Table 1

Generic and disease-specific contraindications to be considered during enrolment

GenericDisease specific
ICD: C00-97ICD: E10-14ICD: I0-99ICD: J30-98
Factors related to treatment
  • Severe tissue reaction to radiation therapy

Haematologic
  • Electrolyte abnormalities

  • Severe arterial hypertension (SBP >200 mm Hg and/or DBP >110 mm Hg) at rest

  • Platelets <50×109·L-1

  • White cell count <3 ×10 9·L-1

  • Haemoglobin <100 g·L-1

Musculoskeletal
  • Neuromuscular, musculoskeletal or rheumatoid disorders that are exacerbated by exercise

  • Physical impairment leading to inability to exercise adequately

  • Bone, back or neck pain of recent origin

  • Unusual muscular weakness

  • Severe cachexia

  • Unusual/extreme fatigue

  • Poor functional status

Systemic
  • Acute systemic infection, accompanied by fever, body aches or swollen lymph glands

  • Uncontrolled metabolic disease (eg, diabetes, thyrotoxicosis or myxoedema)

  • Chronic infectious disease (eg, mononucleosis, hepatitis and AIDS)

  • Acute infections

  • Febrile illness: fever >38°C

  • General malaise

  • Resting SBP >145 mm Hg and/or DBP >95 mm Hg

  • Uncontrolled diabetes (ie, HbA1c >7.0%)

  • Uncontrolled hypertension (ie, SBP >180 and/or DBP >110) at rest

  • Orthostatic BP drop >20 mm Hg with symptoms

  • Acute systemic illness or fever

  • Uncontrolled diabetes mellitus

  • Other metabolic conditions such as acute thyroiditis, hypokalaemia, hyperkalaemia or hypovolaemia

Gastrointestinal
  • Severe nausea

  • Vomiting or diarrhoea within 24–36 hours

  • Dehydration

  • Poor nutrition: inadequate fluid and/or intake

Cardiovascular
  • Recent (2 days) significant ischaemia, myocardial infarction, cardiac surgery or another acute cardiac event

  • Unstable angina

  • Uncontrolled cardiac dysrhythmias causing symptoms or haemodynamic compromise

  • Symptomatic severe aortic stenosis

  • Uncontrolled symptomatic heart failure

  • Acute myocarditis or pericarditis

  • Left main coronary stenosis

  • Moderate stenotic valvular heart disease

  • Tachydysrhythmia or bradydysrhythmia

  • Hypertrophic cardiomyopathy and other forms of outflow tract obstruction

  • Chest pain

  • Resting HR >100 bpm or <50 bpm

  • Irregular heart rate

  • Swelling of ankles

  • Recent (5 weeks)*significant ischaemia, myocardial infarction, cardiac surgery or another acute cardiac event

  • Critical aortic stenosis (ie, peak SBP gradient of >50 mm Hg with an aortic valve orifice area of <0.74 cm2 in an average-size adult)

  • Uncontrolled atrial or ventricular dysrhythmias

  • Uncontrolled sinus tachycardia (>120 bpm)

  • Uncompensated chronic heart failure

  • Third-degree atrioventricular block without pacemaker

  • Active pericarditis or myocarditis

  • Resting ST-segment depression or elevation (>2 mm)

Pulmonary
  • Acute pulmonary embolus or pulmonary infection

  • Severe dyspnoea

  • Cough, wheezing

  • Chest pain increased deep breath

  • Recent embolism

  • Thrombophlebitis

Neurologic
  • Suspected or known dissecting aneurysm

  • Mental impairment leading to inability to exercise adequately (ie, neglect, aphasia and severe depression)

  • Significant decline in cognitive status

  • Dizziness/light headedness

  • Disorientation

  • Blurred vision

  • Ataxia (ie, inability to coordinate voluntary movement)

  • The absolute contraindications to exercise participation and direct exclusion are highlighted in bold. All other criteria are reviewed on a case-by-case basis by the medical practitioner at the time of inclusion if applicable. BP, Blood Pressure; bpm, beat per minute; DBP, Diastolic Blood Pressure; HR, Heart Rate; ICD, International Classification of Disease; SBP, Systolic Blood Pressure

  • *While endurance training can start within 2 days of a cardiac event, the guidelines for resistance training indicate a minimum of 2–3 weeks following transcatheter procedures, and a minimum of 5 weeks after myocardial infarction or cardiac surgery.