Exercise Testing and Prescription Flashcards
What are possible risks associated with exercise?
1 in 15k-18k previously asymptomatic individuals have sudden cardiac events
How much does exercise lower your risk for CVD?
physically fit individuals have a 30-40% decreased risk of CVD
Based on a cost benefit analysis of exercise what would you recommend?
There are far more benefits to exercise than risks even for someone who has a some risk factors. I would recommend people exercise for health and feeling good. It affects pretty much every body system.
A patient is asymptomatic and has fewer than 2 risk factors, do they need a medical exam or exercise test to begin exercising?
No, they do not need a medical exam, exercise test, or medical supervision of the test to begin a moderate or vigorous exercise program.
What are some health screening options available?
- questionnaires
- CVD risk factor assessment
- medical evaluation
What is an example of a health screening questionnaire?
PAR-Q
List examples of CVD risk factor assessments
BP and lipid profiles
What are a few types of medical examinations prior to exercising?
Physical exam or stress test
A patient asks why an exercise routine would be beneficial to them. What would you say?
- it benefits almost every system in the body
- it improves the prognosis for almost every disease
- reduces the risk of injury
- improves psychological well-being
- it is fun
A patient has severe cardiovascular disease. Would you prescribe a vigorous exercise routine for them?
No. Cardiovascular disease is a contraindication for exercise. They would need to consult their physician before beginning an exercise regimen.
What diseases are contraindications to exercise?
- Metabolic disease
- Cardiovascular disease
- Pulmonary
- Renal disease
A patient is diagnosed with diabetes. What type of disease is this?
Metabolic disease
Is a patient with thyroid, renal, or liver disease able to exercise?
These are all metabolic diseases which are contraindications to exercise. They would need to consult their physician first; however, mild exercise would probably still benefit them.
A patient asks if they are able to begin a vigorous exercise program. They are asymptomatic but have more than two risk factors. How would you advise them?
They should get a medical exam before beginning a vigorous exercise program. They could start mild and moderate exercise. They probably do not need an exercise test; however, they should get a physical examination before beginning vigorous exercise.
A patient is symptomatic and has known pulmonary disease. What are the steps they should take to begin an exercise program?
Before beginning moderate or vigorous exercise, they should get a medical examination as well as a stress test. If a patient is presenting with known CVD, pulmonary, renal, or metabolic disease, they should have a medical examination and a doctor supervised stress test.
What are reasons to administer an exercise test?
- evaluate whether someone has a “silent” disease and are asymptomatic
- assessment of exercise-related symptoms
- screening and placement for preventative and rehabilitative exercise programs
- discovery of abnormal exercise-induced responses
- monitoring therapeutic interventions and their effects on ability and performance
- determination of aerobic capacity
- monitoring training and fitness in athletes
What is claudication?
arm or leg pain that is present with physical activity
What pre-exercise tests might you run on someone you suspect of cardiovascular disease?
- HR
- BP
- lipid profile
- resting ECG
What are two basic pre-exercise tests that cover a wide range of symptoms?
- basic physical exam
- blood tests
A patient reports wheezing when exercising and shortness of breath. What tests might you run for pulmonary function (PFT)?
- volumes
- FEV1/FVC
- MVV
- PEF (peak expiratory flow)
What are some other disease tests you can run as pre-exercise tests?
- xrays or other scans
- other radiography (MUGA scans, MRI, angiography)
Under what conditions would you absolutely not run a stress test?
If a patient has severe CVD, they are at a higher risk for MI or death.
- severe aortic stenosis
- symptomatic heart failure
- dissecting aneurysm
- lack of informed consent
If someone is showing relative contraindications for stress testing, how would you proceed?
Need to assess the risk vs benefit. Also want to assess the severity of the disease. Most people with CVD can do a stress test, but if it is too severe, you should not run it.
- disorders exacerbated by exercise, hypertension, moderate valvular disorders
