Evidence-based techniques using intensity indicators like heart rate and perceived exertion can guide exercise prescription for cardiovascular disease patients when baseline stress testing is absent.
How can clinicians safely prescribe and monitor exercise for cardiovascular disease patients in cardiac rehabilitation when a baseline graded exercise test is not performed?
This review provides practical, evidence-based techniques for prescribing exercise in cardiac rehabilitation when the gold-standard baseline graded exercise test is unavailable.
Aerobic exercise is a core component of cardiac rehabilitation (CR). Leading organizations recommend that the exercise prescriptions should be based on a symptom limited baseline graded exercise test (GXT). However, recent evidence suggests that only ~30% of CR clinics perform baseline GXTs. Consequently, exercise prescriptions including exercise progression in CR are not following standard exercise prescription guidelines. Therefore, the purpose of this review is to provide clinicians with evidence-based techniques for prescribing exercise in the absence of a baseline GXT. Intensity indicators (e.g., heart rate, perceived exertion) are reviewed, along with special exercise considerations for various disease states (e.g., heart failure, peripheral artery disease, and coronary artery disease). Baseline exercise testing remains the gold standard approach for prescribing exercise among heart disease patients, however, clinicians must be prepared to safely develop and monitor patients when a baseline GXT is not performed.
Mytinger et al. (Mon,) conducted a review in Cardiovascular Disease. Exercise prescription without baseline graded exercise test was evaluated. Evidence-based techniques using intensity indicators like heart rate and perceived exertion can guide exercise prescription for cardiovascular disease patients when baseline stress testing is absent.