Exercise History

During a holistic assessment of individuals about to embark on CR, exercise history can be an important aspect. It gives the exercise professional a point of reference for the patient's life experience of exercise. The information gained from this subjective discussion can highlight possible barriers to successfully completing a CR, such as having been sedentary and having no exercise history (ACSM, 2001) or having negative memories of physical education at school. This can create a lack of self-efficacy, a known predictor of poor cardiovascular outcomes.

At the other end of the scale, those with a history of competitive sports may highlight a tendency to fail to comply with a given exercise prescription, which itself is recognised as a risk factor for exercise-induced event and therefore a direct link to the risk stratification process. Both the AACPR (1999) and PaulLabrador, et al. (1999) summary of the guidelines describe exceeding exercise prescription as an intermediate risk.

The discussion between CR exercise leader and participant may also highlight cardiac misconceptions, such as a fear of physical exertion, which are generally accepted as related to poorer outcomes and reduced self-efficacy and programme compliance (Maeland and Havik, 1988; SIGN, 2002). The exercise leader can further discuss these misconceptions and attempt to correct them.

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