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Sports Med. 2018 Aug;48(8):1781-1797. doi: 10.1007/s40279-018-0930-4.

Exercise Prescription in Patients with Different Combinations of Cardiovascular Disease Risk Factors: A Consensus Statement from the EXPERT Working Group.

Author information

1
Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium. dominique.hansen@uhasselt.be.
2
UHasselt, Faculty of Medicine and Life Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium. dominique.hansen@uhasselt.be.
3
Institute of Sports Medicine, Prevention and Rehabilitation, Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Sports Medicine of the Olympic Center Salzburg-Rif, Salzburg, Austria.
4
Research group of Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Louvain, Belgium.
5
Family Medicine Department, National O.O. Bogomolets Medical University, Kiev, Ukraine.
6
Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy.
7
University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, Austria.
8
Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital/Inselspital, Bern, Switzerland.
9
Department of Rehabilitation Science and Physiotherapy, Ghent University, Ghent, Belgium.
10
, Fuscaldo, CS, Italy.
11
Hypertension and Cardiovascular Rehabilitation Unit, KU Leuven University, Louvain, Belgium.
12
UHasselt, Faculty of Sciences, Expertise Centre for Digital Media, Hasselt University, Hasselt, Belgium.
13
Heart Failure Unit, Cardiac Department, Guglielmo da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy.
14
Department of Medicine and Cardiorespiratory Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS Tradate, Tradate, Varese, Italy.
15
Cardiologic Rehabilitation Department, Istituti Clinici Scientifici Salvatore Maugeri, SPA, SB, Scientific Institute of di Veruno, IRCCS, Veruno, NO, Italy.
16
Department of Cardiology, Clinic Barmelweid, Barmelweid, Switzerland.
17
Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
18
Department of Internal Medicine with Cardiology, Charité-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.
19
Department of Cardiology and Pneumology, University of Göttingen, Göttingen, Germany.
20
German Center for Cardiovascular Research, Partner Site Berlin, Göttingen, Germany.
21
Cardiology Department, Hospital Santa Marta, Lisbon, Portugal.
22
Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen Am Rhein, Germany.
23
Cardiovascular Rehabilitation Unit, Le Terrazze Clinic, Cunardo, Italy.
24
Department of Cardiology, Antwerp University Hospital, Edegem, Belgium.
25
Translational Pathophysiological Research, Antwerp University, Antwerp, Belgium.
26
Unit of Cardiorespiratory Rehabilitation, Instituti Clinici Maugeri, Institute of Milan, IRCCS, Milan, Italy.
27
Cardiology Department, Spedali Civili, Brescia, Italy.
28
Cardiology Service of Complejo Hospitalario Universitario de León, Léon, Spain.
29
Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
30
CUB Erasme Hospital, Brussels, Belgium.
31
Cardiological Outpatient Clinics at the Park Sanssouci, Potsdam, Germany.
32
UHasselt, Faculty of Medicine and Life Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium.
33
Department of Research and Education, CIRO + , Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands.
34
Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.
35
Division of Pediatrics, Child Development and Exercise Center, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands.
36
Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.
37
Department of Cardiology, Klinik am See, Rüdersdorf, Germany.
38
Center of Rehabilitation Research, University of Potsdam, Potsdam, Germany.
39
Department of Health Sciences, University of York, York, UK.
40
Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.

Abstract

Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia. The impact of physical fitness, CVD risk altering medications and adverse events during exercise testing was further taken into account to fine-tune this exercise prescription. An algorithm, supported by the interactive EXPERT tool, was developed by Hasselt University based on these data. Specific exercise recommendations were formulated with the aim to decrease adipose tissue mass, improve glycaemic control and blood lipid profile, and lower blood pressure. The impact of medications to improve CVD risk, adverse events during exercise testing and physical fitness was also taken into account. Simulations were made of how the EXPERT tool provides exercise prescriptions according to the variables provided. In this paper, state-of-the-art exercise prescription to patients with combinations of CVD risk factors is formulated, and it is shown how the EXPERT tool may assist clinicians. This contributes to an appropriately tailored exercise regimen for every CVD risk patient.

PMID:
29729003
DOI:
10.1007/s40279-018-0930-4
[Indexed for MEDLINE]
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