Quinn R Pack1, Meredith Shea, Clinton A Brawner, Samuel Headley, Jasmin Hutchinson, Hayden Madera, Steven J Keteyian. 1. Division of Cardiovascular Medicine, Baystate Medical Center, Springfield, Massachusetts (Drs Pack and Shea); Institute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts (Dr Pack); Department of Exercise Science and Athletic Training, Springfield College, Springfield, Massachusetts (Drs Shea, Headley, and Hutchinson), Mayo Clinic Arizona, Scottsdale (Dr Shea); Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan (Drs Brawner and Keteyian); and Center for Cardiac Fitness, The Miriam Hospital, Providence, Rhode Island (Ms Madera).
Abstract
PURPOSE: High-quality exercise training improves outcomes in cardiac rehabilitation (CR), but little is known about how most programs prescribe exercise. Thus, the aim was to describe how current CR programs prescribe exercise. METHODS: We conducted a 33-item anonymous survey of CR program directors registered with the American Association of Cardiovascular and Pulmonary Rehabilitation. We assessed the time, mode, and intensity of exercise prescribed, as well as attitudes about maximal exercise testing and exercise prescription. Results were summarized using descriptive statistics. Open-ended responses were coded and quantitated thematically. RESULTS: Of 1470 program directors, 246 (16.7%) completed the survey. In a typical session of CR, a median of 5, 35, 10, and 5 min was spent on warm-up, aerobic exercise, resistance training, and cooldown, respectively. The primary aerobic modality was the treadmill (55%) or seated dual-action step machine (40%). Maximal exercise testing and high-intensity interval training (HIIT) were infrequently reported (17 and 8% of patients, respectively). The most common method to prescribe exercise intensity was ratings of perceived exertion followed by resting heart rate +20-30 bpm, although 55 unique formulas for establishing a target heart rate or range (THRR) were reported. Moreover, variation in exercise prescription between staff members in the same program was reported in 40% of programs. Program directors reported both strongly favorable and unfavorable opinions toward maximal exercise testing, HIIT, and use of THRR. CONCLUSIONS: Cardiac rehabilitation program directors reported generally consistent exercise time and modes, but widely divergent methods and opinions toward prescribing exercise intensity. Our results suggest a need to better study and standardize exercise intensity in CR.
PURPOSE: High-quality exercise training improves outcomes in cardiac rehabilitation (CR), but little is known about how most programs prescribe exercise. Thus, the aim was to describe how current CR programs prescribe exercise. METHODS: We conducted a 33-item anonymous survey of CR program directors registered with the American Association of Cardiovascular and Pulmonary Rehabilitation. We assessed the time, mode, and intensity of exercise prescribed, as well as attitudes about maximal exercise testing and exercise prescription. Results were summarized using descriptive statistics. Open-ended responses were coded and quantitated thematically. RESULTS: Of 1470 program directors, 246 (16.7%) completed the survey. In a typical session of CR, a median of 5, 35, 10, and 5 min was spent on warm-up, aerobic exercise, resistance training, and cooldown, respectively. The primary aerobic modality was the treadmill (55%) or seated dual-action step machine (40%). Maximal exercise testing and high-intensity interval training (HIIT) were infrequently reported (17 and 8% of patients, respectively). The most common method to prescribe exercise intensity was ratings of perceived exertion followed by resting heart rate +20-30 bpm, although 55 unique formulas for establishing a target heart rate or range (THRR) were reported. Moreover, variation in exercise prescription between staff members in the same program was reported in 40% of programs. Program directors reported both strongly favorable and unfavorable opinions toward maximal exercise testing, HIIT, and use of THRR. CONCLUSIONS: Cardiac rehabilitation program directors reported generally consistent exercise time and modes, but widely divergent methods and opinions toward prescribing exercise intensity. Our results suggest a need to better study and standardize exercise intensity in CR.
Authors: Clinton A Brawner; Khaled Abdul-Nour; Barry Lewis; John R Schairer; Shalini S Modi; Dennis J Kerrigan; Jonathan K Ehrman; Steven J Keteyian Journal: Am J Cardiol Date: 2016-01-28 Impact factor: 2.778
Authors: Jelena Toma; Brittany Hammond; Vito Chan; Alex Peacocke; Baharak Salehi; Prateek Jhingan; Dina Brooks; Andrée-Anne Hébert; Susan Marzolini Journal: CJC Open Date: 2020-02-10
Authors: Terence Kavanagh; Donald J Mertens; Larry F Hamm; Joseph Beyene; Johanna Kennedy; Paul Corey; Roy J Shephard Journal: Circulation Date: 2002-08-06 Impact factor: 29.690
Authors: Quinn R Pack; Ray W Squires; Francisco Lopez-Jimenez; Steven W Lichtman; Juan P Rodriguez-Escudero; Victoria N Zysek; Randal J Thomas Journal: J Cardiopulm Rehabil Prev Date: 2014 Sep-Oct Impact factor: 2.081
Authors: Steven J Keteyian; Clinton A Brawner; Patrick D Savage; Jonathan K Ehrman; John Schairer; George Divine; Heather Aldred; Kristin Ophaug; Philip A Ades Journal: Am Heart J Date: 2008-05-22 Impact factor: 4.749