Exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond: why and how: a position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Author:

Hansen Dominique12,Abreu Ana3,Ambrosetti Marco4ORCID,Cornelissen Veronique5,Gevaert Andreas67,Kemps Hareld89,Laukkanen Jari A1011,Pedretti Roberto12,Simonenko Maria13ORCID,Wilhelm Matthias14,Davos Constantinos H15,Doehner Wolfram1617,Iliou Marie-Christine18,Kränkel Nicolle1719,Völler Heinz2021,Piepoli Massimo21

Affiliation:

1. Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium

2. UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Agoralaan, Building A, 3590 Hasselt, Belgium

3. Cardiology Department, Hospital Universitário de Santa Maria/Centro Académico de Medicina de Lisboa (CAML), Exercise and Cardiovascular Rehabilitation Laboratory, Centro Cardiovascular da Universidade de Lisboa (CCUL), Lisbon, Portugal

4. Cardiac Rehabilitation Unit, ASST Ospedale Maggiore Crema, Crema, Italy

5. Research Unit of Cardiovascular Exercise Physiology, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium

6. Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium

7. Department of Cardiology, Antwerp University Hospital (UZA), Belgium

8. Department of Cardiology, Maxima Medical Centre, Veldhoven, The Netherlands

9. Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland

10. Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland

11. Cardiovascular Department, IRCCS MultiMedica, Care and Research Institute, Sesto San Giovanni, Milano, Italy

12. Heart Transplantation Outpatient Department, Cardiopulmonary Exercise Test Research Department, Almazov National Medical Research Centre, St. Petersburg, Russia

13. Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland

14. Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece

15. BCRT—Berlin Institute of Health Center for Regenerative Therapies, Department of Cardiology (Virchow Klinikum), Charité – Universitätsmedizin Berlin, Partner Site Berlin, Germany

16. Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, Assistance Publique Hopitaux de Paris Centre Université de Paris, Paris, France

17. German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin D-1220, Germany

18. Charité – University Medicine Berlin, Campus Benjamin Franklin, Department of Cardiology, Hindenburgdamm 30, 12203 Berlin, Germany

19. Klinik am See, Rehabilitation Centers for Internal Medicine, Berlin, Germany

20. Department of Rehabilitation Medicine, University of Potsdam, Potsdam, Germany

21. Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy

Abstract

Abstract A proper determination of the exercise intensity is important for the rehabilitation of patients with cardiovascular disease (CVD) since it affects the effectiveness and medical safety of exercise training. In 2013, the European Association of Preventive Cardiology (EAPC), together with the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation, published a position statement on aerobic exercise intensity assessment and prescription in cardiovascular rehabilitation (CR). Since this publication, many subsequent papers were published concerning the determination of the exercise intensity in CR, in which some controversies were revealed and some of the commonly applied concepts were further refined. Moreover, how to determine the exercise intensity during resistance training was not covered in this position paper. In light of these new findings, an update on how to determine the exercise intensity for patients with CVD is mandatory, both for aerobic and resistance exercises. In this EAPC position paper, it will be explained in detail which objective and subjective methods for CR exercise intensity determination exist for aerobic and resistance training, together with their (dis)advantages and practical applications.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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