Exercise for Cardio/ Pulmonary Conditions Flashcards
Primary impairment in CAD
imbalance myocaridal oxygen supply n demand
narrowing due to
lumen of coronary artery
how does MI happen
blood to part of heart interrupted
most common cause of Mi (Heart attach)
occlusion (blockage) following by rupture atherosclerotic plaque
atherosclerotic plaque
unstable collection of lipids and WBC in artery
LV functions impaired
SV, Q, 02 delivery, v02 peak, WR
V02 equation
QxC(a-v)D02
what part of equation does CAD effect
Q (HR x SV)
stroke volume
RER higher or lower in CAD
higher
Why RER higher in CAD
impaired 02 delivery
incase metabolic acidosis
T/F Ve / VCo2 ration normal at rest and during exercise in CAD
true
when does respiratory compensation for metabolic acidosis happen
heavy exercise
T/F At similar in health and CAD
yes
Above the ischemic threshold, what happened to Vco2
incase more steeply in CAD
onset of myocardial ischemia
Curvilinear HR response
02 pulse below predicted
Are CAD patients ventilatory limited
not usually
Cardiac rehab
resorting individual with cardiac problem to max activity compatible with heart
goals of cardiac rehab
limit psych effect decrease risk of sudden death control symptoms stabilize atherscleorsis ADL
components of cardiac rehab
lifestyle (PA, Ed, Weight, Smoking)
Psychosocial
long term management
Phases of cardiac rehab
1-4
phase 1 cardiac rehab
in patient period
phase 2 cardiac rehab
early post discharge
up to 12 weeks supervised exercise / education
phase 3 cardiac rehab
supervised out patient program
variable leng program
intermittent or no ECG monitoring
phase 4 cardiac rehab
long term maintenance
no ECG
limited supervision
Met level PT goal for discharge
3-4
how to progress MET of cardiac rehab
3-4 MET
F FITT Cardiac Patient
Early mobilization 2-4/day for 3 days
later mobilization: 2/day on day 4 with exercise bouts increased
I FITT cardiac patient
to tolerance
RPE <13
Post MI/CHF: HR <120 or 20 of upper limit
Poster surgery - Hr rest + 30 of upper limit
T FITT cardiac patient
bouts of 3-5 min as tolerated
2:1 exercise to rest
when to progress cardiac patient
when patient can exercise continuously for 10-15 mins
Activity classifications for inpatient activities
Class 1-6
Class I
sit up with assistance
own self care
sits 15-30 min, 2-3/day
Class II
sits in bed without assistant
walks in room and to bathroom
Class III
sit stand indepedpntly
walks short distances , 3/day
Class IV
does own self care
walks in halls, 3-4 /day
Class V
walks in halls indpendelty (80-150m) 3-4/day
Class Vi
independent ambulation 3-6/day
goals of outpatient cardiac
return to pre morbid activities
establish home exercise program
provide education
6 principals of out patient cardiac rehab
- total conditioning
- health adults prescription adjusted
- test w meds
- don’t use HR, use v02 n RPE
- below threshold of angin
- warm up
Frequency FITT cardiac outpatient
4-7/days
1-10min/day
I FITT cardiac outpatient
RPE 11-16
40-80% of HRR
below ischemic threshold
T FITT cardiac outpatient
5-10 warm up/cool down
aerobic 20-60
add 1-5 min /sessoin
individual
Type FITT cardiac outpatient
arm ergometer, cycle, elliptical, rower, start climber, treadmill
cardiac guidleline to progress to minimal or no supervision
functional capacity >8Met or twice occupation
ECG appropriate
knowledge of abnormal signs
Resistance training in cardiac rehab
technique
12-15 reps
RPE 11-13
2/3 days
what causes COPD
smoking pollution
causes of exercise intolerance in COPD
ventilation limit exertional symptoms metabolic gas exchange abnormal cardiac impairment perhiperhal mm dysfunction
benefits pulmonary rehab
reduce symtoms
improve exercise tolderence
increase functional abiltiy
improve quality of life
T/F pulmonary benefits because of reduce air obstruction and decreed hyperinflation
no
why benefit of pulmonary rehab
improved secondary morbidities
mm deconditionign, resp mm strengt, desensitzation to dysnpnea
COPD intensity
higher intensity better
(increase v02 and oxidative enzymes)
submax exercse
(less lactic n ventilatiON)
dual therapies with pulmonary rehab
bronchodilators internval training single leg exercises EMS helium
why single leg exercises
half the load same metabolic demands reduce ventilation load increase work capacity improve aerobic capacity
mechanism for exercise intolerance CAD
impaired LV, mycardial ischemia (angine)
what happens to Vo2 and Vc02 in CAD
v02 plates due to dec SV
vo2 continues to increase
T/F respiratory compensation normal inCAD
yes
calculate HRR
hr max - hr rest (outpatient!!!!)
what is emphysema
loss lung recoils, dec surface area