There isn't a simple biochemical solution to this question. Several markers
show changes with exercise but will vary with the nature, duration and
intensity of exercise, fitness level and even gender. CK is a classical
example. Levels will rise after exercise but you cannot take any single
level as a marker of complance with the assigned exercise.
Lactate levels have been proposed as a measure of improved fitness and the
lactate response to graded exercise can be shown to be less after a period
of training (see Br J Sports Med 1987; 21(3): 119-124). This, however, is a
measure of efficacy rather than compliance.
The only way to ensure compliance is supervision. In a study in this
hospital patients undertook a circuit of aerobic exercises under the
supervision of a cardiac rehabilitation physiotherapist. This both ensured
compliance and appropriatness of the exercise for the individual.
Joe Begley
Poole Hospital
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