The Influence of Exercise Workload Progression Across 36 Sessions of Cardiac Rehabilitation on Functional Capacity

Defining time frames throughout cardiac rehabilitation (CR) to progress exercise workloads may lead to improve functional capacity outcomes. The purpose of this study was to investigate the role of exercise progression on functional capacity among cardiac patients enrolled in CR. This was a retrospective database analysis study. Extracted data included: Demographic, functional capacity (in METs), and exercise intensity during exercise sessions 2, 12, 24, and 36 of CR from 150 patients who completed a 36-session program. Progression of exercise was determined by calculating percent change in treadmill exercise workload within predefined time frames of CR. The time frames were percent change from exercise session 2 to 12 ("%ΔS2-S12), 12 to 24 (%ΔS12-S24), and 24 to 36 (%ΔS24-S36). A multiple linear regression model was developed to predict change in functional capacity (ΔMETs). A significant proportion (21%) of total variation in ΔMETs was predicted by %ΔS2-12, %ΔS12-24, %ΔS24-36, age, sex, and body mass index (BMI). Percent changes between sessions 12 to 24 (%ΔS12-24; β = 0.17, p = 0.03) and 24 to 36 (%ΔS24-36; β = 0.23, p < 0.01) were significant predictors. Progressing patients between sessions 12 to 24 and 24 to 36 predicted significant changes in functional capacity and reinforced the importance of exercise progression across all 36 sessions of CR.