Key result
Exercise prescription based on predicted heart rate reserve was inaccurate compared to measured values, with 55% of cardiac rehabilitation patients achieving their ventilatory anaerobic threshold outside the recommended 40-70% zone.
Why the study?
The accuracy of prescribing cardiac rehabilitation exercise intensity from fixed percentage heart rate reserve was evaluated against an objective ventilatory anaerobic threshold approach.
Does exercise prescription based on estimated heart rate training zones accurately reflect the ventilatory anaerobic threshold in patients with coronary heart disease undergoing cardiovascular rehabilitation?
Population
112 referred patients in two UK cardiac rehabilitation programmes
Comparison
Fixed %HRR exercise prescription guidelines vs objective VAT determination
Design
Observational comparative study before and following usual-care circuit training
Authors
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Challenges reliance on predicted HRR zones for exercise prescription; leaves open whether VAT-guided training improves outcomes.
Cross-Sectional (n=112)
Yes
Does exercise prescription based on estimated heart rate training zones accurately reflect the ventilatory anaerobic threshold in patients with coronary heart disease undergoing cardiovascular rehabilitation?
Mean Difference: 6.74 (95% CI 2.99–10.49)
Absolute Event Rate: 77.99% vs 72%
p-value: p=0.001
Current UK guidelines using a fixed percentage of heart rate reserve for exercise prescription may be inaccurate for a large proportion of cardiac rehabilitation patients compared to objective ventilatory anaerobic threshold.
Pymer et al. (2019) conducted a cross-sectional in Coronary heart disease (n=112). Estimated heart rate training zones (predicted %HRR) vs. Objective threshold-based approach (measured HRR and VAT) was evaluated on Difference between directly determined and predicted Heart Rate Reserve (HRR) (MD 6.74, 95% CI 2.99-10.49, p=0.001). Exercise prescription based on predicted heart rate reserve was inaccurate compared to measured values, with 55% of cardiac rehabilitation patients achieving their ventilatory anaerobic threshold outside the recommended 40-70% zone.
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