Exercise Programme

Numerous patients are enrolled into CR programmes each week, and the vast majority will undertake their exercise prescription without any adverse event. This is mainly due to the effective pre-entry screening, knowledge and skills of the CR professionals in these patient services.

Historically, CR programmes were delivered in the outpatient areas of local hospitals, but now it is common for the exercise component to be delivered in fitness centres, health centres and community halls, thus improving access. The literature indicates that low to moderate intensity exercise for low to moderate risk patients can be delivered safely in the community (Armstrong, et al., 2004). However, patients deemed to be high risk or undertaking high intensity exercise should be limited to hospital-based programmes, supervised by appropriately trained and experienced health professionals (Stone, et al., 2001) and where full resuscitation facilities are available (SIGN, 2002).

CR professionals would concur that, as far as possible, patients should not be excluded from CR and exercise prescription should be a component of that service. Suggested exclusion criteria from Balady and Donald (1991), ACSM (1995), BACR (1995) and Goble and Worcester (1999) are shown below in Table 2.3. Many of these patients can safely enter exercise-based CR when these exclusion criteria are stabilised.

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