Category: Cross-Cutting; Cross-Cutting
Objective : To describe a high intensity exercise program designed to expose patients in acute rehabilitation to their current exercise capacities.
Design : HIFE is a 1-hour group class provided weekly for inpatients. Included in the time are patient customization, exercise participation, and education.
Setting : Classes take place in an acute rehabilitation hospital.
Participants (or Animals, Specimens, Cadavers) : Patients with CVA, debility, MS, and CIDP/GBS must be able to follow 1-2 step commands, be willing to participate in a group, and require no more than moderate assistance.
Participants utilize an RPE scale to target high cardiovascular effort (7-8/10 RPE) while using body weight, hand weights, and/or medicine balls for resistance training. Movements are multi-joint patterns with everyday activity analogs that utilize upper body, lower body, and trunk stabilizers. The program can be performed sitting and/or standing. Classes include a warm-up, focused exercise programming, celebration of efforts, and education.
Main Outcome Measure(s) : Exposure to a customized program, n= 320, with subjective response emphasized.
Results : Patients and clinicians report increased confidence in performing/prescribing challenging and intense activities that stimulate a cardiovascular and strengthening response. “I didn’t realize I could do this,” “This is the first time I’ve broken a sweat,” and “I could do this with my family.” "My practice has changed in that I push a little harder than I used to for functional strengthening."
Patients in acute inpatient rehabilitation can perform safe and enjoyable concurrent cardiovascular and resistance exercise. Exposure to exercise early in the care continuum promotes confidence. Study of post discharge exercise uptake is important to facilitate long-term physical activity beyond the clinical setting.
Julia Mockeridge– Physical Therapist, Rancho Los Amigos National Rehabilitation Center, Los Angeles, California
Covey Lazouras– Physical Therapist Supervisor, Rancho Los Amigos National Rehabilitation Center, Westminster, California
Oscar Gallardo– Physical Therapist, Rancho Los Amigos National Rehabilitation Center, Hermosa Beach, California
Julie Kasayama– Physical Therapy Supervisor, Rancho Los Amigos National Rehabilitation Center, Downey, California