Exercise Prescription / METs (SB-BP)
what are relative indications for terminating exercise regarding SBP, angina, perfusion, ECG, and ST elevation
* drop in SBP > 10mmHg from baseline despite increase in workload without other evidence of ischemia * other arrhythmias other than sustained v-tach (multifocal PVCs, supraventricular tachycardia, heart block, or bradyarrhythmias) * > 2 mmST depression * fatigue, SOB, wheezing, leg cramps, and claudication * increasing chest pain * hypertensive response (SBP>250mmHg / DBP > 115 mmHg)
what are absolute indications for terminating exercise regarding SBP, angina, perfusion, ECG, and ST elevation
* drop in SBP >10mmHg from baseline despite increase in workload with other evidence of ischemia * moderately severe angina (3 on a scale of 4) * increased nervous system symptoms (ataxia, dizziness) * signs of poor perfusion (cyanosis, pallor) * sustained V-tach * 1.0mm ST elevation in leads without diagnostic Q waves
1. how do we determine the duration of aerobic interventions? 2. what is the difference between duration for lower and higher intensity exercises? 3. what is an appropriate frequency?
1. 20-60 minutes of continuous or intermittent activity (minimum of 10 minute bouts accumulated throughout the day 2. lower: should be performed over a longer period of time (>30 mins) higher: should be performed for 20 minutes or longer 3. 3-5 days per week
How do we measure Heart Rate max?
220 - age
1 met is equivalent to _________ mLO2/kg/min
3.5 mLO2/kg/min
Healthy adults between the ages of 18 and 65 years old should engage in aerobic activity consisting of:
30 minutes of moderate aerobic activity 5 days a week
The first stage of the Bruce protocol requires roughly how many metabolic equivalents (METs)?
5 mets
Which percentage of the maximum heart rate would be the most appropriate exercise parameter for a 72-year-old in excellent cardiovascular health?
70%-80%
describe SBP with a linear increase in workload describe DBP with a linear increase in workload describe respiratory rate and tidal volume with linear increase in workload
8-12mmHg increase with every MET no change or moderate decrease in DBP increased respiratory rate and tidal volume
Which level of exercise intensity would be the most appropriate for a patient who is nearing discharge from inpatient cardiac rehabilitation?
A patient who is in a Phase I cardiac rehabilitation (i.e., inpatient) program is typically exercising at an intensity of 1-4 METs. As they are nearing discharge from their inpatient stay, they should be exercising at an intensity of 3-4 METs, which may include activities such as walking in the hallway and climbing up and down a flight of stairs.
To avoid the risk of heat illness when the humidity is high, what is the recommendation for target heart rate?
Exercise in hot and humid weather can be performed safely if the necessary precautions are taken. For individuals who have a specific target heart rate when training, they should maintain this target heart rate to avoid the onset of heat illness. Though it is not necessary to lower the target heart rate, the patient will reach their normal target heart rate at a lower exercise intensity due to the humidity.
training of which types of muscles is the most effective at improving cardiovascular fitmess?
Exercises that involve large muscle groups are the most effective at improving a patient's cardiovascular fitness. Both bench pressing and squats require the use of multiple different muscle groups to perform the motion. However, squats would be more effective since the muscles of the legs are much larger than the muscles of the arms.
how do we determine lower and upper target hear rate based on heart rate max?
Lower: HRmax x 55% Upper: HRmax x 90%
how do we determine lower and upper target heart rate based on heart rate reserve (KARVONEN FORMULA)?
Lower: [(HRmax-HRrest) x 40%] + HRrest Upper: [(HRmax-HRrest) x 85%] + HRrest
When calculating energy expenditure using metabolic equivalents, which variables must be considered?
One metabolic equivalent is equal to 3.5 milliliters of oxygen per kilogram of body weight per minute. Therefore, when calculating energy expenditure, both the patient's weight and the duration of the activity would need to be considered.
A patient with a cardiovascular disorder should perform resistance training at which intensities?
Resistance training using a low intensity (approximately 40% of the one-repetition maximum) and high repetitions is safe for patients with cardiovascular disease since it lowers the oxygen demand on the myocardium, yet still is effective at improving the patient's muscular and cardiovascular endurance.
what is the difference between upper and lower body exercises with regards to BP? with regards to a debilitated patient with cardiopulmonary dysfunction, which exercises would be least appropriate and why?
Upper body exercise increases heart rate and blood pressure more significantly for any given work load than lower body exercise. upper body exercises, because they would significantly increase HR and BP
Chronic adaptations to aerobic exercises with maximal and submaximal exercises regarding: VO2 Max HR arteriovenous oxygen difference SBP/DBP blood lactate oxidative capacity maximal voluntary ventilation plasma volume skeletal muscle blood flow body mass body heat transfer psychological benefits
VO2 Max: increase at maximal exercise HR: mo change or decrease at maximal exercise, decreased at submaximal exercise arteriovenous oxygen difference: increase at maximal exercise, no changes at submaximal exercise SBP/DBP: no change or slight increase at maximal exercise, no change and slight decrease at submaximal exercise blood lactate: increase at maximal exercise, decrease at submaximal exercise oxidative capacity of muscles: increase in mitichondrial number and size, capillary density, and oxidative enzymes maximal voluntary ventilation: increased at maximal exercise plasma volume: increased skeletal muscle blood flow: increase at maximal exercise, no change at submaximal exercise body mass: reduced body mass and body fat, and increase in fat free body mass body heat transfer: improved body heat transfer due to larger plasma volume and more responsive thermoregulatory mechanism psychological benefits: reduced anxiety, stress, and depression, improved mood, and self-esteem
toileting is considered _______ intensity, equalling ________ METs driving a car is considered _______ intensity, equalling ________ METs working at a computer/desk is considered _______ intensity, equalling ________ METs making bed/washing dishes is considered _______ intensity, equalling ________ METs bathing is considered _______ intensity, equalling ________ METs cooking is considered _______ intensity, equalling ________ METs
light, 1-2 light, 1-2 light, 1.5 light, 2 light, 2-3 light, 2-3
playing cards, arts, and crafts is considered _______ intensity, equalling ________ METs playing a musical instrument is considered _______ intensity, equalling ________ METs fishing (sitting) is considered _______ intensity, equalling ________ METs
light, 1.5 light, 2-2.5 light, 2.5
walking slowly at home is considered _____ intensity, equalling ______ METs walking 3 mph is considered _______ intensity, equalling ________ METs walking 4 mph is considered _______ intensity, equalling ________ METs walking 4.5mph is considered ______ intensity, equalling ______ METs jogging 5 mph is considered ______ intensity, equalling ______ METs running 7mph is considered ______ intensity, equalling ______ METs
light, 2 moderate, 3-4 moderate 4.5-7 vigorous, 6.3 vigorous, 8 vigorous, 11.5
What standardized measurement refers to the amount of oxygen consumed at rest by the average person?
metabolic equivalent
what parameter is recommended for adults who are not training for athletic competition in order to enhance cardiovascular endurance
moderate intensity, long duration
washing windows is considered _______ intensity, equalling ________ METs sweeping, vacuuming is considered _______ intensity, equalling ________ METs light gardening is considered _______ intensity, equalling ________ METs carrying, stacking wood is considered _______ intensity, equalling ________ METs power lawn mowing is considered _______ intensity, equalling ________ METs
moderate, 3 moderate, 3-3.5 moderate, 3-4 moderate, 5.5 moderate, 5.5
slow dancing is considered _______ intensity, equalling ________ METs table tennis is considered _______ intensity, equalling ________ METs fast dancing is considered _______ intensity, equalling ________ METs basketball (sooting around) is considered _______ intensity, equalling ________ METs sexual intercourse is considered _______ intensity, equalling ________ METs golf is considered _______ intensity, equalling ________ METs swimming is considered _______ intensity, equalling ________ METs tennis doubles is considered _______ intensity, equalling ________ METs bicycling 10-12mph is considered _______ intensity, equalling ________ METs
moderate, 3 moderate, 4 moderate, 4.5 moderate, 4.5 moderate, 4-5 moderate, 4-7 moderate, 4-8 moderate, 5 moderate, 6
What two variables are manipulated when using the Bruce protocol?
speed and elevation
An appropriate heart rate to be maintained during the peak period in aerobic training, calculated as a percentage of the individual's maximum heart rate, is termed:
target heart rate
The physiological effects of aquatic therapy on: venous circulation cardiac output cardiac volume hear rate SBP rate of oxygen uptake
venous circulation: increase cardiac output: increase cardiac volume: increased hear rate: decreased SBP: decreased rate of oxygen uptake: decreased
backpacking is considered _______ intensity, equalling ________ METs basketball game is considered _______ intensity, equalling ________ METs bicycling 12-14 mph is considered _______ intensity, equalling ________ METs bicycling 14-16mph is considered _______ intensity, equalling ________ METs
vigorous, 5-11 vigorous, 8 vigorous, 8 vigorous, 10
shoveling is considered _______ intensity, equalling ________ METs carrying heavy loads is considered _______ intensity, equalling ________ METs heavy farm work is considered _______ intensity, equalling ________ METs digging ditches is considered _______ intensity, equalling ________ METs
vigorous, 7 vigorous, 7.5 vigorous, 8 vigorous, 9.5