Absolute & Relative Indications for Stopping Exercise ...

Absolute & Relative Indications for Stopping Exercise & Activities

American Heart Association (AHA) Standards

AHA Standards are guidelines for heart healthy vital sign parameters. Always take into consideration the patient's baseline vital signs and whether or not they are symptomatic before altering treatment. AHA Standard Ranges:

Heart Rate (HR):

Oxygen Saturation (O2 SAT): 90%

Blood Pressure (BP): Systolic: 90-140 mmHg

60-90 beats per minute (bpm) Respiration (R): 12 -16 breaths per minute

Diastolic: 60-90 mmHg

Guidelines: Vital Sign Response to Activity

Absolute Indications

The following signs and symptoms are reasons to IMMEDIATELY stop exercising and assess the patient.

General Signs and Symptoms

Blood Pressure

Chest Pain of any type

Drop in systolic BP > than 10 mmHg from baseline despite

Severe shortness of breath

increase in workload.

Dizziness or faintness

New onset or increase in mental confusion

Oxygen Saturation

Sudden onset of sweating or paleness in color

O2 SAT: 85-89% and symptomatic. Absolute cut-off is 85%.

Relative Indications

The following signs and symptoms are reasons to STOP activity, ASSESS the patient and ADJUST the exercise routine. The routine

may be continued if patient is stable. Drop in diastolic BP > than 10 mmHg from baseline despite

increase in workload. Leg cramps or increase in leg pain

Hypertensive response: systolic > 210 mmHg and/or diastolic blood pressure >115 mmHg

Fatigue, shortness of breath, increase wheezing

Rating of Perceived Exertion (RPE)

Perceived exertion is a subjective rating of how hard a person feels like his/her body is working. It is based on the physical

sensations a person experiences during physical activity, including increased heart rate, increased respiratory rate,

increased sweating, and muscle fatigue.

Using the Borg Scale (6-20), the optimal range of perceived exertion for moderate level intensity is 11-14.

If a patient's goal is to reach moderate-intensity activity, then the patient would aim for a Borg Scale RPE of "somewhat

hard" (13-14). If the patient reports "very light" exertion (9 or 10), the patient would want to increase his/her intensity. If the

exertion was perceived as "very, very hard" (19), the patient would need to slow down to achieve the moderate-intensity

range. Borg Scale:

Score

Perception Score

Perception

6, 7, or 8 9 or 10 11 or 12 13 or 14

very, very light very light fairly light somewhat hard

15 or 16 17 or 18 19 or 20

hard very hard very, very hard

References:

American Heart Association American College of Sportsmedicine, ACSM Guidelines for Exercise Testing and Prescription, 8th ed. Philadelphia: Williams & Wilkins, 2010. ISBN

13 : 9780781769037

Fletcher, G., Froelicher, V., Hartley, L., Haskell, W. & Pollock, M. (1995). Exercise standards. A statement for health professionals from the American

Heart Association. Circulation 91(2), p. 580-615.

Jones, N. & Campbell M. (1982). Clinical exercise testing. Philadelphia, PA: WB Saunders

Gentiva Health Services, Inc., 2012

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