Carnegie School of Sport Fees Funded Masters by Research (MRes) To compare the efficacy of different exercise prescription approaches in Phase IV cardiac rehabilitation programmes

Funding will consist of the UK full tuition fee for one year.

A laptop will be provided and the opportunity to apply for funding to support the research project.

Compare the Efficacy of Different Exercise Prescription Approaches in Phase IV Cardiac Rehabilitation Programmes

In the United Kingdom (UK), over 2.3 million people are living with coronary heart disease (CHD; British Heart Foundation, 2022). Cardiac rehabilitation (CR) is a core component of secondary prevention that can reduce hospitalisations, cardiovascular mortality, and improves an individual’s quality of life (McMahon, Ades, & Thompson, 2017). Traditional CR paths involve four phases: Phase I in hospital, Phase II early outpatient, Phase III early CR of 8-11 weeks, and Phase IV long-term maintenance programme (Kerins, McKee, & Bennett, 2011). It is crucial that individuals engage with longer-term CR programmes (beyond 11 weeks) to ensure long-term health and reduce admissions among these individuals (Driscoll et al., 2020).

Since the publication of the first systematic review in the late 1980’s the efficacy of cardiac rehabilitation (assessed against reduced mortality and morbidity and improved quality of life – QoL) has been contested – especially in UK-based studies. Is this apparent lack of efficacy a product of the improved efficacy of medical interventions (more aggressive medical and interventional therapies), a product of lack of fidelity in the application of the evidence-based dose of exercise (e.g. not delivering the required programme length, duration/intensity of training), or a product of using arbitrary intensity targets instead of basing these on data collected from an exercise test?

Given that a number of reviews, letters to editors, post-hoc trial and audit data analysis has raised the question of exercise programme dose fidelity, the aim of this project is to investigate the influence of the method for prescription of exercise intensity (i.e. based on exercise test results or using generic calculations) and exercise fidelity (i.e. patients closely applying what has been prescribed to them) on measures of aerobic fitness, cardiovascular efficiency and QoL in the setting of Phase IV cardiac rehabilitation.

This Masters by Research will adopt quantitative experimental methods to explore and understand how differences in exercise prescription influence the efficacy of training assessed on several variables. This MRes project may lead to the opportunity to feed into a larger scale project and intervention.

Applicants are encouraged to discuss their proposals with; Mr Costas Tsakirides, c.tsakirides@leedsbeckett.ac.uk or by phone on 0113 812 4716.

1. Dibben G, Faulkner J, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2021;2021(11): https://doi.org/10.1002/14651858.CD001800.pub4. doi:10.1002/14651858.CD001800.pub4
2. Gavin R H S, Fernando C, Meshal A, Garyfallia P. Cardiorespiratory fitness changes in patients receiving comprehensive outpatient cardiac rehabilitation in the UK: a multicentre study. Hear VO  - 99. 2013;(11):785. doi:10.1136/heartjnl-2012-303055
3. Grove T, Jones J, Connolly S. Changes in 6-minute walk test distance and heart rate walking speed index following a cardiovascular prevention and rehabilitation programme. Br J Card Nurs. 2019;14(4):1-12. doi:10.12968/bjca.2018.0036
4. Ibeggazene S, Moore C, Tsakirides C, Swainson M, Ispoglou T, Birch K. UK cardiac rehabilitation fit for purpose? A community-based observational cohort study. BMJ Open. 2020;10(10):e037980. doi:10.1136/bmjopen-2020-037980
5. Khushhal A, Nichols S, Carroll S, Abt G, Ingle L. Insufficient exercise intensity for clinical benefit? Monitoring and quantification of a community-based Phase III cardiac rehabilitation programme: A United Kingdom perspective. PLoS One. 2019;14(6):e0217654. doi:10.1371/journal.pone.0217654
6. Powell R, McGregor G, Ennis S, Kimani PK, Underwood M. Is exercise-based cardiac rehabilitation effective? A systematic review and meta-analysis to re-examine the evidence. BMJ Open. 2018;8(3):e019656-e019656. doi:10.1136/bmjopen-2017-019656
7. Taylor, C., Tsakirides, C., Moxon, J., Moxon, J. W., Dudfield, M., Witte, K., . . . Carroll, S. (2017). Exercise dose and all-cause mortality within extended cardiac rehabilitation: A cohort study. Open Heart, 4(2). https://doi.org/10.1136/openhrt-2017-000623
8. Taylor, C., Tsakirides, C., Moxon, J., Moxon, J. W., Dudfield, M., Witte, K. K., . . . Carroll, S. (2016). Submaximal fitness and mortality risk reduction in coronary heart disease: A retrospective cohort study of community-based exercise rehabilitation. BMJ Open, 6(6). http://dx.doi.org/10.1136/bmjopen-2016-011125

As part of your application, please provide a CV, cover letter and research proposal. The proposal should align to the above theme and include a brief literature review related to this project, with an outline of the studies that you would propose to the answer the aims of the MRes (maximum 5 pages single spaced).

We can only consider complete applications. The research degree application is complete once you have uploaded all of the following:

1. Your application form (include the project reference CR2)
2. Your research proposal, statement of purpose and CV on the Research proposal template
3. Copies of your bachelors certificates, including transcripts
4. Copy of your IELTS (or equivalent) certificate (if applicable) further information can be found on our Graduate School FAQs
5. Copy of your passport

Email the documentation above) to researchadmissions@leedsbeckett.ac.uk 

The deadline for applications is midnight on 6th November 2022

Candidates must be available for interview on 7th December 2022