Pulmonary rehabilitation

Question 1

What are 6 steps in subjective assessment for pulmonary rehab

Answer 1

1. Respiratory diagnosis
2. Recent exacerbations
3. PMHx
4. Medications
5. Social history
6. Educational needs/smoking cessation support

Question 2

What is ventilin

Answer 2

a quick acting respiratory med

Question 3

Why is it important to know if someone is using Nitrospray?

Answer 3

if they are they need to bring it to physio/exercise program everytime

Question 4

what are 5 steps to objective assessment in pulmonary rehab

Answer 4

1. health related quality of life
2. dyspnea
3. Resting measurements
4. IPPA
5. Exercise testing

Question 5

What is the modified MRC Dyspnea scale

Answer 5

classification method for baseline dyspnea

associated well with ADLs

Question 6

What is the grades of the Modified MRC Dyspnea scale

Answer 6

0-4

Question 7

The Modified Borg Dyspnea Scale evaluates what? and ranges from…

Answer 7

0-10

rates breathlessness

Question 8

The rating of Perceived exertion scale (unmodified borg) evaluates what? and ranges from….

Answer 8

Rates exertion

Scaled ranges from 6-20

Question 9

The RPE scale was designed to correlate with what

Answer 9

HR In healthy subjects

Question 10

What are the absolute contraindication to the 6MWT

Answer 10

1. Unstable angina

2. MI within last 30 days

Question 11

What are relative contraindication to the 6MWT

Answer 11

1. Resting HR > 120
2. Systolic BP > 180 mmHg
3. Diastolic BP > 100 mmHG

Question 12

What were the differences between the Enright and Gibbons studies to validate a predictive equation for the 6MWT

Answer 12

Enright - larger sample size, older population, american

Gibbons - Smaller sample size, age 20-40, canadian

Question 13

What are 3 ways to prescribe aerobic exercise

Answer 13

1. based on cardiopulmonary exercise testing
2. Utilizing 6MWT resultls
3. Symptom driven

Question 14

What should be the aerobic exercise prescription based on cardiopulmonary exercise testing

Answer 14

• 50-80% of VO2 peak/peak workload

- 50-80% of watts

Question 15

What should be the aerobic exercise prescription based on 6MWT results

Answer 15

• 50-80% of 6MWT speed

- Speed = (0.5 to 0.8) x (6MWT distance/100)

Question 16

What should be the aerobic exercise prescription based on symptoms

Answer 16

RPE or BORG 3-5

Question 17

What is the FITT for aerobic exercise in pulmonary rehab populations

Answer 17

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

Question 18

what is the FITT for strength exercises in pulmonary rehab populations

Answer 18

F - 3 days per week
I - 8-12 repetitions
T - Varies
T - Free weights/resistance bands/body weights

Question 19

In pulmonary rehab populations, how should you progress the treadmill? bike? resistance exercise?

Answer 19

Treadmill - 5-10% weekly
Bike - 5% weekly
Resistance - 5-10% weekly

Question 20

What are the absolute limits for exercise in pulmonary rehab

Answer 20

• SpO2 below 88%
• BORG greater than 5
• Abnormal cardiac responses (increase in SBP or drop in HR)
• pain, nausea, dizziness, headaches

Question 21

Up to ___% reduction in function capacity post lung transplant vs. healthy, age matched population

Answer 21

60%

Question 22

What are 5 goals for lung transplant patients in Pulmonary rehab

Answer 22

• Improve physical functioning
• Improve respiratory mechanics
• Facilitate secretion clearance
• Prevention of comorbidities
• Education

Question 23

What are post lung transplant exercise limits

Answer 23

• SpO2 <92%
• Abnormal cardiac responses
• Pain/nausea/dizziness/headaches

Question 24

Is dyspnea a reliable measure for exercise tolerance for people with lung transplant

Answer 24

no - will commonly feel SOB with exercise