Effects of physical therapy on blood pressure in daily clinical practice-a pilot study.
Shota Yamada, Gen Nitta, Yuki Takano and 3 others
PMID 32753782WHAT IT FOUND
After a getting-up therapy session combining range-of-motion exercise, strength training, standing-up training, and walking training, systolic blood pressure rose from 127.7 mmHg to 139.1 mmHg in 23 hospitalized patients.
Resting pulse rate predicted the rise, and age and body weight predicted an exaggerated rise.
Key findings
01Using each patient's mean values from days 1, 2, and 7, systolic blood pressure rose from 127.7 mmHg to 139.1 mmHg, diastolic blood pressure rose from 80.9 mmHg to 84.0 mmHg, and pulse rate rose from 73.2 bpm to 76.5 bpm.
02Resting pulse rate before exercise therapy independently predicted the amplitude of the systolic blood pressure increase after exercise therapy.
03Older age and higher body weight independently predicted an exaggerated systolic blood pressure increase after exercise therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 23 participants, and the authors state that a definite conclusion cannot be drawn. Most participants were hospitalized for orthopedic surgery (21 [91.3]), with only 2 (8.7) for stroke, so it says little about stroke rehabilitation. It was an observational before-after study in usual clinical practice, so it cannot show what would have happened without the therapy. The exercise therapy was heterogeneous among patients and across days, so the blood pressure response cannot be attributed to any single exercise component. Antihypertensive medication and other medications may have affected the blood pressure results. Patients with arrhythmia were excluded, so the results may not apply to them. Pain was measured only by a 0-10 self-report scale, so its relationship to blood pressure response is uncertain.
Declared interests
The study was supported by a Nagoya Gakuin University grant, and the authors declared no conflict of interest.
The easy way to misread this
Do not conclude that getting-up exercise therapy is safe for all hospitalized stroke or orthopedic patients. This was a 23-person pilot with heterogeneous therapy, medication effects, and an observational design, so it cannot establish a safe blood pressure response range.