National Physical Therapy Examination (NPTE) Practice Exam

What is the MOST likely maximum heart rate for a 40-year-old patient with complete C7 tetraplegia?

1. 60 beats per minute

2. 80 beats per minute

3. 120 beats per minute

4. 180 beats per minute

The correct answer is: 120 beats per minute

For a 40-year-old individual, the standard method for estimating maximum heart rate is to subtract their age from 220, which would suggest a maximum heart rate of approximately 180 beats per minute. However, in patients with complete tetraplegia, particularly at the C7 level, the physiological responses of the heart can be significantly altered due to the disruption of the sympathetic nervous system. These patients often experience a diminished maximum heart rate and rely more on the remaining muscle mass below the level of injury to affect their cardiovascular response. The heart rate response during exercise is typically attenuated because of the lack of sympathetic stimulation. While a healthy individual may achieve a heart rate close to the calculated maximum, individuals with cervical spinal injuries often exhibit lower heart rates. Consequently, while the raw calculation provides a maximum of 180 beats per minute, patients with complete C7 tetraplegia tend to reach a considerably lower heart rate due to their condition. The most likely maximum heart rate for this specific individual, considering the typical physiological changes in tetraplegia, would likely fall near 120 beats per minute during maximum exertion. This understanding emphasizes the importance of considering not just the age and typical heart rate calculations, but also the specific impact of spinal cord