Insufficient exercise intensity for clinical benefit? Monitoring and quantification of a community-based Phase III cardiac rehabilitation programme: A United Kingdom perspective
| Autor: | Simon Nichols, Sean Carroll, Lee Ingle, Grant Abt, Alaa Khushhal |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_treatment Drug research and development Cardiovascular Medicine 030204 cardiovascular system & hematology Cardiovascular System Clinical trials 0302 clinical medicine Heart Rate Medicine and Health Sciences Medicine Public and Occupational Health Cardiac Rehabilitation Multidisciplinary Rehabilitation Middle Aged Sports Science Phase III clinical investigation Exercise Therapy Cardiovascular Diseases Cohort sports.sport Female Exercise prescription Research Article medicine.medical_specialty Science sports Cardiology Patient Advocacy Rehabilitation Medicine 03 medical and health sciences Heart rate Humans Sports and Exercise Medicine Exercise physiology Exercise Aged Pharmacology Circuit training business.industry Biology and Life Sciences Physical Activity 030229 sport sciences United Kingdom Research and analysis methods Health Care Physical Fitness Clinical medicine Exercise Test Physical therapy Exercise intensity Observational study business human activities |
| Zdroj: | PLoS ONE PLoS ONE, Vol 14, Iss 6, p e0217654 (2019) |
| ISSN: | 1932-6203 |
| Popis: | Background: In recent years, criticism of the percentage range approach for individualised exercise\ud prescription has intensified and we were concerned that sub-optimal exercise dose (especially\ud intensity) may be in part responsible for the variability in the effectiveness of cardiac rehabilitation\ud (CR) programmes in the United Kingdom (UK). The aim was to investigate the fidelity of a structured\ud Phase III CR programme, by monitoring and quantifying exercise training intensity.\ud Design: Observational study.\ud Methods: The programme comprised 16 sessions over 8 weeks, where patients undertook an\ud interval, circuit training approach within national guidelines for exercise prescription (40-70% heart\ud rate reserve [HRR]). All patients wore an Apple Watch (Series 0 or 2, Watch OS2.0.1, Apple Inc.,\ud California, USA). We compared the mean % heart rate reserve (%HRR) achieved during the\ud cardiovascular training component (%HRR-CV) of a circuit-based programme, with the %HRR during\ud the active recovery phases (%HRR-AR) in a randomly selected cohort of patients attending standard\ud CR. We then compared the mean %HRR-CV achieved with the minimal exercise intensity threshold\ud during supervised exercise (40% HRR) recommended by national governing bodies.\ud Results: Thirty cardiac patients (83% male; mean age [SD] 67 [10] years; BMI 28.3 [4.6] kg∙m-2\ud ) were\ud recruited. We captured 332 individual training sessions. The mean %HRR-CV and %HRR-AR were 37\ud (10) %, and 31 (13) %, respectively. There was weak evidence to support the alternative hypothesis\ud of a difference between the %HRR-CV and 40% HRR. There was very strong evidence to accept the\ud alternative hypothesis that the mean %HRR-AR was lower than the mean %HRR-CV (median\ud standardised effect size 1.1 (95%CI: 0.563 to 1.669) with a moderate to large effect.\ud Conclusion: Mean exercise training intensity was below the lower limit of the minimal training\ud intensity guidelines for a Phase III CR programme. These findings may be in part responsible for\ud previous reports highlighting the significant variability in effectiveness of UK CR services and poor\ud CRF improvements observed from several prior investigations. |
| Databáze: | OpenAIRE |
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