Absolute & Relative Indications for Stopping Exercise ...
[Pages:1]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 > 250 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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