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Does exercise prescription based on estimated heart rate training zones exceed the ventilatory anaerobic threshold in patients with coronary heart disease undergoing usual-care cardiovascular rehabilitation? : a United Kingdom perspective

Pymer, Sean; Nichols, Simon; Prosser, Jonathon; Birkett, Stefan; Carroll, Sean; Ingle, Lee

Authors

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Mr Sean Pymer Sean.Pymer@hull.ac.uk
Academic Clinical Exercise Physiologist

Simon Nichols

Jonathon Prosser

Stefan Birkett



Abstract

Background: In the United Kingdom (UK), exercise intensity is prescribed from a fixed percentage range (% heart rate reserve; %HRR) in cardiac rehabilitation (CR) programmes. We aimed to determine the accuracy of this approach by comparing it
with an objective, threshold-based approach incorporating the accurate determination of ventilatory anaerobic threshold (VAT). We also aimed to investigate the role of baseline cardiorespiratory fitness status, and exercise testing mode dependency (cycle
v treadmill ergometer) on these relationships.
Design/Methods: A maximal cardiopulmonary exercise test was conducted on a cycle ergometer or a treadmill before and following usual-care circuit training from two separate CR programmes from a single region in the UK. The heart rate corresponding to VAT was compared to current heart rate-based exercise prescription guidelines.
Results: We included 112 referred patients (61 years [59-63]; body mass index 29 kg∙m-2 [29-30]; 88% male). There was a significant but relatively weak correlation (r=0.32; P=0.001) between measured and predicted %HRR, and values were significantly different from each other (P=0.005). Within this cohort, we found that 54% of patients had their VAT identified outside of the 40-70% predicted HRR exercise training zone. In the majority of participants (45%), the VAT occurred at an exercise intensity

Citation

Pymer, S., Nichols, S., Prosser, J., Birkett, S., Carroll, S., & Ingle, L. (in press). Does exercise prescription based on estimated heart rate training zones exceed the ventilatory anaerobic threshold in patients with coronary heart disease undergoing usual-care cardiovascular rehabilitation? : a United Kingdom perspective. European Journal of Preventive Cardiology, https://doi.org/10.1177/2047487319852711

Journal Article Type Article
Acceptance Date May 3, 2019
Online Publication Date May 22, 2019
Deposit Date May 7, 2019
Publicly Available Date May 7, 2019
Journal European Journal of Preventive Cardiology
Print ISSN 2047-4873
Electronic ISSN 2047-4881
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1177/2047487319852711
Keywords Cardiac rehabilitation; Exercise prescription; Cardiorespiratory fitness; Ventilatory anaerobic threshold
Public URL https://hull-repository.worktribe.com/output/1738829
Publisher URL https://journals.sagepub.com/doi/full/10.1177/2047487319852711

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