Stroke Structured Abstract - S #22
The speed at which patients sand a board has greater influence on heart, lung, and metabolic function than the incline of the board
CITATION: Muraki, T., Kujime, K., Su, M., Kaneko, T., & Ueba, Y. (1990). Effect of one-hand sanding on cardiometabolic and ventilatory functions in the hemiplegic elderly: A preliminary investigation. Physical and Occupational Therapy in Geriatrics, 9, 37-48.
LEVEL OF EVIDENCE: IIC2c
What is the effect of sanding on cardiac and pulmonary functions in elderly patients with stroke?
Nonrandomized repeated measures.
SAMPLING PROCEDURE/INCLUSION CRITERIA
No patients had a history of abnormal cardiopulmonary disease.
N = 8
Male = 6
Female = 2
Mean age = 67.6
LCVA = 2
RCVA = 6
Attrition = NR
NR = Not Reported
Metabolic Equivalent (MET) Level: Derived from calculations applied to expired air
Expiratory volume (VE): Collected using a medical gas analyzer
Pressure rate product (PRP): Calculated from systolic blood pressure times heart rate
Sanding at different velocities and incline of the board.
Condition 1: Rest; 3-minute rest on a chair with the patient's sound arm resting on a table.
Condition 2: Sanding with the unaffected arm, with the board horizontal (zero degrees) for 3 minutes with the metronome set to 15 cycles per minute (CPM).
Condition 3: Sanding with the unaffected arm, with the board horizontal (zero degrees) for 3 minutes with the metronome set to 30 CPM.
Condition 4: Sanding with the unaffected arm, with the board at an angle (15 degrees) for 3 minutes with the metronome set at 15 CPM.
Condition 5: Sanding with the unaffected arm, with the board at an angle (15 degrees) for 3 minutes with the metronome set to 30 CPM.
A 3-minute rest was taken in the chair between exercises.
WHO DELIVERED INTERVENTION
FREQUENCY & DURATION
3 minutes each of five conditions with 3-minute rest between. All within 1 day.
There was a significant difference in MET level between Condition 1 and all other conditions (p < .01).
There was a significant difference in MET levels between Conditions 2 & 3 (p = NR), but not between Conditions 2 & 4 (p = NR) or between Conditions 3 & 5 (p = NR).
PRP reached peak value during Condition 3. PRP was significantly greater for Condition 3 compared with Condition 2 (p = NR), although there was no difference due to incline (Condition 4 vs Condition 5; p = NR).
VE was significantly greater under Conditions 2-4 compared with Condition 1 (p < .01). There were significant differences between Conditions 2 & 3 and between Conditions 4 & 5 (velocity effect).
Effect sizes could not be calculated from the information provided.
Within Groups/Conditions/Times: Not tested
THREATS TO VALIDITY
Possibly maturation because the subjects were not randomly assigned to sequence.
Independent variable operationalization is not clear: Authors speak of Condition (Grade) 5 as 0 degrees at 30 CPM, but actually the Methods section states 15 degrees at 30 CPM. They also speak of incline 30 degrees, but this was not listed as a condition in the Methods section.
The results obtained suggest that the responses to sanding in patients with cerebral vascular disease(CVD) could be more influenced by changing velocity than by angle of the board. One-hand sanding confirms low-intensity work in METS even in the aged CVD subjects with hemiplegia where peak value reached less than 2 METS.
The study suggests that the sanding activity, which used to be used quite often in clinics, could also affect stroke patients' cardiometabolic and pulmonary responses. Therapists need to be aware of the different effects of velocity versus angle when prescribing sanding.
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice-Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Hui-ing Ma, ScD, OTR, and Catherine A. Trombly, ScD, OTR/L, FAOTA.
For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.