Being diagnosed with a heart condition or suffering a heart attack will be terrifying. In the UK, one person is admitted to hospital due to a heart attack roughly every five minutes. Low physical activity, poor eating regimen, and stress can all increase heart disease risk. But cardiac rehabilitation programmes aim to assist individuals who have a heart condition improve their heart health by targeting these lifestyle aspects.
Exercise is a serious a part of this process – exercise cardiac rehab programmes encourage patients to participate in gym or circuit-based fitness classes two to thrice every week, for a period of eight weeks. These classes can have a profound effect on quality of life by improving fitness and reducing the need for hospital re-admission.
But it’s not clear if patients attending UK exercise cardiac rehab actually achieve these advantages. This is potentially all the way down to a niche between the exercise dose that’s prescribed, and the quantity achieved.
It’s also advisable that patients achieve a heart rate reserve (the difference between an individual’s resting heart rate and their predicted maximum heart rate) between 40% and 70% for 20 minutes when attending classes. However, it might be unclear whether patients actually achieve this heart rate in point of fact.
And while cardiac rehab programmes encourage patients to join or complete a full course of rehab, it’s less certain what number of actually perform the programme as intended. This means we don’t know if the present exercise prescription is helpful in improving health and fitness.
In fact, helping people to perform their cardiac rehab accurately is more essential than ever, with many exercise sessions now held online attributable to COVID-19. This means participants have less supervision than a standard exercise class, leaving more margin for error.
Heart health
Our research aimed to explore the health advantages of participating in exercise cardiac rehab, based on how much exercise participants undertake and the way hard they exercise for. We investigated whether cardiac rehab actually improved fitness, vascular health and habit change.
We specifically checked out 60 patients from Leeds who were referred to a six-week programme. This programme involved attending two circuit-based fitness classes every week based in leisure centres. The patients’ vascular health, physical activity levels and fitness (assessed via a shuttle walk test, for which patients need to walk 10m in an allotted time) were recorded at the start and the tip of the programme. Heart rate measurements were taken while they were exercising.
Our measurements found participants were exercising on the lower end of the prescribed intensity level – only just meeting recommendations. The programme only lasted six weeks as well, which is below the usual eight week requirement of most exercise programmes. Importantly, the time patients spent exercising at moderate to vigorous intensity was lower than optimal, and didn’t improve their physiological or vascular health.
While many patients reported feeling more confident and fitter consequently of the programme, it’s also clear their outcomes might have been higher. However, we consider small changes to the structure of exercise sessions could help patients achieve much greater health advantages.
In the unique sessions patients were instructed to finish a two-minute bout of moderate to vigorous cardiovascular exercise akin to cycling, jogging and side steps, alternated with one-minute of more restful activity, akin to performing strength exercises with light dumbells, for a complete of 24 minutes.
But the time spent performing exercise on the cardiovascular exercise stations isn’t actually long enough for participants to boost their heart beat to the required heart rate. By extending the vigorous bouts of exercise to 3 or 4 minutes, patients could also be higher capable of increase their heart rate, and more more likely to fully profit from cardiac rehab.
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Another reason why some patients don’t fully profit from cardiac rehab is because they don’t complete a full exercise programme. While it might be difficult for people to vary their lifestyle, knowledge will be power when attempting to motivate healthy behaviours.
Helping participants understand the targets they need to aim for, and providing the tools to do that (akin to a heart rate monitor) can increase exercise intensity, enjoyment and commitment, as can encouragement from staff. Indeed, giving people specific feedback on their performance has been shown to assist people engage more of their exercise.It also increases their sense of accomplishment from week to week.
Measurable goals and progress give people a tangible measure of success, and will help them keep working hard even in the event that they begin to feel less motivated. Thinking in regards to the wider impact of exercise – akin to how being health sets a superb example for our family and friends – can create a stronger type of motivation. Creating a routine with specific cues and rewards – akin to exercising after work every week on a Tuesday – also helps make the choice to exercise more automatic, and due to this fact easier.
Our research makes clear that there is usually a significant gap between advice and reality. But making small changes – akin to to the length of intense exercise – could make a considerable difference to people’s success and health.
While heart disease remains to be the only most typical reason for death worldwide, an increasing number of individuals are surviving heart attacksso they may need support to administer their symptoms. Carrying out cardiac rehab properly is shown to increase quality of life, and lower the chance of future harm.
