Exercise Prescription Flashcards
What 11 categories of information need to be reviewed prior to exercise prescription?
- Review of systems: MD eval or office note
- Current medical history
- Past medical histroy
- Medications
- Symptoms
- Blood pressure (sit to stand): orthostatic changes
- Risk stratification
- Work status/ physicality of work
- Recreational activities
- Risk factors
- Goals
What 3 factors determine the volume of exercise?
FIT M F: Frequency (# sessions) I: Intensity (how hard) T: Time (duration of session) M: Mode (type of activity)
What type of patients require a high exercise volume for treatment?
- Patients who need to lose weight
What is the minimum frequency and duration of exercise required for a cardiopulmonary benefit to occur?
4 days a week; 30 minutes a day
What volume of exercise is required for cardiovascular benefits in terms of minutes/week, steps/day, and cals/week?
120 - 200 minutes/ week
10,000 steps/day
750 - 1200 cals/week
What volume of exercise is required for weight loss in terms of minutes/week, steps/day, and cals/week?
200 - 300 minutes
> 12,000 steps/day
1200 - 2000 cals/week
What are 6 measures of intensity of exercise?
- Target heart rate
- Rating of perceived exdrtion
- Rating of perceived dyspnea
- METS
- Ischemic threshold
- Oxygen saturation
What target heart rate measure is used in healthy individuals?
200 - age X 0.7
What measure of target heart rate tends to be used in cardiac patients?
- Karvonen
- (HR Max - HR Rest) X Intensity (%) + HR rest
In what patients is a MET measure appropriate?
@Pts with an irregular heart rate.
What % max MET should be used for exercise?
50 - 75 %.
What are 8 considerations for progressing exercise?
- RPE or RPD
- THR
- Oxygen saturation
- Change in clinical status (symptoms/ orthopedic)
- Ejection fraction
- Blood pressure
- Blood glucose
- Goals
What percent of 1rep max does resistance training begin at?
Greater than 50 %.
When may a patient begin resistance training following a MI?
- 5 weeks post surgery and 3 weeks of continuous cardiopulmonary exercise.
When may a patient begin resistance training following a CABG?
- 8 weeks post surgery and following 3 weeks of continuous cardiopulmonary exercise.
When can a patient begin resistance training following a stent procedure?
- 2 weeks following surgery.
What can be done in rehab before full-on resistance training begins?
- Light handweights and therabands.
What are 6 contraindications to resistance training?
- Symptomatic heart failure
- Severe valve disease (not replaced)
- Uncontrolled arrhythmias
- Unstable symptoms
- Uncontrolled hypertension
- High intensity training with active retinopathy
What is hypertension?
SBP > 160
DBP > 100
What is a major concern for resistance training following CABG?
- Sternal precautions
How long should a warm-up be?
5 - 10 minutes
How long should a cool down be?
5 - 10 minutes.
How does a patient cool down?
Lower level activity
Stretching
During what stage of exercise do arrhythmias typically occur?
Following exercise without adequate cool down.
What are 3 types of medication/ treatment of diabetes?
- Insulin
- Oral agent
- Diet alterations
What is considered a critical blood glucose level?
> 400
< 50
What level must the glucose be in order to begin exercise?
> 100
What activity releases insulin?
Exercise.
Where should insulin not be injected previous to beginning exercise?
- Into the muscle group being worked
What type of nutrient should be consumed to help keep blood glucose at normal levels?
Protein.
How should cardiac symptoms be monitored in a patient with diabetes?
- SOB
- Fatigue
- Patients have atypical symptoms due to neuropathy
How can blood sugar be kept at an adequate level for treatment?
- Time meals before treatment
- Bring a snack to treatment
- Eat protein
What effect does neuropathy have on exercise?
- Balance is affected
- Foot care
What is a precaution for resistance training in patients with diabetes?
- Retinopathy.
How can calorie burn be maximized in obese patients?
- Change up routine to keep the body burning fuel inefficiently.
What type of exercise for should patients with diabetes participate in using caution?
Weight-bearing exercise due to neuropathy.
How can an individual burn more calories if their exercise intensity is decreased?
Increase duration.
What non-exercise intervention can be applied to patients who are obese?
Patient education in diet.
What type of arrhythmias are pulmonary patients prone to?
Atrial
What are 3 interventions for patients with pulmonary disease?
- Postural training
- Breathing training
- Resistance training (especially UE)
What is a typical medication for pulmonary patients during exercise?
Supplemental oxygen.
What are 4 considerations that should be taken for patients with heart failure or low ejection fraction?
- Fluid retention (measure body weight)
- Increased heart rate
- Increased fatigue (slower paced progression)
- Increased ventricular ectopy (may have ICD defibrillator)
What is the primary concern in terms of exercise prescription for a patient with arthritis?
Mode of exercise.
What are 2 common categories of interventions for arthritis?
- Stretching and flexibility
- Balance training
What can change the exercise prescription for arthritis daily?
Pain.
What are 2 benefits of exercise for anxiety/fear/depression?
- Builds self confidence
- Empowers patient to be believe in themselves.
What is the therapists role for a patient with anxiety/fear/depression?
- Reinforce progression from first week “doing better!”
- Be confident
- Anticipate the patient’s needs
What type of training is good for patients with anxiety/fear/depression?
- Interval training
What is the treatment for peripheral vascular disease?
- Treadmill training
- Walk to moderate claudication, rest and restart in 3 - 8 minute intervals
- Improvement in 3 - 4 weeks.
- Push into pain; let pain subside; repeat
