Outpatient rehabilitative training in patients with cardiovascular disease: emphasis on training method

As our ability to evaluate cardiovascular patients expands and direct oxygen consumption measurements are available, exercise prescriptions can be better individualized for each patient. By using basic principles of frequency and duration and specifically basing intensity and progression on percent of maximum oxygen consumption, protocols using various modes of exercise may be defined so that each patient entering cardiovascular training programs will gradually progress. This methodology discussion presents concise progressions for both phase II monitored and phase II nonmonitored medically supervised exercise training. The phase II monitored protocol consists of levels 1 through 6 and is designed to be completed within a minimum of six 1-hour sessions. The phase II nonmonitored protocol consists of levels 7 through 12 and is designed to be completed within 12 weeks. The ultimate goal is for each patient to safely progress to a training level that can be maintained safely and effectively by the patient. A total of 192 patients enrolled in our phase II programs have safely completed both components and are in long-term maintenance programs.