• 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, Braga Simona Sarzi SS Department of Medicine and Cardiorespiratory Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS Tradate, Tradate, Varese, Italy., 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, and Paul Dendale.
• Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium. dominique.hansen@uhasselt.be.
• Sports Med. 2018 Aug 1; 48 (8): 1781-1797.

AbstractWhereas 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.

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