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Pediatric rehabilitation therapies differ in intensity: Pilot study to highlight the implications for dose-response relationships


Ambuehl, Maria; van Hedel, Hubertus J A; Labruyère, Rob (2020). Pediatric rehabilitation therapies differ in intensity: Pilot study to highlight the implications for dose-response relationships. American Journal of Physical Medicine & Rehabilitation, 99(3):224-232.

Abstract

OBJECTIVE
When investigating dose-response relationships in rehabilitation studies, dose is often equated with duration of therapy. However, according to the American College of Sports Medicine, dose consists of the factors frequency, intensity, time and type. Thereby, especially quantification of intensity needs improvement to have a more precise estimate of the dose. Thus, the aim was to investigate the intensity during mobility-focused, real-life pediatric rehabilitation therapies.
DESIGN
Eleven participants (5 girls; 12.5±2.1y old) with neurological disorders and independent mobility wore accelerometers at wrists and ankles and a portable heart rate monitor during several of the following therapies: sports therapy, mobility-focused physiotherapy, medical training therapy, and robot-assisted gait training. Intensity of physical activity was quantified by activity counts (measured via accelerometers) and heart rate.
RESULTS
Therapy duration did not correlate with intensity. At the same time we found significant differences between intensities of different therapies.
CONCLUSION
Different therapies elicit different levels of intensity in children with neuromotor disorders. Heart rate and activity counts are suited to estimate the intensity of a therapy and provide complementary information. We recommend against using the duration of a therapy as a proxy for the dose to make statements about dose-response relationships.

Abstract

OBJECTIVE
When investigating dose-response relationships in rehabilitation studies, dose is often equated with duration of therapy. However, according to the American College of Sports Medicine, dose consists of the factors frequency, intensity, time and type. Thereby, especially quantification of intensity needs improvement to have a more precise estimate of the dose. Thus, the aim was to investigate the intensity during mobility-focused, real-life pediatric rehabilitation therapies.
DESIGN
Eleven participants (5 girls; 12.5±2.1y old) with neurological disorders and independent mobility wore accelerometers at wrists and ankles and a portable heart rate monitor during several of the following therapies: sports therapy, mobility-focused physiotherapy, medical training therapy, and robot-assisted gait training. Intensity of physical activity was quantified by activity counts (measured via accelerometers) and heart rate.
RESULTS
Therapy duration did not correlate with intensity. At the same time we found significant differences between intensities of different therapies.
CONCLUSION
Different therapies elicit different levels of intensity in children with neuromotor disorders. Heart rate and activity counts are suited to estimate the intensity of a therapy and provide complementary information. We recommend against using the duration of a therapy as a proxy for the dose to make statements about dose-response relationships.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Physical Therapy, Sports Therapy and Rehabilitation
Health Sciences > Rehabilitation
Language:English
Date:1 March 2020
Deposited On:13 Jan 2020 10:55
Last Modified:29 Jul 2020 12:25
Publisher:Lippincott Williams & Wilkins
ISSN:0894-9115
OA Status:Green
Publisher DOI:https://doi.org/10.1097/PHM.0000000000001323
PubMed ID:31592876

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