ACSM Exercise Prescription

Question 1

Spinal Cord Injury

Answer 1

• Empty their bowels/bladder or urinary bag before exercising
• Complete SCI’s above T6 may exhibit low cardiovascular performance.
• Reach their peak HR, CO, O2 consumption at lower exercise levels.
• Autonomic Dysreflexia
• Sit the patient upright*
• Check the catheter for kinks/tight clothing*

Question 2

Sternotomy

Answer 2

• ~5 to 6 weeks most patients have returned to pain-free, unloaded upper-level range of motion
• Restriction of upper body resistance is usually enforced as for 8 to 12 weeks post surgery
• Exercise prescription specifically related to heart procedure performed (cardiac rehab)

Question 3

Cardiac Transplantation

Answer 3

• Why not use HR and BP as objective measures?
• Elevated at rest
• Peak level is blunted
• Longer warm up and cool downs (5-10 mins)
• Frequency is 3-5 days/week (Aerobic) 1-2 days/week (Resistance)
• Intensity is 11 to 14 on the RPE scale
• Time is to start at 15 minutes of progress the 60 minutes

Question 4

PERIPHERAL ARTERIAL DISEASE

Answer 4

• Non-weightbearing activities are not primary
• Frequency
• 3-5 days/week (Aerobic)
• 2 days/week (Resistance)
• Intensity
• Moderate from 40 to 60% HRR or VO2R
• Up to the point of moderate pain
• 3/4 on the claudication pain scale
• General recommendation
• 15 minutes per day progressing 5 minutes biweekly

Question 5

Pregnancy

Answer 5

• Supine position should be avoided or modified after 4 months (2nd trimester)
• Things to avoid during exercise
• Valsalva Maneuver
• Prolonged isometric contraction
• Motionless standing
• Hot humid environments
• Reduced thermoregulation
• Vigorous exercise
• RPE is more reliable outcome measure (11-14) is recommended beyond 1st trimester

Question 6

HIV/AIDS

Answer 6

• Exercise should be postponed in patients that are undergoing an acute infection
• Frequency
• 3-5 days per week (Aerobic)
• 2-3 days/week (Resistance)
• Intensity
• start light at 30-39% and progress to 40 to 60%
• Vigorous level excessive should be avoided and does not have significant benefits over moderate intensity in this population

Question 7

Hemodialysis

Answer 7

• Exercise should be ideally performed on non-dialysis days
• During Dialysis
• First half only to reduce risk of a hypotensive response
• Not After Dialysis**
• May increase risk for Post hypotensive exercise response
• Measuring exercise intensity
• RPE level (9-13)