Een beroerde conditie: een evidence-based richtlijn voor training van het cardiorespiratoir uithoudingsvermogen in de revalidatiefase na een CVA: verantwoording en toelichting

| M. Kortekaas, E. Hoving, E. Eijwoudt | Opl. Fysiotherapie | Fac. Gezondheid en Techniek | Afstudeerscriptie 2013 Abstract Type of project: Guideline development. Background: Currently more than 120,000 stroke patients are living in the Netherlands. This number is expected to increase by 30 to 45 percent until 2015. Cardiorespiratoir endurance in this patient population has approximately halved compared to healthy peers. This requires an efficient approach. There is much evidence available related to this topic, however this is currently insufficiently implemented in the clinical practice. Therefore this project focuses specifically on training of the cardiorespiratoir endurance as part of rehabilitation. Purpose and research question: The goal of this project is to develop a trainings guideline for physical therapists which can be used for an efficient training of the cardiorespiratoir endurance in the rehabilitation phase of stroke patients. The underlying research question contains: How can training of cardiorespiratoir endurance be applied during rehabilitation phase of patients after a stroke? Which aspects are important and how and how can this information be used to develop a trainings guideline? Guideline development: Primary a literature study was performed to find the best available evidence from literature. The training parameters which form the guideline are as the following: exercise frequency, intensity, duration, building, training equipment and means for evaluating the cardiorespiratory endurance level. The results were transformed into a concept guideline. This concept was evaluated by an expert group of physical therapists using a group discussion. Results: Literature study complemented with opinions and experiences of experts resulted in the trainings guideline „Een beroerde conditie‟. Firstly, In the first step in guideline, the „flowchart Equipment‟ provides a recommendation for the most appropriate exercise equipment. The flowchart refers to the checklists. In the checklist indications are given for the cycle ergometer and treadmill with and without body weight support The „flowchart Measurement‟ leads the physiotherapist to a suitable measuring instrument or a measuring way to describe and evaluate the cardiorespiratory endurance training for the patient. All information can be documented using a trainings form. In addition to these Een beroerde conditie Abstract | M. Kortekaas, E. Hoving, E. Eijwoudt | Opl. Fysiotherapie | Fac. Gezondheid en Techniek | Afstudeerscriptie 2013 components a „modified Borg scale‟ and „Patient Folder‟ can be used to supply extra support for the physiotherapist so that the training can be as patient tailored and efficient as possible. Discussion: An evidence-based guideline is developed to improve the current training of cardiorespiratory endurance during inpatient rehabilitation after a stroke. This guideline contains information and material focused on training equipment selection, measurement, construction and evaluation of training. This is a guideline, not a protocol so that training parameters can be tailored to the individual. Further research to the feasibility and effectiveness of this guideline is needed. | M. Kortekaas, E. Hoving, E. Eijwoudt | Opl. Fysiotherapie | Fac. Gezondheid en Techniek | Afstudeerscriptie 2013 components a „modified Borg scale‟ and „Patient Folder‟ can be used to supply extra support for the physiotherapist so that the training can be as patient tailored and efficient as possible. Discussion: An evidence-based guideline is developed to improve the current training of cardiorespiratory endurance during inpatient rehabilitation after a stroke. This guideline contains information and material focused on training equipment selection, measurement, construction and evaluation of training. This is a guideline, not a protocol so that training parameters can be tailored to the individual. Further research to the feasibility and effectiveness of this guideline is needed.