Recommendations for objective cardiovascular assessment to inform clinical exercise prescription: An Exercise Physiologist and Physiotherapist expert consensus

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Gower, Bethany
Girard, Danielle
Maiorana, Andrew
Durey, Belinda
Holland, David J
Davison, Kade
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2023
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Abstract

Objectives: Exercise is beneficial in managing cardiovascular health. Objective assessments of cardiovascular function assist in identifying the presence or absence of exertional symptoms, and functional and physiological thresholds necessary to inform safe and effective exercise programmes. This study aimed to generate expert consensus on assessments of cardiovascular function to support clinical decision-making for professionals providing clinical exercise services. Design: Three-round e-Delphi. Methods: Expert Exercise Physiologists and Physiotherapists were recruited to participate in an e-Delphi. Experts were asked to list all objective cardiovascular assessments deemed necessary to inform safe and effective exercise prescription. In subsequent e-Delphi rounds, experts rated the importance of each item, provided a rationale to support their assertions, and reconsidered others' ratings and rationale to shift or reaffirm their position. These results were then translated into a clinical guidance document by the authors in consultation with a Cardiologist and an experienced Exercise Physiologist with expertise in cardiovascular assessment. Results: Thirty-one experts participated in the e-Delphi and fourteen participants completed all three rounds. Forty objective assessments were initially suggested. Six items reached consensus by the end of Round 2 (resting and exercise heart rate, resting, exercise, and recovery blood pressure, and peak exercise-induced rating of perceived exertion). One additional item reached consensus in Round 3 (exercise oxygen saturation). Conclusions: In the absence of research evidence, the collective experience and insights of an expert panel can inform an evidence gap. Further research is required to determine the feasibility of implementing these seven assessments in practice where CV assessment is indicated.

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Journal of Science and Medicine in Sport

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© 2023 The Author(s). Published by Elsevier Ltd on behalf of Sports Medicine Australia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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This publication has been entered in Griffith Research Online as an advanced online version.

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Exercise physiology

Cardiovascular medicine and haematology

Clinical sciences

Sports science and exercise

Applied and developmental psychology

Cardiovascular system

Clinical decision-making

Consensus

Evidence-based practice

Exercise

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Gower, B; Girard, D; Maiorana, A; Durey, B; Holland, DJ; Davison, K, Recommendations for objective cardiovascular assessment to inform clinical exercise prescription: An Exercise Physiologist and Physiotherapist expert consensus, Journal of Science and Medicine in Sport, 2023