Exercise Prescription

Question 1

Exercise stress testing procedure

Answer 1

• the patient is required to exercise at progressively greater increments of work on treadmill

Question 2

absolute indications for terminating exercise test

Answer 2

• drop in SBP > 10 from baseline despite increase in workload with other evidence of ischemia
• moderately severe angina (3 on a scale of 4)
• increasing nervous system symptoms
• signs of poor perfusion
• sustained ventricular tachycardia
• 1 mm ST elevation in leads without diagnostic Q waves

Question 3

relative indications for terminating exercise stress test

Answer 3

• drop in SBP >10 from baseline despite increase in workload without other evidence of ishemia
• > 2 ST segment depresion
• arrhythmias other than sustained ventricular tachycardia, including multifocal PVCs, supraventricular tachycardia, heart block or bradyarrhythmias
• fatigue, shortness of breath, wheezing, leg cramps, and claudication
• development of bundle branch block or intraventricular conduction delay
• increasing chest pain
• hypertensive response (SBP >250 or DBP > 115)

Question 4

negative exercise stress test

Answer 4

• indicates a low probability of coronary artery disease

Question 5

positive exercise stress test

Answer 5

• indicates high probability of coronary artery disease

Question 6

aerobic exercise

Answer 6

• refers to submax, rhythmic repetitive exercise of large muscle groups during which adenosine triphosphate is synthesized primarily by the long term energy system and utilization of inspired oxygen

Question 7

indications of aerobic

Answer 7

• reduced cardiorespiratory endurance

- primary and secondary prevention of cardiovascular disease

Question 8

precautions/contraindications of aerobic exercise

Answer 8

• appropriate screening

- avoid valsalva

Question 9

normal cardiorespiratory response to acute aerobic exercise

Answer 9

• increased oxygen consumption due to increased cardiac output, increase blood flow, and oxygen utilization in the exercising skeletal muscles
• linear increase SBP with increasing workload
• no change or moderate decrease in DBP
• increased respiratory rate and tidal volume

Question 10

chronic adaptations to aerobic exercise

Answer 10

• vo2: max increased
• HR: no change with max, decreased with sub max
• arteriovenous oxygen difference: increased at max, no change at submax
• SBP and DBP: no change or slight increase with max, no change or slight decrease with submax
• blood lactate: increased at max, decreased at submax
• oxidative capacity of muscle: increase in mitochondrial size, capillary density, and oxidative enzymes
• max voluntary ventilation: increased at max exercise
• plasma volume: increased
• skeletal muscle blood flow: increase at max, no change at submax
• reduced body mass and body fat and increase in fat free body mass
• improved body heat transfer due to larger plasma volume and more responsive thermoregulatory mechanisms
• psychological benefits: reduced anxiety, stress, and depression, improved mood, and self esteem