What is used as a preparticipation health screening tool by a professional for the general (non-clinical) population? - The ACSM
... [Show More] algorithm
Sedentary
Known CV, metabolic, or renal disease
No signs or sx
Is medical clearance recommended?
At what intensity? - Medical clearance is recommended
Light-moderate, progress as tolerated
Sedentary
No known CV, metabolic, or renal disease
No signs or sx
Is medical clearance recommended?
At what intensity? - Medical clearance is not necessary
Light to moderate, progress to vig
Sedentary
Known CV, metabolic, or renal disease
Has sign or sx
Is medical clearance recommended?
At what intensity? - Medical clearance is recommended
Light-moderate, progress as tolerated
Active
No known CV, metabolic, or renal disease
No signs or sx
Is medical clearance recommended?
At what intensity? - Medical clearance is not necessary
Light to vigorous
Active
Known CV, metabolic, or renal disease
No signs or sx
Is medical clearance recommended?
At what intensity? - Medical clearance is not necessary for light to moderate, but necessary before vigorous
Active
Known CV, metabolic, or renal disease
Has sign or sx
Is medical clearance recommended?
At what intensity? - Discontinue exercise and seek clearance before continuation
Definition for active vs sedentary - Exercised for at least 30 min/day, 3 days/wk for last 3 months
Light intensity VO2R and HRR - 30-39% HRR or VO2R
Light intensity METs - 2-2.9 METs
Light intensity RPE - RPE 9-11
Moderate intensity HRR or VO2R - 40-59% HRR or VO2R
Moderate intensity METs - 3-5.9 METs
Moderate intensity RPE - RPE 12-13
Vigorous intensity VO2R or HRR - ≥ 60% HRR or VO2R
Vigorous intensity METs - ≥ 6 METs
Vigorous intensity RPE - RPE ≥ 14
CV disease - cardiac, peripherovascular, or cerebrovascular disease
Metabolic disease - Any 3 out of 5 of the following:
-increased waist circumference (M ≥ 40in, W ≥ 35in)
-increased triglycerides ≥ 150 mg/dL
-decreased HDL (M < 40mg/dL, W < 50)
-increased BP (SBP ≥ 130 or DBP ≥ 85)
-increased fasting glucose ≥ 100mg/dL
Signs and symptoms suggestive of CV, renal, and metabolic disease - -pain/discomfort in neck, chest, jaw, arms
-SOB at rest or w/mild exertion
-dizziness or syncope
-orthopnea or paroxysmal nocturnal dyspnea
-ankle edema
-palpitations or tachycardia
-intermittent claudication
-known heart murmur
-unusual fatigue or SOB w/usual activities
What is used as a preparticipation health screen in absence of a professionals help? - The 2014 PAR-Q+
What is used as a pre-participation screening tool by a professional for cardiac rehab and other medical fitness facilities? - AACVPR risk stratification
AACVRP lowest risk components during exercise test and recovery - -no complex ventricular dysrhythmias
-no angina or other sig sx
-normal hemodynamics
-functional capacity ≥ 7 METs
PT case:
Normal ECG and asymptomatic
resting HR 60
resting BP 130/60
peak HR 90
peak BP 150/65
fxnal capacity = 8 METs
what risk category according to AACVRP? - Lowest
AACVRP lowest risk components at rest - -no complex ventricular dysrhythmias
-resting EF ≥ 50%
-uncomplicated MI or revascularization
-no CHF
-no signs or sx of post-event/procedure ischemia
-no clinical depression
*must have all of these*
lowest risk EF - ≥ 50%
Pt case:
Resting EF = 50%
normal ECG
fxnal capacity 7 METs
what risk category according to AACVRP? - lowest
Pt case:
Normal ECG
resting HR 60
resting BP 130/60
peak HR 90
peak BP 150/65
fxnal capacity = 8 METs *angina reported at peak
what risk category according to AACVRP? - Moderate
*sx at ≥ 7 METs only
AACVPR moderate risk components during exercise test and recovery - -angina or other sx only when ≥ 7 METs
-mild-moderate silent ischemia (ST↓ < 2 mm)
-functional capacity < 5 METs
angina or sig sx (unusual SOB, dizziness, or light-headedness) at what WL qualifies a clinical pt for moderate risk? high risk? - only occurring at high levels of exertion (≥ 7 METs)
occurring at low levels or exertion or during recovery (<5 METs)
What are considered significant symptoms by the AACVRP standards? - -angina
-unusual SOB
-dizziness
-light-headedness
What amount of silent ischemia qualifies a clinical pt for moderate risk? high risk? - mild-moderate silent ischemia (ST↓ < 2 mm)
high levels of silent ischemia (ST↓ ≥ 2 mm)
What functional capacity qualifies a clinical pt for moderate risk? - < 5 METs
Pt case:
1.5 mm of ST depression
functional capacity is 4 METs
no symptoms
what risk category according to AACVRP? - moderate
AACVPR moderate risk EF - EF 40-49%
AACVPR high risk components during exercise test and recovery - -complex ventricular dysrhythmias
-angina or other sig sx at < 5 METs
-abnormal hemodynamics (ie flat or ↓ SBP w/↑ WL or severe post-exe hypotension)
-high levels of silent ischemia (ST↓ ≥ 2 mm)
Pt has a complex ventricular dysrhythmia during an exercise test. what risk category? - high
pt's SBP does not respond to increased WLs, what risk category? - high
pt's SBP decreased with increased WLs, what risk category? - high
pt's BP drops severely post-exercise. What risk category would that place them? - high
Pt case:
normal ECG
normal hemodynamic response
no sx
clinical depression
what risk category according to AACVRP? - high
AACVPR high risk components at rest - -complex dysrhythmias
-resting EF < 40%
-complicated MI or revascularization
-CHF
-signs or sx of post-event/procedure ischemia
-clinical depression
-hx of cardiac arrest or sudden death
pt has diagnosed CHF. What risk category do they belong in? - high
pt has history of cardiac arrest. what risk category? - high
pt had a complex dysrhythmia at rest, what risk category? - high
at what resting EF does a pt qualify as high risk? - < 40%
pt had a complicated MI, what risk category are they? - high
pt had a complicated revascularization. what risk category do they belong in? - high
Pt case:
resting EF = 37%
CHF
ST segment depression = 2 mm
BP decreases with increased WL
what risk category according to AACVRP? - high
How often should staff train for emergencies? - Every 3 months (at least)
When is age a risk factor for CVD? - M ≥ 45 and F ≥ 55
when is fam hx a risk factor for CVD? - MI, coronary revascularization, or sudden death in a 1st degree member M < 55 F < 65
when is cigarette smoking a risk factor? - current smoker, quit w/in last 6 mo, or exposed via environment
when is physical inactivity a risk factor? - if individual does NOT do at the least moderate PA for 30 min/day, 3 days/wk for 3 months [Show Less]