Stair Climbing Outcomes in Cardiac Rehabilitation Exercise

This study will evaluate the effect of brief, intermittent stair climbing exercise on key cardiovascular and metabolic markers of health in individuals completing a cardiac rehabilitation program. Participants of this study will be placed into one of two exercise groups: one group will perform the standard exercise protocol currently being used by the Cardiac Health and Rehabilitation Centre at Hamilton General Hospital and the second group will perform a variation of interval exercise training, high intensity interval stair climbing.

Cardiac rehabilitation (CR) is a recognized health service for the secondary prevention of CVD, unfortunately, CR is vastly underutilized, due to low referral rates and patient-related factors such as time commitment, travelling distance or user fees. After 2 weeks of CR exercise prescription, \~80% of patients opt to exercise independently rather than join a structured rehabilitation program in the community, suggesting that alternatives for current centre-based CR should focus on at-home programming with the intention of enhancing adherence and maintaining the lifestyle benefits long-term. The implementation of high-intensity interval exercise in CR programming has proven to be time-effective, enjoyable, safe, and capable of inducing similar if not superior cardiorespiratory responses, when compared to traditional, continuous CR programs. Recently, the benefits of interval stair climbing exercise in sedentary women were established, in that completing 3, 60 second bouts of high intensity stair climbing, 3 days/week for 6 weeks improved cardiorespiratory fitness, and represents a model of low-volume high-intensity interval training which is tolerable, effective and easily accessible for sedentary adults.

Eligibility Criteria:
Inclusion Criteria:

* Men and (post-menopausal) women
* Registered to participate in the Cardiac Health and Rehabilitation Centre (CHRC) at the Hamilton Health Sciences General Division
* History of previous myocardial infarction, coronary artery bypass graft, and/or percutaneous coronary intervention
* Non-smoker (within 3-months)
* Local resident, with transportation to the CHRC at the Hamilton Health Sciences General Division.
* Ability to understand written and verbal instructions and provide written informed consent.
* Stable medical therapy.

Exclusion Criteria:

* Non-cardiac surgical procedure within two months
* Positive exercise stress test (i.e. typical symptoms of chest discomfort and ECG changes or positive nuclear scan)
* Myocardial infarction within two months; coronary artery bypass graft surgery within two months; percutaneous coronary intervention within one month
* Baseline work capacity \< 25 W
* NYHA class II-IV symptoms of heart failure
* Documented significant valve stenosis
* Symptomatic peripheral arterial disease that limits exercise capacity
* Uncontrolled supraventricular or ventricular dysrhythmia
* Unstable angina
* Uncontrolled hypertension (blood pressure \>160/90 mmHg)
* Documented chronic obstructive pulmonary disease (FEV1 \<60% and/or FVC \<60%)
* Any musculoskeletal abnormality that would limit exercise participation