302: Applying A New Calculation For Max Heart Rate In PD

In this episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS discuss a new research article, “Refining maximal heart rate estimation to enhance exercise recommendations for persons with Parkinson’s disease.” Parkinson’s is a multi-system condition and changes to the function of the autonomic nervous system are common. At times this can present as a person with PD having trouble reaching aerobic heart rate zones calculated based on age while they’re performing high intensity exercise. Claire explains the challenges they’ve faced using standard heart rate formulas and color-zoned monitoring apps when many clients appear stuck in a “gray zone,” likely due to this autonomic dysfunction and chronotropic incompetence common in Parkinson’s. After exploring but struggling to access cardiopulmonary exercise testing (CPET)—the gold standard for determining true maximal heart rate—Claire finds this new study, which uses CPET data from a cycling trial to derive a more accurate regression-based equation for people with Parkinson’s: 166 − (1.15 × age) + (0.60 × resting heart rate). She describes how they are now applying this formula in practice by calculating individualized max heart rates, manually updating values in their OnBeat app, and offering a public calculator via their website so people with Parkinson’s and clinicians can easily generate appropriate training zones. This shift should make target zones more realistic, motivating, and safer. Listen to the show to easily incorporate this research into your practice today!  

Pull up the article here (free full text available): https://pubmed.ncbi.nlm.nih.gov/40194736/

Use Claire’s calculator that uses the research-based formula here: https://www.roguept.com/cardio