Exercise prescription

Question 1

Exercise intensity options:

Answer 1

1. V02max (GOLD STANDARD)
2. HR: based on HRmax calc or karvonen
3. Subjective: RPE/DOE
4. METS

Question 2

What is V02 max?

Answer 2

max volume of 02 used during max physical effort

Question 3

1 MET = ____

MET is dependent on _____.

Answer 3

3.5 mL 02/kg/min

dependent on body mass

Question 4

What is the frequency goal?

Answer 4

min of 3 x per week

Question 5

What is the duration goal?

Answer 5

Moderate: 30 min
Vigorous: 20-25 min
Intervals of at least 10 min

Question 6

What is the equation for RPP (rate pressure product)? Describe what it means.

Answer 6

RPP = HR x SBP

vital sign threshold at which demand > supply where Angina begins

Question 7

What is the intensity used for patients with stable angina?

Answer 7

60-85% RPP

use RPP as endpoint for exercise intensity

Question 8

What happens to RPP with training?

Answer 8

more work is tolerated because RPP is lower at rest and at each level of work intensity

Question 9

After MI, how long do you have to avoid max exercise testing?

Answer 9

during acute healing stage: first 4-6 weeks

Question 10

Can you do resisted exercise during the acute healing stage post MI?

Answer 10

NO!

Question 11

What intensity is appropriate for patients post MI?

Answer 11

< 5 METS (for first 4 weeks)

Question 12

What should you consider for sternotomy or thoracotomy patients?

Answer 12

1. postural exercise to tolerance to increase thoracic expansion and extension
2. consider sternal precautions for high risk pts
3. protect skin incision

Question 13

What are high risk populations for dehiscence post sternotomy or thoracotomy?

Answer 13

1. DM
2. large breasted women
3. obesity
4. hx of wound infections

Question 14

What are 3 common considerations for all pts post op?

Answer 14

1. hematocrit levels
2. activity tolerance
3. pain control

Question 15

For patients on B-blockers, what values do you use to determine exercise intensity?

Answer 15

combination of adjusted HRmax calculation and subjective scale (DOE/RPE)

Question 16

What level of angina is considered an absolute indication for terminating exercise?

Answer 16

> or = 3 on scale

moderate-severe

Question 17

What arrhythmias are considered absolute indications for terminating exercise?

Answer 17

ST segment elevation > 1mm

sustained VT

Question 18

What arrhythmias are considered relative indications for terminating exercise?

Answer 18

ST depression > 2mm

multifocal PVCs, triplets, SVT, bradyarrthythmias

Question 19

Within one minute of recovery, how should HR change?

Answer 19

falls by > 12 bmp

if not, poor prognosis

Question 20

What does initial phase ex Rx look like?

Answer 20

3-7x/week
40-60% HRmax
15-20mins

Question 21

What does improvement phase ex Rx look like?

Answer 21

3-5x/week
60-85% HRmax
25-40mins

Question 22

What does maintenance phase ex Rx look like?

Answer 22

similar to improvement phase with potential to increase intensity and/or duration

Question 23

What element of ex Rx is most important for post-transplant pts?

Answer 23

warmup/cooldown: due to absence of autonomic cardiac innervations