A new La Trobe University study warns that some common fitness tests used in cardiac rehabilitation may not be accurate enough to safely set exercise levels - especially in regional and rural programs.
The research from La Trobe’s Holsworth Biomedical Research Centre compared these low cost tests with cardiopulmonary exercise testing (CPET), a specialist assessment that measures how the heart and lungs respond during exercise. Cardiac rehabilitation helps people recover after a heart attack or heart surgery and supports people living with heart disease. Exercise needs to be set at the right level; enough to help, but not so hard that it becomes unsafe.
“In many rehab services, particularly outside major cities, simple tests are used because they’re practical and affordable,” said lead researcher Dr Blake Collins from the Holsworth Biomedical Research Centre. “But our results suggest they aren’t reliable enough on their own to work out the safest exercise level for every patient.”
Key findings
The team reviewed several quick, low cost tests used in rehab, including the 6 Minute Walk Test, step tests, shuttle walk tests and sit to stand checks.
- The simple “field” tests didn’t match CPET closely, which could mean some people are asked to exercise too hard or not hard enough.
- CPET was especially important for people on beta blockers, or anyone whose heart rate doesn’t rise in the usual way during activity.
- Field tests can still help track progress, but shouldn’t be the only way to set exercise intensity.
CPET is used in only about 13% of cardiac rehab programs and can be difficult to access in regional and rural areas.
What this means for regional communities
Heart disease affects people in every part of Australia. The researchers say fair access to accurate testing matters because local services in regional areas may not have the same equipment or specialist support as city programs. “People in regional areas deserve the same standard of care as anyone else,” said Dr Collins.
The study highlights the need for:
- Better access to CPET (for example, through visiting clinics, shared regional services or clear referral options.
- Clear guidance and support so services can use the right test for the right patient, no matter the postcode.
A Heart Week message for all Australians
During Heart Week this month, the researchers say safe, evidence based rehab - and fair access to the right testing - can support recovery and help people stay well at home.
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Explore how our researchers are improving safety and outcomes for cardiac patients and more at Holsworth Biomedical Research Centre
