Attainment of Cardiovascular Intensity and Functional Walking Outcomes for Persons with Spinal Cord Injury

Research Objectives: To investigate the association between attainment of 70-85% HR max intensities and meaningful changes in functional gait outcomes, while receiving inpatient rehabilitation, for persons with SCI. Additionally, we sought to determine if the use of advanced rehabilitation technology was positively associated with attainment of target heart rate intensities.

Design: 3-year retrospective observational cohort

Setting: 114 bed inpatient rehabilitation hospital

Participants: We examined records of 127 persons with AIS A-D, traumatic and non-traumatic, SCI who were admitted to inpatient rehabilitation from June 2020-June 2023.

Interventions: Included patients were consulted to the Locomotor specialist, a knowledge broker role, with the primary purpose of facilitating intensive locomotor training with patients and their primary Physical Therapists. These sessions included locomotor training centered on attaining 5 locomotor targets. Advanced rehabilitation technologies were chosen to facilitate attainment of these locomotor targets.

Main Outcome Measures: For this study we conducted a secondary analysis of records of patients with SCI admitted to a 114 bed inpatient rehabilitation hospital from June 2020-June 2023. All the demographic (age), clinical severity variables (level of injury, AIS level), advanced technology use (body weight supported technologies, robotics), overground gait training, and outcomes (heart rate intensity levels, WISCI II scores and10MWT speeds) were obtained from the extracted data from the patient records. In addition, we linked data extracted from patients' records with billing data to obtain demographic (e.g., gender) information.

Results: Attainment of 70-75% HR Max intensity was associated with positive changes of WISCI II scores (OR=3.09, 95% CI=1.41-7.01). Attainment of 70% HR Max intensity was associated with positive changes in 10 MWT (OR=3.06, 95% CI=1.29-7.82). No specific type of advanced rehabilitation technology was associated with target HR attainment.

Conclusions: Persons with SCI can achieve significant improvements in functional walking outcomes with attainment of 70-75% HR max intensities during inpatient rehabilitation. The use of robotics, body-weight support systems, and overground gait training are viable options for attainment of target heart rate intensities for persons with SCI.

Author(s) Disclosures: No conflicts or disclosures.