Optimizing adherence to exercise in CR is a particular

challenge.26 The best type of exercise is the one you enjoy

and will commit to in the long term. In our study, the patients
reported high contentment with the program and found
group-based high-intensity interval training including music
motivating and enjoyable. Many of the patients reported participation
in maintenance (Phase 3) exercise programs,
including the Norwegian Ullevaal model, which are frequently
available in Oslo. In addition, the importance of
happiness and joy with the inclusion of motivating music seems
crucial. Music can make exercisers produce more power,
improve energy efficiency, and increase enjoyment.27,28 We
also believe that inclusion of different modes of highintensity
interval training during CR and individual instruction
on the use of HR monitors could have motivated the patients
to maintain their new exercise habits. To offer exercise
classes outdoor and concomitantly stimulate for active commuting
seems to be important for a lot of patients in our CR
program.
There are some limitations in the present study that need
to be addressed. First, the sample size is modest, and 35 %
of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
2016;23:NP1NP96.
5. Liou K, Ho S, Fildes J, Ooi SY. High intensity interval versus moderate
intensity continuous training in patients with coronary artery disease:
a meta-analysis of physiological and clinical parameters. Heart Lung
Circ 2016;25:166174.
6. Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer
K, Schlierf G, Kubler W, Schuler G. Various intensities of leisure time
physical activity in patients with coronary artery disease: effects on cardiorespiratory
fitness and progression of coronary atherosclerotic lesions.
J Am Coll Cardiol 1993;22:468477.
7. Ingjer F. Factors influencing assessment of maximal heart rate. Scand
J Med Sci Sports 1991;1:134140.
8. Borg G. Perceived exertion as an indicator of somatic stress. Scand J
Rehabil Med 1970;2:9298.
9. Bruusgaard D, Nessioy I, Rutle O, Furuseth K, Natvig B. Measuring
functional status in a population survey. The Dartmouth COOP functional
health assessment charts/WONCAused in an epidemiological study.
Fam Pract 1993;10:212218.
10. Lam CL, Lauder IJ, Lam DT. How does a change in the administration
method affect the reliability of the COOP/WONCA Charts?World
Organization of National Colleges, Academies and Academic Associations
of General Practitioners/Family Physicians. Fam Pract 1999;16:184
189.
11. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise
capacity and mortality among men referred for exercise testing.
N Engl J Med 2002;346:793801.
12. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, Sugawara
A, Totsuka K, Shimano H, Ohashi Y, Yamada N, Sone H. Cardiorespiratory
fitness as a quantitative predictor of all-cause mortality and
cardiovascular events in healthy men and women: a meta-analysis. JAMA
2009;301:20242035.
13. Ross R, Blair SN, Arena R, Church TS, Despres JP, Franklin BA, Haskell
WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis
R, Sawada SS, Sui X, Wisloff U, American Heart Association PhysicalActivity
Committee of the Council on Lifestyle and Cardiometabolic
Health; Council

. First, the sample size is modest, and 35 %

of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
. First, the sample size is modest, and 35 %
of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
. First, the sample size is modest, and 35 %
of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
2016;23:NP1NP96.
5. Liou K, Ho S, Fildes J, Ooi SY. High intensity interval versus moderate
intensity continuous training in patients with coronary artery disease:
a meta-analysis of physiological and clinical parameters. Heart Lung
Circ 2016;25:166174.
6. Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer
K, Schlierf G, Kubler W, Schuler G. Various intensities of leisure time
physical activity in patients with coronary artery disease: effects on cardiorespiratory
fitness and progression of coronary atherosclerotic lesions.
J Am Coll Cardiol 1993;22:468477.
7. Ingjer F. Factors influencing assessment of maximal heart rate. Scand
J Med Sci Sports 1991;1:134140.
8. Borg G. Perceived exertion as an indicator of somatic stress. Scand J
Rehabil Med 1970;2:9298.
9. Bruusgaard D, Nessioy I, Rutle O, Furuseth K, Natvig B. Measuring
functional status in a population survey. The Dartmouth COOP functional
health assessment charts/WONCAused in an epidemiological study.
Fam Pract 1993;10:212218.
10. Lam CL, Lauder IJ, Lam DT. How does a change in the administration
method affect the reliability of the COOP/WONCA Charts?World
Organization of National Colleges, Academies and Academic Associations
of General Practitioners/Family Physicians. Fam Pract 1999;16:184
189.
11. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise
capacity and mortality among men referred for exercise testing.
N Engl J Med 2002;346:793801.
12. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, Sugawara
A, Totsuka K, Shimano H, Ohashi Y, Yamada N, Sone H. Cardiorespiratory
fitness as a quantitative predictor of all-cause mortality and
cardiovascular events in healthy men and women: a meta-analysis. JAMA
2009;301:20242035.
13. Ross R, Blair SN, Arena R, Church TS, Despres JP, Franklin BA, Haskell
WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis
R, Sawada SS, Sui X, Wisloff U, American Heart Association PhysicalActivity
Committee of the Council on Lifestyle and Cardiometabolic
Health; Council

. First, the sample size is modest, and 35 %

of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
2016;23:NP1NP96.
5. Liou K, Ho S, Fildes J, Ooi SY. High intensity interval versus moderate
intensity continuous training in patients with coronary artery disease:
a meta-analysis of physiological and clinical parameters. Heart Lung
Circ 2016;25:166174.
6. Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer
K, Schlierf G, Kubler W, Schuler G. Various intensities of leisure time
physical activity in patients with coronary artery disease: effects on cardiorespiratory
fitness and progression of coronary atherosclerotic lesions.
J Am Coll Cardiol 1993;22:468477.
7. Ingjer F. Factors influencing assessment of maximal heart rate. Scand
J Med Sci Sports 1991;1:134140.
8. Borg G. Perceived exertion as an indicator of somatic stress. Scand J
Rehabil Med 1970;2:9298.
9. Bruusgaard D, Nessioy I, Rutle O, Furuseth K, Natvig B. Measuring
functional status in a population survey. The Dartmouth COOP functional
health assessment charts/WONCAused in an epidemiological study.
Fam Pract 1993;10:212218.
10. Lam CL, Lauder IJ, Lam DT. How does a change in the administration
method affect the reliability of the COOP/WONCA Charts?World
Organization of National Colleges, Academies and Academic Associations
of General Practitioners/Family Physicians. Fam Pract 1999;16:184
189.
11. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise
capacity and mortality among men referred for exercise testing.
N Engl J Med 2002;346:793801.
12. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, Sugawara
A, Totsuka K, Shimano H, Ohashi Y, Yamada N, Sone H. Cardiorespiratory
fitness as a quantitative predictor of all-cause mortality and
cardiovascular events in healthy men and women: a meta-analysis. JAMA
2009;301:20242035.
13. Ross R, Blair SN, Arena R, Church TS, Despres JP, Franklin BA, Haskell
WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis
R, Sawada SS, Sui X, Wisloff U, American Heart Association PhysicalActivity
Committee of the Council on Lifestyle and Cardiometabolic
Health; Council

. First, the sample size is modest, and 35 %

of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
2016;23:NP1NP96.
5. Liou K, Ho S, Fildes J, Ooi SY. High intensity interval versus moderate
intensity continuous training in patients with coronary artery disease:
a meta-analysis of physiological and clinical parameters. Heart Lung
Circ 2016;25:166174.
6. Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer
K, Schlierf G, Kubler W, Schuler G. Various intensities of leisure time
physical activity in patients with coronary artery disease: effects on cardiorespiratory
fitness and progression of coronary atherosclerotic lesions.
J Am Coll Cardiol 1993;22:468477.
7. Ingjer F. Factors influencing assessment of maximal heart rate. Scand
J Med Sci Sports 1991;1:134140.
8. Borg G. Perceived exertion as an indicator of somatic stress. Scand J
Rehabil Med 1970;2:9298.
9. Bruusgaard D, Nessioy I, Rutle O, Furuseth K, Natvig B. Measuring
functional status in a population survey. The Dartmouth COOP functional
health assessment charts/WONCAused in an epidemiological study.
Fam Pract 1993;10:212218.
10. Lam CL, Lauder IJ, Lam DT. How does a change in the administration
method affect the reliability of the COOP/WONCA Charts?World
Organization of National Colleges, Academies and Academic Associations
of General Practitioners/Family Physicians. Fam Pract 1999;16:184
189.
11. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise
capacity and mortality among men referred for exercise testing.
N Engl J Med 2002;346:793801.
12. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, Sugawara
A, Totsuka K, Shimano H, Ohashi Y, Yamada N, Sone H. Cardiorespiratory
fitness as a quantitative predictor of all-cause mortality and
cardiovascular events in healthy men and women: a meta-analysis. JAMA
2009;301:20242035.
13. Ross R, Blair SN, Arena R, Church TS, Despres JP, Franklin BA, Haskell
WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis
R, Sawada SS, Sui X, Wisloff U, American Heart Association PhysicalActivity
Committee of the Council on Lifestyle and Cardiometabolic
Health; Council

. First, the sample size is modest, and 35 %

of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders
Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Simone
B, Document Reviewers, De Backer G, Roffi M, Aboyans V, Bachl N,
Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M,
Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof
P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A,
Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G,
Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice: The Sixth Joint
Task Force of the European Society of Cardiology and Other Societies
on Cardiovascular Disease Prevention in Clinical Practice (constituted
by representatives of 10 societies and by invited experts): Developed
with the special contribution of the European Association for Cardiovascular
Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol
2016;23:NP1NP96.
5. Liou K, Ho S, Fildes J, Ooi SY. High intensity interval versus moderate
intensity continuous training in patients with coronary artery disease:
a meta-analysis of physiological and clinical parameters. Heart Lung
Circ 2016;25:166174.
6. Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer
K, Schlierf G, Kubler W, Schuler G. Various intensities of leisure time
physical activity in patients with coronary artery disease: effects on cardiorespiratory
fitness and progression of coronary atherosclerotic lesions.
J Am Coll Cardiol 1993;22:468477.
7. Ingjer F. Factors influencing assessment of maximal heart rate. Scand
J Med Sci Sports 1991;1:134140.
8. Borg G. Perceived exertion as an indicator of somatic stress. Scand J
Rehabil Med 1970;2:9298.
9. Bruusgaard D, Nessioy I, Rutle O, Furuseth K, Natvig B. Measuring
functional status in a population survey. The Dartmouth COOP functional
health assessment charts/WONCAused in an epidemiological study.
Fam Pract 1993;10:212218.
10. Lam CL, Lauder IJ, Lam DT. How does a change in the administration
method affect the reliability of the COOP/WONCA Charts?World
Organization of National Colleges, Academies and Academic Associations
of General Practitioners/Family Physicians. Fam Pract 1999;16:184
189.
11. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise
capacity and mortality among men referred for exercise testing.
N Engl J Med 2002;346:793801.
12. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, Sugawara
A, Totsuka K, Shimano H, Ohashi Y, Yamada N, Sone H. Cardiorespiratory
fitness as a quantitative predictor of all-cause mortality and
cardiovascular events in healthy men and women: a meta-analysis. JAMA
2009;301:20242035.
13. Ross R, Blair SN, Arena R, Church TS, Despres JP, Franklin BA, Haskell
WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis
R, Sawada SS, Sui X, Wisloff U, American Heart Association PhysicalActivity
Committee of the Council on Lifestyle and Cardiometabolic
Health; Council

. First, the sample size is modest, and 35 %

of the participants dropped out during the long-term followup
period. Whether it was the nonadherent participants that
missed the retest is not known, but 23 of the 47 participants
who did not show-up reported co-morbidities (acute lumbago
[n = 5], obstructive pulmonary disease [n = 5], musculoskeletal
injury [n = 7], cancer [n = 2], cardiac disease [n = 4]).
Totally, 18 reported no interest or time due to job and 6 did
not answer the phone. Secondary, our study participants were
quite fit and mainly were middle-aged men. However, the data
confirm that the patients exercise habits had improved in the
long term with preserved or improved VO2peak from the
program end to the long-term follow-up.
Disclosure
The authors have no conflicts of interest to disclose.
Acknowledgement: We gratefully acknowledge the cardiac
rehabilitation team at the Norwegian Sport Clinic in Oslo,
Norway. Especially, Even Jarstad and Else-Kari Nordli Scheele.
1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J,
Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169
men referred for cardiac rehabilitation. Circulation 2002;106:666
671.
2. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P,
Shephard RJ. Peak oxygen intake and cardiac mortality in women referred
for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139
2143.
3. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ,
Thompson PD, Williams MA, Lauer MS, American Heart Association,
Council on Clinical Cardiology, Council on Nutrition, Physical
Activity, and Metabolism, American association of Cardiovascular and
Pulmonary Rehabilitation. Cardiac rehabilitation and secondary prevention
of coronary heart disease: an American Heart Association scientific
statement from the Council on Clinical Cardiology (Subcommittee on
Exercise, Cardiac Rehabilitation, and Prevention) and the Council on
Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical
Activity), in collaboration with the American Association of
Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369
376.
4. Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C,
Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C,
Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-
Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders