Exercise is an important part of the process. Cardiac rehab encourages patients to attend circuit-based or gym-based fitness classes twice to three times per week for eight weeks. These classes have a significant impact on the quality of life by increasing fitness as well as reducing hospital readmission.
It’s unclear if the patients who attend UK cardiac exercise rehab achieve these benefits. It could be due to a discrepancy between the prescribed exercise dose and what is actually achieved.
Patients should also achieve a heart-rate reserve (the difference in heart rate between their resting heartbeat and predicted maximum heartbeat) of between 40% and 70% during class. It is not always clear whether the patient actually achieves this heart rate.
While cardiac rehab programs encourage their patients to complete the full course of rehabilitation, it is less clear how many follow through with the program as intended. We don’t yet know if current exercise recommendations are effective in improving fitness and health.
Due to COVID-19 , many exercise sessions are now conducted online. The participants are less supervised than in a traditional class. This leaves more room for error.
Heart health
The research was designed to examine the health benefits associated with exercise cardiac rehabilitation, taking into account how much and how long participants exercise. We discussed whether cardiac rehabilitation improved fitness, vascular function, and habit changes.
We looked at 60 patients in Leeds who had been referred to an intensive six-week program. The program consisted of two circuit-based classes per week in leisure centres. At the start and end of the program, the patients’ vascular and physical health levels, as well as their fitness were assessed. This was done by a shuttle-walk test in which the patients had to walk 10m within a given time. The heart rate was measured while the patients were exercising.
Participants were only meeting the recommendations based on our measurements. The program lasted only six weeks, which is also below the eight-week requirement for most exercise programs. The time spent by patients exercising at moderate or vigorous intensity was not optimal and did little to improve their physiological health.
While it is true that many patients felt more confident and fitter after the program, their results could have been even better. Small changes in the way exercise sessions are structured could have a much greater impact on patients’ health.
The original sessions instructed patients to perform a two-minute bout of moderate-to-vigorous cardiovascular exercise, such as cycling, side steps and jogging, followed by a one-minute restful activity, such as strength exercises using light dumbells. This was done for 24 minutes.
The time participants spend exercising at cardiovascular exercise stations does not allow them to reach the heart rate required. Patients may benefit more from cardiac rehabilitation if they extend the intense bouts of activity to three to four minutes.
A heart rate monitor can help patients achieve the required heart rate. BallBall14/ Shutterstock
Some patients do not fully benefit from cardiac rehabilitation because they do not complete the full exercise program. Can help motivate people to adopt healthy lifestyles, even though it is difficult to make a change.
Staff encouragement and helping participants understand their targets can increase intensity, enjoyment, and commitment. Giving people feedback on their performance can help them engage in their exercise.
Measurable goals and progress can help people stay motivated even when they start to lose motivation. Motivating yourself by thinking about the larger impact of exercise, such as setting a good example to your family and friends. Create a routine that includes specific rewards and cues, such as working out every Tuesday after work. This will help make exercising easier.
Our research shows that there is a large gap between what people are told and what they actually do. Making small changes, such as adjusting the duration of intense exercise, can have a significant impact on people’s health and success.
Heart disease is the leading cause of death in the world, but more and more people are recovering from heart attacks. They will, therefore, need help to manage their symptoms. It has been shown that a properly performed cardiac rehab can improve quality of life and reduce the risk of future harm.
