NICHOLS, Simon, MCGREGOR, Gordon, BRECKON, Jeff and INGLE, Lee (2020). Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure. International Journal of Sports Medicine.
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26911:554512
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Nichols_CurrentInsightsExercise-based(AM).pdf - Accepted Version
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Nichols_CurrentInsightsExercise-based(AM).pdf - Accepted Version
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Abstract
Abstract: Cardiac rehabilitation is a package of lifestyle secondary prevention
strategies designed for patients with coronary heart disease and chronic
heart failure. A community-based cardiac rehabilitation programme provides
patients with a structured exercise training intervention alongside
educational support and psychological counselling. This review provides an
update regarding the clinical benefits of community-based cardiac
rehabilitation from a psycho-physiological perspective, and also focuses on
the latest epidemiological evidence regarding potential survival benefits.
Behaviour change is key to long-term adoption of a healthy and active
lifestyle following a cardiac event. In order for lifestyle interventions
such as structured exercise interventions to be adopted by patients,
practitioners need to ensure that behaviour change programmes are mapped
against patient’s priorities and values, and adapted to their level
of readiness and intention to engage with the target behaviour. We review
the evidence regarding behaviour change strategies for cardiac patients and
provide practitioners with the latest guidance. The ‘dose’
of exercise training delivered to patients attending exercise-based cardiac
rehabilitation is an important consideration because an improvement in peak
oxygen uptake requires an adequate physiological stimulus to invoke positive
physiological adaptation. We conclude by critically reviewing the latest
evidence regarding exercise dose for cardiac patients including the role of
traditional and more contemporary training interventions including high
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