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Lack of Cited Evidence Underpinning Recommendations for Objective Assessment of Cardiovascular Function to Inform Exercise Prescription: A Systematic Review

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Abstract

Background

The effectiveness of exercise in managing cardiovascular (CV) health and function is well established. Less clear is the process for optimising the safety and efficacy of an intervention, particularly how objective assessments might inform this process.

Objective

The aim of this review was to investigate the cited evidence underpinning recommendations for assessing CV function to inform the safe and effective prescription of exercise in populations with established CV disease, as published in documents to guide practice authored by prominent organisations in cardiology and sports medicine.

Methods

A systematic review of position statements and guiding documents on exercise prescription for CV health was conducted. Included documents were published between 1997 and 2016.

Results

Following removal of duplicates, 3158 documents were considered, with full-text screening required for 334. Twenty-seven documents were included which provided 106 individual recommendations for specific objective assessments. Of the total number of recommendations, 60% had no accompanying citation and 28% of recommendations provided citations that did not directly support the statement made. Additionally, 52% of included documents did not state the methods of document development. That is, it was not clear if there was a literature review and/or expert consensus that was used to form recommendations included within.

Conclusion

Almost no cited evidence underpinning the extracted recommendations from the included guiding documents, nor any acknowledgement of this deficiency was established. There were limited explanations found for the methods involved in developing such guiding documents.

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Data Availability Statement

The datasets generated during and/or analysed during the current review are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia

    Bethany Gower, Danielle Girard, Braden L. Mitchell & Kade Davison

  2. TG Exercise Physiology Services, Adelaide, SA, Australia

    Thomas Gehling

  3. School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia

    Andrew Maiorana

  4. Allied Health Department, Fiona Stanley Hospital, Perth, WA, Australia

    Andrew Maiorana

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  1. Bethany Gower
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Corresponding author

Correspondence to Kade Davison.

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Funding

Bethany Gower and Braden Mitchell are supported by an Australian Government Research Training Program Scholarship. No other sources of funding were used to assist specifically in the preparation of this article.

Conflict of interest

Bethany Gower, Danielle Girard, Braden Mitchell, Thomas Gehling, Andrew Maiorana, and Kade Davison declare that they have no conflicts of interest relevant to the content of this review.

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Gower, B., Girard, D., Mitchell, B.L. et al. Lack of Cited Evidence Underpinning Recommendations for Objective Assessment of Cardiovascular Function to Inform Exercise Prescription: A Systematic Review. Sports Med 50, 1469–1481 (2020). https://doi.org/10.1007/s40279-020-01283-y

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