PRINCIPLES OF REHAB CARDIORESP Flashcards
What is the 6 minute walk test?
Measure the distance covered on a flat hard surface in 6 minutes.
Exercise test to assess sub maximal aerobic capacity and endurance
Can be used before and after exercise rehabilitation eg pulmonary rehab
Can also be used pre-op to give an indication of a patient’s recovery
What are some advantages of the 6 minutes walk test?
Easy to administer, better tolerated, and more reflective of activities of daily living
Simple and reproducible
No additional equipment or advances training
Evaluates the responses of all the systems involved during exercise
Reliable and valid measures in patients with asthma
Valid and objective to assess clinical status
Reliable with duplicate measurements
Supports chronic respiratory disease
What are some conditions you can use the 6 minutes test for?
Arthiritis, fibromyalgia, geriatrics, multiple sclerosis, spinal cord injury
What is the 30 seconds sit to stand test?
Used for testing leg strength and endurance in older adults. Participant is encouraged to complete as many full stands as possible.
Explain the 3 minute aerobic test?
Can be performed on a wattbike. t will calculate your maximum minute power and maximum heart rate. Can use this information to set training zones and give structure to training with your smart bike
What position is recommended by the british thoracic society and association of chartered physiotherapists in respiratory care?
The forward lean position and passively fixing the shoulder girdle. This helps dome the diaphragm which lengthens its muscle fibres and improving the force generation.
Also improves accessory muscles of exhalation as it places them in a better position
What is the breathing, thinking, functioning model?
Breathing within the chest, thinking about dying due to not being able to get enough air - state of panic. Respiratory muscles become less active and so less fit, so small ‘chesty’ breathing continues.
What are some strategies for managing respiration?
Relaxation
Breathing control - reeducating breathing pattern
- re education in diaphragmatic function
- slowing breathing
- pursed lip breathing/SOS breathing
Pacing and lifestyle management
Other strategies
- Fan therapy
- Keep active - Pulmonary Rehab
What is the breathing, thinking, functioning model?
A viscous cycle in which unhelpdul emotions prolong and worsen the effects of breathlessness.
Breathing - small breathes stemming from the upper chest, so breathing becomes harder work
Thinking - thoughts about dying and gasping for breath, panic
Functioning - becoming less active due to fear, need help with daily activities, muscles involved in breathing become less fit
Back to breathing - worsening cycle.
What are some of the oxygen delivery devices?
Nasal cannulae
Simple face mask (hudson mask)
Non-rebreather mask (reservoir mask)
Venturi mask
Humidified oxygen
Describe an asthma action plan?
So patients can manage their asthma between asthma reviews. It tells the patient which medications to take every day, what to do if their asthma symptoms get worse, what emergency action to take if they have an asthma attack.
Section 1: everyday asthma care eg number of puffs, taking preventer medication everyday atc
Section 2: if they feel worse eg extra puffs, oral steroids, rescue packs, see a GP if it gets worse, or start the course of steroids. Maintainence and reliever therapy
Section 3: in an asthma attack. Signs and symptoms, what to do, when to call 999, when to contact GP after an attack
Tracking peak flow scores
Asthma triggers
Asthma review
What is the A to E assessment of an acutely ill adult?
A - airway, are they talking? Obstructor, stridor?
B - breathing, rate, pattern, SaO2, ascultation, oxygen?
C - circulation, BP, pulse, CRT
D - disability, pupils ACVPU, blood sugar, pain
E - exposure, injuries, rashes, signs of infection
ACVPU stands for alert, confused, responds to voice, responds to pain, unresponsiveness.
What is a vasovagul syncope?
Clinical word for fainting
What are some consideration to make after getting someone up after an episode of syncope?
Recovery position
Elevate legs to improve venous return
Monitor your patient as they regain consciousness
Maintain oxygen therapy if necessary
Assess for any injuries.
A person often fees nauseous and may vomit
Often there is prolonged fatigue after a faint.
Worrying symptoms: chest pain, breathlessness, severe headache, stiffness or jerky movement, not breathing or going blue. Prolonged unconscioussness lasting more than 5-10 minutes once lying down.
What is SBAR?
Review after an event has occured
S - situation: what happened, indtify self, place, patient, problem, what it is, when it happened, how severe
B - background: diagnosis and date of admission, current medications, IV fluids, past medical history, resus status
A - assessment: current vital signs, positive vital signs, action and response, interpretation?
R - recommendation: what do you need or want to happen eg check bp every 2 hours.
What are METS?
Metabolic equivalents
1 MET - the energy you spend sitting at rest (resting metabolic rate)
4 METs - you are exerting 4 times the energy you would do if you were sitting still.
Less than 1.5 - sitting, sleeping
1.6-3 - sweeping floors, folding laundry, cooking, walking 2.0 miles on a level surface.
3.1-6 - walking the dog, carrying load upstairs, food shopping. Walking 3.0 miles on flat surface
Greater than 6 - swimming, jogging, shoveling.
What are the principles of exercise therapy?
Overload - intensity?
Progression - adapt exercises for improvement?
Specificity - which body systems are challenges?
Individual differences - specific to the patient
Recovery - building recovery into the exercise scheme.
