Does performance during the ISWT truly reflect changes in physiological function?

This aim of this dissertation is to evaluate whether changes in performance i.e. maximum distance walked (MDW) in the ISWT truly reflect improvements in physiological fitness in patients who have undergone a 3 month course of cardiac rehabilitation. (CR) A retrospective analysis of 184 patients was carried out and data was collected from an ISWT before and after CR. A Wilcoxan Signed Rank test was used to analyse the variables of heart rate (HR), RPE, MDW and walking speed index (WSI) for all participants. The inclusion of a WSI, looking at peak HR in relation to speed of walking, was used to determine if there was a significant decline in HR at increasing workloads post CR. This was used to signify if a true physiological change in fitness had occurred. There was a 27% mean increase (p=0.0005) in MDW for all participants post CR. Peak HR increased an average 7% (p=0.0005) and RPE significantly increased from 12 to 13 (p=0.0005). WSI indicated an 8% average (p=0.0005) increase in physiological fitness, based on HR, in all participants. In Men MDW increased significantly from 440metres to 555 metres (26%), peak HR increased by an average 6% (p=0.0005), RPE from12.6 to 13.6 (p=0.0005) and WSI by 7% (p=0.0005). In women mean distance achieved rose 30% from 303metres to 393metres (p=0.0005), peak HR by 6bpm (p=0.001), RPE rose from 11.8 to 12.4, which was not significant (p=0.131) and WSI showed an average increase of 9%. This study showed that 8% of a 27% increase in walking performance following a CR programme could be attributed to a true physiological (fitness) adaptation. In circumstances where a practice walk is not always carried out, the addition of HR in relation to a given walking speed should be used to assess and quantify the true physiological change related to a programme of exercise based CR