Cardiovascular and Pulmonary: Exercise Prescription for Patients Requiring Special Considerations

Question 1

Heart Failure: Criteria for Exercise

Answer 1

• Compensated or Chronic HF

- No signs of acute Heart Failure

Question 2

Heart Failure: Criteria for Exercise: Poor Prognostic Factors

Answer 2

• Exercise induced ischemia and arrhythmias

Question 3

Heart Failure: Signs of Decompensation

Answer 3

• Increased SOB
• Sudden weight gain
• Increased LE edema
• Abdominal Swelling
• Increased pain or fatigue
• Pronounced cough
• Lightheadedness or dizziness

Question 4

Heart Failure: Vital response

Answer 4

• HR response may be impaired
• At risk for persistent post exercise vasodilation with later stages of Heart Failure
• Caution with exercising prone or supine due to orthopnea
• Avoid Valsalva

Question 5

Cardiac Transplant: Patient presentation

Answer 5

• Exercise intolerance due to prolonged deconditioning
• Side effects from immunosuppressive drug therapy
• Decreased lower extremity strength
• Increased risk of fracture due to long term corticosteroid use

Question 6

Cardiac Transplant: Monitoring

Answer 6

• HR alone is not appropriate

- A combination of measures should be used )HR, RPE etc)

Question 7

Cardiac Transplant: Warm up and Cool Down

Answer 7

• Periods should be longer due to prolonged physiologic responses to exercise

Question 8

Pacemakers: Guidelines

Answer 8

• Avoid UE exercises for 4-6 weeks after implantation to allow the leads to scar down

Question 9

Automatic Implantable Cardioverter Defibrillators

Answer 9

• Will deliver and electric shock if HR exceeds a set limit and/or ventricular arrhythmia is detected
• Should know settings for HR limits on AICD
• With exercise make sure HR stays at least 10 beats below the AICD shock and antitachycardia threshold