Chapters 16 & 17

Question 1

What is COPD characterized by?

Answer 1

Disease “characterized by chronic airway inflammation and
progressive airflow limitation”

Question 2

What are four risk factors of COPD?

Answer 2

 Smoking (#1)
 Exposure to air pollution at home or work
 Family hx
 Respiratory infection

Question 3

What is COPD often seen with?

Answer 3

Often seen with CVD, osteoporosis, sleep disorders, cognitive
decline, metabolic syndrome, anxiety/depression, lung cancer, and
skeletal muscle dysfunction

Question 4

Who is COPD common in?

Answer 4

Typically seen in individuals >40

Question 5

What are some symptoms and criteria for COPD?

Answer 5

Dyspnea, chronic cough or sputum production, history of exposure

 Post-bronchodilator FEV1.0/FVC of <0.7

Question 6

What can symptoms of COPD lead to?

Answer 6

-Symptoms can limit exercise
-Leads to deconditioning
-Disease process worsens

Question 7

What is recommend in prescreening for COPD patients?

Answer 7

Recent medical exam by physician and 12-lead ECG are highly
recommended

 If risk for heart disease, also obtain echocardiogram

Question 8

What should you make sure of prior to beginning and exercise program for patients with COPD?

Answer 8

Ensure that the patient has and is using their medication properly prior to beginning exercise program

Question 9

What to consider/do when COPD patient is exercising?

Answer 9

Also consider use of pulse oximeter to monitor hypoxemia during
exercise

Supplemental oxygen can improve exercise training by addressing
hypoxemia

Question 10

What is CPET?

Answer 10

cardiopulmonary exercise testing

Question 11

When doing cardiopulmonary exercise testing (CPET) for COPD patients: ????

Answer 11

Consider modified protocols depending on functional limitations

Monitor with pulse ox and 12-lead ECG

Question 12

When to stop a test for a COPD patient?

Answer 12

Stop test if SpO2 drops below 80%

Question 13

What should be monitored continuously in COPD patients?

Answer 13

SpO2 and HR are monitored continuously

Question 14

____ tests (6MWT or shuttle walk) may also be appropriate

Answer 14

Submaximal

Question 15

What to recorded for 6MWT?

Answer 15

6-minute walk test

 Distance walked
 # of rests and total stoppage time
 Lowest SpO2
 Ending HR

Question 16

Aerobic exercise is key for pulmonary rehab:
Frequency?
Intensity?
Goal time?

Answer 16

Aerobic exercise is key for pulmonary rehab COPD:
 3-5 days per week
 Moderate-to-vigorous intensity (12-14 RPE)
 Goal is 20-60 minutes per day; may need to start by accumulating at
least 20 minutes of intermittent lower intensity bouts

Question 17

Resistance training COPD:
Frequency?
Set and reps?
Additional training idea?

Answer 17

Resistance training
 At least 2 days (non-consecutive) per week
 Strength: 2-4 sets of 8-12; Endurance: at most 2 sets, 15-20 reps
 May consider inspiratory muscle training

Question 18

 ____-____ and ____-____ are vital
 Low-to-moderate intensity ____ and local muscle ____
 ____ exercise at least twice a week seems to improve
outcomes
 Aim to maintain SpO2 of at least _____% w/ or w/o oxygen
 ____-____ adherence is a key for improved outcomes
 ____ extremity exercise may be poorly tolerated

Answer 18

 Warm-up and cool-down are vital
 Low-to-moderate intensity cardio and local muscle endurance
 Supervised exercise at least twice a week seems to improve
outcomes
 Aim to maintain SpO2 of at least 88% w/ or w/o oxygen
 Long-term adherence is a key for improved outcomes
 Upper extremity exercise may be poorly tolerated

Question 19

What is asthma determined by?

Answer 19

Hx of wheezing, dyspnea, chest tightness, and cough that varies over time and in intensity.

Variations seen in FEV limitations

Symptoms typically resolve spontaneously or w/ treatment

Question 20

What can asthma be triggered by?

Answer 20

Typically triggered by exercise, exposure, weather, or respiratory
infections

Question 21

What can asthma lead to?

Answer 21

Can lead to decreased levels of exercise and PA

Question 22

____ ____ plays a crucial role in treatment and
management
Such as?

Answer 22

Medication therapy plays a crucial role in treatment and
management
 Short-acting and long-acting bronchodilators

Question 23

What can help reduce exacerbations?

Answer 23

Regular exercise helps reduce exacerbations

Question 24

What should patients with asthma be monitored for?

Answer 24

Need to monitor for exercise-induced bronchospasm (EIB) that can
occur during or after exercise
 SABA (short-acting beta-agonists) is best way to treat EIB

Question 25

What test is recommended for those with moderate to severe asthma?

Answer 25

Recommend using 6MWT for those with moderate-to-severe asthma

Question 26

____-____ asthma should not limit exercise participation

Answer 26

Well-controlled asthma should not limit exercise participation

Question 27

For people with asthma what should they try to avoid?

Answer 27

Try to avoid irritants/pollutants when exercising

Question 28

What to administer 15 min before exercise in patients with asthma?

Answer 28

Administer SABA 15 minutes before exercise and warm up gradually

Question 29

What may be needed following and asthma flare up?

Answer 29

Several days of recovery may be needed following airway exacerbations

Question 30

What did the journal article on asthma highlight?

Answer 30

• Intervention group was 6 mo. 3x/wk 30 min. of HIIT program (17 asthmatics)
• Intervention improved over control in V ̇ O2
  time constant (τp)
• No difference in degree of improvement between those w/ and w/o asthma