Exercise for Special Populations - Cardiac Rehab & Physical disabilities (SCI) (NOT IN EXAM)

Question 1

What % of adults (UK) don’t meet PA recommendations, and what % have obesity?

Answer 1

37% do not meet PA recommendations.
28% have obesity

Question 2

What are common medications for cardiac patients?

Answer 2

B-blockers
- decrease HR and/or BP
- decrease work of the heart

Anti-arrhythmia medication (calcium channel blockers)
- control dangerous heart rhythms, risk of bleeding increase

Nitroglycerin
- relax smooth muscle in veins to reduce venous return
- reduce angina symptoms

patient implications: decrease maximal exercise capacity, increase muscle fatigue, risk of hypotension

Question 3

What does graded exercise testing (GXT) include monitoring of?

Answer 3

• ECG (12-lead) - HR and rhythm, signs of ischemia
• BP
• RPE

Question 4

If any of the following symptoms occur, stop exercise and evaluate:

Answer 4

• chest pain or tightness
• dizziness or faintness
• pain in the arm or jaw
• severe shortness of breath
• an irregular heartbeat
• excessive fatigue

Question 5

Cardiac rehab is safe and effective and should start within 10 days of discharge from hospital. What are the 3 phases of cardiac rehab?

Answer 5

1) inpatient exercise program
2) outpatient exercise, close supervision
3) less direct supervision, may be home-based

Question 6

What are the AHA recommendations for PA in adults for overall CV health?

Answer 6

• > 30 mins mod-intensity aerobic activity at least 5 days per week. Per week for a total of 150 mins.
  OR…
• > 25 mins vig-aerobic activity at least 3 days per week. Per week for a total of 75 mins,

Question 7

Rank (%) the disability types who get no aerobic PA

Answer 7

Mobility (57%)
Cognitive (40%)
Vision (36%)
Hearing (33%)
None (26%)

Question 8

What does the summary of evidence suggest with regards to exercise prescription for disabled people?

Answer 8

‘Low to moderate confidence in evidence that 3-5 sessions per week of upper-body aerobic exercise at moderate to vigorous-intensity for 20 –44 mins can improve cardiorespiratory fitness, body composition and CVD risk’

Question 9

What are some considerations when prescribing exercise to disabled individuals?

Answer 9

Determine the level of functional independence and assistance required
- ROM, sitting and standing balance, spasticity, strength imbalances

Invisible issues
- post exercise hypotension could lead to syncope
- minimise triggers for autonomic dysreflexia (should empty bowel and bladder before exercise)
- impaired thermoregulatory control