Competency: Resistance Training in Outpatient Cardiac Rehab Programs

Competency: Calculation of MET-minutes to evaluate total exercise volume compared to the evidence-based recommendation of 500 – 1000 MET-minutes per week.

Name ______Date ______Dept. CARDIAC REHAB

Expectation: The cardiac rehab staff member will use MET-minutes to determine if the amount of exercise a patient performs in a week meets the evidence-based recommendation for 500-1000 MET-minutes per week.

Essential Elements of Performance: Proficient Needs Review/ Inadequate Improvement ** 1. Define a MET as a metabolic equivalent indicating the body’s need for oxygen to fuel various activities; to patients this concept is often referred to as an “energy need” 2. Discuss the underlying physiology that 1 MET, the baseline need while sitting in a chair awake, alert, & upright, requires the body to take in, transport, & use 3.5 ml of oxygen per kilogram of weight per minute, i.e. 1 MET = 3.5 ml/Kg/min.; therefore, 2 METS = 7.0 ml/Kg/min., 10 METS = 35 ml/KG/min., etc. 3. Connect exercise intensity verbiage to appropriate MET values: light exercise = < 3 METS, moderate exercise = 3 – 5.9 METS, vigorous exercise = > 6 METS 4. State that for optimal benefits of exercise patients need to achieve at least moderate levels of exercise, 3 METS or more. 5. Using a selected patient’s case as an example, determine the average METs performed on exercise devices used in rehab gym during the most recent week of rehab participation; some exercise devices have gauges that show METS performed, others require formulas or reference tables to convert workloads to METS, a few cannot be converted. 6. On the same patient, locate a recent note of what/how much physical activity or exercise the patient was performing outside of rehab; to be counted that activity/exercise must be: purposeful = recognized & done as activity/ exercise, not just a normal daily activity at least 10 minutes in duration = short bouts of activity are insufficient; 2 intervals of 5 minutes each are acceptable

7. Identify references/resource lists of how many METS are required to perform various activities 8. Locate the patient’s reported activity/exercise on the MET list & find the matching MET value 9. At rehab entry, multiply the number of minutes that activity/exercise was performed in a week by the MET value in the table to get MET-minutes performed last week. 10. At rehab exit, repeat steps 8 & 9 PLUS add the average MET-mins/wk for exercise done in the rehab center to get total MET-mins/wk which determines the patient’s total exercise volume 11. Compare total MET-mins/wk to the evidence- based recommendation of 500-1000 MET- mins/wk to determine if the patient has achieved that exercise goal 12. Record the total MET-mins/wk on the patient’s Outcome Data sheet to report to both patient & physician at program discharge

Resources & References: Ainsworth, Haskell, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Medicine & Science in Sports & Exercise; August 2011.

Cross-reference: Core Competencies for Cardiac Rehabilitation/Secondary Prevention Professionals: 2010 Update – pg 8 Physical activity counseling, Knowledge 1-2-7, Skills 1-3-4-6.

Evaluation: Signature ______Date ______

** any/all ratings of Inadequate require a corrective action plan tailored to the staff member involved