Chapters 16 & 17 Flashcards
What is COPD characterized by?
Disease “characterized by chronic airway inflammation and
progressive airflow limitation”
What are four risk factors of COPD?
Smoking (#1)
Exposure to air pollution at home or work
Family hx
Respiratory infection
What is COPD often seen with?
Often seen with CVD, osteoporosis, sleep disorders, cognitive
decline, metabolic syndrome, anxiety/depression, lung cancer, and
skeletal muscle dysfunction
Who is COPD common in?
Typically seen in individuals >40
What are some symptoms and criteria for COPD?
Dyspnea, chronic cough or sputum production, history of exposure
Post-bronchodilator FEV1.0/FVC of <0.7
What can symptoms of COPD lead to?
-Symptoms can limit exercise
-Leads to deconditioning
-Disease process worsens
What is recommend in prescreening for COPD patients?
Recent medical exam by physician and 12-lead ECG are highly
recommended
If risk for heart disease, also obtain echocardiogram
What should you make sure of prior to beginning and exercise program for patients with COPD?
Ensure that the patient has and is using their medication properly prior to beginning exercise program
What to consider/do when COPD patient is exercising?
Also consider use of pulse oximeter to monitor hypoxemia during
exercise
Supplemental oxygen can improve exercise training by addressing
hypoxemia
What is CPET?
cardiopulmonary exercise testing
When doing cardiopulmonary exercise testing (CPET) for COPD patients: ????
Consider modified protocols depending on functional limitations
Monitor with pulse ox and 12-lead ECG
When to stop a test for a COPD patient?
Stop test if SpO2 drops below 80%
What should be monitored continuously in COPD patients?
SpO2 and HR are monitored continuously
____ tests (6MWT or shuttle walk) may also be appropriate
Submaximal
What to recorded for 6MWT?
6-minute walk test
Distance walked
# of rests and total stoppage time
Lowest SpO2
Ending HR
Aerobic exercise is key for pulmonary rehab:
Frequency?
Intensity?
Goal time?
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
Resistance training COPD:
Frequency?
Set and reps?
Additional training idea?
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
____-____ 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
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
What is asthma determined by?
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
What can asthma be triggered by?
Typically triggered by exercise, exposure, weather, or respiratory
infections
What can asthma lead to?
Can lead to decreased levels of exercise and PA
____ ____ plays a crucial role in treatment and
management
Such as?
Medication therapy plays a crucial role in treatment and
management
Short-acting and long-acting bronchodilators
What can help reduce exacerbations?
Regular exercise helps reduce exacerbations
What should patients with asthma be monitored for?
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
What test is recommended for those with moderate to severe asthma?
Recommend using 6MWT for those with moderate-to-severe asthma
____-____ asthma should not limit exercise participation
Well-controlled asthma should not limit exercise participation
For people with asthma what should they try to avoid?
Try to avoid irritants/pollutants when exercising
What to administer 15 min before exercise in patients with asthma?
Administer SABA 15 minutes before exercise and warm up gradually
What may be needed following and asthma flare up?
Several days of recovery may be needed following airway exacerbations
What did the journal article on asthma highlight?
- 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
