Exercise training programs in Dutch cardiac rehabilitation centres

Vromen, Tom; Spee, Ruud F.; Kraal, Jos J.; Peek, Niels; Engen-Verheul, Mariëtte M. van; Kraaijenhagen, R. A.; Gijsbers, Harm; Kemps, Hareld

doi:10.1007/s12471-013-0374-2

Cited by 31 publications

(41 citation statements)

References 24 publications

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“…A questionnaire was modified based upon a similar research study conducted among Dutch CR programs (3). Cardiac rehabilitation clinicians from 58 phase II facilities across the states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin completed the questionnaire over the phone.…”

Section: Methodsmentioning

confidence: 99%

Exercise Prescription Techniques in Cardiac Rehabilitation Centers in Midwest States

O'Neil¹,

Thomas²,

Pettit‐Mee³

et al. 2018

Journal of Clinical Exercise Physiology

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Introduction: Cardiac rehabilitation (CR) is a primary prescribed treatment for a variety of cardiovascular disease states, including: coronary artery disease, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), myocardial infarction (MI), and heart failure. For this reason, exercise prescription guidelines for cardiac patients have been established. However, it is unclear how these guidelines are being administered at cardiac rehabilitation centers. The purpose of this study is to assess current exercise prescription techniques at cardiac rehabilitation clinics across several Midwest states in the United States. Methods: Fifty-eight CR programs from Michigan, Indiana, Illinois, Minnesota, Wisconsin, and Ohio were administered a questionnaire assessing clinic characteristics, aerobic and resistance exercise prescription techniques. Results: Most reported patient types were PCI, CABG, and MI. Clinical exercise physiologists were the primary exercise prescription writers (81%). Only 32% of the clinics required a clinical certification. Baseline stress tests prior to CR were performed in 33% of programs. Rating of Perceived Exertion (RPE) was the most commonly used indicator of exercise intensity, followed by heart rate reserve (HRR), and METs. Resistance exercise was practiced in 89% of CR programs. The most common intensity indicator was trial and error, and RPE. Conclusion: Results demonstrate exercise prescription variability among CR programs. This emphasizes the complexity and expertise among clinical exercise physiologists. These results also highlight the importance that academic programs place on training students across all prescription techniques, and utilization of research-based prescription guidelines published by professional organizations.

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Section: Methodsmentioning

confidence: 99%

Exercise Prescription Techniques in Cardiac Rehabilitation Centers in Midwest States

O'Neil¹,

Thomas²,

Pettit‐Mee³

et al. 2018

Journal of Clinical Exercise Physiology

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“…Second, this guideline provides clear practical guidance on how to tailor exercise with respect to intensity and duration individually, using results of a maximum or symptom-limited exercise test. In this way we aim to reduce the considerable practice variation which has recently been reported in Dutch CR centres [11], and thereby, to increase effectivity of exercise-based CR in the Netherlands [10]. A third novel topic is the addition of HIT as a training strategy in CHD patients.…”

Section: Conclusion and Recommendationsmentioning

confidence: 99%

“…Recently, it was reported that among Dutch CR centres, considerable variation exists in methods for determination of exercise intensity, training intensity and volume, and uniformity of physiotherapeutic interventions [11]. A possible explanation for this is that both the 2011 multidisciplinary CR guideline [12] and the 2005 CR guideline by the Dutch Royal Society for Physiotherapists (KNGF) [13] lack clear practical guidance for PTs.…”

Section: Introductionmentioning

confidence: 99%

Exercise-based cardiac rehabilitation in patients with coronary heart disease: a practice guideline

et al. 2013

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BackgroundTo improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisciplinary CR guideline, as it includes several novel topics.MethodsA systematic literature search was performed to formulate conclusions on the efficacy of exercise-based interventions during all CR phases in patients with CHD. Evidence was graded (1–4) according the Dutch evidence-based guideline development (EBRO) criteria. In case of insufficient scientific evidence, recommendations were based on expert opinion. This guideline comprised a structured approach including assessment, treatment and evaluation.ResultsRecommendations for exercise-based CR were formulated covering the following topics: preoperative physiotherapy, mobilisation during the clinical phase, aerobic exercise, strength training, and relaxation therapy during the outpatient rehabilitation phase, and adoption and monitoring of a physically active lifestyle after outpatient rehabilitation.ConclusionsThere is strong evidence for the effectiveness of exercise-based CR during all phases of CR. The implementation of this guideline in clinical practice needs further evaluation as well as the maintenance of an active lifestyle after supervised rehabilitation.

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“…In addition to the already low uptake of CR in the Netherlands median total training duration seems to be less than 3 months [10, 11]. Consolidating lifestyle habits require continued attention and appropriate guidance [3].…”

Section: Introductionmentioning

confidence: 99%

Rationale and design of a randomised clinical trial for an extended cardiac rehabilitation programme using telemonitoring: the TeleCaRe study

Snoek

Meindersma

Prins

et al. 2016

BMC Cardiovasc Disord

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BackgroundDespite the known positive effects of cardiac rehabilitation and an active lifestyle, evidence is emerging that it is difficult to attain and sustain the minimum recommendations of leisure time physical activity. The long-term benefits are often disappointing due to lack of adherence to the changes in life style. Qualitative research on patients’ perspectives suggests that motivation for lifestyle change tends to diminish around 3 months after the index-event. The time most cardiac rehabilitation programmes end. The aim of the present study is to determine if prolongation of a traditional cardiac rehabilitation programme with additional heart rate based telemonitoring guidance for a period of 6 months results in better long term effects on physical and mental outcomes, care consumption and quality of life than traditional follow-up.MethodsIn this single centre randomised controlled trial 120 patients with an absolute indication for cardiac rehabilitation will be randomised in a 1:1 ratio to an intervention group with 6 months of heart rate based telemonitoring guidance or a control group with traditional follow-up after cardiac rehabilitation. The primary endpoint will be VO2peak after 12 months. Secondary endpoints are VO2peak after 6 months, quality of life, physical-, emotional- and social functioning, cardiac structure, traditional risk profile, compliance to the use of the heart rate belt and smartphone, MACE and care-consumption.DiscussionThe TeleCaRe study will provide insight into the added value of the prolongation of traditional cardiac rehabilitation with 6 months of heart rate based telemonitoring guidance.Trial registrationDutch Trial Register: NTR4644 (registered 06/12/14).

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Exercise training programs in Dutch cardiac rehabilitation centres

Cited by 31 publications

References 24 publications

Exercise Prescription Techniques in Cardiac Rehabilitation Centers in Midwest States

Exercise Prescription Techniques in Cardiac Rehabilitation Centers in Midwest States

Exercise-based cardiac rehabilitation in patients with coronary heart disease: a practice guideline

Rationale and design of a randomised clinical trial for an extended cardiac rehabilitation programme using telemonitoring: the TeleCaRe study

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