The Exercise Debate
The Exercise Debate
Heart failure has a number of aetiologies many of which are non-ischaemic, however, the challenges in relation to exercise remain the same, if not greater. These challenges include delivery of appropriate patient-focused exercise and lifestyle interventions. With an increasing incidence of non-ischaemic cardiomyopathy in the young adult population, services need to be able to offer contemporary exercise options to high-risk patients alongside more traditional programmes for those with the functional capacity that is a feature of a myriad of symptoms associated with a New York Heart Association (NYHA) grade 3 classification.
Current staffing levels in a large majority of CR services would not meet the recommended patient–staff ratio for exercise in high-risk groups or for the anticipated increase in numbers participating in the exercise component of CR programmes. Pathways for onward referral to community exercise facilities need to be in place in order to meet capacity concerns within phase III programmes.
With the projected increase in the numbers of individuals being diagnosed with heart failure there will be a substantial increase in numbers of possible participants referred to already over-subscribed exercise programmes in CR services. The waiting time to access the exercise component of CR programmes has risen dramatically. With improved referral processes and a greater buy-in from stakeholders involved in both delivery and commissioning we can expect to see an increase in participation with subsequent increase in waiting times unless additional resources are available.
Changing Population
Heart failure has a number of aetiologies many of which are non-ischaemic, however, the challenges in relation to exercise remain the same, if not greater. These challenges include delivery of appropriate patient-focused exercise and lifestyle interventions. With an increasing incidence of non-ischaemic cardiomyopathy in the young adult population, services need to be able to offer contemporary exercise options to high-risk patients alongside more traditional programmes for those with the functional capacity that is a feature of a myriad of symptoms associated with a New York Heart Association (NYHA) grade 3 classification.
Current staffing levels in a large majority of CR services would not meet the recommended patient–staff ratio for exercise in high-risk groups or for the anticipated increase in numbers participating in the exercise component of CR programmes. Pathways for onward referral to community exercise facilities need to be in place in order to meet capacity concerns within phase III programmes.
With the projected increase in the numbers of individuals being diagnosed with heart failure there will be a substantial increase in numbers of possible participants referred to already over-subscribed exercise programmes in CR services. The waiting time to access the exercise component of CR programmes has risen dramatically. With improved referral processes and a greater buy-in from stakeholders involved in both delivery and commissioning we can expect to see an increase in participation with subsequent increase in waiting times unless additional resources are available.
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