MCCCD Official Course Competencies:

EXS145  2009 Spring – 2009 Fall

Guidelines for Exercise Testing and Prescription

1.

Describe benefits and risks associated with exercise. (I)

2.

Describe procedures for health screening and determining level of risk. (I)

3.

Perform exercise tests, including pretest evaluation, physical fitness testing, and clinical exercise testing. (II)

4.

Describe how to interpret the results of an exercise test. (II)

5.

Describe general principles and clinical considerations related to influencing an exercise prescription. (III)

6.

Prescribe an exercise program for cardiac and/or pulmonary patients based on exercise tests results. (III)

7.

Describe clinical considerations for prescribing exercise programs for special populations, such as children, the elderly, and pregnant women. (III)

8.

Perform metabolic calculations. (III)

9.

Describe emergency management with regards to the facility and the participants. (III)

10.

Describe environmental considerations for exercise. (III)

11.

Describe pharmacology fundamentals for patients with cardiovascular and pulmonary disease. (IV)

MCCCD Official Course Outline:

EXS145  2009 Spring – 2009 Fall

Guidelines for Exercise Testing and Prescription

I. Health appraisal, risk assessment, and safety of exercise

A. Benefits and risks associated with exercise

1. Public health perspective

2. Benefits of regular physical activity

3. Risks associated with exercise testing

4. Risks associated with physical activity

B. Health screening and risk stratification

1. Health screening for physical activity

2. Risk stratification

II. Exercise testing

A. Pre-test evaluation

1. Clinical assessment

2. Contraindications to exercise testing

3. Informed consent

4. Patient instructions

B. Physical fitness testing

1. Purposes of fitness testing

2. Basic principles and guidelines

3. Body composition

4. Cardiorespiratory endurance

5. Muscular fitness

C. Clinical exercise testing

1. Indications and applications

2. Exercise test modalities

3. Exercise protocols

4. Measurements

5. Post-exercise period

6. Indications for exercise test termination

7. Radionuclide exercise testing

8. Non-exercise stress tests or pharmacological tests

9. Considerations for pulmonary patients

10. Summary of methodology

D. Interpretation of test data

1. Interpretation of fitness test data

2. Graded exercise testing as a screening tool for CAD

3. Interpretation of responses to graded exercise testing

4. Interpretation of clinical test data

5. Predictive value of exercise testing

6. Interpretation of exercise tests in pulmonary patients

III. Exercise prescription

A. General principles of exercise prescription

1. Introduction

2. Cardiorespiratory endurance

3. Caloric thresholds for adaptation

4. Rate of progression

5. Musculoskeletal flexibility

6. Muscular fitness

7. Program supervision

B. Exercise prescription for cardiac patients

1. Inpatient programs

2. Outpatient programs

3. Resistance training

4. Other considerations

C. Exercise prescription for pulmonary patients

1. Exercise prescription

2. Special considerations

3. Alternative modes of exercise training

4. Program design and supervision

D. Other clinical considerations influencing exercise prescription

1. Hypertension

2. Peripheral vascular disease

3. Diabetes mellitus

4. Obesity

E. Exercise testing and prescription

1. Children

2. Elderly

3. Pregnancy

F. Emergency management

G. Metabolic calculations

H. Environmental considerations

IV. Pharmacology

A. Cardiac medications

1. Beta blockers

2. Nitrates

3. Calcium channel blockers

4. Digitalis

5. Diuretics

6. Vasodilators

7. Ace inhibitors

8. Antiarrhythmic agents

9. Sympathomimetic agents

10. Antihyperlipidemic agents

B. Pulmonary medications

1. Bronchodilators

2. Oxygen

3. Steroids