{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:11:17Z","timestamp":1788487877945,"version":"build-2803163510"},"reference-count":82,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cardiac rehabilitation is a package of lifestyle secondary prevention\nstrategies designed for patients with coronary heart disease and chronic\nheart failure. A community-based cardiac rehabilitation programme provides\npatients with a structured exercise training intervention alongside\neducational support and psychological counselling. This review provides an\nupdate regarding the clinical benefits of community-based cardiac\nrehabilitation from a psycho-physiological perspective, and also focuses on\nthe latest epidemiological evidence regarding potential survival benefits.\nBehaviour change is key to long-term adoption of a healthy and active\nlifestyle following a cardiac event. In order for lifestyle interventions\nsuch as structured exercise interventions to be adopted by patients,\npractitioners need to ensure that behaviour change programmes are mapped\nagainst patient\u2019s priorities and values, and adapted to their level\nof readiness and intention to engage with the target behaviour. We review\nthe evidence regarding behaviour change strategies for cardiac patients and\nprovide practitioners with the latest guidance. The \u2018dose\u2019\nof exercise training delivered to patients attending exercise-based cardiac\nrehabilitation is an important consideration because an improvement in peak\noxygen uptake requires an adequate physiological stimulus to invoke positive\nphysiological adaptation. We conclude by critically reviewing the latest\nevidence regarding exercise dose for cardiac patients including the role of\ntraditional and more contemporary training interventions including high\nintensity interval training.<\/jats:p>","DOI":"10.1055\/a-1198-5573","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T18:57:27Z","timestamp":1594407447000},"page":"19-26","source":"Crossref","is-referenced-by-count":64,"title":["Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure"],"prefix":"10.1055","volume":"42","author":[{"given":"Simon","family":"Nichols","sequence":"additional","affiliation":[{"name":"Sheffield Hallam University Centre for Sports and Exercise Science,\nSheffield, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-9107","authenticated-orcid":false,"given":"Gordon","family":"McGregor","sequence":"additional","affiliation":[{"name":"University Hospital Coventry and Warwickshire National Health Service\nTrust, Coventry, Coventry University, United Kingdom of Great Britain and\nNorthern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Breckon","sequence":"additional","affiliation":[{"name":"Academy of Sport and Physical Activity, Sheffield Hallam University,\nSheffield, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Ingle","sequence":"additional","affiliation":[{"name":"Department of Sport, Health & Exercise Science, University of\nHull, Hull, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,7,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1152\/advan.00136.2013","article-title":"The history of \u201cExercise Is Medicine\u201d in ancient\ncivilizations","volume":"38","author":"C M Tipton","year":"2014","journal-title":"Adv Physiol Educ"},{"key":"ref3","first-page":"38","article-title":"Cardiac rehabilitation past, present and future: An overview","volume":"2","author":"W M Mampuya","year":"2012","journal-title":"Cardiovasc Diagn Ther"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease cochrane\nsystematic review and meta-analysis","volume":"67","author":"L Anderson","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"ref8","first-page":"Cd003331","article-title":"Exercise-based cardiac rehabilitation for adults with heart failure","volume":"1","author":"L Long","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"ref9","volume-title":"AACVPR Cardiac Rehabilitation Resource Manual","year":"2006"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.15420\/cfr.2016:25:2","article-title":"Global public health burden of heart failure","volume":"3","author":"G Savarese","year":"2017","journal-title":"Card Fail Rev"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart\nfailure: The Task Force for the diagnosis and treatment of acute and chronic\nheart failure of the European Society of Cardiology [ESC]. 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A systematic review and\nmeta-analysis to re-examine the evidence","volume":"8","author":"R Powell","year":"2018","journal-title":"BMJ Open"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1093\/eurheartj\/ehq398","article-title":"Routine early coronary angioplasty versus ischaemia-guided angioplasty after\nthrombolysis in acute ST-elevation myocardial infarction: A meta-analysis","volume":"32","author":"S P D\u2019Souza","year":"2011","journal-title":"Eur Heart J"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0140-6736(03)12113-7","article-title":"Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial\ninfarction: A quantitative review of 23 randomised trials","volume":"361","author":"E C Keeley","year":"2003","journal-title":"Lancet"},{"key":"ref19","first-page":"CD003331","article-title":"Exercise-based rehabilitation for heart failure","volume":"4","author":"R S 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diabetes mellitus undergoing long-term cardiac\nrehabilitation","volume":"92","author":"S Carroll","year":"2011","journal-title":"Arch Phys Med Rehab"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.numecd.2006.07.003","article-title":"Long-term cardiac rehabilitation and exercise training programs improve\nmetabolic parameters in metabolic syndrome patients with and without coronary\nheart disease","volume":"18","author":"M Gayda","year":"2008","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/1741826710393993","article-title":"Comparable short-term prognosis in diabetic and non-diabetic patients with acute\ncoronary syndrome after cardiac rehabilitation","volume":"19","author":"R Reibis","year":"2012","journal-title":"Eur J Prev Cardiol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1559-4572.2008.00002.x","article-title":"Impact of cardiac rehabilitation on coronary risk factors, inflammation, and the\nmetabolic syndrome in obese coronary patients","volume":"3","author":"C J Lavie","year":"2008","journal-title":"J Cardiometab Syndr"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.ejheart.2006.02.013","article-title":"Effects of exercise training on cardiac performance, exercise capacity and\nquality of life in patients with heart failure: A meta-analysis","volume":"8","author":"BA F van Tol","year":"2006","journal-title":"Eur J Heart Fail"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"3152","DOI":"10.1161\/01.CIR.0000074229.93804.5C","article-title":"Regular physical activity improves endothelial function in patients with\ncoronary artery disease by increasing phosphorylation of endothelial nitric\noxide synthase","volume":"107","author":"R Hambrecht","year":"2003","journal-title":"Circulation"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"776","DOI":"10.2340\/16501977-0254","article-title":"Effects of 6 months exercise training on ventricular remodelling and autonomic\ntone in patients with acute myocardial infarction and percutaneous coronary\nintervention","volume":"40","author":"H Zheng","year":"2008","journal-title":"J Rehabil Med"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1161\/01.CIR.0000121360.31954.1F","article-title":"Percutaneous coronary angioplasty compared with exercise training in patients\nwith stable coronary artery disease: A randomized trial","volume":"109","author":"R Hambrecht","year":"2004","journal-title":"Circulation"},{"key":"ref30","first-page":"322","article-title":"Exercise-based cardiac rehabilitation in patients with heart failure: A\nmeta-analysis of randomised controlled trials between 1999 and 2013","volume":"6","author":"C 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Monitoring and\nquantification of a community-based Phase III cardiac rehabilitation programme:\nA United Kingdom perspective","volume":"14","author":"A Khushhal","year":"2019","journal-title":"PLoS One"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1177\/2047487318825350","article-title":"Lifestyle and impact on cardiovascular risk factor control in coronary patients\nacross 27 countries: Results from the European Society of Cardiology ESC-EORP\nEUROASPIRE V registry","volume":"26","author":"K Kotseva","year":"2019","journal-title":"Eur J Prev Cardiol"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1136\/heartjnl-2011-300302","article-title":"Rehabilitation after myocardial infarction trial [RAMIT]: Multi-centre\nrandomised controlled trial of comprehensive cardiac rehabilitation in patients\nfollowing acute myocardial infarction","volume":"98","author":"R R West","year":"2012","journal-title":"Heart"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1891\/0889-8391.27.2.126","article-title":"Towards a universal maintenance intervention: integrating motivational\ninterviewing with cognitive-behavioural strategies for maintenance of behaviour\nchange","volume":"27","author":"S Naar-King","year":"2013","journal-title":"J Cogn Psychother"},{"key":"ref40","first-page":"CD003180","article-title":"Interventions for promoting physical activity","volume":"1","author":"C Foster","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1037\/0278-6133.19.Suppl1.32","article-title":"Physical activity behavior change: Issues in adoption and maintenance","volume":"19","author":"B Marcus","year":"2000","journal-title":"Health Psychol"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1177\/1742395318769370","article-title":"An integrated motivational interviewing and cognitive behavioural intervention\npromoting physical activity maintenance for adults with chronic health\nconditions: A feasibility study","volume":"15","author":"S Scott","year":"2019","journal-title":"Chronic Illn"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1080\/14780880903304527","article-title":"Grounded theory based research within exercise psychology: A critical\nreview","volume":"8","author":"A Hutchison","year":"2011","journal-title":"Qual Res Psychol"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"I Ajzen","year":"1991","journal-title":"Organ Behav Hum Decis Process"},{"key":"ref46"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1037\/a0024509","article-title":"Mechanisms of health behavior change in persons with chronic illness or\ndisability: The health action process approach [HAPA]","volume":"56","author":"R Schwarzer","year":"2011","journal-title":"Rehabil Psychol"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1080\/17437199.2018.1435299","article-title":"How can interventions increase motivation for physical activity? 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A CARE CR Study","volume":"4","author":"S Nichols","year":"2018","journal-title":"Sports Med Open"},{"key":"ref64","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/S0002-9149(99)80287-2","article-title":"Prognostic value of training-induced change in peak exercise capacity in\npatients with myocardial infarcts and patients with coronary bypass surgery","volume":"76","author":"L Vanhees","year":"1995","journal-title":"Am J Cardiol"},{"key":"ref65","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.mayocp.2013.02.013","article-title":"Cardiovascular fitness and mortality after contemporary cardiac\nrehabilitation","volume":"88","author":"B J Martin","year":"2013","journal-title":"Mayo Clin Proc"},{"key":"ref67","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1177\/2047487316657669","article-title":"A review of guidelines for cardiac rehabilitation exercise programmes: Is there\nan international consensus?","volume":"23","author":"K J Price","year":"2016","journal-title":"Eur J Prev Cardiol"},{"key":"ref68","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.ijcard.2019.02.065","article-title":"Availability and delivery of cardiac rehabilitation in the Eastern Mediterranean\nRegion: How does it compare globally?","volume":"285","author":"K Turk-Adawi","year":"2019","journal-title":"Int J Cardiol"},{"key":"ref70","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/01.hjr.0000136414.40017.10","article-title":"Differences in sustainability of exercise and health-related quality of life\noutcomes following home or hospital-based cardiac rehabilitation","volume":"11","author":"K M Smith","year":"2004","journal-title":"Eur J Prev Cardiol"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1001\/jama.2009.681","article-title":"Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and\ncardiovascular events in healthy men and women: A meta-analysis","volume":"301","author":"S Kodama","year":"2009","journal-title":"JAMA"},{"key":"ref72","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.mayocp.2013.02.013","article-title":"Cardiovascular fitness and mortality after contemporary cardiac\nrehabilitation","volume":"88","author":"B-J Martin","year":"2013","journal-title":"Mayo Clin Proc"},{"key":"ref74","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1177\/2047487312460484","article-title":"Aerobic exercise intensity assessment and prescription in cardiac\nrehabilitation: A joint position statement of the European Association for\nCardiovascular Prevention and Rehabilitation, the American Association of\nCardiovascular and Pulmonary Rehabilitation and the Canadian Association of\nCardiac Rehabilitation","volume":"20","author":"A Mezzani","year":"2013","journal-title":"Eur J Prev Cardiol"},{"key":"ref75","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1249\/MSS.0b013e318213fefb","article-title":"American College of Sports Medicine position stand. 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