Mytinger Megan, Nelson Rachael K, Zuhl Micah
School of Health Sciences, Central Michigan University, Mount Pleasant, MI 48859, USA.
J Cardiovasc Dev Dis. 2020 Apr 27;7(2):15. doi: 10.3390/jcdd7020015.
Aerobic exercise is a core component of cardiac rehabilitation (CR). Leading organizations recommend that the exercise prescriptions should be based on a symptom limited baseline graded exercise test (GXT). However, recent evidence suggests that only ~30% of CR clinics perform baseline GXTs. Consequently, exercise prescriptions including exercise progression in CR are not following standard exercise prescription guidelines. Therefore, the purpose of this review is to provide clinicians with evidence-based techniques for prescribing exercise in the absence of a baseline GXT. Intensity indicators (e.g., heart rate, perceived exertion) are reviewed, along with special exercise considerations for various disease states (e.g., heart failure, peripheral artery disease, and coronary artery disease). Baseline exercise testing remains the gold standard approach for prescribing exercise among heart disease patients, however, clinicians must be prepared to safely develop and monitor patients when a baseline GXT is not performed.
有氧运动是心脏康复（CR）的核心组成部分。主要机构建议运动处方应基于症状受限的基线分级运动试验（GXT）。然而，最近的证据表明，只有约30%的心脏康复诊所进行基线GXT。因此，心脏康复中包括运动进展的运动处方并未遵循标准运动处方指南。因此，本综述的目的是为临床医生提供在没有基线GXT的情况下进行运动处方的循证技术。同时对强度指标（如心率、主观用力程度）以及各种疾病状态（如心力衰竭、外周动脉疾病和冠状动脉疾病）的特殊运动注意事项进行了综述。基线运动测试仍然是为心脏病患者开具运动处方的金标准方法，然而，当不进行基线GXT时，临床医生必须准备好安全地制定和监测患者。
