Educational Articles -
References

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Talk Test - How to use the Talk Test to estimate exercise intensity?

  • Garber CE et al (2011) Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc. 43(7):1334-1359. doi: 10.1249/MSS.0b013e318213fefb.
  • Borg GAV (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 14(5):377-381.
  • Reed JL and Pipe AL (2014) The talk test: a useful tool for prescribing and monitoring exercise intensity. Curr Opin Cardiol. 29(5):475-480. doi: 10.1097/HCO.0000000000000097
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Last Reviewed:

January 4, 2023

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Sternal precautions - Things to know after median sternotomy

  • Cahalin L, Lapier TK, Shaw DK. Sternal precautions: Is it time for change? Precautions versus restrictions – a review of literature and recommendations for revision. Cardiopulm Phys Ther J. 2011;22:5–15.
  • El-Ansary D, LaPier TK, Adams J, et al. An evidence-based perspective on movement and activity following median sternotomy. Phys Ther. 2019;99:1587–1601.
  • Adams J, Pullum G, Stafford P, Hanners N, Hartman J, Strauss D, Hubbard M, Lawrence A, Anderson V, McCullough T. Challenging traditional activity limits after coronary artery bypass graft surgery: a simulated lawn-mowing activity. J Cardiopulm Rehabil Prev 2008;28(2):118–121.
  • Parker R, Adams JL, Ogola G, McBrayer D, Hubbard JM, McCullough TL, Hartman JM, Cleveland T. Current activity guidelines for CABG patients are too restrictive: comparison of the forces exerted on the median sternotomy during a cough vs. lifting activities combined with Valsalva maneuver. Thorac Cardiovasc Surg 2008;56(4):190–194.
  • Adams J, Schmid J, Parker RD, Coast JR, Cheng D, Killian AD, McCray S, Strauss D, McLeroy Dejong S, Berbarie R. Comparison of force exerted on the sternum during a sneeze versus during low-, moderate-, and high-intensity bench press resistance exercise with and without the Valsalva maneuver in healthy volunteers. Am J Cardiol 2014;113(6):1045–1048.
  • Brocki BC, Thorup CB, Andreasen JJ. Precautions related to midline sternotomy in cardiac surgery: a review of mechanical stress factors leading to sternal complications. Eur J Cardiovasc Nurs. 2010;9:77–84.
  • Adams J, Lotshaw A, Exum E et al. An alternative approach to prescribing sternal precaution after median sternotomy, “Keep Your Move in the Tube.” Proc (Bayl Univ Med Cent). 2016;29(1):97-100.
  • WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
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Last Reviewed:

March 31, 2023

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Implantable cardiac devices

  • Ahn J, et al. Role of early short-term cardiac rehabilitation in patients undergoing pacemaker implantation. Rev Cardiovasc Med. 2021 Dec 22;22(4):1603-1610. doi: 10.31083/j.rcm2204166.
  • St Vincent’s Hospital Sydney (2014) How to care for yourself after getting a pacemaker or defibrillator. https://www.svhhearthealth.com.au/procedures/procedures-treatments/pacemaker
  • Glikson M, et al; ESC Scientific Document Group. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021 Sep 14;42(35):3427-3520. doi: 10.1093/eurheartj/ehab364.
  • Heidbuchel H, et al; EAPC/EHRA update of the Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions.  Part 2: ventricular arrhythmias, channelopathies, and implantable defibrillators. Europace. 2021 Jan 27;23(1):147-148. doi: 10.1093/europace/euaa106.
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Last Reviewed:

February 3, 2023

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Reducing the risk of knee OA after knee injury - What you need to know

References:

  • Whittaker JL, et al. OPTIKNEE 2022: consensus recommendations to optimise knee health after traumatic knee injury to prevent osteoarthritis. Br J Sports Med. 2022 Dec;56(24):1393-1405. doi: 10.1136/bjsports-2022-106299. Epub 2022 Nov 15.
  • World Health Organization. WHO guidelines on physical activity and sedentary behaviour. World Health Organization, 2020. https://apps.who.int/iris/handle/10665/336656
  • Culvenor AG, et al. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. Br J Sports Med. 2019 Oct;53(20):1268-1278. doi: 10.1136/bjsports-2018-099257. Epub 2018 Jun 9.
  • Roos, E., Arden, N. Strategies for the prevention of knee osteoarthritis. Nat Rev Rheumatol  12, 92–101 (2016). doi: 10.1038/nrrheum.2015.135
  • Whittaker JL, et al. Risk factors for knee osteoarthritis after traumatic knee injury: a systematic review and meta-analysis of randomised controlled trials and cohort studies for the OPTIKNEE Consensus. Br J Sports Med. 2022 Dec;56(24):1406-1421. doi: 10.1136/bjsports-2022-105496. Epub 2022 Sep 2.
  • Bricca A, et al. Infographic. Therapeutic exercise relieves pain and does not harm knee cartilage nor trigger inflammation. Br J Sports Med. 2020 Jan;54(2):118-119. doi: 10.1136/bjsports-2019-100727. Epub 2019 Jun 21. PMID: 31227490.
  • Lo GH, et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol. 2018 Sep;37(9):2497-2504. doi: 10.1007/s10067-018-4121-3. Epub 2018 May 4.
  • Arundale AJH, et al. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention. J Orthop Sports Phys Ther. 2018 Sep;48(9):A1-A42. doi: 10.2519/jospt.2018.0303.
  • Knee and hip osteoarthritis. Current Care Guidelines. Working group set up by the Finnish Medical Society Duodecim and the Finnish Orthopaedic Association. Helsinki: The Finnish Medical Society Duodecim, 2018. Available online at: www.kaypahoito.fi [in Finnish]
  • National Institute for Health and Care Excellence (NICE). Osteoarthritis in over 16s: diagnosis and management [NICE Guideline No.115], 2022. Available at: https://www.nice.org.uk/guidance/ng226
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Last Reviewed:

July 28, 2023

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence: