Exam 1 (cont) Flashcards
10 year EX training in CHF:
- 123 pts
- Trained group: supervised EX training @ 60% VO2 peak , 2x/week, x10 years
- Nontrained group: “did not Ex formally
- Changes in peak VO2 (T vs NT)
- Conclusion, “Moderate supervised ET performed _____ weekly for 10 years maintains _______________________ of more than 60% of maximum VO2…”
- NT pts, peak VO2 _________progressively
twice
functional capacity
decreased
"Aerobic interval training versus moderate continuous training" - HF, Results: VO2 peak increased (\_\_) Decreased LVEDV and LVESV (\_\_\_) Increase LV EF (\_\_\_) BNP decreased (\_\_\_)
(IT & C)
(IT only)
(IT only)
(IT only)
Benefits of EX in HF:
Exercise training may reverse peripheral abnormalities
autonomic function, skeletal muscle blood flow, localized oxidative capacity
Heart failure education:
- frequent bouts w/ rests in-between
- teach daily weighting to check for changes in fluid
- Teach daily checks on activity by instructing in RPE or dyspnea monitoring
- Teach about watching for dyspnea when laying down
- Energy conservation
Perception scales:
- “How hard are you working?”
- “Pain scale” (1+light, barely noticeable ,2+ moderate/bothersome, 3+ server/very uncomfortable, 4+ most severe pain)
- “Breathing Scale” (1+mild noticeable to pt, 2+ mild noticeable to observer, 3+ moderate difficulty , 4+ severe difficulty)
Aerobic EX improves:
- VO2 max
- Dyspnea
- LV function
Resistance Ex improves:
- LV function
- Peak lactate levels
- Muscle strength & muscle endurance
Do you need to include both (aerobic Ex & resistance Ex) types of Ex in patients with HF?
yes, include both
Name 1 Contraindication to EX training:
progressive worsening of exercise tolerance or dyspnea at rest over previous 3-5 days
Name a 2nd Contraindication to EX training:
significant ischemia during low-intensity EX (2 METS)
Name a 3rd Contraindication to EX training:
uncontrolled diabetes
Name a 4th Contraindication to EX training:
Recent embolism
Name a 5th Contraindication to EX training:
thrombophlebitis
Name a 6th Contraindication to EX training:
New-onset atrial fibrillation / atrial flutter
Name some potential outcome tools:
- knowledge of disease /self management of disease
- chair raise
- Gait speed
- 6 MWT
- Balance
- Symptom history
- Anxiety/ depression
- Quality of life - HRQOL
Inspiratory muscle training leads to:
- Pi max –>
- Peak oxygen uptake –>
- 6 MWT –>
- VO2 slope during recovery, ventilatory response to exercise and QOL ________
115%
17%
19%
improved
** List 5 clinical implications for PT regarding HF:
- screen for CV & orthopedic conditions
- identify medication action & side effects
- re-evaluate CV status every session & throughout EX
- Know abnormal responses to EX and observe patient carefully (HR, BP, dyspnea, fatigue, angina)
- Prescribe effectively (aerobic & strength
Cardiac rehab is defined asa supervised program to help pts recover from:
- Myocardial infarction (MI)
- Heart surgery such as bypass, ventricular assist device (VAD), valve repair
- Minimally invasive procedures such as angioplasty, stenting, valve replacement, pacemaker or implantable cardioverter defibrillator (ICD)
- risk factors such as CAD or angina
- HF
“All cardiac rehab programs should contain specific core components that aim to _____________________________________, foster healthy behaviors and compliance with these behaviors, ______________ and promote an active lifestyle for pts w/ cardiovascular disease.”
“All cardiac rehab programs should contain specific core components that aim to OPTIMIZE CARDIOVASCULAR RISK REDUCTION, foster healthy behaviors and compliance with these behaviors, REDUCE DISABILITY and promote an active lifestyle for pts w/ cardiovascular disease.”
What is one goal of cardiac rehab:
Mitigate the adverse physiologic effects of cardiac illness
What is a 2nd goal of cardiac rehab:
mitigate the adverse psychological effects of cardiac illness
What is a 3rd goal of cardiac rehab:
reduce the risk of sudden death or reinfarction
What is a 4th goal of cardiac rehab:
control cardiac symptoms
What is a 5th goal of cardiac rehab:
stabilize or reduce atherosclerosis