Cardiopulmonary Rehabilitation

Question 1

Cardiac Rehabilitation

Answer 1

Endorse a progression from moderate to vigorous intensity aerobic exercise with resistance training in order to obtain improvements:
QoL, physical strength, aerobic capacity, ↓ cardiac risk, functional capacity.

Question 2

Goals of Cardiac Rehabilitation

Answer 2

↓ symptoms burden
↑ maximal exercise capacity
↑ QoL
↑ autonomy
↑ participation in ADLs
↑ health behavior changes

Question 3

Principles of Exercise Prescription (4)

Answer 3

Overload (↑velocity, weight, incline, set, ↓ rest)
Specificity (specific system overloaded will only adapt)
Reversibility (adaptation revert back)
Individuality (effects people differently)

Question 4

What should be considered when prescribing exercise?

Answer 4

Individuals goals, physical ability, fitness, health status, schedule, physical and social environment, available equipment and facilities should be considered.

Question 5

FITT-VP

Answer 5

Frequency
Intensity
Time
Type
Volume
Progression

Question 6

Frequency

Answer 6

3-5 times per week.
Maintenance: at least once per week.

Question 7

Intensity (8)

Answer 7

HRR% / VO2R% most accurate, takes into consideration fitness levels.
HRmax% / VO2max%
Perceived exertion: Borg/mBorg - moderate intensity: 12-13/3-4.
%1RM
%Wmax of cycle-ergometer
%max speed in shuttle walk test (convert to km/h x3,6, to have speed for treadmill)
%6MWDistance
%MIP (for inspiratory muscle training)

Question 8

HRR%/VO2R%

Answer 8

HRR: HRmax-HRrest. HRmax (formula) or from CPET.
Desired exercise intensity: 50-60%
0,5xHRR and 0,6xHRR =%HRRbpm
Determine training zone (THR)
%HRR+HRrest
Lower limit: (0,5xHRR) + HRrest =bpm
Upper limit: (0,6xHRR) + HRrest =bpm

Question 9

HRmax% / VO2max%

Answer 9

Use formula and calculate training zone with desired exercise intensity.
VO2max: use CPET or estimate with 6MWT formula.

Question 10

Type - Aerobic

Answer 10

Treadmill, bike, swimming.
O2 used to produce ATP, type 1 fibers.

Question 11

Type - Interval Training

Answer 11

More engagement from patient. Can handle more intensity and feel less dyspnea.

Question 12

Type - Anaerobic/Resistance

Answer 12

Intense physical activity of short duration, glucose for energy, type 2 fibers.
1-3 sets, 30-80%1RM, 6-25 reps, 2-4 times per week.

Question 13

Time

Answer 13

Warm up: 5-10min
Conditioning: at least 20-60min
Cool down: 5-10min

Question 14

Volume

Answer 14

Total volume or amount of exercise weekly. 150min per week of moderate intensity.

Question 15

Progression

Answer 15

Advancement of program, increased weekly.
Only increasing load.
Increasing duration and load in alternate weeks.

Question 16

Safety in Rehabilitation

Answer 16

Monitoring: Bp, HR, SpO2, Peak expiratory flow, symptoms, medication use.
Stop if: unwell, fever and acute systemic illness, resting SBP >200mmHg and/or >110 DBP. Failure to increase BP during exercise, unexplained drop in BP.
Dizziness, angina, nausea, headache.