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"We don't stop playing because we grow old; we grow old because we stop playing."

—George Bernard Shaw (1856–1950)


By the end of this chapter, readers will be able to:

  1. Describe the age-related changes that are expected in cardiopulmonary and cardiovascular function.

  2. Describe the factors that should be considered in prioritizing the goals of an intervention for cardiopulmonary and cardiovascular conditioning and provide the rationale.

  3. Outline the focus of the assessment and the measures that would be most relevant to record based on the older adult's needs and wants.

  4. Outline an intervention plan vis-à-vis prescribing training for cardiovascular and pulmonary function as these relate to activities of daily living and other areas of activity and participation.

  5. Describe the precautions that are necessary when assessing and prescribing activities to enhance cardiopulmonary function.

  6. Provide the rationale for deciding whether a maximal test or submaximal test is indicated.

  7. On the basis of the findings of a maximal test or submaximal test: (a) outline the short-term and long-term responses expected for the intervention plan and (b) describe adverse responses the older adult could exhibit in response to the plan.

Clinical Vignette

Mr. Miciej Kasper, aged 69 years, is a retired college professor. He was born in Poland and immigrated to the United States when he was 27 years old. His father died of heart disease. His mother lived to 88 years and had a history of high blood pressure. Other than having smoked a pack of cigarettes daily since he was 16 years old, Mr. Kasper reports good general health and that he has "never been sick a day in his life."

  1. Although Mr. Kasper currently reports good health, what are the implications of his history on your assessment and decision-making?

  2. Like many people, Mr. Kasper may have long-established beliefs and practices about health and well-being. How will you identify and consider these in your short- and long-term intervention plan?

This chapter focuses on the health of older people with special reference to the cardiopulmonary and cardiovascular systems. In contemporary rehabilitation practice, occupational and physical therapists appreciate the need to consider context, given that the lungs and heart do not function independently of the person in whom they reside. This topic is discussed in relation to the World Health Organization (WHO; 2001) definition of health and the International Classification of Functioning, Disability and Health (ICF), which frames the importance of physical activity with respect to what an individual needs or wants to do, and his or her capacity for activity and participation. Physical activity and exercise are key to offsetting age-related changes and maximizing function and health-related quality of life of older people. Physical activity and exercise reduce illness and disability, and their impact and may mitigate side effects of medical treatment. Considering the needs of older adults, the exercise-based means of assessing cardiopulmonary and cardiovascular status are ...

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