Monitoring during exercise may be warranted for those:
- With complicated disease
- Who are symptomatic with exercise
- Who have poor understanding of their condition
Throughout the rehabilitation program, all patients should be educated and encouraged to self-monitor their progress and response, in order to promote self-confidence in undertaking exercise or activity outside of a clinical environment. For this reason, physiological monitoring may be weaned when appropriate, as the individual nears completion of the program.
Data from exercise assessments should be recorded on an exercise monitoring form. Only parameters relevant to the individual should be recorded.
Examples of parameters that may need monitoring include:
- Blood pressure and heart rate assessment – in those who are:
- Symptomatic during exercise or those with BP concerns prior to the exercise session
- At high risk of an exercise-related cardiac event (see Safety considerations)
- Oxygen saturation monitoring – in those with excessive breathlessness during exercise or those with marginal SpO2 prior to the exercise session
- Blood glucose level – in diabetics who are symptomatic during exercise
ECG telemetry monitoring
In cardiac rehabilitation, ECG telemetry monitoring does not reduce adverse events or prevent sudden death, but can be useful for several sessions to document a patient’s exercise response and to identify rhythm abnormalities if the HR is irregular on palpation, linking symptoms with arrhythmias. However, long-term reliance on ECG monitoring can be detrimental to a patient exercising confidently away from a monitored environment.[#van-camp-sp-peterson-ra.-1986]
TIP: If using a HR monitor, it is still valuable to palpate the pulse manually to determine regularity and to confirm the accuracy of the monitor. HR monitors are less accurate for irregular pulses such as occurs with AF or those with frequent ectopics.