Exercise and health

Question 1

Benefits of regular PA:

Improvement in cardiovascular and respiratory function

Answer 1

• increased maximal O2 uptake
• decreased min ventilation at submaximal intensity
• decreased myocardial oxygen cost for submaximal intensity
• decreased HR and BP at submaximal intensity
• increased capillary density in skeletal muscle
• increased exercise threshold for accumulation of lactate in blood
• increased exercise threshold for onset of disease signs or symptoms (e.g. ischemic ST-segment depression)

Question 2

Benefits of regular PA:

Reduction in CVD risk factors

Answer 2

• reduced resting systolic/diastolic pressure
• reduced blood platelet adhesiveness and aggregation
• reduced total body fat and intra-abdominal fat
• reduced inflammation

Question 3

Benefits of regular PA:

decreased morbidity and mortality

Answer 3

• primary prevention (interventions to prevent initial occurence)
• high PA is associated with lower death rates from CAD.
• secondary prevention (interventions after a cardiac event to prevent another)
• all-cause mortality are reduced in patients with post-myocardial infarction (MI) who participate in cardiac rehab exercise training.

Question 4

Benefits of regular PA:

other benefits

Answer 4

• decreased anxiety and depression
• improved cognitive function
• enhanced physical function and independent living in older adults
• enhanced feelings of well-being
• reduced risk of falls
• prevention or mitigation of functional limitations in older adults

Question 5

contraindications for inpatient and outpatient cardiac rehabilitation

Answer 5

• unstable angina
• uncontrollable hypertension - resting systolic BP over 180, diastolic BP over 110
• uncontrolled atrial or ventricular arrhythmias
• uncontrolled sinus tachycardia (over 120 beats per min)
• 3rd degree atrioventricular (AV) block without pacemaker

Question 6

Adverse responses to inpatient exercise leading to exercise discontinuation

Answer 6

• diastolic BP over 110mmHg
• decrease in systolic BP >10mmHg during exercise without increasing workload
• ventricular or atrial arrhythmias with or without signs/symptoms
• second or third degree heart block
• signs/symptoms of exercise intolerance - angina, ECG changes suggestive of ischemia

Question 7

FITT recommendations for outpatient programs

Frequency

Answer 7

• at least 3 days, but preferably on most days of the week
• depends on individual exercise tolerance, intensity, health goals, etc.
• multiple short (1-10 min) daily sessions can be prescribed for those with limited exercise ability.

Question 8

FITT recommendations for outpatient programs

Intensity

Answer 8

• 40 to 80% of exercise capacity
• RPE of 11-16 on a scale of 6-20.
• HR below ischemic threshold

Question 9

FITT recommendations for outpatient programs

Type

Answer 9

• Aerobic - rhythmic, large muscle groups, emphasis on increased caloric expenditure for maintenance of a healthy body weight.

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Question 9

FITT recommendations for outpatient programs

Time

Answer 9

• warm up and cool downs of 5-10 mins - static stretching, ROM and light intensity.
• aerobic activities 20-60 min per session
• after a cardiac-related event, patients may start with 5-10 min of aerobic activity, and gradually increase.