Week 6 HF, CM, Valve dx Rehab

Question 1

HF key takeaways CPG

Answer 1

increase physical activity levels
aerobic exercise
education on disease management
HIT
Resistance training
IMT

Question 2

HF Objective information

Answer 2

vitals
RPE/activity tolerance
strength + ROM
balance
functional mobility

Question 3

HF Intervention recommendations

Answer 3

Balance
gait speed/mechanics
activity tolerance
proximal strengthening

Question 4

Aerobic exercise recommendations for HF

Answer 4

Time: 20–60 min
Intensity: 50%–90% of peak VO2 or peak work
Frequency: 3–5/wk
Duration: at least 8–12 wks
Mode: treadmill or cycle ergometer or dancing

Question 5

Resistance Exercise Recommendations for HF

Answer 5

HIIT: indicated with NYHA II-III HF; >35 min @ 90-95% peak VO2, 2-3x/wk, over 8-12 wks on treadmill or bike
Resistance training: indicated with NYHA II-III HF; 2-3 sets; 3x/wk for 8-12 wks @ 60-80% 1RM
May combine aerobic with resistance training: 20-30 min each, 3x/wk for 8-12 wks

Question 6

Cardiomyopathy subjective history

Answer 6

Past Medical History
Type of cardiomyopathy
Symptoms and prevalence with physical activity
DME/AD needs
Baseline mobility/ADL levels
Typical RPE with mobility/ADL tasks

Question 7

Cardiomyopathy objective information

Answer 7

Strength
Posture
Functional endurance
Balance
Functional mobility

Question 8

Cardiomyopathy intervention considerations

Answer 8

Study on hypertrophic CM: >50% of subjects did not meet exercise criteria; common barriers=pain, disability; older adults w/ more education more likely to meed criteria
Patients with HCM are typically less active than age-matched peers
Barriers: MD restrictions, patient fear/avoidance behaviors

Question 9

Cardiomyopathy intervention recommendations

Answer 9

Target 150 min/wk of physical activity
Athletes: avoid hot environments, pre-screening EKG, avoid certain athletic activities
Acute care patient: gradual increase in physical activity, patient education, energy conservation, symptom monitoring and management

Question 10

Valve disease subjective history info

Answer 10

Extent of disease
Secondary symptoms such as SOB, fatigue
Extent of symptoms, frequency, effect on mobility/physical activity
Surgical history

Question 11

Valve disease objective info

Answer 11

Strength
Posture
Functional endurance
Balance
Functional mobility

Question 12

Valve disease intervention considerations

Answer 12

Avoid HIIT, straining, Valsalva, and high intensity in most cases
Consider: symptoms, ventricular function, type of valve disease
Individuals with valve regurgitation may tolerate activity better than those with stenosis

Question 13

Valve disease intervention recommendations

Answer 13

Per BMJ: 150 min of mod intensity activity is appropriate
With severe aortic or mitral valve stenosis, low intensity exercise recommended by experts
Avoid sedentary behaviors
Resistance training and flexibility training

Question 14

Individuals with severe aortic regurgitation can still partake in

Answer 14

moderate-intensity exercise provided the left ventricle (LV) and aorta are not significantly dilated and the ejection fraction (EF) remains >50%.

Question 15

individuals with severe mitral regurgitation can partake in

Answer 15

moderate-intensity exercise if the LV end-diastolic diameter <60 mm, the EF ≥60%, resting pulmonary artery pressure <50 mm Hg and there is an absence of arrhythmias on exercise testing

Question 16

Asymptomatic individuals with minor valvular abnormalities may engage in all forms of competitive sport, whereas those with lesions of moderate severity may

Answer 16

exercise intensively if an exercise stress test tailored to the relevant physical activity reveals good functional capacity without myocardial ischaemia, haemodynamic disturbances or arrhythmia