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Cardiopulmonary PT > Exercise Prescription > Flashcards

Exercise Prescription Flashcards

1
Q

What 11 categories of information need to be reviewed prior to exercise prescription?

A
  • 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
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2
Q

What 3 factors determine the volume of exercise?

A 
FIT M
F: Frequency (# sessions)
I: Intensity (how hard)
T: Time (duration of session)
M: Mode (type of activity)
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3
Q

What type of patients require a high exercise volume for treatment?

A
  • Patients who need to lose weight
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4
Q

What is the minimum frequency and duration of exercise required for a cardiopulmonary benefit to occur?

A

4 days a week; 30 minutes a day

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5
Q

What volume of exercise is required for cardiovascular benefits in terms of minutes/week, steps/day, and cals/week?

A

120 - 200 minutes/ week
10,000 steps/day
750 - 1200 cals/week

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6
Q

What volume of exercise is required for weight loss in terms of minutes/week, steps/day, and cals/week?

A

200 - 300 minutes
> 12,000 steps/day
1200 - 2000 cals/week

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7
Q

What are 6 measures of intensity of exercise?

A
  • Target heart rate
  • Rating of perceived exdrtion
  • Rating of perceived dyspnea
  • METS
  • Ischemic threshold
  • Oxygen saturation
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8
Q

What target heart rate measure is used in healthy individuals?

A

200 - age X 0.7

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9
Q

What measure of target heart rate tends to be used in cardiac patients?

A
  • Karvonen

- (HR Max - HR Rest) X Intensity (%) + HR rest

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10
Q

In what patients is a MET measure appropriate?

A

@Pts with an irregular heart rate.

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11
Q

What % max MET should be used for exercise?

A

50 - 75 %.

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12
Q

What are 8 considerations for progressing exercise?

A
  • RPE or RPD
  • THR
  • Oxygen saturation
  • Change in clinical status (symptoms/ orthopedic)
  • Ejection fraction
  • Blood pressure
  • Blood glucose
  • Goals
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13
Q

What percent of 1rep max does resistance training begin at?

A

Greater than 50 %.

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14
Q

When may a patient begin resistance training following a MI?

A
  • 5 weeks post surgery and 3 weeks of continuous cardiopulmonary exercise.
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15
Q

When may a patient begin resistance training following a CABG?

A
  • 8 weeks post surgery and following 3 weeks of continuous cardiopulmonary exercise.
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16
Q

When can a patient begin resistance training following a stent procedure?

A
  • 2 weeks following surgery.
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17
Q

What can be done in rehab before full-on resistance training begins?

A
  • Light handweights and therabands.
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18
Q

What are 6 contraindications to resistance training?

A
  • Symptomatic heart failure
  • Severe valve disease (not replaced)
  • Uncontrolled arrhythmias
  • Unstable symptoms
  • Uncontrolled hypertension
  • High intensity training with active retinopathy
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19
Q

What is hypertension?

A

SBP > 160

DBP > 100

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20
Q

What is a major concern for resistance training following CABG?

A
  • Sternal precautions
21
Q

How long should a warm-up be?

A

5 - 10 minutes

22
Q

How long should a cool down be?

A

5 - 10 minutes.

23
Q

How does a patient cool down?

A

Lower level activity

Stretching

24
Q

During what stage of exercise do arrhythmias typically occur?

A

Following exercise without adequate cool down.

25
Q

What are 3 types of medication/ treatment of diabetes?

A
  • Insulin
  • Oral agent
  • Diet alterations
26
Q

What is considered a critical blood glucose level?

A

> 400

< 50

27
Q

What level must the glucose be in order to begin exercise?

A

> 100

28
Q

What activity releases insulin?

A

Exercise.

29
Q

Where should insulin not be injected previous to beginning exercise?

A
  • Into the muscle group being worked
30
Q

What type of nutrient should be consumed to help keep blood glucose at normal levels?

A

Protein.

31
Q

How should cardiac symptoms be monitored in a patient with diabetes?

A
  • SOB
  • Fatigue
  • Patients have atypical symptoms due to neuropathy
32
Q

How can blood sugar be kept at an adequate level for treatment?

A
  • Time meals before treatment
  • Bring a snack to treatment
  • Eat protein
33
Q

What effect does neuropathy have on exercise?

A
  • Balance is affected

- Foot care

34
Q

What is a precaution for resistance training in patients with diabetes?

A
  • Retinopathy.
35
Q

How can calorie burn be maximized in obese patients?

A
  • Change up routine to keep the body burning fuel inefficiently.
36
Q

What type of exercise for should patients with diabetes participate in using caution?

A

Weight-bearing exercise due to neuropathy.

37
Q

How can an individual burn more calories if their exercise intensity is decreased?

A

Increase duration.

38
Q

What non-exercise intervention can be applied to patients who are obese?

A

Patient education in diet.

39
Q

What type of arrhythmias are pulmonary patients prone to?

A

Atrial

40
Q

What are 3 interventions for patients with pulmonary disease?

A
  • Postural training
  • Breathing training
  • Resistance training (especially UE)
41
Q

What is a typical medication for pulmonary patients during exercise?

A

Supplemental oxygen.

42
Q

What are 4 considerations that should be taken for patients with heart failure or low ejection fraction?

A
  • Fluid retention (measure body weight)
  • Increased heart rate
  • Increased fatigue (slower paced progression)
  • Increased ventricular ectopy (may have ICD defibrillator)
43
Q

What is the primary concern in terms of exercise prescription for a patient with arthritis?

A

Mode of exercise.

44
Q

What are 2 common categories of interventions for arthritis?

A
  • Stretching and flexibility

- Balance training

45
Q

What can change the exercise prescription for arthritis daily?

A

Pain.

46
Q

What are 2 benefits of exercise for anxiety/fear/depression?

A
  • Builds self confidence

- Empowers patient to be believe in themselves.

47
Q

What is the therapists role for a patient with anxiety/fear/depression?

A
  • Reinforce progression from first week “doing better!”
  • Be confident
  • Anticipate the patient’s needs
48
Q

What type of training is good for patients with anxiety/fear/depression?

A
  • Interval training
49
Q

What is the treatment for peripheral vascular disease?

A
  • 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

Cardiopulmonary PT (10 decks)

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