Cardiac Rehabilitation: some tips on individualising exercise programs | fit.test

Cardiac Rehabilitation saves lives but is under-utilised

This post highlights the physical, mental and social benefits of cardiac rehabilitation (CR). Together, these health benefits save lives and drastically improve the quality of life of patients with cardiovascular disease. But only about 30% of people referred for CR actually complete a program. Are you as an exercise professional going to encourage your clients to be in the 30% of people who benefit from CR or the other 70%?

The post also highlights the benefits of individualising the CR program that you deliver to your clients. Individualising means to assess your clients properly at entry and even exit points of your program….it should be self-evident that benefits from an individualised program are always going to be much much greater than the old ‘cook book’ program (Hi…. Please get onto the bike and ride for 10 minutes….then I will give you some pamphlets on smoking cessation and diet…..yuk!). It is probably true that your clients have arrived to where they are now in their health journey by NOT responding well to lecturing on their unhealthy habits.

Cardiac rehabilitation improves the lives of people with heart disease

Hi, I’m Steve Selig, the founder of fit.test. In this short video I’m going to show you how fit.test is ideally set up to help any people working in cardiac rehabilitation to provide exceptional exercise services for your clients. 

This post is based on a recent (2019) publication by the National Heart Foundation of Australia, designed for health professionals. If you’re not a health professional but are an exercise professional such as a Personal Trainer, by all means look at this video, but you are advised to involve health professionals in order to guide you into providing exercise services for clients. Personal Trainers are encouraged to provide CR programs under the guidance of a health professional.

The Heart Foundation of Australia recommends that CR participants are given a tailored (i.e. individualised), progressive and supervised exercise training program. 

And we want to educate participants about strategies to increase general physical activity and reduce sedentary behaviours. 

Now, importantly, there is a strong recommendation to perform an initial exercise assessment, and for that matter and end of program assessment, if your program has a cut off. Now fit.test is ideally set up for not only doing the initial assessments and the post program, but also for tracking your client through a multi week / month program. 

The importance of assessing your client at the start of cardiac rehabilitation

The recommendation by the Heart Foundation for exercise assessments at the beginning of the program is to provide what’s called a symptom limited exercise test, and this can be done typically on a bicycle ergometer or on a treadmill. 

And this can be either using one of the published protocols, or better still by individualising your assessment using fit.test. I’ve provided a lot of information including other videos, blog posts and articles on my platform fit.test, https://myfittest.com.au/ to guide you in how to do a customize a symptom limited exercise test for each individual client. This is a very strong recommendation. I have also provided much advice on how to perform either submaximal or maximal assessments.  

In my own practice, which is outside of a hospital, I use and rely on submaximal exercise evaluations using fit.test.

You can use fit.test beautifully to perform submaximal exercise evaluations, and that’s exactly what I do, and I’ve given a lot of information on the platform on how to do that, so that’s my strongest recommendation. 

I do not like or use the six minute walk test. I don’t like it because it is a single a single data point exercise test and it’s almost impossible to prescribe exercise individually and scientifically based on the results from a single point test. 

You can also do incremental shuttle walk tests, but if you have a treadmill or even if you have a walking track where a client can keep walking in the same direction and not having to turn directions such as in the shuttle walk test, that is my preferred. I prefer if someone can walk in a single direction. 

What we are wanting to do is assess exercise tolerance at the beginning of a CR program to develop an individualized exercise prescription. This is what fit.test does better than any other platform.

We can also use fit.test beautifully to reassess our clients and to reprogram the exercise prescription as you go along, because the exercise test can be as simple as just doing another exercise session, it’s that easy to do, or even within an exercise session. 

So, you can keep tuning the program up or down depending on how well the client is doing. 

Fit.test also automatically generates simple and informative reports to send in pdf format to both your client and their primary medical primary care medical practitioner. 

30% of heart disease is caused by sedentary living

We know that 30% of heart disease is caused by physical inactivity, and exercise is a tremendously powerful tool for improving the clinical status of people undergoing cardiac rehabilitation. By increasing participation to exercise we can reduce hospital admissions and increase health related quality of life. 

Now this just summarizes my approach and how fit.test can be used beautifully to do the things I’ve just been talking about. 

Because I operate outside of the hospital, I would stop on the occurrence of any adverse signs or symptoms. Whereas if you’re in a hospital and working with a cardiologist, you can proceed all the way up to someone’s peak exercise capacity and this may include the presence of adverse signs or symptoms.

Either way, you can use fit.test simply and beautifully to design an individualized exercise plan. 

You can contact me at info@myfitness.com.au and I provide ongoing help and support to all of my subscribers.

Finally, whether or not you are a health professional, go and look up the resource of the National Heart Foundation of Australia.

https://www.heartfoundation.org.au/recovery-and-support/cardiac-rehabilitation-for-health-professionals