Egan's Chapter 55- Cardiopulmonary
Rehabilitation
measure of an individual's ability to perform common tasks - ANS ADL
measure of an individual's perception of breathing difficulty - ANS Borg Scale
Medicare-approved facility that provides ambulatory rehab services - ANS CORF
common method used to calculate target heart rate for exercise - ANS Karvonen's formula
training method that gradually increases muscle workloads - ANS Progressive resistance
point where there is insufficient O2 to meet the demands of energy metabolism - ANS OBLA
physical activities designed to strengthen muscles and improve O2 utilization - ANS
Reconditioning
ratio of CO2 production to O2 consumption - ANS Respiratory quotient
cardiac goal for aerobic conditioning based on 65% of maximum O2 consumption - ANS Target
heart rate
what event placed a focus on hospital readmissions and the importance of pulmonary
rehabilitation? - ANS The passage in 2010 of the Patient Protection and Affordable Care Act
(PPACA), the reduction of early hospital readmissions for various chronic diseases, including
COPD, is a major concern and focus of health care today.
In your own words, define pulmonary rehabilitation - ANS Answer should be a paraphrased
version of "art of medical practice wherein an individually tailored, multidisciplinary program is
formulated, which through accurate diagnosis, therapy, emotional support and education
stabilizes or reverses both the physio- and psychopathology of pulmonary diseases and
attempts to return the patient to the highest possible functional capacity allowed by his or her
pulmonary handicap and overall life situation."
List three general goals of pulmonary rehabilitation - ANS A. Control and alleviate symptoms
and complications of respiratory impairment.
B. Restore functional capabilities as much as possible.
, C. Improve quality of life.
How do clinical and social sciences play a role in establishing ways to improve the patient's
quality of life? - ANS Knowledge from the clinical sciences can help quantify the degree of
physiologic impairment and establish outcome expectations for reconditioning. Application of the
social sciences is helpful in determining the psychological, social, and vocational impact of the
disability on the patient and family and in establishing ways to improve the patient's quality of
life.
Define OBLA and describe it in relation to physical reconditioning. - ANS If the body cannot
deliver sufficient O2 to meet the demands of energy metabolism, blood lactate levels increase
above normal. In exercise physiology, this point is called the onset of blood lactate accumulation
(OBLA). As this excess lactic acid is buffered, CO2 levels increase and the stimulus to breathe
increases. The result is an abrupt upswing in both CO2 and (referred to as the ventilatory
threshold). Beyond this point, metabolism becomes anaerobic, the efficiency of energy
production decreases, lactic acid accumulates, and fatigue sets in.
How can you estimate MVV using simple spirometry? - ANS FEV1 35 = ~MVV
Identify the three general ways reconditioning will increase exercise tolerance. - ANS A.
Strengthens muscle groups.
B. Improves overall oxygen (O2) utilization.
C. Enhances cardiovascular response to physical activity.
Compare the roles of psychosocial and physical methods in terms of outcomes of rehabilitation.
- ANS Psychosocial indicators are generally better predictors of hospitalization and whether or
not a patient will complete the rehabilitation program. Physical methods, however, are
fundamental to resolving problems COPD patients typically encounter.
Describe the two-way relationship of physical reconditioning and psychosocial support. - ANS
Emotional tension can lead to physical fatigue. Emotional states can aggravate physical
problems. Physical manifestations of disease, such as dyspnea, can worsen stress.
Why is it so important to have specific objectives for the program goals? How should these
objectives be stated? - ANS A. Specific objectives help in development of strategies for
success. Demonstration of effectiveness then leads to better acceptance by the medical
community.
B. Objectives must be stated in measurable terms.
List five accepted benefits of exercise reconditioning. - ANS A. Increased physical endurance
Rehabilitation
measure of an individual's ability to perform common tasks - ANS ADL
measure of an individual's perception of breathing difficulty - ANS Borg Scale
Medicare-approved facility that provides ambulatory rehab services - ANS CORF
common method used to calculate target heart rate for exercise - ANS Karvonen's formula
training method that gradually increases muscle workloads - ANS Progressive resistance
point where there is insufficient O2 to meet the demands of energy metabolism - ANS OBLA
physical activities designed to strengthen muscles and improve O2 utilization - ANS
Reconditioning
ratio of CO2 production to O2 consumption - ANS Respiratory quotient
cardiac goal for aerobic conditioning based on 65% of maximum O2 consumption - ANS Target
heart rate
what event placed a focus on hospital readmissions and the importance of pulmonary
rehabilitation? - ANS The passage in 2010 of the Patient Protection and Affordable Care Act
(PPACA), the reduction of early hospital readmissions for various chronic diseases, including
COPD, is a major concern and focus of health care today.
In your own words, define pulmonary rehabilitation - ANS Answer should be a paraphrased
version of "art of medical practice wherein an individually tailored, multidisciplinary program is
formulated, which through accurate diagnosis, therapy, emotional support and education
stabilizes or reverses both the physio- and psychopathology of pulmonary diseases and
attempts to return the patient to the highest possible functional capacity allowed by his or her
pulmonary handicap and overall life situation."
List three general goals of pulmonary rehabilitation - ANS A. Control and alleviate symptoms
and complications of respiratory impairment.
B. Restore functional capabilities as much as possible.
, C. Improve quality of life.
How do clinical and social sciences play a role in establishing ways to improve the patient's
quality of life? - ANS Knowledge from the clinical sciences can help quantify the degree of
physiologic impairment and establish outcome expectations for reconditioning. Application of the
social sciences is helpful in determining the psychological, social, and vocational impact of the
disability on the patient and family and in establishing ways to improve the patient's quality of
life.
Define OBLA and describe it in relation to physical reconditioning. - ANS If the body cannot
deliver sufficient O2 to meet the demands of energy metabolism, blood lactate levels increase
above normal. In exercise physiology, this point is called the onset of blood lactate accumulation
(OBLA). As this excess lactic acid is buffered, CO2 levels increase and the stimulus to breathe
increases. The result is an abrupt upswing in both CO2 and (referred to as the ventilatory
threshold). Beyond this point, metabolism becomes anaerobic, the efficiency of energy
production decreases, lactic acid accumulates, and fatigue sets in.
How can you estimate MVV using simple spirometry? - ANS FEV1 35 = ~MVV
Identify the three general ways reconditioning will increase exercise tolerance. - ANS A.
Strengthens muscle groups.
B. Improves overall oxygen (O2) utilization.
C. Enhances cardiovascular response to physical activity.
Compare the roles of psychosocial and physical methods in terms of outcomes of rehabilitation.
- ANS Psychosocial indicators are generally better predictors of hospitalization and whether or
not a patient will complete the rehabilitation program. Physical methods, however, are
fundamental to resolving problems COPD patients typically encounter.
Describe the two-way relationship of physical reconditioning and psychosocial support. - ANS
Emotional tension can lead to physical fatigue. Emotional states can aggravate physical
problems. Physical manifestations of disease, such as dyspnea, can worsen stress.
Why is it so important to have specific objectives for the program goals? How should these
objectives be stated? - ANS A. Specific objectives help in development of strategies for
success. Demonstration of effectiveness then leads to better acceptance by the medical
community.
B. Objectives must be stated in measurable terms.
List five accepted benefits of exercise reconditioning. - ANS A. Increased physical endurance
