Respiratory Exercise Prescription

Question 1

Exercise Considerations: Mild Lung Disease

Answer 1

-80 of predicted values but <70% of FEV1/FVC
-does well with exercise

s/s: SOB, cough

Question 2

Exercise Considerations: Moderate Lung Disease

Answer 2

<80 FEV1
-limited exercise tolerance
-consider meds being taken
-vitals

s/s:
-SOB with mild acivity, modify ADLs
-decreased respiiratory capacity

Question 3

Exercise Considerations: Severe Lung Disease

Answer 3

FEV1 <50
-limited walking
-need for O2, elevated CO2

Question 4

Exercise Considerations: Poor Oxygenation

Answer 4

-limits exercise capacity

s/s: SOB, decreased SaO2, secretions, cyanosis

Treat:
-postural drainage, huffing, coughing, percussion, O2, bronchodilators

Question 5

Exercise Considerations: Pump Dysfunction/Failure

Answer 5

Dysfunction
-weakness of diaphragm or fatigue
-reliance of accessory muscles and costal retraction
s/s: SOB, drop in O2
-Treat:
-breathing, positioning, supplementarry O2 (not too much or decrease in breathing drive), exercise training

Failure
-advancement of dysfunction
-further decline
-Mechanical dysfunction: obstruction of lungs, increased effort, accessory muscles (paradoxical breathing= hoover’s sign)
-Muscle Dysfunction: diaphragm ineffective
-Control Dysfunction: brainstem of breathing control

-Treat: leaning forward, urse liped

Question 6

Exercise Considerations: Pulmonary Hypertension

Answer 6

->20mmhg at rest and 30 during exercise
-40-50 stop exercise
-increased O2 demand, vasodilators, Ca blockers

s/s: hypoxia, dizziness, LOC

1. PAH
2. Left Heart Disease
3. Lung Disease
4. Chronic PE
5. Insidious

Question 7

Exercise Considerations: Downward Spiral of Dyspnea Deconditioning

Answer 7

-Dyspnea during exercise
-less exercise: avoidance
-deconditioning: type 1 fibers then 2
-dysnea in early exercise…ADLs

Question 8

Exercise Considerations: Chronic Bronchitis

Answer 8

-hypersecretion of mucus
-low endurance, dyspnea, obesity, muscle fatigue

-reduced FEV1/FVC and FEV1

Question 9

Exercise Considerations: Emphysema

Answer 9

-decreased gas exchange
-hyperinflation
-low endurance
-accessory msucle use
-muscle wasting

-reduced FEV1/FVC and FEV1

Question 10

Exercise Considerations: Asthma

Answer 10

-wheezing, chest tightness, SOB
-low FEV1/FVC

Question 11

Predicted Percentage of Static Lung Volumes

Answer 11

<80% = Restricted Lung disease
>120%= obstructive lung disease

Question 12

Exercise tests for Muscle Strength

Answer 12

-if minute ventilation and max volume of inhalation are withing 70%= lungs were cause of end of exercise
-look for low dyspnea with high SpO2

Question 13

Dyspnea Scale

Answer 13

-1-5

Question 14

COPD Inspiratory Muscle Training

Answer 14

-<60% predicted
-diaphragmatic breathing
-facilitate expiration
-start at 30%