优化耐力运动强度处方对于最大程度地提高临床益处和最大程度地减少有心血管疾病(CVD)风险的个体的并发症至关重要。然而,由于临床指南的差异,标准化仍然不完整。这篇综述为卫生专业人员提供了关于如何为心血管康复(CR)人群规定耐力运动强度的实用和更新的指南,解决国际准则,跨不同临床环境和资源可用性的实际适用性。在CR的背景下,心肺运动试验(CPET)被认为是金标准评估,基于通气阈值(VT)的处方是优选的方法。在无法访问此方法的设置中,这在低资源环境中经常发生,近似VT涉及结合客观评估-理想情况下,没有气体交换分析的运动测试,但至少是替代功能测试,如6分钟步行测试-用主观方法调整处方,例如博格对感知努力的评价和谈话测试。因此,增强运动强度处方并为有心血管疾病风险或有心血管疾病的患者提供个性化的身体活动指导依赖于使锻炼与个体生理变化相一致。量身定制的处方可促进一致且有影响力的锻炼程序,以增强健康结果,考虑患者的偏好和动机。因此,选择和实施最佳方法应考虑可用资源,在FITT-VP处方模型(频率,强度,时间,type,volume,和进展)。
Optimizing endurance
exercise intensity prescription is crucial to maximize the clinical benefits and minimize complications for individuals at risk for or with cardiovascular disease (CVD). However, standardization remains incomplete due to variations in clinical guidelines. This review provides a practical and updated guide for health professionals on how to prescribe endurance
exercise intensity for cardiovascular rehabilitation (CR) populations, addressing international guidelines, practical applicability across diverse clinical settings and resource availabilities. In the context of CR, cardiopulmonary
exercise test (CPET) is considered the gold standard assessment, and prescription based on ventilatory thresholds (VTs) is the preferable methodology. In settings where this approach isn\'t accessible, which is frequently the case in low-resource environments, approximating VTs involves combining objective assessments-ideally, exercise tests without gas exchange analyses, but at least alternative functional tests like the 6-minute walk test-with subjective methods for adjusting prescriptions, such as Borg\'s ratings of perceived exertion and the Talk Test. Therefore, enhancing
exercise intensity prescription and offering personalized physical activity guidance to patients at risk for or with CVD rely on aligning workouts with individual physiological changes. A tailored prescription promotes a consistent and impactful
exercise routine for enhancing health outcomes, considering patient preferences and motivations. Consequently, the selection and implementation of the best possible approach should consider available resources, with an ongoing emphasis on strategies to improve the delivery quality of exercise training in the context of FITT-VP prescription model (frequency, intensity, time, type, volume, and progression).