PT Interventions 5 Flashcards
1 MET =
Energy expended while sitting quietly
3.5 mLO2/kg/min OR 1kcal/kg/hr
A RPE of 12-16 is
Somewhat hard to hard
40-85% maximal capacity
RPE 11-13 =
Fairly light to somewhat hard
*Appropriate upper limit during initial phases of OP cardiac rehab
RPE of 14-16 appropriate for
Appropriate for higher intensity training later in cardiac rehab if there are no s/s of ischemia or dysrhythmias
Phase II cardiac rehab: duration
- initially 15-20 mins during first month (initial training stage)
- 25-30 mins during next 3-4 months (improvement stage)
- 40 mins or longer after 6 months (maintenance phase)
METs: light
Less than 3 METs
METs: moderate
3-6 METs
METs: vigorous
Greater than 6 METs
METs: walking slowly at home or office
2 METs
METs: walking 3 mph
3-4 METs
METs: walking 4 mph
4.5-7 METs
METs: walking 4.5 mph
6.3 METs
METs: jogging 5 mph
8 METs
METs: running 7 mph
11.5 METs
METs: bicycling (flat) 10-12 mph
6 METs
METs: bicycling (flat) 12-14 mph
8 METs
METs: bicycling (flat) 14-16 mph
10 METs
Phase II OP cardiac rehab: expected outcomes
- promote active lifestyle
- improved functional capacity
- lower cardiovascular risk factors
- improve sx and physiological responses to physical challenges
- modification of unhealthy behaviors and psychosocial characteristics
- improve pt understanding of safety
What may be happening (exercise in hot environments)?
Disorientation, dizziness, apathy, HA, N/V, hyperventilation, dry skin
Heat stroke
What may be happening (exercise in hot environments)?
Low BP, elevated HR and RR, wet and pale skin, weakness, dizziness
Heat exhaustion
What may be happening (exercise in hot environments)?
Decreased HR and RR, pale skin, weakness, vertigo, nausea
Heat syncope
What may be happening (exercise in hot environments)?
Localized mm spasms progressing to debilitating muscle cramps
Heat cramps
Exercise in cold may _____ angina threshold and increase risk of death or individuals with heart disease
Lower
What may be happening (exercise in cold environments)?
Loss of feeling and a while or pale appearance in finger, toes, ear lobes, and tip of nose
Frostbite
What may be happening (exercise in cold environments)?
Body temp under 97˚ F, shivering, confusion, disorientation, incoherence, poor coordination, slurred speech
Hypothermia
When does hypothermia develop?
heat loss exceeds heat production
Factors that increase risk of hypothermia include:
- water immersion
- rain
- wet clothing
- low body fat
- age ≥ 60
- hypoglycemia
Decreased atmospheric pressure at ≥ 5000 ft and oxygen
Causes decrease in partial pressure of oxygen in the air
Reduced arterial oxygen levels
What may be happening (altitude)?
Headache, nausea, fatigue, poor appetite and sleep, mild swelling in hands, feet, or face
Acute mountain sickness
What may be happening (altitude)?
Crackles/rales in the lungs, cyanosis of lips and nail beds
High altitude pulmonary edema
RPE for pulmonary rehab (aerobic)
4-6 on the 0-10 scale
12-16 on the 6-20 scale
PT role in pulmonary rehab
- administer 6MWT or other appropriate tests
- develop exercise prescription considering mode, intensity, duration, frequency
- monitor vitals
- supervise and promote proper technique/breathing patterns
- airway clearance and breathing exercises as needed
- instruct in energy conservation techniques
Contraindications for pulmonary rehab
- ischemic cardiac disease
- CHF
- acute cor pulmonale
- severe pulmonary HTN
- significan hepatic dysfunction
- metastatic cancer
- renal failure
- severe congestive deficit
- visual, hearing, or ortho impairments may require modification of program
Indications for pulmonary rehab
- chronic bronchitis
- emphysema
- asthma
- interstitial lung disease
- bronchiectasis
- CF
- lung cancer
- chest wall disease
- NM disease
- preoperative and postoperative lung resection, transplantation, or volume reduction
- ventilator dependency
