Setting</h3> 114 bed inpatient rehabilitation hospital. <h3>Participants</h3> 16 clinicians (9 physical therapists, 6 occupational therapists, 1 recreational therapist). <h3>Interventions</h3> 1 year, 4 phase Multicomponent Knowledge Translation initiative using the Knowledge to Action Cycle Framework. <h3>Main Outcome Measures</h3> -Clinician Participation (session count). Clinician Satisfaction, Clinician Perceived Relevance (summative feedback questionnaire). <h3>Results</h3> This four phase study will end August 2022. The first 13-week phase included 6 therapists (4 PTs, 2 OTs) that engaged in 70 sessions with an average of 5.38 sessions/week. The second phase included 10 therapists (6 PTs, 4 OTs), engaging in 152 sessions, averaging 11.69 sessions/week. The third phase included 13 therapists (8 PTs, 5 OTs), engaging in 436 sessions, averaging 33 sessions/week. The final phase included 16 therapists (9 PTs, 6 OTs, 1 RT), engaging in 503 sessions, averaging 38 sessions/week. In the one year follow up survey responses, 81% of pilot group users reported high satisfaction with heart rate monitor use. Clinician perceived relevance of heart monitor use differed for persons with non-neurological and neurological diagnoses. <h3>Conclusions</h3> Current data suggests that implementation of wearable heart rate monitoring devices for a transdisciplinary inpatient rehab team is feasible and supported by a multicomponent knowledge to action framework. Majority of pilot group participants were very satisfied with participation in heart rate monitoring interventions and highest perceived clinical relevance was for patients with neurological injuries, consistent with clinical practice guideline recommendations. Future studies will expand implementation among onsite clinicians, further investigate barriers of use, and determine optimal interventions for promoting high intensity and specificity within each discipline. <h3>Author(s) Disclosures</h3> None.