title: A review of guidelines for cardiac rehabilitation exercise programmes: Is there an international consensus?
abstract: Cardiac rehabilitation is an important component in the continuum of care for individuals with cardiovascular disease, providing a multidisciplinary education and exercise programme to improve morbidity and mortality risk. Internationally, cardiac rehabilitation programmes are implemented through various models. This review compared cardiac rehabilitation guidelines in order to identify any differences and/or consensus in exercise testing, prescription and monitoring.
  
  
  
  Guidelines, position statements and policy documents for cardiac rehabilitation, available internationally in the English language, were identified through a search of electronic databases and government and cardiology society websites. Information about programme delivery, exercise testing, prescription and monitoring were extracted and compared.
  
  
  
  Leading cardiac rehabilitation societies in North America and Europe recommend that patients progress from moderate- to vigorous-intensity aerobic endurance exercise over the course of the programme, with resistance training included as an important adjunct, for maintaining independence and quality of life. North American and European guidelines also recommend electrocardiograph-monitored exercise stress tests. Guidelines for South America and individual European nations typically include similar recommendations; however, those in the United Kingdom, Australia and New Zealand specify lower-intensity exercise and less technical assessment of functional capacity.
  
  
  
  Higher-intensity aerobic training programmes, supplemented by resistance training, have been recommended and deemed safe for cardiac rehabilitation patients by many authorities. Based on research evidence, this may also provide superior outcomes for patients and should therefore be considered when developing an international consensus for exercise prescription in cardiac rehabilitation.
authors.affiliation: Discipline of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia kym.price@rmit.edu.au.
authors.forename: Kym Joanne
authors.initials: KJ
authors.lastname: Price
authors.affiliation: Discipline of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
authors.forename: Brett Ashley
authors.initials: BA
authors.lastname: Gordon
authors.affiliation: Discipline of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.
authors.forename: Stephen Richard
authors.initials: SR
authors.lastname: Bird
authors.affiliation: Discipline of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.
authors.forename: Amanda Clare
authors.initials: AC
authors.lastname: Benson
mesh_terms: D000072038:Cardiac Rehabilitation / Q000592:standards*; D002309:Cardiology; D032921:Consensus; D005081:Exercise Therapy / Q000592:standards*; D006801:Humans; D007391:International Cooperation; D017410:Practice Guidelines as Topic
keywords: Cardiac rehabilitation; cardiovascular disease; exercise; exercise test; exercise therapy; guidelines