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Developing Exercise Programs for Complex Patients (Recorded Webinar)

presented by Ellen Hillegass, PT, EdD, CCS, FAPTA

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Disclosure Statement:

Financial: Ellen Hillegass is the President and CEO of PT Cardiopulmonary Educators. She is editor and author of Essentials of Cardiopulmonary Physical Therapy and author of PT Clinical Notes. She also a faculty member for the department of physical therapy at Mercer University, Atlanta, Georgia. Ellen Hillegass also receives compensation from MedBridge for this course.

Non-Financial: Ellen Hillegass has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 177 Minutes, Learning Assessments: 19 Minutes

This course is a recording of a previously hosted live webinar event. Polling and question submission features are not available for this recording. Format and structure may differ from standard MedBridge courses.

Clinicians are currently dealing with a wide variety of complex patients and are concerned about how much to push them to do activities due to safety, yet clinicians know they should not be too conservative.

This webinar will provide physical and occupational therapists with tools and strategies to help problem-solve regarding the level of complexity of the patient as well as the patient's tolerance to exercise and activities of daily living as demonstrated on an exercise assessment, and determine if the responses to activity are normal or abnormal. From this information, the learner will be able to make appropriate clinical decisions for an initial exercise prescription, including tolerance to activities of daily living, for these complex patients.

Meet Your Instructor

Ellen Hillegass, PT, EdD, CCS, FAPTA

Dr. Ellen Hillegass is a physical therapist with APTA board certification in cardiovascular and pulmonary clinical specialty. She currently holds the position of adjunct professor in the departments of physical therapy at Mercer University in Atlanta and Western Carolina University in Cullowhee, North Carolina. Ellen is also the president and CEO of Cardiopulmonary Specialists, a…

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Chapters & Learning Objectives

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1. Assessment of Patient Complexity

This chapter will cover strategies to help differentiate complexity based on the patient’s comorbidities and frailty. Frailty can be determined by physical assessments as well as past medical history information. Comorbidities are determined by past medical history and used in indexes such as the Charlson Comorbidity Index to determine complexity.

2. Differentiating Complexity Based On Past Medical History, Lab Values, Diagnostic Tests, and Symptoms

This chapter will discuss key aspects of the medical history that should be reviewed to identify the patient’s complexity. Items that help determine complexity include an individual’s past medical history, certain lab values, diagnostic tests, and past and current symptoms.

3. Assessment of Exercise Tolerance

In this chapter, we will discuss indications and contraindications of testing and termination criteria. Discussion of risk stratification and tools available to use for risk stratification will be presented. Exercise principles will be briefly discussed, including specificity of exercise.

4. Specific Exercise Tests, Including the Pros and Cons

This chapter will provide the more common exercise tests that are available to be used to assess exercise tolerance. The pros and cons and evidence of these tests will also be presented.

5. Assessment and Interpretation of Vital Signs

This chapter will discuss monitoring patients’ vital signs during exercise tests or activities in general. Normal and abnormal responses will be discussed, and participants will be able to determine abnormal responses that require termination of exercise.

6. Developing of Exercise Programs

From the initial exercise assessment, exercise programs can be developed based on the patient’s complexity and performance on the exercise assessment. Time will be spent discussing setting the intensity of the exercise prescription. Strength, flexibility, and pulmonary exercise programs will be included.

7. Case Studies: Heart Failure and Cerebrovascular Accident (CVA)

In this chapter, we will apply exercise prescription principles and complexity assessment to determine the appropriate exercise prescription for patients with heart failure and CVA. Strengthening, flexibility, and pulmonary exercises will briefly be applied to cases.

8. Case Studies: Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), and Other Pulmonary Issues

In this chapter, we will apply exercise prescription principles and complexity assessment to determine the appropriate exercise prescription for patients with COPD, ILD, and other pulmonary dysfunctions. Strengthening, flexibility, and pulmonary exercises will briefly be applied to cases.

9. Question and Answer Session

This section is a viewer-submitted question and answer session facilitated by Ellen Hillegass.

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