Dr Terence Kavanagh was a clinician, researcher, teacher, and advocate in the field of cardiac rehabilitation. He was also a pioneer who recognized the need for the rehabilitation of patients with heart disease and started his program in 1968. Dr Kavanagh was the Medical Director of the Cardiac Rehabilitation and Secondary Prevention Programme at the Toronto Rehabilitation Centre (TRC) from the inception of the outpatient program in September 1968 until his retirement in 2000. In its first year, the program treated about 50 patients but, through Dr Kavanagh's leadership, innovation and vision, it grew to receive about 1600 referrals annually from more than 400 physicians, becoming the largest such program in North America. During his tenure, the program assisted approximately 25 000 patients. Many of whom were instrumental in establishing a foundation that went on to support the expansion of patient care facilities and research initiatives.
Dr Kavanagh was born in Manchester, England, spent his formative years in Dublin, Eire, and received his medical undergraduate and postgraduate training at the University of Manchester, University of London, and, after emigrating to Canada in 1956, at the University of Toronto. In 1967, Dr Kavanagh was appointed the Medical Director of the Toronto Rehabilitation Centre and started the cardiac rehabilitation program the following year.
He was a visionary and innovator in cardiac rehabilitation with many ideas that were revolutionary at the time. Some examples of his clinical innovation included: using a combination of 1 weekly supervised exercise session and 4 home exercises during a 12-month program; patient education at every supervised exercise session; unique exercise prescription methodology using walking pace and distance; minimal routine use of ECG monitoring during exercise training; and the importance of depression in patient recovery.
In the 1970s, running was contraindicated for cardiac patients, but Dr Kavanagh thought otherwise. He gained international attention in 1973 when he trained a group of post-myocardial infarction patients to be the first patients to finish the Boston Marathon. In 1985, he trained and ran with the first heart transplant patients to complete the Boston Marathon.
In addition to his significant clinical accomplishments, Dr Kavanagh was a prolific researcher having published more than 100 articles in peer-reviewed journals that contributed significantly to the scientific body of knowledge. His research focused on a broad range of topics over the years including: documenting the benefits of exercise training; effects and management of psychological issues; exercise testing and training in heart transplant and chronic heart failure; effectiveness of cardiac rehabilitation in women and the elderly; and long-term effects of exercise training in cardiac rehabilitation on morbidity and mortality. He also authored 3 books on heart disease and cardiac rehabilitation.
Throughout his career, Dr Kavanagh was active in the education of students, clinicians, and physicians. Healthcare professionals and students from Canada and around the world benefitted from practicums in cardiac rehabilitation at the TRC over many years. He was also a national and international ambassador for exercise and cardiac rehabilitation as an invited speaker at scientific meetings. Dr Kavanagh was instrumental in forming the Canadian Association of Cardiac Rehabilitation and served as vice-president of the association and a member of the board of directors.
His accomplishments over a 32-year career were recognized with numerous prestigious awards including the Eugene Drake Memorial Award from the American Heart Association, Award of Merit from the City of Toronto for his pioneering efforts to promote physical activity in the primary and secondary prevention of cardiovascular disease, AACVPR Award of Excellence, Canadian Cardiovascular Society's Dr. Harold N. Segall Award of Merit, American College of Sports Medicine Citation Award, Career Award at the Third Quebec International Symposium on Cardiopulmonary Rehabilitation, "Living Legend" Award from the World Society of Cardiothoracic Surgeons; and an award on the 150th anniversary of Bayer, Inc, honoring him as an outstanding Canadian for his contributions to cardiovascular health and science. In 2003, he received a Doctor of Science, honoris causa, degree from the University of Toronto. He was further honored with the establishment of the Dr. Terry Kavanagh Heart Health Laboratory at the University of Toronto.
Dr Kavanagh held appointments as Professor in both the Faculty of Kinesiology and Physical Education and the Graduate Program in Exercise Sciences; Associate Professor in the School of Medicine at the University of Toronto; Honorary Rehabilitation Consultant at the Cardiac Transplant Unit at Harefield Hospital in London; and, following his retirement, Honorary Consultant to the Cardiac Rehabilitation and Secondary Prevention Program at the Toronto Rehabilitation Institute.
This pioneering giant in cardiac rehabilitation will be missed by many of his former patients, current and former TRC program staff, and many professionals in the field he helped mentor and who benefitted from his groundbreaking clinical advancements and research.
Larry F. Hamm, PhD, MAACVPR, FACSM
Editor-in-Chief
Journal of Cardiopulmonary Rehabilitation and Prevention