Standardised Exercise Prescription for Patients with Chronic Coronary Syndrome and/or Heart Failure: A Consensus Statement from the EXPERT Working Group

Dominique Hansen, Paul Beckers, Daniel Neunhäuserer, Birna Bjarnason-Wehrens, Massimo F Piepoli, Bernhard Rauch, Heinz Völler, Ugo Corrà, Esteban Garcia-Porrero, Jean-Paul Schmid, Michel Lamotte, Patrick Doherty, Rona Reibis, Josef Niebauer, Paul Dendale, Constantinos H Davos, Evangelia Kouidi, Martijn A Spruit, Luc Vanhees, Véronique CornelissenFrank Edelmann, Olga Barna, Christoph Stettler, Cajsa Tonoli, Eugenio Greco, Roberto Pedretti, Ana Abreu, Marco Ambrosetti, Simona Sarzi Braga, Maurizio Bussotti, Pompilio Faggiano, Tim Takken, Carlo Vigorito, Bernhard Schwaab, Karin Coninx

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Whereas exercise training, as part of multidisciplinary rehabilitation, is a key component in the management of patients with chronic coronary syndrome (CCS) and/or congestive heart failure (CHF), physicians and exercise professionals disagree among themselves on the type and characteristics of the exercise to be prescribed to these patients, and the exercise prescriptions are not consistent with the international guidelines. This impacts the efficacy and quality of the intervention of rehabilitation. To overcome these barriers, a digital training and decision support system [i.e. EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool], i.e. a stepwise aid to exercise prescription in patients with CCS and/or CHF, affected by concomitant risk factors and comorbidities, in the setting of multidisciplinary rehabilitation, was developed. The EXPERT working group members reviewed the literature and formulated exercise recommendations (exercise training intensity, frequency, volume, type, session and programme duration) and safety precautions for CCS and/or CHF (including heart transplantation). Also, highly prevalent comorbidities (e.g. peripheral arterial disease) or cardiac devices (e.g. pacemaker, implanted cardioverter defibrillator, left-ventricular assist device) were considered, as well as indications for the in-hospital phase (e.g. after coronary revascularisation or hospitalisation for CHF). The contributions of physical fitness, medications and adverse events during exercise testing were also considered. The EXPERT tool was developed on the basis of this evidence. In this paper, the exercise prescriptions for patients with CCS and/or CHF formulated for the EXPERT tool are presented. Finally, to demonstrate how the EXPERT tool proposes exercise prescriptions in patients with CCS and/or CHF with different combinations of CVD risk factors, three patient cases with solutions are presented.

Original languageEnglish
JournalSports Medicine (Auckland, N.Z.)
Early online date30 Aug 2023
Publication statusE-pub ahead of print - 30 Aug 2023

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© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

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