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 Cornelissen; Frank 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

doi:10.1007/s40279-023-01909-x

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

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

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 language	English
Journal	Sports Medicine (Auckland, N.Z.)
Early online date	30 Aug 2023
DOIs	https://doi.org/10.1007/s40279-023-01909-x
Publication status	E-pub ahead of print - 30 Aug 2023

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10.1007/s40279-023-01909-x

Cite this

Hansen, D., Beckers, P., Neunhäuserer, D., Bjarnason-Wehrens, B., Piepoli, M. F., Rauch, B., Völler, H., Corrà, U., Garcia-Porrero, E., Schmid, J.-P., Lamotte, M., Doherty, P., Reibis, R., Niebauer, J., Dendale, P., Davos, C. H., Kouidi, E., Spruit, M. A., Vanhees, L., ... Coninx, K. (2023). Standardised Exercise Prescription for Patients with Chronic Coronary Syndrome and/or Heart Failure: A Consensus Statement from the EXPERT Working Group. Sports Medicine (Auckland, N.Z.). Advance online publication. https://doi.org/10.1007/s40279-023-01909-x

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

abstract = "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.",

author = "Dominique Hansen and Paul Beckers and Daniel Neunh{\"a}userer and Birna Bjarnason-Wehrens and Piepoli, {Massimo F} and Bernhard Rauch and Heinz V{\"o}ller and Ugo Corr{\`a} and Esteban Garcia-Porrero and Jean-Paul Schmid and Michel Lamotte and Patrick Doherty and Rona Reibis and Josef Niebauer and Paul Dendale and Davos, {Constantinos H} and Evangelia Kouidi and Spruit, {Martijn A} and Luc Vanhees and V{\'e}ronique Cornelissen and Frank Edelmann and Olga Barna and Christoph Stettler and Cajsa Tonoli and Eugenio Greco and Roberto Pedretti and Ana Abreu and Marco Ambrosetti and Braga, {Simona Sarzi} and Maurizio Bussotti and Pompilio Faggiano and Tim Takken and Carlo Vigorito and Bernhard Schwaab and Karin Coninx",

note = "{\textcopyright} 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.",

year = "2023",

month = aug,

day = "30",

doi = "10.1007/s40279-023-01909-x",

language = "English",

journal = "Sports Medicine (Auckland, N.Z.)",

issn = "0112-1642",

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Hansen, D, Beckers, P, Neunhäuserer, D, Bjarnason-Wehrens, B, Piepoli, MF, Rauch, B, Völler, H, Corrà, U, Garcia-Porrero, E, Schmid, J-P, Lamotte, M, Doherty, P, Reibis, R, Niebauer, J, Dendale, P, Davos, CH, Kouidi, E, Spruit, MA, Vanhees, L, Cornelissen, V, Edelmann, F, Barna, O, Stettler, C, Tonoli, C, Greco, E, Pedretti, R, Abreu, A, Ambrosetti, M, Braga, SS, Bussotti, M, Faggiano, P, Takken, T, Vigorito, C, Schwaab, B & Coninx, K 2023, 'Standardised Exercise Prescription for Patients with Chronic Coronary Syndrome and/or Heart Failure: A Consensus Statement from the EXPERT Working Group', Sports Medicine (Auckland, N.Z.). https://doi.org/10.1007/s40279-023-01909-x

TY - JOUR

T1 - Standardised Exercise Prescription for Patients with Chronic Coronary Syndrome and/or Heart Failure

T2 - A Consensus Statement from the EXPERT Working Group

AU - Hansen, Dominique

AU - Beckers, Paul

AU - Neunhäuserer, Daniel

AU - Bjarnason-Wehrens, Birna

AU - Piepoli, Massimo F

AU - Rauch, Bernhard

AU - Völler, Heinz

AU - Corrà, Ugo

AU - Garcia-Porrero, Esteban

AU - Schmid, Jean-Paul

AU - Lamotte, Michel

AU - Doherty, Patrick

AU - Reibis, Rona

AU - Niebauer, Josef

AU - Dendale, Paul

AU - Davos, Constantinos H

AU - Kouidi, Evangelia

AU - Spruit, Martijn A

AU - Vanhees, Luc

AU - Cornelissen, Véronique

AU - Edelmann, Frank

AU - Barna, Olga

AU - Stettler, Christoph

AU - Tonoli, Cajsa

AU - Greco, Eugenio

AU - Pedretti, Roberto

AU - Abreu, Ana

AU - Ambrosetti, Marco

AU - Braga, Simona Sarzi

AU - Bussotti, Maurizio

AU - Faggiano, Pompilio

AU - Takken, Tim

AU - Vigorito, Carlo

AU - Schwaab, Bernhard

AU - Coninx, Karin

PY - 2023/8/30

Y1 - 2023/8/30

N2 - 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.

AB - 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.

U2 - 10.1007/s40279-023-01909-x

DO - 10.1007/s40279-023-01909-x

M3 - Article

C2 - 37648876

SN - 0112-1642

JO - Sports Medicine (Auckland, N.Z.)

JF - Sports Medicine (Auckland, N.Z.)

ER -