Pulmonary rehabilitation Flashcards
What are 6 steps in subjective assessment for pulmonary rehab
- Respiratory diagnosis
- Recent exacerbations
- PMHx
- Medications
- Social history
- Educational needs/smoking cessation support
What is ventilin
a quick acting respiratory med
Why is it important to know if someone is using Nitrospray?
if they are they need to bring it to physio/exercise program everytime
what are 5 steps to objective assessment in pulmonary rehab
- health related quality of life
- dyspnea
- Resting measurements
- IPPA
- Exercise testing
What is the modified MRC Dyspnea scale
classification method for baseline dyspnea
associated well with ADLs
What is the grades of the Modified MRC Dyspnea scale
0-4
The Modified Borg Dyspnea Scale evaluates what? and ranges from…
0-10
rates breathlessness
The rating of Perceived exertion scale (unmodified borg) evaluates what? and ranges from….
Rates exertion
Scaled ranges from 6-20
The RPE scale was designed to correlate with what
HR In healthy subjects
What are the absolute contraindication to the 6MWT
- Unstable angina
2. MI within last 30 days
What are relative contraindication to the 6MWT
- Resting HR > 120
- Systolic BP > 180 mmHg
- Diastolic BP > 100 mmHG
What were the differences between the Enright and Gibbons studies to validate a predictive equation for the 6MWT
Enright - larger sample size, older population, american
Gibbons - Smaller sample size, age 20-40, canadian
What are 3 ways to prescribe aerobic exercise
- based on cardiopulmonary exercise testing
- Utilizing 6MWT resultls
- Symptom driven
What should be the aerobic exercise prescription based on cardiopulmonary exercise testing
- 50-80% of VO2 peak/peak workload
- 50-80% of watts
What should be the aerobic exercise prescription based on 6MWT results
- 50-80% of 6MWT speed
- Speed = (0.5 to 0.8) x (6MWT distance/100)
What should be the aerobic exercise prescription based on symptoms
RPE or BORG 3-5
What is the FITT for aerobic exercise in pulmonary rehab populations
F - 3-5 times per week
I - Based on testing/symptoms
T - Progression towards 30-40 mins continous
T - Large muscle groups, ideally lower extremities
what is the FITT for strength exercises in pulmonary rehab populations
F - 3 days per week
I - 8-12 repetitions
T - Varies
T - Free weights/resistance bands/body weights
In pulmonary rehab populations, how should you progress the treadmill? bike? resistance exercise?
Treadmill - 5-10% weekly
Bike - 5% weekly
Resistance - 5-10% weekly
What are the absolute limits for exercise in pulmonary rehab
- SpO2 below 88%
- BORG greater than 5
- Abnormal cardiac responses (increase in SBP or drop in HR)
- pain, nausea, dizziness, headaches
Up to ___% reduction in function capacity post lung transplant vs. healthy, age matched population
60%
What are 5 goals for lung transplant patients in Pulmonary rehab
- Improve physical functioning
- Improve respiratory mechanics
- Facilitate secretion clearance
- Prevention of comorbidities
- Education
What are post lung transplant exercise limits
- SpO2 <92%
- Abnormal cardiac responses
- Pain/nausea/dizziness/headaches
Is dyspnea a reliable measure for exercise tolerance for people with lung transplant
no - will commonly feel SOB with exercise
