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Comparing methods for prescribing exercise for individuals with chronic heart failure

Patterson, Jeremy A., Selig, Steve E., Toia, Deidre, Geerling, Ralph H., Bamroongsuk, Voramont and Hare, David L. 2005, Comparing methods for prescribing exercise for individuals with chronic heart failure, Journal of exercise physiology online, vol. 8, no. 4, pp. 9-19.

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Title Comparing methods for prescribing exercise for individuals with chronic heart failure
Author(s) Patterson, Jeremy A.
Selig, Steve E.
Toia, Deidre
Geerling, Ralph H.
Bamroongsuk, Voramont
Hare, David L.
Journal name Journal of exercise physiology online
Volume number 8
Issue number 4
Start page 9
End page 19
Publisher American Society of Exercise Physiologists
Place of publication Duluth, Minn.
Publication date 2005-08
ISSN 1097-9751
Keyword(s) metabolic equations
chronic heart failure
%VO2R
resting VO2
Summary This study examined the accuracy of current recommended guidelines for prescribing exercise intensity using the methods of percentage of heart rate reserve (%HRR), percentage of VO2 peak (%VO2peak) and percentage of VO2 reserve (%VO2R) in a clinical population of chronic heart failure (CHF) patients. The precision of prescription of exercise intensity for 45 patients with stable CHF (39:6 M:F, 65±9 yrs (mean±SD)) was investigated. VO2peak testing is relatively common among patients with cardiac disease, but the assessment of VO2rest is not common practice and the accepted standard value of 3.5 mL/kg/min is assumed in the application of %VO2R (%VO2R3.5). In this study, VO2rest was recorded for 3 min prior to the start of a symptom-limited exercise test on a cycle ergometer. Target exercise intensities were calculated using the VO2 corresponding to 50 or 80 %HRR, VO2peak and VO2R. The VO2 values were then converted into prescribed speeds on a treadmill in km/hr at 1 %grade using ACSM’s metabolic equation for walking. Target intensities and prescribed treadmill speeds were also calculated with the %VO2R method using the mean VO2rest value of participants (3.9 mL/kg/min) (%VO2R3.9). This was then compared to the exercise intensities and prescribed treadmill speeds using patient’s measured VO2rest. Error in prescription correlates the difference between %VO2R3.5 and %VO2R3.9 compared to %VO2R with measured VO2rest. Prescription of exercise intensity through the %HRR method is imprecise for patients on medications that blunt the HR response to exercise. %VO2R method offers a significant improvement in exercise prescription compared to %VO2peak. However, a disparity of 10 % still exists in the %VO2R method using the standard 3.5 mL/kg/min for VO2rest in the %VO2R equation. The mean measured VO2rest in the 45 CHF patients was 11 % higher (3.9±0.8 mL/kg/min) than the standard value provided by ACSM. Applying the mean measured VO2rest value of 3.9 mL/kg/min rather than the standard assumed value of 3.5 mL/kg/min proved to be closer to the prescribed intensity determined by the actual measured resting VO2. These results suggest that the %HRR method should not be used to prescribe exercise intensity for CHF patients. Instead, VO2 should be used to prescribe exercise intensity and be expressed as %VO2R with measured variables (VO2rest and VO2peak).
Notes Reproduced with the kind permission of the copyright owner.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2005, American Society of Exercise Physiologists
Persistent URL http://hdl.handle.net/10536/DRO/DU:30033431

Document type: Journal Article
Collections: School of Exercise and Nutrition Sciences
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.