Symposium

Head vs Heart: Applying Intensity-driven Neuroplasticity Principles in Patients with Anoxic Brain Injury and High Cardiac Risk Factors 0571

Corresponding Presenter(s)

• 

  Katie L. Sewell, PT, DPT, NCS (she/her/hers)

  Program Director, Atrium Health Neurologic Physical Therapy Residency Program, Clinical Coordinator- Therapy Education
  Atrium Health Carolinas Rehabilitation
  Charlotte, NC, United States

  Slides

Presenter(s)

• 

  Nathan Darji, DO (he/him/his)

  Assistant Professor
  Atrium Health/Wake Forest School of Medicine
  Huntersville, NC, United States
• 

  Kristen Hammack (she/her/hers)

  Physical Therapist
  Atrium Health Carolinas Rehabilitation Charlotte
  Charlotte, NC, United States
• 

  Claire E. Spech, PT, DPT

  Physical Therapist
  Atrium Health Carolina's Rehabilitation
  Charlotte, NC, United States

Anoxic brain injuries are the leading causes of morbidity following cardiac arrest and often lead to a long-term disability. While advancements in medical management post-arrest care have notably raised survival rates compared to a decade ago, the functional recovery of these patients has not shown significant improvement with less than 50% of these individuals returning to work and over 50% with long term neurocognitive deficits.2 This underscores the necessity for effective rehabilitation programs and interventions tailored to this population.
Recently, research has focused on intensity-driven neuroplastic mechanisms to improve recovery following neurologic injury. This presentation will detail the application of high intensity training in the management of patients with high cardiac risk factors following anoxic brain injury. The presenters will highlight two patient cases demonstrating physical therapy management of such patients with resultant improvements in functional outcomes with the application of high intensity training in this patient population.

Learning Objectives:

• Explore the evidence supporting intensity-driven aerobic exercise and strength training for promoting function, cardiovascular health, and neurologic recovery following brain injury.
• Examine recent research emphasizing high intensity aerobic exercise and high repetition stepping training for enhancing walking outcomes and broader functional improvements.
• Evaluate the physiological responses triggered by intense aerobic exercise, including elevated levels of brain-derived neurotrophic factor (BDNF), reduced intracortical inhibition, and heightened corticospinal excitability, and their relevance to neurologic recovery.
• Describe the AACVPR classification of patients based on cardiac risk and the implications fo high intensity training interventions.
• Apply evidence-based recommendations and guidelines for the safe implementation of high intensity training principles in patients with high cardiac risk factors following anoxic brain injury.