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243 Cards in this Set
- Front
- Back
- 3rd side (hint)
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23% of deaths from leading chronic diseases attribute in part to
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Sedentary lifestyle
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What does not change in cardiovascular system?
What increases? |
Resting HR
Plasma volume, hematocrit Left vent mass (blood volume dec) Valve thickening Epicardial fat HR + BP response to submax exercise peripheral vascular resistance Total Cholesterol, LDL |
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Does heart size Dec or Inc with aging?
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Dec
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Does speed of RBC production in response to stress of illness change with aging?
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Yes it decreases
So does: HDL lipoprotein lipase activity End diastolic filling |
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What happens to HR max with aging?
CO ? SV? |
Dec
Dec Dec |
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What happens to BP with aging?
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Inc
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What pulmonary thing stays the same with aging?
What decreases? |
TLC
VA, Tv Respiratory muscle strength Lung expansion Elastic recoil Alveolar surface area Cilia Alveoli tend to collapse sooner on expiration |
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What pulmonary things increase
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Chest wall stiffness
Mucus producing cells Rv FRC RR |
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Type 1 fibers
Type 2 |
Slow, oxidative, endurance
Fast twitch |
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Does muscle connective tissue Inc or decrease with age?
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Increase
But muscle mass decreases |
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Diagnosis for sarcopenia
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Low muscle mass +
Low strength Or Low physical performance |
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Literally define sarcopenia
Who suffers from this most men or women? |
Skeletal mass less than 2 SD below healthy young adult mean
Natural aging is 10% loss per Decade- Dec loss by exercise Men! Almost x2! |
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What causes sarcopenia?
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Dec activity!!
Dec aloha MN input Dec testosterone Dec GH Dec protein |
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What happens to attention span in aging?
Cognitive processing speed? Cognitive accuracy? |
All decrease
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What happens to SNS response to stress?
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Inc
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What eye issue is from too much pressure?
Degenerative opacity? Pigmentary change of retina? |
Glaucoma
Cataract Macula degeneration |
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What happens to estrogen with age?
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Dec
So does progesterone and testosterone and GH |
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What happens to insulin concentration with age?
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Inc!
Also hormonal response to stress increases too |
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Urinary changes with age
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Bladder Dec volume able to hold but also retains more after peeing
Dec strength of urinary sphincter Dec GFR Dec vasopressin Inc a natriuretic peptide |
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What % of people are independent but rapidly progress to frailty if activity levels were decreased
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70%
Also 5%are elite- will remain great unless ill |
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367meteres are required to complete a community errand
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What gait speed is needed for community ambulation?
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1.2 m/s
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Community dwellers need to carry what poundage?
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6.7 lbs
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Each year what percent of community dwelling adults over 75 development a disability
Depending on degree of fitness, for every week of bed rest how much time needed to recover? |
10%
3 months! |
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What is a geriatric syndrome
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Multifactorial health conditions that occur when the accumulated effects of impairment in multiple systems that render an older person vulnerable to situation changes
Ex) frailty |
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What is considered low grip. Strength?
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Average best of 2 from both sides under 20th percentile for sex and BMI
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Predictor of successful aging
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Physical function
Absence of hearing issues No arthritis No disability Good cognitive function Lower systolic BP Dec depression Satisfaction |
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Yep
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Great!
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Borg scale (6-20) easy way to relate to HR
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Add 0 to each number
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Acsm dyspnea scale
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Acsm anginal Scale
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Claudication scale
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Ankle brachial index
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Compares posterior tib to brachial systolic
Normally ankle is equal.or greater than brachial (test in supine!) Norm= above. 90 (to 1.2) |
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Yes
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6MWT is used with what populations
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Also used in phase 2-3 of cardiac rehab
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Conversion for meters to feet
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X 3.28
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Can you do the 6mwt if the diastolic BP is over 100
MDC |
Yes exercise caution
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When would you use the 2MWT??
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Mod to severe COPD
Amputations Frail Stroke To measure exercise capacity Set up 50ft between cones |
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Reasons for termination of 400MWT
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Hr under 40 or above 135
Chest pain Sob Faint /dizzy Leg pain |
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400MWT cut off time
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Slower than 5:30 may be at risk for functional difficulty
Less than 7min may have difficulty crossing the street **for each additional minute risk of death Inc by 35% |
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2 min step test
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Must lift knee midway between iliac Crest and patella
Count times R knee reaches this height |
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What test is based on principal cardiopulm fitness is based on the sooner HR returns to baseline?
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3min step test
Not graded so easier for fit individuals Does not estimate max capacity Too many confounding variables |
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Total body recumbent stepper exercise test good for
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Chronic stroke or balance issues
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Geriatric depression scale scores
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15 question geriatric depression scale to be used with those..
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Medically ill
Mild-mod cog issues Adults with hemodialysis |
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SLUMS exam
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Mental test to detect dementia and mild neuro cognitive disorder (may be better then mmse)
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MOCA
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montreal cog assessment to detect mild cog impairment
Free online, many languages Excellent to detect mild alzheimers |
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MMSE norms
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Trail making test is for
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Diagnostic tool for brain impairment especially frontal lobe lesions
Can correct during test Stop test if it's taking longer than 5 minutes |
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3 cognitive screens by Medicare
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GPCOG
MINI COG MIS (memory impairment screen ) |
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Is TUG good for dementia?
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Yes
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TUG cut off scores
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Community dwellers >13.5 sec fall risk
Olders with stroke >14sec fall risk |
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TUG MDC
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TUG dual task
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For frail older adults in Institute settings
TUG with water cup If carrying a cup slowed them down over 4 sec more risk of falls in next 6 months |
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Does gait speed have ceiling effect?
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No
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Gait speed needed to cross street
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1.2m/s
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Narrow corridor walk
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Measure dynamic balance
6.meters c tape guidelines |
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Four square step test is used with who
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Geriatric
Vestibular Parkinsons |
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4 square step test cut off scores
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Dynamic gait index
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To assess likelihood of falling in aging adults or vestibular or stroke
Also a short form (4 things instead of 8) long form has stairs though |
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Dynamic gait index cut off scores
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Under 12 balance deficits
Under ten fall risk |
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Functional gait assessment FGA
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Gait and stairs
Forward and backwards walking MDC : 4.2 stroke, 8 vestibular |
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Functional reach test
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Cut off under 6: 4x likelihood to fall, can't safely use reciprocal stair climbing
6-10 : 2xlikly to fall Can be modified in sitting |
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Modified total body rotation test
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That's all
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SLS
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Can predict fall risk but difficult for older people.
But didn't mention cut off scores |
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What does equal sway during Romberg with eyes open or. Closed?
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Proprioceptive or Cerebellar disorder
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Purpose of sharpened Romberg
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Cerebellar involvement
MDC Pd: 39 sec eyes open, 19 eyes closed |
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CTSIB clinical test for sensory interaction of balance tests for
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To see what the person is relying on for balance
*** look up |
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Modified CTSIB
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Measures the way balance triad interacts to maintain balance against gravity (eliminates dome)
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Berg balance is good for?
Weakness es |
Frail population "due to scales emphasis on discrimination when balance is relatively poor
-Ceiling effect with active adults - no external stimulus - no uneven surface - no gait |
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Is Berg good enough alone for predicting falls?
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No, use in conjunction with other tests
64% sensitivity for correctly predicting fallers 90% specificity for correctly predicting non fallers |
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Berg cut off
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48 low fall risk
40 med 39 high Good at identifying people at risk for multiple falls |
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Berg balance MDC
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4pts
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Fullerton advanced balance scale FAB
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To identify balance problems in independently higher functioning older adults
Based on systems control :sensory motor and musculoskeletal system contributions to balance Every 1 pt deduction = 8 % Inc in fall risk |
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Who should not do thales Fullerton balance test?
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Osteoporosis because there is a jumping component
Lower body joint pain |
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What wii game was correlated statistically to the TUG and 10mwt?
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Basic step
Generalizability Useful in community dwelling Also balance board is good for PD |
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Cut off score for ABC scale
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Under 67% Inc fall risk
Under 50 is homebound (add up responses decided by total number of items) |
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Can you use ABC scale with vestibular patients?
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Yes
Correlated to the TUG and DGI (but not the best predictor with stroke) |
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FES falls efficacy scale
Good for... Weakness... |
Frail elders in/out Institute
Weakness... -Doesn't capture challenges of community mobility - doesn't predict frequently of falls or activity limitations However cut off > 70% = fear of falling |
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Since FES can't predict frequently of falls... What version can?
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FES international
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Fear of falling avoidance behavior questionnaire ffabq
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Measures avoidance behavior instead of fear or self efficacy
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Muscle performance tests
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Chair rise test correlates to gait speed?
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Yah
Cut off for falling were 15sec to do 5 MDC : 3.12 sec (it's how long does it take to do like 5) |
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Hip extensor test purpose
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To enable MMT of hip. Extensors without being in prone (lay flat and push down while PT. Lifts limb 90cm)
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Heel rise test
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Test terminated if patient pushes on therapists hands
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Toe tap test
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To determine speed of ankle (how many taps in ten sec)
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Getting up. From floor test is a strong independent risk factor for predicting
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Serious fall related injury
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Do cardiologists use grip strength in cardiac rehab?
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Yes
Phase 2+3 MDC 5.2kg R hand 5.1 L hand |
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Is low grip strength associated with low bone mineral density?
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Yes and Inc risk of vert fx
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Grip. Strength and Cap?
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Positive correlation with bad outcome. For lower grip. Strength (2 weeks in hospital or death)
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Grip strength, hospital, death?
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Death within a year of hospitalization Correlated with low grip. Strength
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Postural tests
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How do you do flexicurve?
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Measure standing without shoes
Mark c7 and lumbosacral L5joint space Mold curve from. C7 to L5 interspace Trace mold. On grid 10 X 10 paper Clinical kyphosis is defined as 13 or greater |
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Wall to occiput distance test
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Hand person stand as straight as possible against wall, measure distance from occiput to wall
Unable to touch wall is a + finding Wall occiput distance (WOO) Inc 1.2.cm for every vertebral fx Consider xray if > 4cm |
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Rib/pelvis test
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>2 fingers rules out lumbar compression fx with high degree of certainty
Under two get xray <1 finger rules in fx with high degree of certainty |
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What's the point of assessing pes planus?
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When compensated with orthotics static and dynamic balance immediately improved!
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ROM tests
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What's the best measure of shoulder flexible
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Back scratch test
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Thomas test
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Tests for hip flexion contracture
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Sensory tests
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LOP =monofilament scoring, should get all 10 for intact protective sensation
Ipswich-test light touch toes for those at risk of ulceration Up down is for proprioceptive of big toe |
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What's the primary reason those over 65 visit doctor?
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Dizziness
93% bppv vestibular neuritis or menieres |
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Good review
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Semicircular canal. Senses
Otoliths sense |
Angular acceleration
Linear acceleration |
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Most common type bppv
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Canalithiasis free floating otoconia
Latent onset with head movement resolves within a minute |
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Immediate onset of nystagmus that doesn't resolve
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Cupulothiasis
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Contraindications to dix hallpike
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Describe central nystagmus
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-Doesn't fatigue
- Can change direction vs head posistion - can also be vertical |
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What direction is...
Posterior canal beat Anterior Horizontal |
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Physical performance test was developed for
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Older adults : adl iadl and physical
Two versions 7 and 9 item |
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9 item modified physical performance test for
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Frail
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Purpose of short performance physical battery
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LE function aging adults in community
Predict disability mobility and ADL predict need for Institute |
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Elderly mobility scale purpose
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Asses mobility in frail elders to determine post acute placement
TX, gait, times, functional reach |
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DE Morton mobility index
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Measures mobility States acute care hospital patients
But also for any setting Bed mobility, TX, balance, gait, dynamic balance |
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Senior fitness test
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Seven functional assessments of general strength endurance flexible mobility
Assess functional capacity of non frail adults living independently who may be at risk for decline in function Only a general appraisal |
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Senior fitness test contraindications
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Bestest balance evaluation systems test
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6 components
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Mini bestest
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Dynamic balance assessment
4 of the usual 6 components |
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Brief bestest
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Grip strength for each sex
Slow walking speed is Low physical activity measured by |
Men under 30kg is frail
Women under 18kg is frail Under. 65 m/s for 15 feet Calories burned |
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What two tests can distinguish between frail and nonfrail?
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Stair climb and chair rise test
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Post exercise SBP declines because of venous pooling and should normalize in supine
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What DBP change after exercise means HF and what means CAD
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Drops-hf
Inc: cad (labels HTN) |
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Doubling exercise volume from 40%1rm to 75% maxmizines
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Post exercise my fibrillation protein synthesis in aging men
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Exercise and cognitive function
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Increased especially executive function via plasticity and also thereby reducing falls
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Exercise and gh
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Inc
Also Inc testosterone |
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V02max peaks..... years old!
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15-20
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Hr max equation in geriatric
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208-(.7x Age)
The 220-age is low estimate |
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What intensity to use for aerobic training when determining target HR
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Healthy adult 60-80%
Frail can use as low as 40 |
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Hr from the borg scale 0-10 scale
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Number of RPE X 10
12-14 is somewhat hard fyi |
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What about predicting HRmax from RPE (6-20) in those on beta blockers?
What's recommendation for exercise |
Great with RPE...
RPE of 12-13 is 60 max HR 16 is 85%hrmax 13-15 RPE for those on beta blockers |
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Claudication scale
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Normal and abnormal response to exercise
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Does hrmax rise as high in geriatric patient?
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No
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Spinal mobility may Dec up to.... By the time we r 70
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50%
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Single most important predictor for need for eventual nursing home
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Leg strength
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Older adults gain strength similar to young people
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Early hypertrophy is from neuro factors not effected by age
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Strength training intensity
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Doms should not occur at 80% 1rm
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How do you assess 70-80% 1rm
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And they should have muscle fatigue around 8-12 rep
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Gold standard for knee extension testing for strength
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Isokinetic dynamometer and this is Correlated well with the 8rep test (that test also determines 80% of 1rm
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When should you use 30-60%1rm instead of 70-80%?
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mi (wait 3-6 weeks to start)
MS RA Extremely frail (should be between fairly light and somewhat hard) |
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Who should not be strength training
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Advanced CHf.
Cancer tumor in target area Recent unstable MI |
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How to progress from 30-60%1rm
70-80%? |
Once 25 reps can be reached Inc intensity by 10%
If 12 reps can be reached Inc by 5% |
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How long is the recommended resistance training session for sub acute MI
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20-30min
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3 sets?
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Research shows 1 is equally as good if reps to fatigue!
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High % +Low reps =
Low % + high reps = |
Strength
Power! Some say power is better than strength for older adults. But a meta analysis said only small. Advantage And also might be a better predictor |
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Acsm recommendations for strength training, hypertrophy, power
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Lab values hgb, hematocrit and WBC normal levels and exercise recommendations
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Clotting time INR values/exercise
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PaCO2 <35 =
PaCO2 > 45= |
Hyperventilation so teach PLB
Hypoventilation so teach deep breathing and sit up right to improve CO2 removal |
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Acsm flexibility recommendations
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2d/week
10 min |
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Does acsm recommend muscle or single join therex?
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Both
Free weights and machines 1-3 sets 60-80% 8-12 reps 1-3 min rest |
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Acsm aerobic recommendations
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How does CO change with age effect drugs
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Dec output = Dec absorption and distribution
Dec blood flow = Dec absorption and distribution |
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How does GI change with age effect drugs
Liver |
Inc PH and Dec peristalsis = delayed gastric emptying and breakdown of coating of capsules* but absorption in the gut remains normal. Into the tenth decade and beyond!
Dec drug metabolism, does usually effect aging adult unless alcoholism |
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How does lean body mass decrease with age effect distribution
Inc fat? |
Water soluble drugs reach higher unit concentration, easily toxic
Half life increases so last longer |
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Warfarin is a med that competes for protein binding sites so...
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May potentiate another drug, compete for binding sites
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Renal. Function with age and pharmokinetics
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Decreased so drugs have prolonged half life
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Can nsaids cause irreversible damage to aging adult?
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Yes
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Can beta blockers cause confusion?
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Yes!
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Can nonsteriodals or salicylate cause falls?
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Yes
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Can beta blockers cause depression?
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Yes!
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Can Calcium channel blockers cause incontinence?
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ACE
Can be combined with |
Dec sympathetic hormones and aldosterone release (same as angiotensin 2)
Antihypertensive! HCT can cause Oh or cramps |
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Two anti arrythmics that promote dilation, stabilize HR and Dec contractibility force
Side effects |
BB and CC
Swelling in ankles Brochoconstriction |
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Beta blockers as antiarryrhmic
Side effects Effects on exercise |
Mask hypoglycemia
Reduce heat tolerance Premature fatigue Reduce time to claudication Inc exercise with angina Blunts HR response Base exercise on target HR |
Antenolol
Metoprolol/lopressor Inderal/propranlol |
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Calcium channel blocker as antiarryrhmic
Effect on exercise |
May in or Dec capacity
Usually doesn't effect capacity with those with HTN |
Dilatiazem/cardizem
Verapamil Nifedipine |
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Digitalis effect on exercise
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Used for CHf /improves left vent function
Improves exercise only in people with afib or CHf Adrs: gi, blurred vision, depression, arrythmics, fatigue, confusion |
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Nitrates effect on exercise
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Helps those with angina at submax work load
Exaggerated response to systemic heat ** vasodilation after exercise! |
Nitroglycerin
Isosorbide Dinitrate |
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Two classes of bronchodilators
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Anticholinergic and short acting beta 2 sympathomimetics
- beta adrenergic agonists (albuteral) - xanthine derivative (theophylline) Reduce doe and improve exercise with COPD |
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Can you exercise with BG over 300 without ketosis?
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With caution yes if person is feeling well and hydrated
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Glipizide
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Sulfonylureas (insulin secretagogues)
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Action times. Of insulin
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Classes of anti dementia drugs
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Cholinesterase inhibitors :aricept, rivastigmine (for psychotic symptoms lewy body dementia, alzheimers, PD)
NMDA receptor antagonist (namenda) Dec aggression |
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Urinary incontinence meds adrs
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Dry mouth
Worse glaucoma Heart burn Dec. Memory Fatigue |
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Meds for urge incontinence
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Antispasmodic :Enabled, Ditropan, Detrol
Stress: cymbalta Overflow : proscar, fiomax |
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Suggested calories for low activity level.. Moderate... Active
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Cyrene recommended protein
Carbs.. |
80g may be greater In older adults
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What interferes with calcium in diet
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Best indicator vit D status
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Serum 25OHD
Recommended Dailey value 600-4000 |
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Cancer facts of exercise
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Resistance helped them complete chemo on schedule, Inc efficacy and Dec anxiety
No AdRs with aerobic Good response post breast cancer Inc peak 02 consumption, Dec fatigue 3-5 hours walk per week 50%less likely to die from breast cancer then those with 1hr per week Reduced colon cancer recurrence 42-49% Dec depression in all those except breast cancer |
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Acsm guidelines for cancer
Free, intensity, duration, type |
Freq:
*aerobic 3-5dys (20-60min), *resistance 2-3dys (1-3 sets 8-12 reps or 15 if frail) * flex 2-7 days (4 reps) Intensity : aerobic 40-60%HRR resistance 40-60%1rm |
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Acsm guidelines for cardiac disorders who have not undergone a stress test even if you told them too
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Closely supervise
Continuous ECG Regular bp HR rest + 20 2-4 METS (progress 1-2 increments) 11-14 RPE |
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Cardiac rehab
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With Coronary heart disease which is better high calorie expenditure or standard cardiac rehab
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High calorie expenditure
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Absolute contraindications to resistive training
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Relative contraindications to resistive training
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When can you start RT with...
Mi Revascularzation |
5weeks after MI or cabg and within 4 weeks of supervision rehab
3weeks post |
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%rm vs load
60, 70, 80, 90 |
17, 12, 8, 5
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CHf benefits of exercise
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-Increase cardiac output
- Skeletal muscle metabolism improvement -peak blood flow increase to the exercising limb because of the vascular resistance reduction - arterial function improve |
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Acsm guidelines CHf
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3 Mets or more
THR of 40 to 75% vo2max 3 to 7 days a week 20 to 40 minutes but start with 10 to 20 with interval training : of 2 to 6 minutes of exercise and 1 to 2 minutes of rest RPE of 11 to 14 |
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Acsm guidelines HF
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They should first have exercise testing then it should be initially supervised with a goal of 30 minutes of moderate activity 5 days a week
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Is it ok to exercise with hypertension in a pool
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Yes
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Under how many steps a day is considered sedentary
What is considered active |
Under 5000
over 10,000 |
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What happens to blood pressure after resistance training in older adults with high to normal blood pressure
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Reduction in resting blood pressure and the benefit remained unchanged for a month without exercise
3mmhg change for SBP and DBP this has been associated with reduced cardiac morbidity by 5 to 9 percent and reduce stroke by 8 to 14 percent and all-cause mortality by 4% |
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Acsm guidelines HTN
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Acsm guidelines PVD
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What minimum gait speed must be accomplished for sub acute stroke with severe gate impairment to experience a meaningful improvement and disability level
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0.16 m/s this is the MCID
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Ahaaa stroke guidelines
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Any large muscle activity
40 to 50 percent peak oxygen uptake 40 to 70 percent heart rate reserve 11 to 14 or 6 to 20 RPE 3 to 7 days a week 20 to 60 minute sessions or multiple 10 minute session |
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Aha stroke guidelines strength
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Circuit training, weight machines, free weights, isometric exercises
1 to 3 sets of 10 to 15 repetitions 8 to 10 exercises involving major muscle group 2 to 3 days a week |
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What exercise is most effective in improving glucose intolerance and a risk reduction of diabetes
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Resistance may be more effective than aerobic exercise
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Is physical activity advice alone associated with a1c changes
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No need structure exercise
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What met intensity made a significant improvement and glycine at control with older adults at risk
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Short intermittent bouts 15 minutes three METS ( barely moderate intensity) was equally as effective as 45 minutes of sustained morning walking at 3 METS
this improved 24-hour glycemic control post meal exercise is significant lowering three hour post-dinner glucose levels |
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Is high intensity interval training effective and safe for type 2 diabetes
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Yes one study did 5 series of three minute brisk walking at 70% heart rate reserve interspersed with three minutes at 30 percent heart rate reserve
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How should intensity be measured with diabetes
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RPE should be used as an adjunct
exercise intensity should be based on target heart rate using the karvonen formula (40-90%) the heart rate max should be determined by a stress test Resistance intensity should be measured by no more than 8 max they should not be able to lift a weight more than eight to ten times |
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Does moderate walking with peripheral neuropathy and diabetes increase risk of foot ulcer or re ulceration
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No
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Does decreased proprioception contribute to development of OA
Decreased and hip abductor strength will increase load on what side of the knee |
Yes
Medial, strengthening will decrease knee pain and physical function but it will not improve knee ad duction moment |
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Can you exercise with OA with acute inflammation
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Yes
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Patients with weakness strengths could still maintain high levels of dynamic balance with strong ankles
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Are runners at increased risk for OA
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No there is no evidence
older age is a strong risk factor as well as obesity and also serious knee injury |
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Just tia chi training help with OA pain control and function
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Yes but improvements disappear after detraining
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Oa modalities
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What intensity should people with arthritis workout
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60 to 80 percent heart rate max for aerobic
and 40 to 60 percent in one rep max for intensity |
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Can high intensity weight bearing exercise retard progression of rheumatoid arthritis
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Yes also less use of glucocorticoids activation of bone remodeling
feet were more protected then hands |
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A change in what is the strongest predictor for observing improvements in all of the assessed cardiovascular disease risk factors and disease characteristics
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Vo2 max
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What percent intensity is good for rheumatoid arthritis
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The goal should eventually be 60 to 85 percent of heart rate max
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Water or land base is good
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What is the angle for thoracic hyperkyphosis
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Cobb angle of 50 to 65 degrees this also is a risk of falls
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Risk factors for severe vertebral fractures
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More previous non vertebral fractures
low serum albumin levels prednisone |
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What muscles with osteoporosis are significantly less compared to women without osteoporosis
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Back extensors
isometric contractions of back extensors can decrease post fracture pain and edema |
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Would you have increased time on the tug test just because of hyperkyphosis
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Yes
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ACSM guidelines for patients who are at risk of osteoporosis
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Acsm guidelines who have osteoporosis
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Risk factors for fracture risk for osteoporosis according to FRAX - The Who
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Physical signs that should make you want to screen for osteoporosis
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FYI marginal evidence for hip protectors
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Is golf allowed after a total hip replacement
Jogging? |
Yes (Bowling is too with experience)
No |
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Is horseback riding allowed after a total knee replacement
swimming? |
Yes and yes, so is doubles tennis with experience but not singles
And so is low impact aerobics |
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Should people with fibromyalgia exercise at a high intensity
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Moderate is good and low intensity if that's all they can tolerate
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4 point Hopkins fall grading scale
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Is gender a predictor of fall
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Yes
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MMSE under what indicates fall risk
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17
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Exercise recommendations from multiple sclerosis
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What about heart rate with multiple sclerosis for blood pressure
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They may be dulled because of cardiovascular disautonomia
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What program can help people with Parkinson's delay mobility disability
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Sensorimotor agility programs which includes resistance training and coordination with progressive challenges
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Can aerobic training increase gray matter volume in the frontal and superior temporal lobe
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Yes
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What functional tests are good for people with dementia
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Figure 8 walk test
tug grip dynamometer six minute walk test 30 second chair rise |
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Standard cardiac rehab program burns how many calories per week
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700 to 800
it also recommends a deficit of 3500 calories via dietary deficit |
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How much exercise is required to maintain substantial weight loss
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80 minutes of moderate activity every day or
35 minutes of vigorous activity Fyi: it takes 45 to 60 minutes to prevent transition from overweight and obesity |
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When intensity is appropriate for COPD
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When intensity is appropriate for COPD426 on the Borg dyspnea scale and at least greater than 60% peak exercise capacity
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Patients with COPD and significant muscle atrophy could do resistance training at what level
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50-80% % one rep max for 6 to 12 reps and 2-4sets
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Acsm guidelines from moderate to severe COPD
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Acsm guidelines for well controlled asthma and mild COPD
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