What is the estimated prevalence of adults (≥20 years old) diagnosed with coronary heart disease (CHD) in the United States?

7.1%

In which sex is coronary heart disease (CHD) more prevalent?

higher in males (8.7%) than in females (5.8%)

What are the benefits of aerobic exercise training in patients with CHD?

26% lower risk of cardiovascular-related mortality, 23% lower risk of all-cause hospitalization, and 18% lower risk of MI

What type of exercise should exercise programs for patients with CHD focus on?

aerobic exercise training utilizing exercise modes that engage large muscle groups

What intensity should patients with myocardial ischemia avoid during exercise?

intensity that causes signs or symptoms of myocardial ischemia or symptoms of poor perfusion

Is resistance training generally safe for patients with CHD?

Generally safe for patients with CHD

When should resistance training be added for patients with CHD?

Only add RT after 2-4 weeks of aerobic training

What conditions commonly require cardiac rehabilitation?

post-MI, CABGS, PTCA, heart failure

What components are included in cardiac rehabilitation?

Medical evaluation, Prescribed exercise, Education

What are the major goals of cardiac rehabilitation?

limit the physiologic and psychological effects of cardiac illness reduce the risk for sudden death or reinfarction control cardiac symptoms enhance the psychosocial and vocational status of selected patients

How long does inpatient exercise commonly last?

3-5 days

What should be determined during inpatient exercise recommendations?

Determine the patient’s risk

What should be assessed during inpatient exercise recommendations?

Assess the patient’s tolerance to anticipated requirements of daily living

What should patients be educated on during inpatient exercise recommendations?

the benefits of a healthy diet and physical activity

What is the recommended frequency for inpatient exercise?

3-4x/day

What exercise modes are recommended during inpatient exercise?

Arm and leg ROM, Postural change,Self-care activities,Walking and other similar modes if tolerated and available

What should outpatient exercise recommendations include?

aerobic, resistance-training, and flexibility

What is another term for stroke?

cerebrovascular accidents (CVAs) or brain attacks

What happens during a stroke?

Blood flow to the brain is reduced and leads to death of brain tissue

What are the two major types of stroke?

Ischemic (most common) vs hemorrhagic

What comorbidities are commonly associated with stroke?

Coronary artery disease, Hypertension, Hyperlipidemia, Diabetes mellitus, Obesity, Peripheral vascular disease

What consideration should be made regarding VO2 in stroke survivors?

VO2 may be higher at a given workload

What exercise modes may be preferred for stroke survivors with balance issues?

Seated/recumbent cycling/stepping may be preferred if balance issues exist

What maneuver should stroke survivors avoid during aerobic and resistance exercises?

Avoid the Valsalva maneuver during aerobic and resistance exercises.

What treadmill speed should stroke survivors begin at?

slow speed (~0.8 mph).

What is COPD?

Disease characterized by airflow obstruction attributable to either chronic bronchitis or emphysema

What are the major causes of COPD?

Cigarette smoking, Exposure to smoke, Air pollution

What are the major symptoms of COPD?

Dyspnea/shortness of breath with exertion, chronic cough, sputum produciton

What is chronic bronchitis?

Presence of a productive cough for 3 consecutive months in each of 2 successive years

What causes the cough in chronic bronchitis?

hypersecretion of mucus, which enlarges mucus-secreting glands

What is emphysema?

Abnormal permanent enlargement of alveoli and respiratory bronchioles

What occurs in emphysema?

progressive destruction of lung tissue

What is forced vital capacity (FVC)?

volume measured when exhale as fast and as forceful as possible (~3-5 L)

What is forced expiratory volume in 1 sec (FEV1)?

volume expired in 1 sec when exhale as fast and as forceful as possible (~2-4 L)

What should FEV1/FVC be in non-diseased individuals?

>80

What is maximal voluntary ventilation (MVV)?

measure maximal ventilation for 15-sec and estimate minute ventilation (~80-180 L/min)

What are treatments for COPD?

Smoking cessation, Bronchodilators, Corticosteroids for inflammation, Supplemental oxygen, Pulmonary rehabilitation (including exercise)

What exercise intensity recommendation is appropriate for individuals with mild COPD?

intensity guidelines for healthy older adults are appropriate

What exercise intensity recommendation is appropriate for moderate-to-severe COPD?

intensities representing >60% peak work rate have been recommended

What exercise intensity is appropriate for severe COPD or very deconditioned individuals?

Light-intensity aerobic exercise

What Borg CR10 dyspnea rating may be used to determine exercise intensity in COPD?

between 3 and 6 on the Borg CR10 scale

What oxygen saturation level indicates supplemental oxygen for individuals with COPD?

PaO2 <55 mm Hg or an SaO2 ≤88% while breathing room air

What is inspiratory muscle training designed to increase?

inspiratory muscle strength and endurance

How often should inspiratory muscle training be performed?

At least 4-5 days/week

What intensity is recommended for inspiratory muscle training?

30% of maximal inspiratory pressure

What duration is recommended for inspiratory muscle training?

30 min/day or 2, 15-min bouts

What is pursed-lips breathing?

Patient inhales via the nose and exhales with the lips closed except for a small opening in the center

How long should exhalation be compared to inhalation during pursed-lips breathing?

Exhalation is 2x as long as inhalation

What is asthma?

chronic inflammatory disorder of the airways that is characterized by a history of episodes of bronchial hyperresponsiveness; variable airflow limitation; and recurring wheeze, dyspnea, chest tightness, and coughing that occur particularly at night or early morning.

What is exercise-induced bronchoconstriction (EIB)?

airway narrowing that occurs as a result of exercise

When should individuals experiencing asthma exacerbations avoid exercise?

until symptoms and airway function have improved

What medications may be necessary before or after exercise to prevent or treat EIB?

short-acting bronchodilators

Why may individuals on prolonged treatment with oral corticosteroids benefit from resistance training?

may experience peripheral muscle wasting

What environments should individuals with asthma limit exercise in?

cold environments or those with airborne allergens or pollutants

What type of pool is preferable for individuals with asthma?

nonchlorinated pool