Applying exercise consultation to CR

Is it feasible to incorporate the exercise consultation into current CR services? First, the consultations are relatively inexpensive in terms of time, resources and personnel. Exercise consultations last approximately 20 to 30 minutes and the support phone calls five to 10 minutes. In addition, it is possible that patients could record their physical activity habits and the pros and cons of physical activity before attending the consultation, in order to reduce time spent on the consultation. Resources required to conduct the exercise consultation include recording materials (e.g. goals sheet, and guidelines for physical activity) and a quiet room. The exercise consultation could be delivered by a number of health professionals. In the UK, physiotherapists play a central role in the exercise component of cardiac rehabilitation (Thow, et al., 2003).

Physiotherapists have an ideal opportunity to deliver the exercise consultation to patients, as they have good insight, i.e. they are in a position to facilitate the patient's progress from phase I to phase III cardiac rehabilitation and could incorporate exercise consultation into existing programmes. In addition, the transition to the less clinical and supervised phase IV is an ideal opportunity to use exercise consultation. In addition, BACR-trained phase IV exercise staff can use the exercise consultation to provide support to patients who are having difficulty remaining active. In order to be qualified to deliver the exercise consultation, BACR phase IV leaders and exercise leaders require knowledge of the behaviour change theories on which the consultation is based (i.e.Transtheoretical Model and Relapse Prevention Model), and should develop the counselling skills and strategies required to deliver the intervention. This knowledge and skills development can be achieved by appropriate in-service training and/or postgraduate continual professional development (CPD). In addition, individuals need to practise the consultation process.

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