Streptococcus bovis - Gundersen Lutheran Health System

the hiStory of CArdiAC rehAbiLitAtion At the uniVerSity of WiSConSin–LA CroSSSe
would visit a number of existing cardiac rehabilitation programs
around the country. The pair traveled to and observed programs
at San Diego State College, the University of San Francisco, the
University of Wisconsin–Madison, and the Cleveland Jewish
Community Center. Shortly after the visits, the task force
drafted a policies and procedures document for the LEHP. In the
spring of 1971, an LEHP executive board was created and held
its first meeting. The board consisted of Drs Robert Batchelder,
Donovan Riley, and Philip Wilson (UW–L); Drs Allen Brailey,
Robert Green, Robert McMahon, and Edward Winga (Gundersen
Clinic); Dr Charles Link (Skemp Clinic); and Cal Jahn (consumer
representative). The executive board was responsible for developing
and monitoring the policies and procedures of the LEHP.
Even though the LEHP was incorporated as an operational body
of UW–L, the creation of the program truly was a collaborative
effort between the University, the Wisconsin Heart Association,
the La Crosse County Medical Society, and La Crosse Lutheran
and St. Francis hospitals. The initial cost of LEHP was shared
across institutions, and it was agreed that the program would be
offered for a 1-year pilot period and then evaluated for possible
continuance.
On June 6, 1971, the first exercise session of the newly created
LEHP was offered. Six cardiac rehabilitation patients completed
an exercise class under the supervision of exercise physiologists and
physicians. Program personnel made a strong effort to promote
and market the LEHP, and after the first year the enrollment had
grown from 6 to 31 participants. Area physicians appeared to be
supportive of the program as well, with 14 physicians volunteering
to help supervise LEHP activities.
Over the next few years the program continued to grow in
enrollment, and new policies and procedures were developed.
Program personnel sought grants from the Grandview Foundation,
the National Institutes of Health, the Wisconsin Heart Association,
and the United Fund to help offset program costs, and a new cardiac
rehabilitation internship program was created. It was decided
that all cardiac rehabilitation participants would receive a graded
exercise stress test prior to admittance into the program, and again
after 3 and 6 months of participation. It was also decided that
LEHP participants would be divided into cardiac-prone (1 or more
cardiovascular risk factors) and advanced cardiac (known disease)
groups and would exercise on different days of the week.
In 1974, the American College of Cardiology selected UW-L
(with support from Gundersen Clinic) as a training center for
physicians interested in cardiac rehabilitation and exercise testing.
It was also about this time that the LEHP sponsored a cardiac
exercise technician workshop. Since the early 1970s, the LEHP has
sponsored and conducted hundreds of educational programs on
topics including cardiac rehabilitation, electrocardiogram (ECG)
interpretation, weight management, industrial fitness, pulmonary
rehabilitation, and exercise testing. One of the more successful
workshops, a sports sciences symposium, was offered in 1984 and
brought more than 600 medical personnel from the United States
and around the world to La Crosse. It is estimated that over the
past 35 years, over 10 000 participants, from all 50 states and 43
countries, have attended LEHP workshops and symposia.
In the fall of 1975 the LEHP began publishing Cardio-Gram,
a bi-monthly newspaper that contained articles of interest to both
LEHP participants and medical personnel working in the field of
cardiac rehabilitation. Over the next few years the paper became
more popular and grew to a circulation of over 3500 subscribers.
In the early 1980s, LEHP staff secured a sponsorship for Cardio-
Gram through Pfizer Laboratories (New York), which resulted in the
paper being circulated to roughly 25 000 healthcare professionals.
The paper was eventually replaced by a program newsletter. The
Sun Rise Express, The Beat Goes On, and The Pacesetter are all titles
the newsletter has had over the past 25 years. The program still
publishes a popular monthly newsletter, The La Crosse Exercise and
Health Program Newsletter.
The mid 1970s was also a time when LEHP staff began
offering educational programming to participants. Topics
included nutrition, benefits of exercise, behavior modification,
and risk factors for cardiovascular disease. Offering educational
opportunities to both participants and community members
has been a hallmark of the program for the past 30 years. Some
current examples include 10-minute tidbits—short educational
programs presented to participants every 2 weeks—and the LEHP
Health Lecture Series, a new series of talks that will be offered
every February to help recognize the American Heart Association’s
Heart Health Month.
Throughout the early and mid 1970s, the LEHP offered exercise
programming for individuals in need of cardiac rehabilitation.
However, in January of 1977, the program expanded services to
nonclinical populations and created an adult fitness unit. The
adult fitness unit was to serve apparently healthy individuals with
the goal of helping participants prevent disease and maintain or
increase fitness levels. Also in 1977, the Board of Regents of the
University of Wisconsin System approved a master’s degree in
Adult Fitness and Cardiac Rehabilitation at UW–L. This was an
exciting time for the university because this was the first program
of its kind in the country, and because until this program was
approved, the only UW system school that offered medically
related degree programs was UW–Madison. A number of other
colleges and universities adopted the university-based cardiac
rehabilitation model created at UW–L. In 2004, the Adult Fitness
and Cardiac Rehabilitation Program was renamed and is now
the Clinical Exercise Physiology program. In the past 30 years,
roughly 500 students have graduated from this program and are
employed in cardiac and pulmonary rehabilitation programs in
nearly every state in the country, as well as a number of countries
around the world.
Over the years, LEHP staff has employed a variety of incentivebased
initiatives to help motivate participants. One of the first,
implemented in 1977, was a program in which participants who
attended 3 exercise sessions a week for 6 months were rewarded
with a t-shirt. The LEHP still uses a variety of incentive programs
to help motivate participants to achieve their health- and fitnessrelated
goals. Longtime LEHP member Don Kirby recently posed
for a photograph wearing a 1000 Mile Club shirt he received in the
late 1970s (Figure 2).
In the early to mid 1980s, the LEHP continued to expand the
services offered to the community. A collaborative diabetic services
program was created and implemented with cooperation from
the Gundersen and Skemp-Grandview clinics. The program also
began offering services related to pulmonary rehabilitation and
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