The prescribing of exercise for the patient with ischaemic heart disease demands, for reasons of safety as well as efficacy, precision in specifying not only the mode but also the intensity, duration and frequency of training sessions. A preliminary exercise test is essential, and preferably this should include the collection and analysis of expired gases in order to measure oxygen consumption and estimate anaerobic threshold. Walking, progressing to jogging as the patient becomes fitter, is the most appropriate mode to use since it requires little or no equipment, can be interpreted easily in terms of distance and pace, and requires little or no motor skill. Games and sports, particularly those of a competitive nature, should be added only as the cardiovascular system becomes more conditioned and then at the discretion of the physician.
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