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Characteristics of structured physical training currently provided in cardiac patients: insights from the Exercise Training in Cardiac Rehabilitation (ETCR) Italian survey

Marco Ambrosetti, Patrick Doherty, Pompilio Faggiano, Ugo Corrà, Carlo Vigorito, Dominique Hansen, Patrizio Sarto, Ana Abreu, Roberto F.E. Pedretti
  • Patrick Doherty
    University of York, Department of Health Sciences, United Kingdom
  • Pompilio Faggiano
    University of Brescia, Department of Cardiology, Italy
  • Ugo Corrà
    IRCCS Salvatore Maugeri Foundation, Department of Cardiac Rehabilitation, Italy
  • Carlo Vigorito
    University of Naples Federico II, Department of Translational Medical Sciences, Italy
  • Dominique Hansen
    Hasselt University, REVAL Rehabilitation Research Centre, BIOMED Biomedical Research Centre, Belgium
  • Patrizio Sarto
    Local Health Unit 9, Department of Sports Medicine, Italy
  • Ana Abreu
    Hospital Santa Marta, Department of Cardiology, Portugal
  • Roberto F.E. Pedretti
    IRCCS Salvatore Maugeri Foundation, Italy


BACKGROUND.  Uncertainty exists about current delivery levels of exercise training (ET) during Cardiac Rehabilitation (CR) programmes. AIM OF THE STUDY. To evaluate ET modalities in the real world of CR facilities in Italy. METHODS. This was an observational survey of aggregate data, collected from CR facilities on a voluntary basis. Snapshots of a single working day at a local site were made, in terms of characteristics of patients and ET programmes delivered. RESULTS. Overall, 612 patients from 26 CR units were included, with an in-patient vs. out-patient ratio of 3:1. Coronary artery disease (57.6%), heart failure (20.3%), and valve disease/surgery (22.1%) were the most represented target groups. The prevalence of endurance continuous training, interval training, and resistance/strength training was 66.7%, 11.1%, and 9.0%; other non-aerobic endurance and non-resistance training modalities such as respiratory muscle training and calisthenics were reported in 39.9% and 42.9% of cases respectively. Workloads for endurance exercise training were determined by cardiopulmonary test, conventional 12-leads ECG exercise testing, 6min-walking test, theoretical determination of heart rate, and rating of perceived exertion in 9%, 8%, 27%, 9%, and 40% of cases respectively. The average duration of the programmes (on an intention to treat basis) was 25 sessions of 42±11  minutes, with a frequency of >4 sessions/week in 67% of patients. CONCLUSIONS. Despite advances in CR interventions, there is a significant need for improvement of functional evaluation and exercise training prescription, and consideration of a wider range of training modalities in Italy. 


Exercise; cardiac rehabilitation; survey.

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Submitted: 2016-09-20 10:21:14
Published: 2017-05-18 10:46:54
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