Exercise prescription Flashcards
Exercise intensity options:
- V02max (GOLD STANDARD)
- HR: based on HRmax calc or karvonen
- Subjective: RPE/DOE
- METS
What is V02 max?
max volume of 02 used during max physical effort
1 MET = ____
MET is dependent on _____.
3.5 mL 02/kg/min
dependent on body mass
What is the frequency goal?
min of 3 x per week
What is the duration goal?
Moderate: 30 min
Vigorous: 20-25 min
Intervals of at least 10 min
What is the equation for RPP (rate pressure product)? Describe what it means.
RPP = HR x SBP
vital sign threshold at which demand > supply where Angina begins
What is the intensity used for patients with stable angina?
60-85% RPP
use RPP as endpoint for exercise intensity
What happens to RPP with training?
more work is tolerated because RPP is lower at rest and at each level of work intensity
After MI, how long do you have to avoid max exercise testing?
during acute healing stage: first 4-6 weeks
Can you do resisted exercise during the acute healing stage post MI?
NO!
What intensity is appropriate for patients post MI?
< 5 METS (for first 4 weeks)
What should you consider for sternotomy or thoracotomy patients?
- postural exercise to tolerance to increase thoracic expansion and extension
- consider sternal precautions for high risk pts
- protect skin incision
What are high risk populations for dehiscence post sternotomy or thoracotomy?
- DM
- large breasted women
- obesity
- hx of wound infections
What are 3 common considerations for all pts post op?
- hematocrit levels
- activity tolerance
- pain control
For patients on B-blockers, what values do you use to determine exercise intensity?
combination of adjusted HRmax calculation and subjective scale (DOE/RPE)
What level of angina is considered an absolute indication for terminating exercise?
> or = 3 on scale
moderate-severe
What arrhythmias are considered absolute indications for terminating exercise?
ST segment elevation > 1mm
sustained VT
What arrhythmias are considered relative indications for terminating exercise?
ST depression > 2mm
multifocal PVCs, triplets, SVT, bradyarrthythmias
Within one minute of recovery, how should HR change?
falls by > 12 bmp
if not, poor prognosis
What does initial phase ex Rx look like?
3-7x/week
40-60% HRmax
15-20mins
What does improvement phase ex Rx look like?
3-5x/week
60-85% HRmax
25-40mins
What does maintenance phase ex Rx look like?
similar to improvement phase with potential to increase intensity and/or duration
What element of ex Rx is most important for post-transplant pts?
warmup/cooldown: due to absence of autonomic cardiac innervations
