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Impact of ICARE Training Speed and Motor Assistance on Cardiovascular Response

Burnfield, Judith M., PhD, PT; Pfeifer, Chase M., PhD; Kwapiszeski, Sarah J., PT, DPT; Irons, Sonya L., PT, DPT, CCS; Buster, Thad W., MS; Cesar, Guilherme M., PhD, PT

Cardiopulmonary Physical Therapy Journal: September 10, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/CPT.0000000000000098
Research Report: PDF Only

Purpose: A motor-assisted elliptical, ICARE, is used to address walking and fitness goals; yet, only limited data guide understanding of the impact of ICARE training parameters (e.g., speed and motor assistance) on cardiovascular response. A repeated-measures design investigated the influence of 5 predetermined ICARE speeds (25, 35, 45, 55, and 65 revolutions per minute) and 2 motor-assistance levels (with and without assistance) on heart rate (HR), Borg ratings of perceived exertion (RPE), and blood pressure (BP).

Methods: Ten healthy participants' HR, RPE, and BP were recorded during steady state Active Assist (ICARE's motor assisting leg movement) and Active Assist Plus exercise (without motor's assistance) at 5 speeds.

Results: Significant main effects on HR were documented for ICARE speed (F[4,36] = 77.313, P < .001) and motor assistance (F[1,36] = 224.813, P < .001), and an interaction (F[4,36] = 4.410, P = .005). Significant main effects on RPE were documented for speed (F[4,36] = 47.106, P < .001) and motor assistance (F[1,36] = 24.929, P < .001). Significant main effects on systolic BP were documented for speed (F[4,36] = 78.849, P < .001) and motor assistance (F[1,36] = 6.911, P = .027), and an interaction (F[4,36] = 5.695, P = .001). Only the main effect of motor assistance on diastolic BP was significant (F[1,36] = 7.917, P = .020).

Conclusions: Increases in ICARE speed and decreases in motor assistance contributed to clinically relevant increases in HR, RPE, and systolic BP in a cohort of young, nondisabled adults.

Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE

Correspondence: Judith M. Burnfield, PhD, PT, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, 5401 South Street, Lincoln, NE 68506 (

Three patents (2 US and 1 Canadian) have been issued to J. M. Burnfield and T. W. Buster for the ICARE technology. The patented technology has been licensed to SportsArt for commercial distribution. The inventors receive royalties. The remaining authors declare no conflicts of interest.

Madonna Rehabilitation Hospitals' Institutional Review Board.

Institutional review board approval number: IRB # CY17-005-FB.

© 2019 Cardiovascular and Pulmonary Section, APTA
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