Patients who were screened by the investigators and fulfilled the eligibility criteria were invited to participate by their treating physiotherapist. All participants had

exercise data recorded by a heart rate monitor for three classes in Week 1. The exercise data were then averaged over the baseline period to determine if the participant could achieve the minimum criteria required to induce a cardiorespiratory fitness training effect. Participants received learn more no feedback regarding their intensity of exercise during these classes because the digital readout from the heart rate monitor was covered and the sound muted. To determine if feedback from heart rate monitors can increase exercise intensity (ie, Question 2), a single-centre parallel-group randomised controlled trial was conducted. Participants who failed to reach the minimum

criteria designated for a fitness training effect (at least 20 minutes at ≥ 50% heart rate reserve) (Swain and Leutholtz 2007) during Epigenetics inhibitor the baseline period progressed into the randomised controlled trial, as presented in Figure 1. In the initial trial registration (ACTRN12607000522415), the criterion was at least 30 minutes ≥ 50% to 70% heart rate reserve. This was adjusted before commencing the trial to match the American College of Sports Medicine guidelines (Swain and Leutholtz 2007) more closely. The upper limit of the heart rate training zone was not included because the focus of this trial was investigating whether people could exercise to at least the minimum criteria for a fitness training stimulus. We were not concerned if people in this low risk population

spent short periods above 85% heart rate reserve and wanted this included as part of their effective training time. A randomisation schedule was prepared from a computer-generated list of random numbers by a person until independent of the recruitment process. Sealed, sequentially numbered, opaque envelopes were prepared for the site. The investigator selected the next envelope to determine allocation to either the experimental group receiving feedback from the heart rate monitor, or to the control group who continued to receive no feedback from the heart rate monitor. The intervention period lasted two weeks (six classes) and then both groups returned to the original condition (heart rate monitor covered and sound muted) for the re-assessment period (three classes). The assessor was not blinded to group allocation as the only outcome data collected was from the heart rate monitor; this objective measure of exercise intensity has low susceptibility to bias.