Clinical assessments are building blocks
If you’re a CP+R client, you’ll probably have seen or heard us using the expression ‘if you’re not assessing you’re guessing’ quite a lot at CP+R and it’s not just a throw-away line, it underpins our entire ethos.
‘if you’re not assessing you’re guessing’
To help explain what we mean, we wanted to share a summary of a recent position statement on cardiac rehabilitation, released this year by The European Society of Cardiology. It was entitled, “Exercise intensity assessment and prescription in Cardiovascular Rehabilitation and beyond”. Although the paper is cardiac rehab specific, the principles can be widely applied.
TRAIN SMARTER NOT HARDER:
The paper emphasises the importance of accurate and regular assessments in cardiac rehab for the correct determination of exercise intensity for both CV and resistance training.
Specifically, reassessments every 3 months if not before lead to exercise programmes that are more time efficient in inducing short-term clinical benefits and in ensuring prescription remains optimal in the long term.
CARDIOVASCULAR TRAINING:
CPET testing is the gold standard to determine cardiovascular fitness and prescribe exercise optimally. A CPET test is typically performed on a treadmill and involves the collection of expired air, as we do at CP+R.
The paper suggests the most important components of fitness collected during a CPET test are measures called Ventilatory Threshold 1 (VT1) and Ventilatory Threshold 2 (VT2).
+ VT1 is the point at which your body starts to produce fatiguing by-products and is slightly out of its comfort zone.
+ VT2 is when your body can no longer deal with those by-products and fatigue starts to accumulate.
A heart rate training zone will usually be prescribed between VT1 and VT2. Over time, these markers should increase meaning daily tasks will become easier, exercise capacity will also increase, and cardiovascular strain will decrease.
If VT1 and VT2 do increase, then it makes sense that we need to regularly reassess them to ensure you stay at the optimal intensity.
RESISTANCE TRAINING:
The paper also states that dynamic resistance training at the correct intensity leads to greater improvements in muscle strength whilst remaining safe for individuals with cardiovascular disease.
To properly determine the exercise intensity during resistance training, a strength test should be used to set the initial weight and regularly throughout. At CP+R, we use the BIODEX machine, which also allows us to identify imbalances between muscle groups and which side of your body is dominant.
For further improvements in muscle strength, progressive resistance training is promoted in cardiac rehab, in which the repetitions, intensity and resting periods are adjusted. This is where your Cardiac Coach comes to the fore in sessions!
CARDIAC REHAB:
Across the UK,
only 27% of people who take up cardiac rehab are female.
TAKE-HOMES:
Regular 3-monthly CV and resistance assessments are key to getting the most out of your exercise. The assessment of VT1 and VT2 during CPET should be used for the determination of the CV exercise intensity in the majority of cardiovascular disease patients. To properly determine the exercise intensity during resistance training, a strength test (such as the BIODEX) can be used to set the initial weight, while your Cardiac Coach can help progress the exercises during the sessions.