Function and Exercise Capacity

Question 1

Benefits of Exercise - disease prevention

Answer 1

• reduces the risk of premature mortaility
• reduces risk of CAD
• reduces risk of HTN
• reduces risk of stroke
• reduces risk of T2D
• reduces risk of metabolic syndrome
• reduces obesity
• helps prevent colon cancer and breast cancer
• reduces depression
• reduces falls risk
• improves cognitive function

Question 2

Benefits of Exercise - CV and Respiratory System

Answer 2

increased Vo2 max
reduced minute ventilation at submaximal intensities
reduced myocardial O2 cost at submaximal intensity
reduced HR and BP at submaximal intensity
increased capillary density of skeletal muscle
increased lactate threshold

Question 3

Benefits of Exercise - CV disease risk factors

Answer 3

reduced resting BP
increased HDL cholesterol and reduced LDL cholesterol
reduced total body fat
reduced glucose needs and improve glucose tolerance

Question 4

Benefits of Exercise - decreased morbidity and mortality

Answer 4

lower incidence of CAD, CVD and stroke
reduced risk of osteoporotic fractures
reduced risk of diabetes and some cancers

Question 5

Benefits of Exercise - biopsychosocial benefits

Answer 5

reduced anxiety and depression
reduced pain
improved cognition
enhanced feeling of overall well being

Question 6

Exercise Prescription Recommendation healthy adult

Answer 6

Frequency - aerobic exercise most days of the week
- resistance training minimum 2 days each week
Intensity - moderate-vigorous
Type - combination of purposeful aerobic and strength
Time - 150-300 mins per week at moderate intensity
- 75-150 mins per week at vigorous intensity

Question 7

Pre-Participation Health Screening

Answer 7

prior to commencing exercise testing - risk identification, classification and medical evaluation if indicated

• identification of individuals with CIs
• identification of individuals who should undergo medical evaluation
• identification of individuals with clinically significant disease

Question 8

Prevention of Cardiac Events

Answer 8

• all people should undergo self guided screening before initiating an exercise program
• HCP need good physiology and pathophysiology knowledge
• HCP working with patients with known CVD in cardiac rehab setting need more in depth procedures
• physically active individuals need to know how to identify cardiac symptoms and that they need to seek help immediately
• need to adjust and monitor training program
• use appropriate equipment, staffing and training

Question 9

Participant Instructions

Answer 9

• refrain from eating large amounts of food, consuming alcohol or caffeine, or tabacco 3 hrs prior
• need to be rested
• suitable clothing and footwear
• advise that test will be fatiguing
• continue normal use of medication - bring medication list
• consume ample fluids 24 hours prior

Question 10

Termination Criteria

Answer 10

• onset of angina
• reduced BP with increased work rate
• excessive rise in BP
• excessive SOB/wheezing
• leg cramps, claudication
• signs of poor perfusion
• failure of HR to increase with increased exercise intensity
• if subject requests to stop
• physical or verbal manifestation of severe fatigue
• failure of testing equipment that is a safety hazard

Question 11

Modes of testing

Answer 11

Field tests

• can estimate VO2
• easy to administer
• can be a maximal test - depends on motivation of the patient

Motor Drive Treadmills

• maximal or submaximal
• cater for a wide range of fitness levels
• expensive

Mechanically Braked Cycle Ergometers

• less expensive
• better at monitoring ability
• non-weight bearing
• can be limited by muscle fatigue

Step test

• minimal equipment
• difficult to monitor HR and BP
• limited by muscle fatigue

Question 12

Components of Exercise Prescription

Answer 12

frequency 
intensity 
type 
duration/time 
volume 
progression 

measuring intensity - Borg Scale
- % of max HR
- METs
consider which is best for the patient

Question 13

Absolute CIs

Answer 13

• recent changes in ECG suggestive of a cardiac event
• unstable angina
• uncontrolled dysrhythmias
• symptomatic severe aortic stenosis
• acute myocarditis or pericarditis
• acute systemic infection
• suspected or known disecting aneurysm

Question 14

Relative CIs

Answer 14

• left main coronary stenosis
• moderate stenotic valvular heart disease
• electrolye abnormalities
• severe arterial HTN
• tachydysrhythmias/bradydysrhythmias
• any neuromotor, musc or rheumatoid disorders that are exacerbated by exercise
• uncontrolled metabolic disease
• mental of physical impairment that impacts ability to participate in exercise