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Is the Cardiovascular Response Equivalent Between a Supervised Center-Based Setting and a Self-care Home-Based Setting When Rating of Perceived Exertion Is Used to Guide Aerobic Exercise Intensity During a Cardiac Rehabilitation Program?

Tang, Lars H. MSc; Zwisler, Ann-Dorthe PhD; Berg, Selina K. PhD; Doherty, Patrick PhD; Taylor, Rod S. PhD; Langberg, Henning PhD, DMSc

American Journal of Physical Medicine & Rehabilitation: June 2017 - Volume 96 - Issue 6 - p 381–387
doi: 10.1097/PHM.0000000000000628
Original Research Articles

Objectives The aim of this study was to investigate if exercise intensity guided by rating of perceived exertion (RPE) results in an equivalent cardiovascular response when applied in either a center-based or a home-based setting.

Design Data from patients with heart disease (post–valve surgery and atrial fibrillation post–radiofrequency ablation) participating in exercise-based rehabilitation were included. Patients performed a 12-week program in either a center- or a home-based setting. Using RPE, patients recorded their exercise intensity 3 times during an aerobic training phase. Exercise intensity was objectively measured using heart rate (HR) monitors.

Results A total of 2622 RPE values with corresponding HR data were available. There was no difference in the level of association (interaction P = 0.51) between HR and RPE seen in the center-based setting (mean of 6.1 beats/min per 1.0 difference in RPE; 95% confidence interval, 4.8–7.5 beats/min) compared with the home-based setting (mean of 5.3 beats/min per 1.0 difference in RPE; 95% confidence interval, 4.0–6.5 beats/min). The level of patient familiarization, exercise intensity, and patient characteristics did not affect the level of association between RPE and HR.

Conclusions Independent of exercise setting, RPE appears to be equally effective in guiding exercise intensity of patients participating in cardiac rehabilitation.

From the Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital (LHT, SKB); CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen (LHT, HL); Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen (LHT); National Centre for Rehabilitation and Palliative Care, University of Southern Denmark and Odense University Hospital, Odense (ADZ), Denmark; Department of Health Sciences, University of York, York (PD); and Institute of Health Research, University of Exeter Medical School, Exeter, England (RST).

All correspondence and requests for reprints should be addressed to: Lars H. Tang, MSc, The Heart Centre, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.

Financial support was given by the Danish Council for Strategic Research (no. 10-092790), Faculty of Health and Technology at Metropolitan University College, The Research Committee at the Heart Centre at Righospitalet and the Association of Danish Physiotherapists. All funding was provided as nonrestricted research grants, and funders have no influence on the trial design, the execution of the trial, or the interpretation of the data.

The manuscript contains original unpublished material and has never been presented elsewhere.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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