CARDIOPULMONARY REHAB Flashcards
Cardiopulmonary rehab program: ≠ components & steps of program
Patient assessment:
- Initial center-based assessment by health care professional
- Exercise test at time of assessment
- Field exercise test
- Quality of life measure
- Dyspnea assessment
- Nutritional status evaluation
- Occupational status evaluation
Program components:
8. Endurance training
9. Resistance training
Method of delivery
10. Exercise program individually prescribed
11. Exercise program that is individually progressed
12. Team includes health care professional with experience in exercise prescription & progression
Quality assurance
13. Health care professionals trained to deliver components of model that is deployed
1st step of CPR
Check need of CPR
Exercise intolerance
→ identification of criteria describing reason
- Lung function tests, dyspnea assessment, oxygenation
- HR max, HR reserve, VO2max/VO2peak, blood pressure - MRC scale & dynamometry
Which assessment for ≠ values of FEV1
Algorithm
Pulmonary rehab: def, types of patient
= Comprehensive intervention based on thorough patient assessment followed by patient-tailored therapies, exercise training, education & behavior change
- Designed to improve physical & psychological condition of people with chronic respiratory disease
- Promote long-term adherence of health enhancing behaviors
Focus on patients with ventilatory limitation. COPD subjects = largest proportion of patients referred for PR
Also effective in subjects with:
- Asthma
- Bronchiectasis
- Interstitial lung disease
- Lung cancer (cystic fibrosis) - Before/after lung surgery
Goals of PR x CR
↓ Symptom burden
↑ Maximal exercise capacity
↑ Quality of life
↑ Autonomy
↑ Participation daily life activities
↑ Health behavior change
Clinical features similar in cardiac & pulmonary disease regarding exercise limitation
Cardiac rehab: def, phases, progression, improvements, recommendations from UK, France & Japan
= Sum of activities required to influence favorably underlying cause of disease
- Provide best possible physical, mental & social conditions, so that patients may, by their own efforts, preserve or resume when lost as normal place as possible in community
1) Inpatient period
2) Early post discharge period
3) Intermediate post discharge period involving multidisciplinary rehabilitation in groups or home-based individualized program
4) Long-term maintenance program
Endorse progression from moderate- to vigorous- intensity aerobic exercise in conjunction with resistance training in order to obtain improvements
- Quality of life
- Physical strength
- Aerobic capacity
- Decrease cardiac risk - Functional capacity
UK, France & Japan recommend lower-intensity aerobic exercise, with reduced focus on resistance training
Inpatient period
- Physical ability compromised after surgery/bed rest
- Bed rest induces changes in skeletal muscle atrophy & inflammatory markers
- Muscle activity serves as anti-inflammatory action
- In addition, bed rest also results in decrease of VO2max as function of aerobic capacity, associated with decreased stroke volume & cardiac output
- Taken together, early mobilization, which counters effects of bed rest, prevent decrease in aerobic capacity & patients undergoing early mobilization might walk longer distance during 6MWT as result of prevention of dysfunction due to bed rest
1-2/3-4 METs
Vital signs are stable = physical exercise
Risk factors: low/moderate/high for
- left ventricular systolic fct
- complex ventricular arrhythmia
- exercise induced cardiac ischemia
- exercise capacity
- hemodynamic response to exercise
- clinical data
Tableau
General description of training: type of activity, training frequency, duration & intensity
Tableau
≠ training + types, intensity, frequency & duration of each
Tableau
Physical activity: def, values of 1 MET & ≠ types of PA for light , moderate & high intensity
= Any bodily movement produced by skeletal muscles resulting in energy expenditure beyond resting energy expenditure
METs = Metabolic Equivalent of Tasks
1 MET = 3,5 mL O2/min/kg body weight
Tableau
Number of steps per day for adult > 60y & <60y
- Adults ≥60 y with increasing number of steps/day until 6000–8000 steps/day
- Adults < 60 y until 8000–10000 steps/day
Physical exercise: def & characteristics of FITT-VP
= Subset of physical activity planned, structured & repetitive & has final or intermediate objective improvement or maintenance of physical fitness
FITT-VP
- How often
- How hard
- What type
- Amount
- How long
- Advancement
Def & characteristics of physical exercise & physical activity
Physical exercise
- Strengthening activities work all major muscle groups (legs, hips, back, abdomen, chest, shoulders & arms) on at least 2 days a week
- At least 150 min of moderate intensity activity week or 75 min of vigorous intensity activity week
- Spread exercise evenly over 3 to 5 days week, or every day
Physical activity
Reduce time spent sitting or lying down & break up long periods of not moving with some activity
Which activity increase risk of CVD
Sedentary
