Impact of supervised exercise rehabilitation on daily physical activity of people with cardiopulmonary disorders

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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632

towards their new everyday life. While motor skills are at the core of physiotherapy, physiotherapists must also attend to the parents’ need to understand their child as a competent and interactive individual. This ongoing negotiation of how to see the child is a matter of participatory sense-making, where successful treatment relies on the therapists’ ability to attend to what is significant both to the parents and the infant. Future observational studies of clinical encounters can expand the knowledge of how physiotherapy contributes to competence and self-efficacy for parents of preterm infants. Implications: This phenomenological and enactive perspective on physiotherapy shows that treatment for preterm infants should focus on the exploration of the child and its capabilities, in joint attention and joint action with the parents. By this, we can contribute to the parents’ perception of their child, not as a sick infant, but as an individual developing its selfhood through interactions with the world. Keywords: Parent perspective; Preterm infants; Interaction Funding acknowledgements: We thank The Norwegian Fund for Post-Graduate Training in Physiotherapy for funding this project. Ethics approval: Norwegian Social Science Data Services. http://dx.doi.org/10.1016/j.physio.2015.03.3298 Research Report Poster Presentation Number: RR-PO-01-24-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 IMPACT OF SUPERVISED EXERCISE REHABILITATION ON DAILY PHYSICAL ACTIVITY OF PEOPLE WITH CARDIOPULMONARY DISORDERS A. Ramadi 1 , M. Stickland 2 , W. Rodgers 3 , R. Haennel 1 1 University

of Alberta, Physical Therapy, Edmonton, Canada; 2 University of Alberta, Medicine, Edmonton, Canada; 3 University of Alberta, Physical Education and Recreation, Edmonton, Canada Background: While an improved exercise capacity is one of the benchmark outcomes associated with participating in exercise rehabilitation (ER), the impact of these programs on the objectively measured daily physical activity (PA) in people with cardiopulmonary disorders is not completely understood. Purpose: To objectively assess the impact of ER on daily PA of people with cardiopulmonary disorders. Methods: Thirty-seven patients (16 cardiac: 21 pulmonary; age: 75 ± 6 years) participated in this study. Participants completed a twice weekly ER for 8–10 weeks in either a cardiac or pulmonary ER facility. Exercise sessions

consisted of aerobic and strengthening exercises. Exercise capacity and PA were measured at baseline and at the end of the ER program. Exercise capacity was measured using the 6 minute walk test (6MWT). Daily PA was assessed objectively using the SenseWear ProTM Armband (SWA). Changes in variables were analyzed using paired t-tests and Wilcoxon Signed Ranks tests. The relationships between change in exercise capacity and changes in measures of PA were also analyzed using Pearson correlations. Results: Exercise capacity increased at the end of the ER (396 ± 91 m to 444 ± 101 m; p = 0.000). Participants wore the SWA for 21 ± 3 hours/day at baseline and 20 ± 3 hours/day at the end of ER (p > 0.05). Participants’ sedentary time (≤1.5 metabolic equivalents [METs]) decreased (17.33 ± 3.44 hours/day to 15.98 ± 3.64 hours/day; p = 0.005) while time spent in light PA (1.6-2.9 METs) increased (2.76 ± 1.16 hours/day to 3.12 ± 1.33 hours/day; P = 0.045); however, time spent in moderate-vigorous PA (MVPA) (≥3.0 METs) did not change (p > 0.05). There was an increase in steps/day(>1.5METs) (3544 ± 2200 to 4032 ± 2481; p = 0.027) and PA energy expenditure (PAEE>1.5 METs ) (676 ± 266 kcal/day to 836 ± 484 kcal/day; p = 0.015); whereas steps/day(≥3METs) and PAEE(≥3 METs) remained unchanged (p > 0.05). There was no correlation between the change in 6MWT distance and the changes in PA measures (p > 0.05). Conclusion(s): Findings imply that changes in daily PA in ER participants occur in activities where the energy expenditure is in light intensity rather than in MVPA. This observation underlines the importance of considering the entire spectrum of PA rather than focusing exclusively on MVPA. Furthermore, increased exercise capacity may not result in a more active lifestyle, as the improvement in exercise capacity was unrelated to increases in PA. Implications: Our findings highlight the value of a thorough PA assessment in patients who are referred to ER. For patients entering ER it is imperative that the clinicians have an understanding of their patient’s current PA. The majority of these patients appear to be habitually inactive. Therefore changes in the high end of the PA continuum (i.e., MVPA) may not be easily achieved or maintained. A more achievable goal may be to encourage these patients to reduce sedentary time and increase light PA. Once this is accomplished patients might be better equipped to transition to MVPA. Keywords: Cardiopulmonary; Exercise rehabilitation; Daily physical activity Funding acknowledgements: None. Ethics approval: This study was approved by the University of Alberta health research ethics board. http://dx.doi.org/10.1016/j.physio.2015.03.3299