Exercise Prescription

Question 1

What is measured during an exercise stress test and when are they measured?

Answer 1

HR, BP, ECG, RPE, and abnormal Signs and symptoms are measured before, during, and after exercise stress testing

Question 2

What are the absolute indications for terminating an exercise stress test?

Answer 2

• drop in SBP over 10 mm Hg from baseline despite increase in workload with other signs of ischemia
• moderately severe (3/4) angina
• increasing nervous system symptoms (ataxia, dizziness, etc.)
• signs of poor perfusion (cyanosis, pallor)
• sustained ventricular tachycardia
• 1 mm ST elevation in leads w/o diagnostic Q waves

Question 3

What are the relative indications for terminating Exercise stress tests?

Answer 3

• drop in SBP over 10 mm Hg from baseline w/o evidence of ischemia
• 2+ mm ST depression
• arrythmias other than sustained ventricular tachycardia such as PVCs or heart blocks
• fatigue, SoB, wheezing, leg cramps, and claudication
• increasing chest pain
• hypertensive response (SBP over 250 and/or DBP over 115)

Question 4

What does a positive exercise stress test indicate?

Answer 4

high probability of coronary artery disease

Question 5

What are the indications for prescribing aerobic exercise?

Answer 5

• reduced cardiorespiratory endurance

- primary and secondary prevention of cardiovascular disease

Question 6

What are the precautions/contraindications for aerobic exercise?

Answer 6

• avoid valsalva

- appropriate screening must be done prior to exercise to evaluate for risk factors and identify known diseases

Question 7

What are the two most common methods of prescribing intensity for aerobic exercise?

Answer 7

Percent of Max HR (usually between 55-90%)

Heart rate reserve using the Karvonen formula (usually between 40-85%)

Question 8

What does the duration of aerobic exercise depend on?

Answer 8

Intensity of the activity with low intensity exercise having a longer duration (over 30mins) and higher intensity exercise having a lower duration (20mins)

Question 9

What duration and intensity is most recommended for adults not training for athletic competition?

Answer 9

moderate intensity for a longer duration to avoid hazards and adherence problems with high intensity exercise

Question 10

How frequently should patients who have been prescribed aerobic exercise perform workouts?

Answer 10

3-5 days a week

Question 11

What are the normal cardiorespiratory response to acute aerobic exercise?

Answer 11

• increased oxygen consumption due to increased cardiac output
• linear increase in SBP with increasing workload
• no change or moderate decrease in DBP
• increased respiratory rate and tidal volume

Question 12

What are the chronic adaptations to aerobic exercise?

Answer 12

-increased VO2 Max
-Decreased HR response to sub max exercise
-no change or slight increase of BP with maximal exercise or slight decrease with submaximal
-increased blood lactate at maximal exercise, decreased at submaximal
-increase in mitochondrial number and size in muscle cells as well as increased capillary density and oxidative enzymes
-increased plasma volume
-reduced body fat and increased lean body mass
-improved psychological factors
=increased body heat transfer