Exercise leadership in cardiac rehabilitation : an evidence-based approach PDF
Preview Exercise leadership in cardiac rehabilitation : an evidence-based approach
Exercise Leadership in Cardiac Rehabilitation An evidence-based approach Edited by Morag K.Thow Dip PE, BSc,PhD,MCSP Lecturer in Physiotherapy,Glasgow Caledonian University Glasgow,UK Exercise Leadership in Cardiac Rehabilitation An evidence-based approach Exercise Leadership in Cardiac Rehabilitation An evidence-based approach Edited by Morag K.Thow Dip PE, BSc,PhD,MCSP Lecturer in Physiotherapy,Glasgow Caledonian University Glasgow,UK Copyright © 2006 Whurr Publishers Limited (a subsidiary of John Wiley & Sons Ltd) The Atrium,Southern Gate,Chichester, West Sussex PO19 8SQ,England Telephone (+44) 1243 779777 Email (for orders and customer service enquiries):[email protected] Visit our Home Page on www.wiley.com All Rights Reserved.No part of this publication may be reproduced,stored in a retrieval system or transmitted in any form or by any means,electronic,mechanical,photocopying,recording,scan- ning or otherwise,except under the terms of the Copyright,Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd,90 Tottenham Court Road, London W1T 4LP,UK,without the permission in writing of the Publisher.Requests to the Pub- lisher should be addressed to the Permissions Department,John Wiley & Sons Ltd,The Atrium, Southern Gate,Chichester,West Sussex PO19 8SQ,England,or emailed to [email protected], or faxed to (+44) 1243 770620. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names,service marks,trademarks or registered trademarks of their respective owners.The Publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the Publisher is not engaged in rendering professional services.If professional advice or other expert assistance is required,the services of a competent professional should be sought. Other Wiley Editorial Offices John Wiley & Sons Inc.,111 River Street,Hoboken,NJ 07030,USA Jossey-Bass,989 Market Street,San Francisco,CA 94103-1741,USA Wiley-VCH Verlag GmbH,Boschstr.12,D-69469 Weinheim,Germany John Wiley & Sons Australia Ltd,42 McDougall Street,Milton,Queensland 4064,Australia John Wiley & Sons (Asia) Pte Ltd,2 Clementi Loop #02-01,Jin Xing Distripark,Singapore 129809 John Wiley & Sons Canada Ltd,22 Worcester Road,Etobicoke,Ontario,Canada M9W 1L1 Wiley also publishes its books in a variety of electronic formats.Some content that appears in print may not be available in electronic books. Library of Congress Cataloging-in-Publication Data Exercise leadership in Cardiac Rehabilitation:An evidence based approach / [edited by] Morag K Thow. p.;cm. Includes bibliographical references and index. ISBN 0-470-01971-9 (pbk.) 1. Heart – Diseases – Patients – Rehabilitation. 2. Evidence-based medicine. [DNLM:1. Heart Diseases – rehabilitation. 2. Evidence-Based Medicine. 3. Exercise Therapy – methods.WG 166 C2638 2006] I. Thow,Morag K. II. Title. RC681.C1798 2006 616.1¢203 – dc22 2005025382 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN-13 978-0-470-01971-9 ISBN-10 0-470-01971-9 Typeset by SNP Best-set Typesetter Ltd.,Hong Kong Printed and bound in Great Britain by TJ International Ltd,Padstow,Cornwall This book is printed on acid-free paper responsibly manufactured from sustainable forestry in which at least two trees are planted for each one used for paper production. I would like to dedicate this book to Alex and Sylvia Johnston who were our first cardiac rehabilitation participants at Gartnavel General Hospital, Glasgow.Also to all the other cardiac rehabilitation participants and partners at Jordanhill Heartbeats who have given me as much as I hope I have given them. Contents Contributors ix Foreword xi Preface xiii Acknowledgements xv 1 Cardiac Rehabilitation Overview 1 Christine Proudfoot 2 Risk Stratification and Health Screening for Exercise in Cardiac Rehabilitation 19 Ann Ross and Mhairi Campbell 3 Exercise Physiology and Monitoring of Exercise in Cardiac Rehabilitation 47 John Buckley 4 Exercise Prescription in Cardiac Rehabilitation 97 Hilary Dingwall,Kim Ferrier and Joanne Semple 5 Class Design and Use of Music in Cardiac Rehabilitation 133 Linda Harley and Gillian Armstrong 6 Leadership,Exercise Class Management and Safety in Cardiac Rehabilitation 161 Fiona Lough 7 Teaching Skills for Cardiac Rehabilitation Exercise Classes 183 Morag K.Thow 8 Maintaining Physical Activity in Cardiac Rehabilitation 195 Adrienne Hughes and Nanette Mutrie Appendix A – Glossary 220 Index 224 Contributors Gillian Armstrong BSc MCSP Senior Physiotherapist, Cardiac Rehabilitation, Glasgow Royal Infirmary, University NHS Glasgow,16 Alexandra Parade,Glasgow,G31 2ER. John Buckley BPE MSc PhD Lecturer in Exercise Science, School of Health and Rehabilitation, Keele University,Staffordshire,ST5 5BG. Mhairi Campbell,BSc MCSP Cardiac Rehabilitation Co-ordinator, Health at Heart Centre, Royal Alexandra Hospital,NHS Paisley,Corsebar Road,Paisley,PA2 9PN. Hilary Dingwall BSc MCSP Superintendent Physiotherapist, Cardiac Rehabilitation, Victoria Infirmary University NHS Glasgow,Langside,Glasgow,G42 9TY. Kim Ferrier BSc MCSP Senior Physiotherapist, Cardiac Rehabilitation, Glasgow Royal Infirmary, University NHS Glasgow,16 Alexandra Parade,Glasgow,G31 2ER. Linda Harley RGN Cardiac Specialist Nurse,Vale of Leven District Hospital NHS,Main Street, Alexandria,G83 OUA. Adrienne Hughes PhD Research Fellow,University Department,Human Nutrition,Yorkhill Hospi- tal NHS Glasgow,G3 8SJ. Fiona Lough MPhil MCSP Superintendent Physiotherapist, Cardiac Rehabilitation, University College London NHS,London,WC1E 6AU. x Exercise Leadership in Cardiac Rehabilitation Nanette Mutrie PhD FBASES Professor,Department of Sport,Culture and the Arts,Strathclyde University, PESO Building,Glasgow,G13 1PP. Christine Proudfoot MSc MCSP Senior Physiotherapist,Cardiac Rehabilitation,Hairmyres Hospital NHS,East Kilbride,G4 8RG. Ann Ross MPhil MCSP Superintendent Physiotherapist,Western Infirmary University NHS,Glasgow, Dumbarton Road,Glasgow,G11 6NT. Joanne Semple BSc MCSP Senior Physiotherapist, Cardiac Rehabilitation, Southern General NHS Glasgow. Morag K.Thow PhD MCSP Lecturer in Physiotherapy, Glasgow Caledonian University, Cowcaddens Road,Glasgow G4 OBA. Foreword EXERCISE LEADERSHIP IN CARDIAC REHABILITATION The benefits of cardiac rehabilitation are now well established in a wide range of patients with cardiac disease. A cardiac rehabilitation programme is a vehicle for the delivery of holistic secondary prevention and could be consid- ered as one method of chronic disease management. This includes risk factor modification, prescription of appropriate medication and health behaviour change. It therefore consists of a series of evidenced based interventions designed to optimise these outcome for patients.Although several meta analy- sis have shown mortality benefits from exercise based cardiac rehabilitation programmes, the evaluation of modern programmes should focus on the outcomes described above and hospital re-admission. Cardiac rehabilitation programmes should be tailored to the individual needs of the patient and extended to the broader group of cardiac patients a step change in their condition. Programmes must deliver evidence based practise and adhere to national guidelines. However research and development should be encour- aged and supported.Audit of cardiac rehabilitation programmes,using nation- ally agreed datasets is essential to measure outcomes, inform programme development and secure resources. This book entitled Exercise Leadership in Cardiac Rehabilitation is a com- prehensive account of the exercise component of health behaviour change within cardiac rehabilitation.It is written by clinicians for clinicians and con- tains a practical guide to exercise prescription. The book will be invaluable to clinicians involved in cardiac rehabilitation and will facilitate programme development. By Dr Paul.D.MacIntyre Consultant Cardiologist RAH
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