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Sports Medicine

, Volume 48, Issue 8, pp 1781–1797 | Cite as

Exercise Prescription in Patients with Different Combinations of Cardiovascular Disease Risk Factors: A Consensus Statement from the EXPERT Working Group

  • Dominique Hansen
  • Josef Niebauer
  • Veronique Cornelissen
  • Olga Barna
  • Daniel Neunhäuserer
  • Christoph Stettler
  • Cajsa Tonoli
  • Eugenio Greco
  • Robert Fagard
  • Karin Coninx
  • Luc Vanhees
  • Massimo F. Piepoli
  • Roberto Pedretti
  • Gustavo Rovelo Ruiz
  • Ugo Corrà
  • Jean-Paul Schmid
  • Constantinos H. Davos
  • Frank Edelmann
  • Ana Abreu
  • Bernhard Rauch
  • Marco Ambrosetti
  • Simona Sarzi Braga
  • Paul Beckers
  • Maurizio Bussotti
  • Pompilio Faggiano
  • Esteban Garcia-Porrero
  • Evangelia Kouidi
  • Michel Lamotte
  • Rona Reibis
  • Martijn A. Spruit
  • Tim Takken
  • Carlo Vigorito
  • Heinz Völler
  • Patrick Doherty
  • Paul Dendale
Review Article

Abstract

Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia. The impact of physical fitness, CVD risk altering medications and adverse events during exercise testing was further taken into account to fine-tune this exercise prescription. An algorithm, supported by the interactive EXPERT tool, was developed by Hasselt University based on these data. Specific exercise recommendations were formulated with the aim to decrease adipose tissue mass, improve glycaemic control and blood lipid profile, and lower blood pressure. The impact of medications to improve CVD risk, adverse events during exercise testing and physical fitness was also taken into account. Simulations were made of how the EXPERT tool provides exercise prescriptions according to the variables provided. In this paper, state-of-the-art exercise prescription to patients with combinations of CVD risk factors is formulated, and it is shown how the EXPERT tool may assist clinicians. This contributes to an appropriately tailored exercise regimen for every CVD risk patient.

Notes

Author Contributions

DH, JN, VC, OB, DN, CS, CT, EG, RF, KC, LV, MP, RP, GRR, UC, J-PS, CD, FE, AA, BR, MA, SSB, PB, MB, PF, EG-P, EK, ML, RR, MS, TT, CV, HV, PD, and PD contributed to the conception or design of the work. DH, JN, VC, OB, DN, CS, CT, EG, RF, KC, LV, MP, RP, GRR, UC, J-PS, CD, FE, AA, BR, MA, SSB, PB, MB, PF, EG-P, EK, ML, RR, MS, TT, CV, HV, PD, and PD contributed to the acquisition, analysis, or interpretation of data for the work. DH, PD and KC drafted the manuscript. JN, VC, OB, DN, CS, CT, EG, RF, LV, MP, RP, GRR, UC, J-PS, CD, FE, AA, BR, MA, SSB, PB, MB, PF, EG-P, EK, ML, RR, MS, TT, CV, HV, and PD critically revised the manuscript. All gave final approval and agreed to be accountable for all aspects of work ensuring integrity and accuracy.

Compliance with Ethical Standards

Funding

The realisation of the proof of concept of the EXPERT tool was supported by an UHasselt IOF PoC project.

Conflicts of interest

Dominique Hansen, Josef Niebauer, Veronique Cornelissen, Olga Barna, Daniel Neunhäuserer, Christoph Stettler, Cajsa Tonoli, Eugenio Greco, Robert Fagard, Karin Coninx, Luc Vanhees, Massimo Piepoli, Roberto Pedretti, Gustavo Rovelo Ruiz, Ugo Corrà, Jean-Paul Schmid, Constantinos Davos, Frank Edelmann, Ana Abreu, Bernhard Rauch, Marco Ambrosetti, Simona Sarzi Braga, Paul Beckers, Maurizio Bussotti, Pompilio Faggiano, Esteban Garcia-Porrero, Evangelia Kouidi, Michel Lamotte, Rona Reibis, Martijn Spruit, Tim Takken, Carlo Vigorito, Heinz Völler, Patrick Doherty and Paul Dendale declare that they have no conflicts of interest relevant to the content of this review.

Supplementary material

40279_2018_930_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Dominique Hansen
    • 1
    • 2
  • Josef Niebauer
    • 3
  • Veronique Cornelissen
    • 4
  • Olga Barna
    • 5
  • Daniel Neunhäuserer
    • 6
    • 7
  • Christoph Stettler
    • 8
  • Cajsa Tonoli
    • 9
  • Eugenio Greco
    • 10
  • Robert Fagard
    • 11
  • Karin Coninx
    • 12
  • Luc Vanhees
    • 4
  • Massimo F. Piepoli
    • 13
  • Roberto Pedretti
    • 14
  • Gustavo Rovelo Ruiz
    • 12
  • Ugo Corrà
    • 15
  • Jean-Paul Schmid
    • 16
  • Constantinos H. Davos
    • 17
  • Frank Edelmann
    • 18
    • 19
    • 20
  • Ana Abreu
    • 21
  • Bernhard Rauch
    • 22
  • Marco Ambrosetti
    • 23
  • Simona Sarzi Braga
    • 14
  • Paul Beckers
    • 24
    • 25
  • Maurizio Bussotti
    • 26
  • Pompilio Faggiano
    • 27
  • Esteban Garcia-Porrero
    • 28
  • Evangelia Kouidi
    • 29
  • Michel Lamotte
    • 30
  • Rona Reibis
    • 31
  • Martijn A. Spruit
    • 2
    • 32
    • 33
  • Tim Takken
    • 34
  • Carlo Vigorito
    • 35
  • Heinz Völler
    • 36
    • 37
  • Patrick Doherty
    • 38
  • Paul Dendale
    • 1
    • 2
  1. 1.Heart Centre HasseltJessa HospitalHasseltBelgium
  2. 2.UHasselt, Faculty of Medicine and Life Sciences, BIOMED-REVAL-Rehabilitation Research CentreHasselt UniversityDiepenbeekBelgium
  3. 3.Institute of Sports Medicine, Prevention and Rehabilitation, Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Sports Medicine of the Olympic Center Salzburg-RifSalzburgAustria
  4. 4.Research group of Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesKU LeuvenLouvainBelgium
  5. 5.Family Medicine DepartmentNational O.O. Bogomolets Medical UniversityKievUkraine
  6. 6.Sport and Exercise Medicine Division, Department of MedicineUniversity of PadovaPaduaItaly
  7. 7.University Institute of Sports Medicine, Prevention and RehabilitationParacelsus Medical University of SalzburgSalzburgAustria
  8. 8.Division of Endocrinology, Diabetes and Clinical NutritionUniversity Hospital/InselspitalBernSwitzerland
  9. 9.Department of Rehabilitation Science and PhysiotherapyGhent UniversityGhentBelgium
  10. 10.FuscaldoItaly
  11. 11.Hypertension and Cardiovascular Rehabilitation UnitKU Leuven UniversityLouvainBelgium
  12. 12.UHasselt, Faculty of Sciences, Expertise Centre for Digital MediaHasselt UniversityHasseltBelgium
  13. 13.Heart Failure Unit, Cardiac Department, Guglielmo da Saliceto HospitalAUSL PiacenzaPiacenzaItaly
  14. 14.Department of Medicine and Cardiorespiratory Rehabilitation, Istituti Clinici Scientifici MaugeriIRCCS TradateTradateItaly
  15. 15.Cardiologic Rehabilitation DepartmentIstituti Clinici Scientifici Salvatore Maugeri, SPA, SB, Scientific Institute of di Veruno, IRCCSVerunoItaly
  16. 16.Department of CardiologyClinic BarmelweidBarmelweidSwitzerland
  17. 17.Cardiovascular Research Laboratory, Biomedical Research FoundationAcademy of AthensAthensGreece
  18. 18.Department of Internal Medicine with CardiologyCharité-Universitaetsmedizin BerlinBerlinGermany
  19. 19.Department of Cardiology and PneumologyUniversity of GöttingenGöttingenGermany
  20. 20.German Center for Cardiovascular ResearchGöttingenGermany
  21. 21.Cardiology DepartmentHospital Santa MartaLisbonPortugal
  22. 22.Institut für Herzinfarktforschung LudwigshafenLudwigshafen Am RheinGermany
  23. 23.Cardiovascular Rehabilitation UnitLe Terrazze ClinicCunardoItaly
  24. 24.Department of CardiologyAntwerp University HospitalEdegemBelgium
  25. 25.Translational Pathophysiological ResearchAntwerp UniversityAntwerpBelgium
  26. 26.Unit of Cardiorespiratory Rehabilitation, Instituti Clinici Maugeri, Institute of MilanIRCCSMilanItaly
  27. 27.Cardiology DepartmentSpedali CiviliBresciaItaly
  28. 28.Cardiology Service of Complejo Hospitalario Universitario de LeónLéonSpain
  29. 29.Laboratory of Sports MedicineAristotle University of ThessalonikiThessalonikiGreece
  30. 30.CUB Erasme HospitalBrusselsBelgium
  31. 31.Cardiological Outpatient Clinics at the Park SanssouciPotsdamGermany
  32. 32.Department of Research and EducationCIRO + , Centre of Expertise for Chronic Organ FailureHornThe Netherlands
  33. 33.Department of Respiratory Medicine, Maastricht University Medical CentreNUTRIM School of Nutrition and Translational Research in MetabolismMaastrichtThe Netherlands
  34. 34.Division of Pediatrics, Child Development and Exercise CenterWilhelmina Children’s Hospital, UMC UtrechtUtrechtThe Netherlands
  35. 35.Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical SciencesUniversity of Naples Federico IINaplesItaly
  36. 36.Department of CardiologyKlinik am SeeRüdersdorfGermany
  37. 37.Center of Rehabilitation ResearchUniversity of PotsdamPotsdamGermany
  38. 38.Department of Health SciencesUniversity of YorkYorkUK

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