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Cardiac Rehabilitation Communications Toolkit. As evident among the means for various measures in the Table , there was considerable variability in the data as a whole. All of the exercise protocol variables were within acceptable limits: mean exercise time, maximum heart rate, maximum METs, and RPE. They also compared women and men through all phases of the study. Significance levels were as follows.
Men had a much higher dropout rate than women The sex comparison for the dropout group yielded the largest absolute difference in means for METs women 3. Similar results were found with RPE women Among the full-protocol group, men had higher mean pretest scores for exercise time, maximum heart rate, and maximum METs;they also had lower RPE scores.
The posttest results for gender disparity again yielded more favorable results for men. After cardiac rehabilitation, patients exercised a mean of 2 minutes and 8 seconds longer and increased their physiologic capacity by 0. While they were also able to decrease their RPE rating by nearly 1 point indicating more tolerance at the same work level , that change was not statistically significant.
Greater changes in these measures would be key indicators of improved health and improved outcomes. When pretest and posttest results were compared only for women or only for men, the differences remained, suggesting that both sexes were able to benefit from cardiac rehabilitation. This study investigated an ETT with emphasis on comparing results for men and women enrolled in cardiac rehabilitation to see if the test was safe and effective and provided outcomes data.
The results identify some important, although exploratory, findings. First, physiological response data showed that the test protocol was safe. Further, maximum heart rates did not exceed beats per minute, which is within the common range of resting heart rate plus 20 to 30 beats per minute given in exercise prescription. Second, the test protocol provided outcomes. Maximum METs increased by 0. The corresponding 0. Typically in cardiac rehabilitation, patients should increase their physiological capacity by 1 MET every 2 weeks If we assume that patients in this study were prescribed such a progression, the test protocol needs to allow them to demonstrate their actual aerobic capabilities.
Here, METs increased by only 0. Therefore, this test should be viewed as a minimal test, and a more challenging test within the confines of not requiring a charge to insurance or a doctor's presence should be pursued. Some limitations to the study should be noted. In addition, the significant difference between pretest and posttest values cannot be attributed completely to the cardiac rehabilitation program because of factors that cannot be controlled for, such as exercise outside of supervised cardiac rehabilitation.
Nevertheless, the examination of this test, which is safe, not charged to patients or insurance, and does not require the presence of a physician, provides evidence for the valuable use of an ETT in every cardiac rehabilitation program. While only one test protocol was examined, future research can develop a standard testing protocol that can be used before and after cardiac rehabilitation at all facilities nationally and globally. A standardized ETT can help change the way cardiac rehabilitation operates through safe and effective assessments of patients.
The great diversity of methods used to conduct and investigate exercise protocols suggests that this is an area that needs further analysis. National Center for Biotechnology Information , U. Proc Bayl Univ Med Cent. Author information Copyright and License information Disclaimer. Corresponding author. Our team, consisting of nurses, exercise physiologists and a respiratory therapist, realized we did not have a standardized process to evaluate the fall risk of our patients at the time of initial cardiac rehab evaluation.
One of our nurses volunteered to champion this project. After discussing next steps with the group, this nurse planned to research what methods and tools were being used for fall risk assessment in other cardiac rehabilitation programs.
In addition, she would review the current process used for our inpatients for fall risk screening. She began by performing a literature review, which did not uncover any data published on the topic of fall risk assessment in the cardiac rehabilitation environment. Her next steps were to bring back to the nurses examples of instruments currently in use for fall risk assessment, as well as a sample of the Timed Get Up and Go Test used on our inpatient admissions.
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