Australian cardiac rehabilitation exercise parameter characteristics and perceptions of high-intensity interval training: a cross-sectional survey

Abstract

PurposeThis study explored current demographics, characteristics, costs, evaluation methods, and outcome measures used in Australian cardiac rehabilitation (CR) programs. It also determined the actual usage and perceptions of high-intensity interval training (HIIT).MethodsA cross-sectional observational web-based survey was distributed to 328 Australian CR programs nationally.ResultsA total of 261 programs completed the survey (79.6% response rate). Most Australian CR programs were located in a hospital setting (76%), offered exercise sessions once a week (52%) for 6–8 weeks (49%) at moderate intensity (54%) for 46–60 min (62%), and serviced 101–500 clients per annum (38%). HIIT was reported in only 1% of programs, and 27% of respondents believed that it was safe while 42% of respondents were unsure. Lack of staff (25%), monitoring resources (20%), and staff knowledge (18%) were the most commonly reported barriers to the implementation of HIIT. Overall, Australian CR coordinators are unsure of the cost of exercise sessions.ConclusionThere is variability in CR delivery across Australia. Only half of programs reassess outcome measures postintervention, and cost of exercise sessions is unknown. Although HIIT is recommended in international CR guidelines, it is essentially not being used in Australia and clinicians are unsure as to the safety of HIIT. Lack of resources and staff knowledge were perceived as the biggest barriers to HIIT implementation, and there are inconsistent perceptions of prescreening and monitoring requirements. This study highlights the need to educate health professionals about the benefits and safety of HIIT to improve its usage and patient outcomes.

Impact of wearable physical activity monitoring devices with exercise prescription or advice in the maintenance phase of cardiac rehabilitation: systematic review and meta-analysis

“…No cardiac events reported were related to exercise training, which suggests that exercise and the addition of WPAM does not increase incidences of cardiac events. This is in line with numerous studies that have shown low adverse event rates with CR exercise [23, 77, 78]. The specific effect of WPAM on safety cannot be determined from these studies, as only one reported which group (control or intervention) the participants who suffered an adverse event were in.…”

“…Several countries have reported one fifth to one third of eligible patients enrol in CR [19–22]. Australia has reported a higher enrolment rate (51–80%) [23]. To improve this low uptake, researchers have investigated alternate models of CR delivery.…”

Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity

“…Furthermore, studies from the United Kingdom have highlighted that in CR practice the actual exercise training intensities performed by patients, may not progress to the upper range of exercise intensity recommendations (13). Despite numerous publications outlining international CR practices and program characteristics from national registries or surveys, relatively few include data on exercise intensity prescription or implementation (15)(16)(17)(18). This data is important to determine whether exercise training during CR is being prescribed and implemented effectively across international programs.…”

National survey of Australian cardiac rehabilitation programmes: does current exercise programming adhere to evidence-based guidelines and best practice?

“…Our findings share some consistency with results from previous Australian surveys. Specifically, the majority of survey responses were from New South Wales and Victoria, 13 exercise was commonly supervised by a nurse or physiotherapist, 12 and walking or indoor cycling were the most common aerobic exercise modes. 12 …”

“…Section 4 gathered information on the type of pre-exercise assessment and exercise tests used and how exercise training sessions were progressed. The design of previous Australian surveys 12 13 was considered to ensure novel information was collected. The survey primarily contained categorical variables with the option to include additional open-ended feedback on each question.…”