Special Considerations for Exercise Prescription Flashcards
(51 cards)
Signs of HR failure to increase with increasing workload could be a signs of:
LV dysfunction or medication effect (beta blockers)
Failure of SBP to inc c workload could be indicative of:
Ischemia or LV dysfunction or medication effect
How much should DBP inc c exercise?
DBP should not have a big change (5-10 mmHg)
Poor HR recovery ________
low VO2 _______ for men
Low VO2 ________ for women correlated c 10 year mortality
<13 bpm; <19 ml/kg/min; <15 ml/kg/min
Mortality rate associated with poor HR recovery
Poor HR recovery and low peak
VÓ are predictive of mortality
Even in pts c good peak VÓ those pt who have poor HR recover have higher mortality
What are the levels of cardio respiratory fitness?
Low CRF <7.9 METS (inc mortality)
Intermediate CRF 7.9-10.8 METS
Higher CRF >10.9 METS
Frequency
3 to 5 days per week
Depends on your goals
3 days are sufficient at higher intensities
Intensity
HR
RPE
MET level
Time
20-60 min (90 min AMA)
Continuous or non-continuous
Minimum of 10 min bouts
Low intensity = longer duration
High intensity = shorter duration
HR c Stress test
(MHR-RHR) x % + RHR
HR without stress with dx
20 above rest MI
30 above rest open heart
HR without stress without dx
((220 - age) - RHR) x % + RHR
Target MET level
Use max MET level attained on stress test (last completed stage)
50-85% max MET achieved
Ex. Max MET level achieved 6 METs (6 x 50%) = 3 METs
What MET level should you use if a stress test wasn’t used?
Start at 2-3 METs
____________ ft above sea level and less, most pts find little discomfort exercising
3000 ft
Significance of >5000 ft altitude in pt’s with angina
Atmospheric pressure begins to drop, body adapts to achieve same CO by inc HR
Angina levels may be reached sooner c exercise intensity
At what altitude should pts be counseled about activity at these levels
3500 ft
Effects of cold at rest and with exercise
Increase in peripheral resistance
Peripheral vasoconstriction causes inc in arterial BP, possibly causing earlier ischemic changes with an inc in myocardial demand and cold induced vasospasms
T/F: Pulmonary patients may shovel snow as the MET levels are in range
FALSE
Considerations with heat and humidity
Higher temps cause dilation of peripheral vasculature (inc HR to maintain CO)
What is the primary concern with heat and humidity for pulmonary patients?
Dehydration
At what temperature and humidity should pulmonary pt’s avoid vigorous exercise?
> 80 or humidity >65% to 70%
Elderly
With aging comes:
Inc BP
Dec exercise HR
Prolonged contraction time of cardiac mm
Dec rate and force of contraction
Impaired ventricular filling
Dec mm strength
Exercise prescription special considerations with elderly population
Good MSK screen
Prolonged warmup and cool down
WB activities
Stretching
Avoid jarring exercises (jogging)
Rest periods
