Exercise Rx Flashcards
TYPE:
Cardiorespiratory endurance activities: walking, jogging, cycling recommended to improve ______ ______, can be maintained at constant ____; very low interindividual variability
Exercise tolerance
Velocity
TYPE:
Dynamic arm exercise (arm ergometer): uses smaller muscle mass, results in lower ______ (___%-____% lower) than leg ergometry. At given workload, HR will be ___, SV will be ____, SBP and DBP will be ____.
VO2 max 60-70 Higher Lower Higher
TYPE:
Dancing, basketball, racquetball, competitive activities should not be used with _____ ____, and ____individuals.
High-risk symptomatic
Low-fit
TYPE:
Early rehab- activity is _____ (____ training), with frequent rest periods, progressing to ____ training. ____training can be incorporated in vigorous training to allow pt to work at higher percentage of VO2 max.
Discontinuous, interval
Continuous
Interval
TYPE:
Warm-up and cool-down activities:
Gradually increase or decrease ___ of exercise, promote circulatory and muscular adjustment to exercise
Intensity
TYPE: Warm-up and cool-down activities -what type? -how long? Also: Don’t recommend abrupt beginning or cessation of exercise (not safe)
Low-intensity cardiorespiratory endurance
Flexibility (ROM) exercises
Functional mobility activities
Duration: 5-10 minutes
TYPE: RESISTIVE EXERCISE
Used to improve strength/endurance in clinically stable patients. Usually prescribed after period of _____ conditioning. Moderate intensities typically used (___-___% of 1RM). Monitor responses using ______ (and why?).
Precautions: carefully monitor BP, avoid _____.
Contraindicated for pts with ___ and ___.
Aerobic 60-80% **RPP- safer measure b/c incorporates BP** Valsalva HTN, arrhythmias
INTENSITY:
Prescribed as % of functional capacity revealed on ETT within range of ___-___% depending on initial level of fitness. Typical training intensity is ___-___% of functional capacity; lower training intensities may necessitate increase in training ____. Most clinicians use combination of ___, ___, and ___ to prescribe exercise intensity.
40-85%
60-80%
Duration
HR, RPE, METs
INTENSITY: Heart Rate
% of maximum HR achieved on ETT. Without ETT, what is formula?
_____% of HR max closely corresponds to ____% of functional capacity or VO2max.
208-0.7 x age
75-85%
60-80%
INTENSITY: HR
Beta blockers affect ability of HR to __in response to exercise stress.
PPM can affect ability of HR to ___ if it is fixed.
Estimated HR max used in cases where ____ ____ is given.
Rise
Rise
Submax test
INTENSITY: RPE
Useful with other measures of effort if ___ ___ or other ___ ____ are used
Beta blockers
HR suppressants
INTENSITY: METs
___-___% of functional capacity (maximal METs) are achieved on ETT.
Problems with use of METs alone to prescribe intensity:
With high intensity activities, need to adopt ____ work pattern. Varying skill level, stress of competition, or environmental stresses may affect the known ____ ____ of an activity.
40-85%
Discontinuous
Metabolic cost
DURATION:
Conditioning phase may last from __ to __ minutes, depending on _____. Increase ____, decrease duration.
10-60
Intensity
Intensity
FREQUENCY:
Depends on ___ and ___. The lower the ___, the shorter the ____, the more the ____.
Intensity and duration
Intensity, duration, frequency
FREQUENCY:
Average is ___x/week at ___ intensity. (How many METs?)
OR daily at low intensity.
3-5, moderate (>5 METs)
Exercise and progressive physical activity require monitoring of __ and __.
HR, BP
PROGRESSION:
Modify exercise rx if:
-HR is ___ than THR for given intensity
-RPE is ____ (exercise perceived as ___) for given exercise
-Symptoms of ____ do not appear at given exercise intensity
Lower
Lower, easier
Ischemia (ex: angina)
PROGRESSION:
Increase ___ first, then ___.
Duration, intensity
Consider reduction in exercise/activity with:
- Acute ___
- Acute ___
- Progression of ___ ___: edema, weight gain, unstable ____
- Overindulgence
- ____ stressors
Illness
Injury
Cardiac disease, angina
Environmental
Consider terminating exercise:
Absolute indications for termination-
1. Drop in ____ > ____mmHg with increased workload
2. Moderate to severe ____
3. Increasing ___ ___ symptoms (ataxia, dizzy, near syncope)
4. Signs of poor _____
5. Technical difficulties in monitoring ___ or ___.
6. Subject
7. Sustained ____
8. See this on EKG
SBP >10 Angina Nervous system Perfusion ECG or BP Wants to stop VT ST elevation > or = 1.0 mm
Consider terminating exercise:
RELATIVE indications to stop-
1. ___ or ___ changes on ECG or marked ___ shift
2. ___ other than sustained VT (ex: multifocal PVCs, triplets, SVT, heart block, bradyarrhythmias)
3. Fatigue, ____, wheezing, leg ____, or _____
4. Development of ___ ___ ___ that can’t be distinguished from VT
5. Increasing ____ pain
6. ___ response (SBP >____ or DBP > ___).
ST or QRS (excessive ST depression), axial Arrhythmias SOB, cramps, claudication Bundle branch block Chest Hypertensive, 250/115
ExRx post-PTCA (percutaneous transluminal coronary angioplasty): how long for vigorous exercise? What can be done immediately? How to determine prescription?
Wait to exercise vigorously 2 weeks post-PTCA.
Can initiate walking program immediately
Post-PTCA ETT to prescribe
ExRx post-CABG?
- limit UE exercise while sternal incision healing
- avoid lifting, pushing, pulling for 4-6 wks post-op
