Thanks, Frank, especially for the detail on the Borg Score ...... I'm glad I
won't have to change all those patient leaflets with the 6-20 score!
Kate
----- Original Message -----
From: Frank Underwood <[log in to unmask]>
To: <[log in to unmask]>
Sent: 02 April 2000 21:19
Subject: Re: heart transplant rehab
> /snip/
>
> > >When surgeons do a heart transplant they don't reconnect the nerves to
the
> > >heart. As Nancy Howes explains in her reply, this increases the
resting
> > >heart rate. This is because there is no sympathetic nerve inhibition of
the
> > >heart rate. Also, the heart rate responds slowly to exercise, with less
> > >increase in heart rate than normal.
>
> /snip/
>
> A minor observation; when the heart is denervated, there is an increased
> in the resting heart rate due to the loss of the inhibitory influence of
> the para-sympathetic division of the autonomic nervous system. At rest,
> with normal innervation, the heart receives both sympathetic and
> para-sympathetic input, and the para-sympathetic is dominant. Therefore,
> with denervation, the intrinsic rate of depolarization of the sino-atrial
> cells is manifest, increasing the heart rate.
>
> Regarding the 6-20 and 0-10 Borg RPE scales; they are both for exertion,
> but the 0-10 scales has been adapted for use with patients with pulmonary
> disorders by using descriptors for dyspnea. When used for exertion, the
> two scales are equivalent. One of the principle reasons for creating the
> 0-10 scale was that some researchers were criticized for using parametric
> statistical procedures on the old RPE scale, because if the scale was
> 6-20, it couldn't be an interval or ratio scale. So, by converting to a
> 0-10 scale, the phenomenon was magically converted to a ratio scale.
>
> So, there was no real physiological or clinical reason to convert to the
> 0-10 scale, and the statistical rationale is false as well, so those who
> continue to use the 6-20 scale, keep it up.
>
> Frank Underwood
> Evansville, Indiana
>
>
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