Sean Pymer1, Simon Nichols2, Jonathon Prosser3, Stefan Birkett4, Sean Carroll5, Lee Ingle5. 1. Academic Vascular Surgical Unit Hull York Medical School, Hull, UK. 2. Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK. 3. Atrium Health, Centre for Exercise and Health, Coventry, UK. 4. School of Sport & Wellbeing, University of Central Lancashire, Preston, UK. 5. School of Sport and Health Sciences, University of Hull, UK.
Abstract
BACKGROUND: In the United Kingdom (UK), exercise intensity is prescribed from a fixed percentage range (% heart rate reserve (%HRR)) in cardiac rehabilitation programmes. We aimed to determine the accuracy of this approach by comparing it with an objective, threshold-based approach incorporating the accurate determination of ventilatory anaerobic threshold (VAT). We also aimed to investigate the role of baseline cardiorespiratory fitness status and exercise testing mode dependency (cycle vs. treadmill ergometer) on these relationships. DESIGN AND METHODS: A maximal cardiopulmonary exercise test was conducted on a cycle ergometer or a treadmill before and following usual-care circuit training from two separate cardiac rehabilitation programmes from a single region in the UK. The heart rate corresponding to VAT was compared with current heart rate-based exercise prescription guidelines. RESULTS: We included 112 referred patients (61 years (59-63); body mass index 29 kg·m-2 (29-30); 88% male). There was a significant but relatively weak correlation (r = 0.32; p = 0.001) between measured and predicted %HRR, and values were significantly different from each other (p = 0.005). Within this cohort, we found that 55% of patients had their VAT identified outside of the 40-70% predicted HRR exercise training zone. In the majority of participants (45%), the VAT occurred at an exercise intensity <40% HRR. Moreover, 57% of patients with low levels of cardiorespiratory fitness achieved VAT at <40% HRR, whereas 30% of patients with higher fitness achieved their VAT at >70% HRR. VAT was significantly higher on the treadmill than the cycle ergometer (p < 0.001). CONCLUSION: In the UK, current guidelines for prescribing exercise intensity are based on a fixed percentage range. Our findings indicate that this approach may be inaccurate in a large proportion of patients undertaking cardiac rehabilitation.
BACKGROUND: In the United Kingdom (UK), exercise intensity is prescribed from a fixed percentage range (% heart rate reserve (%HRR)) in cardiac rehabilitation programmes. We aimed to determine the accuracy of this approach by comparing it with an objective, threshold-based approach incorporating the accurate determination of ventilatory anaerobic threshold (VAT). We also aimed to investigate the role of baseline cardiorespiratory fitness status and exercise testing mode dependency (cycle vs. treadmill ergometer) on these relationships. DESIGN AND METHODS: A maximal cardiopulmonary exercise test was conducted on a cycle ergometer or a treadmill before and following usual-care circuit training from two separate cardiac rehabilitation programmes from a single region in the UK. The heart rate corresponding to VAT was compared with current heart rate-based exercise prescription guidelines. RESULTS: We included 112 referred patients (61 years (59-63); body mass index 29 kg·m-2 (29-30); 88% male). There was a significant but relatively weak correlation (r = 0.32; p = 0.001) between measured and predicted %HRR, and values were significantly different from each other (p = 0.005). Within this cohort, we found that 55% of patients had their VAT identified outside of the 40-70% predicted HRR exercise training zone. In the majority of participants (45%), the VAT occurred at an exercise intensity <40% HRR. Moreover, 57% of patients with low levels of cardiorespiratory fitness achieved VAT at <40% HRR, whereas 30% of patients with higher fitness achieved their VAT at >70% HRR. VAT was significantly higher on the treadmill than the cycle ergometer (p < 0.001). CONCLUSION: In the UK, current guidelines for prescribing exercise intensity are based on a fixed percentage range. Our findings indicate that this approach may be inaccurate in a large proportion of patients undertaking cardiac rehabilitation.
Authors: Dorota Dolecińska; Izabela Przywarska; Tomasz Podgórski; Piotr Dylewicz; Jacek Lewandowski Journal: Kardiochir Torakochirurgia Pol Date: 2021-01-15
Authors: Karin Vonbank; Antje Lehmann; Dominik Bernitzky; Maximilian Robert Gysan; Stefan Simon; Pavla Krotka; Ralf-Harun Zwick; Marco Idzko; Martin Burtscher Journal: Scand J Med Sci Sports Date: 2021-12-26 Impact factor: 4.645
Authors: Fengrun Zhao; Chen Liang; Christopher John Zaslawski; Zhenyu Cao Journal: Evid Based Complement Alternat Med Date: 2022-09-14 Impact factor: 2.650