From the Rehabilitation Center for Children and Adolescents, Children's University Hospital Zurich, Affoltern am Albis, Switzerland (MA, HJAvH, RL); Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland (MA); and Children's Research Center, Children's University Hospital Zurich, Zurich, Switzerland (HJAvH, RL).
Am J Phys Med Rehabil. 2020 Mar;99(3):224-232. doi: 10.1097/PHM.0000000000001323.
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.
Eleven participants (5 girls, 12.5 ± 2.1 yrs 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.
Therapy duration did not correlate with intensity. At the same time, we found significant differences between intensities of different therapies.
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.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Appraise the importance of measuring the intensity of various types of inpatient rehabilitation therapy for determining the dose; (2) Describe the differences in intensities between different training forms and name factors that influence this intensity; and (3) Discuss the influence of the functional level of a patient on his/her potential to engage in physically intensive therapy sessions.
Advanced.
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
在康复研究中调查剂量-反应关系时，通常将剂量等同于治疗持续时间。然而，根据美国运动医学学院的说法，剂量由频率、强度、时间和类型这四个因素组成。因此，特别是需要改进强度的量化，以更准确地估计剂量。因此，本研究旨在调查以运动为重点的现实生活中的儿科康复治疗中的强度。
11 名（5 名女孩，12.5±2.1 岁）患有神经障碍且独立移动的参与者在手腕和脚踝处佩戴加速度计，并在以下几种治疗期间佩戴便携式心率监测器：运动治疗、以运动为重点的物理治疗、医学训练治疗和机器人辅助步态训练。通过加速度计（通过加速度计测量）和心率来量化身体活动的强度。
治疗持续时间与强度无关。同时，我们发现不同治疗方法之间的强度存在显著差异。
患有神经运动障碍的儿童接受不同的治疗方法会产生不同的强度。心率和活动计数适合估计治疗强度，并提供互补信息。我们建议不要将治疗持续时间用作剂量的替代物来对剂量-反应关系做出陈述。
要求 CME 学分：在 http://www.physiatry.org/JournalCME 上在线完成自我评估活动和评估。CME 目标：完成本文后，读者应该能够：（1）评估测量各种类型的住院康复治疗强度以确定剂量的重要性；（2）描述不同训练形式之间的强度差异，并说明影响这种强度的因素；（3）讨论患者的功能水平对其进行身体强化治疗的能力的影响。
高级。
学术物理治疗师协会由继续教育医学认证委员会认可，为医生提供继续医学教育。学术物理治疗师协会将这项基于期刊的 CME 活动指定为最多 1.0 个 AMA PRA 类别 1 学分。医生应仅根据其参与活动的程度申报学分。
