A Clinical Guide for Assessment and Prescription of Exercise and Physical Activity in Cardiac Rehabilitation. A CSANZ Position Statement

Verdicchio, Christian V.; Freene, Nicole; Hollings, Matthew; Maiorana, Andrew; Briffa, Tom; Gallagher, Robyn; Hendriks, Jeroen; Abell, Bridget; Brown, Alex; Colquhoun, David; Howden, Erin J.; Hansen, Dominique; Reading, Stacey; Redfern, Julie

doi:10.1016/j.hlc.2023.06.854

Cited by 21 publications

(5 citation statements)

References 64 publications

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“…31,32 Exercise capacity is one of the main factors in improving the quality of life of patients with heart failure, and exercise intervention in this population should be aimed to improve the exercise capacity and cardiac output of these patients. 31,33,34 To accomplish that, exergaming should follow a proper exercise prescription that takes into account the frequency, intensity, time (duration), type, volume, and progression (FITT-VP model) of the exercise 35 (Fig. 2).…”

Section: Discussionmentioning

confidence: 99%

Exergames in exercise-based cardiac rehabilitation for patients with heart failure: a systematic review

Leo,

Scalona,

Lopomo

et al. 2024

Journal of Cardiovascular Medicine

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Aim The aim of this study was to systematically review the current literature on the use of exergames as an exercise-based cardiac rehabilitation intervention for patients with heart failure. Methods PubMed, SCOPUS and CINAHL Plus databases were searched from January 2007 to August 2023. Studies considered eligible for inclusion had to report one or more of the following outcomes: functional capacity (e.g. VO2 max), quality of life, mortality, hospital admissions, physical activity level, and engagement/satisfaction of the intervention. Only studies reported in English were included. Two reviewers independently assessed studies for their eligibility. Results Two studies (in four reports) were included. Included studies reported only data on functional capacity (6-min walking test) and on physical activity level (accelerometers). Due to the low number of included studies, no meta-analysis was performed, and results were discussed narratively. Conclusion Exergames may potentially be a promising tool for exercise-based cardiac rehabilitation in patients with heart failure; however, the low number of included studies was insufficient to drawn proper conclusions. Benefits of exergames compared with traditional interventions could be the possibility of it being delivered at home, reducing some of the barriers that patients with heart failure must face. Further studies are required to assess the efficacy of exergame interventions in patients with heart failure, and to define proper guidelines to deliver exergame interventions in this population. This systematic review was registered on PROSPERO (CRD42023446948).

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Section: Discussionmentioning

confidence: 99%

Exergames in exercise-based cardiac rehabilitation for patients with heart failure: a systematic review

Leo,

Scalona,

Lopomo

et al. 2024

Journal of Cardiovascular Medicine

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“… 11 There is a need for formulating guidelines on the use of telehealth for exercise, ensuring that any risks are mitigated and service workflows enhanced. 12 , 13 Overall guidance and recommendations have recently been released for Australia 14 with more in-depth exercise-specific guidelines requiring development and/or updating in many countries. Resource constraints are also a major barrier to hybrid care, which needs careful consideration.…”

Section: Discussionmentioning

confidence: 99%

Expanding access to telehealth in Australian cardiac rehabilitation services: a national survey of barriers, enablers, and uptake

Thomas,

Cartledge,

Murphy

et al. 2023

European Heart Journal - Digital Health

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Background and Aims Cardiac rehabilitation (CR) is traditionally delivered in-person, however, the COVID-19 pandemic provided impetus for alternate offerings such as telehealth. We investigated uptake, barriers, and enablers in a national survey during the pandemic in Australia. Methods We surveyed CR programs between April-June 2021 using professional association networks. The anonymous online questionnaire addressed program characteristics, COVID-19 impacts, and barriers to and enablers of telehealth use. Open text responses were coded and presented as themes. Results In total 105 programs responded (33% response rate). All states and geographical areas were represented. Use of every modality of telehealth care (telephone, video conferencing, text messaging and web-based) increased significantly during and post-COVID with a strong preference for telephone (85% of services). Respondents perceived video (53%) and telephone (47%) formats as safe and effective for delivering CR. The most common barriers to telehealth were difficulties conducting assessments and reduced engagement with patients. Prominent enablers were increased reach and reduced patient barriers to CR access. Conclusions Telehealth use by CR programs increased during the peak pandemic period. However, additional support is required to ensure telehealth services can be maintained. There is considerable potential to increase the reach of CR by embedding telehealth into existing models of care.

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“…The benefits of PA, the PA guidelines post‐PCI according to the frequency, intensity, time, and type principle, and individual barriers and enablers of PA were discussed, including the level of confidence to be physically active, as well as safety measures such as the warning signs of a heart attack. Individuals undertaking secondary prevention post‐PCI are encouraged to meet the public health PA guidelines to improve health outcomes 13 . The World Health Organization PA guidelines for adults with chronic disease recommend that individuals should complete 150–300 min of moderate‐intensity aerobic PA; or 75–150 min of vigorous‐intensity aerobic PA or a combination of both per week 14 .…”

Section: Methodsmentioning

confidence: 99%

“…Individuals undertaking secondary prevention post‐PCI are encouraged to meet the public health PA guidelines to improve health outcomes. 13 The World Health Organization PA guidelines for adults with chronic disease recommend that individuals should complete 150–300 min of moderate‐intensity aerobic PA; or 75–150 min of vigorous‐intensity aerobic PA or a combination of both per week. 14 MVPA should be completed on most days per week (frequency) and a variety of MVPA (type) is recommended including domestic, occupational, transportation, and leisure activities, noting any activity is better than none.…”

Section: Methodsmentioning

confidence: 99%

“…Individuals undertaking secondary prevention post-PCI are encouraged to meet the public health PA guidelines to improve health outcomes. 13 The World Health Organization PA guidelines for adults with chronic disease recommend that individuals should complete 150-300 min of moderateintensity aerobic PA; or 75-150 min of vigorous-intensity aerobic PA or a combination of both per week. 14…”

Section: Physiotherapist-led Pa Counselingmentioning

confidence: 99%

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Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

Freene,

Carroll,

Flynn

et al. 2024

Health Science Reports

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BackgroundPhysical activity (PA) levels of people with coronary heart disease are low in the first 30 days after percutaneous coronary intervention (PCI), increasing the risk of recurrent cardiac events. Following PCI, PA counseling delivered by a physiotherapist before discharge may increase the PA levels of patients. Preliminary work is required to determine the effects of the counseling session compared to usual care.ObjectivesTo investigate the feasibility and potential efficacy of a brief physiotherapist‐led PA counseling session immediately after an elective PCI compared to usual care for improved PA early post‐PCI.MethodsUsing concealed allocation and blinded assessments, eligible participants (n = 30) were randomized to a physiotherapist‐led PA counseling session (30 min) or usual care (nurse‐led PA advice < 5 min). The primary outcome was daily minutes of moderate‐to‐vigorous PA (accelerometry; 3 weeks). Secondary outcomes included cardiac rehabilitation intention, anxiety and depression levels (Hospital Anxiety and Depression Scale), and quality‐of‐life (MacNew questionnaire). Recruitment, retention, and attrition were assessed for feasibility. Semistructured interviews were conducted with 13 participants to determine intervention acceptability, and barriers and enablers to PA.ResultsBetween and within‐group comparisons were not significant in intention‐to‐treat analyses. All feasibility criteria were met except for retention and attrition of participants. At 3 weeks, only 25% of participants were planning to attend cardiac rehabilitation, with no between‐group differences. Increased PA at 3 weeks was associated with participants that were younger, without other chronic disease,s and more active immediately following discharge. Interviews revealed personal, environmental, and program‐based themes for barriers and enablers to PA.ConclusionsA physiotherapist‐led PA counseling session may not improve PA levels early post‐elective PCI compared to very brief PA advice delivered by nurses. A larger multicentre randomized controlled trial is feasible with minor modifications to participant follow‐up. Further research is required.

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A Clinical Guide for Assessment and Prescription of Exercise and Physical Activity in Cardiac Rehabilitation. A CSANZ Position Statement

Cited by 21 publications

References 64 publications

Exergames in exercise-based cardiac rehabilitation for patients with heart failure: a systematic review

Exergames in exercise-based cardiac rehabilitation for patients with heart failure: a systematic review

Expanding access to telehealth in Australian cardiac rehabilitation services: a national survey of barriers, enablers, and uptake

Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

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