Article

Background Although disease-specific exercise guidelines for cardiovascular
disease (CVD) are widely available, it remains uncertain whether these different
exercise guidelines are integrated properly for patients with different CVDs. The
aim of this study was to assess the inter-clinician variance in exercise
prescription for patients with various CVDs and to compare these prescriptions
with recommendations from the EXercise Prescription in Everyday practice and
Rehabilitative Training (EXPERT) tool, a digital decision support system for
integrated state-of-the-art exercise prescription in CVD. Design The study was a
prospective observational survey. Methods Fifty-three CV rehabilitation
clinicians from nine European countries were asked to prescribe exercise
intensity (based on percentage of peak heart rate (HRpeak)), frequency, session
duration, programme duration and exercise type (endurance or strength training)
for the same five patients. Exercise prescriptions were compared between
clinicians, and relationships with clinician characteristics were studied. In
addition, these exercise prescriptions were compared with recommendations from
the EXPERT tool. Results A large inter-clinician variance was found for
prescribed exercise intensity (median (interquartile range (IQR)): 83 (13) % of
HRpeak), frequency (median (IQR): 4 (2) days/week), session duration (median
(IQR): 45 (18) min/session), programme duration (median (IQR): 12 (18) weeks),
total exercise volume (median (IQR): 1215 (1961) peak-effort training hours) and
prescription of strength training exercises (prescribed in 78% of all cases).
Moreover, clinicians' exercise prescriptions were significantly different from
those of the EXPERT tool ( p < 0.001). Conclusions This study reveals significant
inter-clinician variance in exercise prescription for patients with different
CVDs and disagreement with an integrated state-of-the-art system for exercise
prescription, justifying the need for standardization efforts regarding
integrated exercise prescription in CV rehabilitation.

Langue : ANGLAIS