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Cardiopulmonary > Pulmonary Rehab > Flashcards

Pulmonary Rehab Flashcards

1
Q

What does pulmonary rehab combine?

A

Exercise training and behavioral and educational programs

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2
Q

What are the objectives of pulmonary rehab?

A

Control and alleviate symptoms and optimize functional capacity and independence

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3
Q

What increases independent function in pulmonary diseases?

A

More physical activity

Learn about the disease

Treatment options

Coping strategies

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4
Q

Can you reverse pulmonary diseases?

A

No but you can decrease symptoms

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5
Q

What are the components of pulmonary rehab?

A

Assessment

Exercise training

Education

Nutritional intervention

Psychosocial support

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6
Q

Who is appropriate for pulmonary rehab?

A

Any stable patient with a chronic lung disease who is disabled by respiratory symptoms (must have had PFTs within 1 year)

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7
Q

What does the plan of care durations range from in pulmonary rehab?

A

4-12 weeks (2-3 times a week)

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8
Q

What is ideal in pulmonary rehab?

A

For the clinic to have their own oxygen (often hospital setting)

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9
Q

How long do sessions of pulmonary rehab typically last?

A

75-90 min

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10
Q

What is the work to rest ratio in pulmonary rehab?

A

1:3

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11
Q

What does SpO2 need to be maintained at during pulmonary rehab?

A

Greater than 90%

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12
Q

Why do a lot of patients have respiratory muscle weakness but not very many are treated for it?

A

Lack of referral

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13
Q

What does evidence say that supports pulmonary rehab?

A

It is safe and effective

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14
Q

What did pulmonary rehab result in greater improvements over?

A

Inhaled bronchodilators

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15
Q

What disease has pulmonary rehab as an essential component of management?

A

Interstitial pulmonary fibrosis

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16
Q

Why is respiratory muscle testing done in the clinical assessment?

A

To see if respiratory muscles are contributing to Dyspnea

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17
Q

What tests assesses exercise capacity?

A

6 MWT and incremental shuttle walk test

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18
Q

How long should endurance training be in pulmonary rehab?

A

20-40 min

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19
Q

How long should resistance training be in pulmonary rehab?

A

10-15 min

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20
Q

How long should balance training be in pulmonary rehab?

A

10-15 min

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21
Q

How long should respiratory muscle training be in pulmonary rehab?

A

5-10 min

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22
Q

What needs to be provided in patients who desaturate?

A

Oxygen supplementation

23
Q

What do intervals between exercises allow?

A

Better oxygenation

24
Q

When should a patient be reassessed in pulmonary rehab?

A

At the end of 6 weeks

25
Q

What intensity of aerobic training should those in pulmonary rehab train at?

A

40-60% VO2 max (talk test or 80% of average 6MWT)

26
Q

How long should aerobic training be in pulmonary rehab?

A

30 minutes continuously or 10 minute intervals

27
Q

What percentage of people with chronic lung disease have reductions in skeletal muscle strength?

A

30-70%

28
Q

Why is it better to sometimes do strength training over aerobic training?

A

Strength training has lower ventilatory demands

29
Q

How many reps should be performed in strength training?

A

Higher reps

30
Q

What can taking intervals during exercise do for pulmonary rehab patients?

A

Allow them to triple their exercise duration

31
Q

What do patients with COPD have a high susceptibility of?

A

Falls

32
Q

How often should inspiratory muscle training take place?

A

10-15 minutes, 2-3 times per day (5 days a week)

33
Q

What is the biggest improvement with inspiratory muscle training?

A

Decreases Dyspnea

34
Q

How much more is pain reported in COPD patients compared to normal patients?

A

2.5 times

35
Q

Where is pain most common in COPD patients?

A

Neck and trunk

36
Q

What role does the diaphragm play other than respiratory function?

A

Stabilizes the spine during balancing and loading tasks unconsciously

37
Q

How does diaphragm weakness result in pain?

A

Because the diaphragm will prioritize breathing over stabilization and so if it is weak stabilization is not performed

38
Q

What is the most commonly used respiratory assessment?

A

Maximal inspiratory pressure (MIP)

39
Q

What is the maximal inspiratory pressure (MIP) test?

A

Patient fully expires to RV and then performs a maximum inspire (peak negative pressure)

40
Q

What is a maximal expiratory test?

A

Patient inspires fully to TLC and then performs a maximum expire (peak positive pressure)

41
Q

When would sniff pressure be used over the mouth?

A

For those who have facial weakness or kids

42
Q

What is true about normal MIP?

A

Decreases with age and women are lower than men

43
Q

What is the most common breathing endurance test?

A

Constant/fixed loading protocol

44
Q

What is the load set at in the constant/fixed loading protocol?

A

50% of MIP (pace set with metronome and go til failure)

45
Q

What is the maximal incremental threshold loading protocol?

A

Patients breathe against resistive lead that is increased at regular intervals by 10% of baseline MIP until failure

46
Q

What is hyperpnoea test?

A

Patient breathes at a constant ventilation to failure

47
Q

What is inspiratory duration?

A

Duration of maximal breath in measured in seconds

48
Q

How does the respiratory muscle metaboreflex work?

A

Blood shunts to tired respiratory muscles because it prioritizes breathing the most (this leads to less blood flow to legs causing muscle fatigue)

49
Q

What percentage of MIP does endurance inspiratory muscle training start at?

A

15-20%

50
Q

What percentage of MIP does strength inspiratory muscle training start at?

A

50-60%

51
Q

What is the TIRE IMT (isokinetic training) test?

A

Patients inspire to match on screen target that is set at 60-80% of MIP until failure

52
Q

What did IMT training show a decrease in?

A

LBP

53
Q

BODE scoring

A

0-2 (80% survival rate)

3-4 (67% survival rate)

5-6 (57% survival rate)

7-10 (18% survival rate)

Cardiopulmonary (20 decks)

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