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Unit D520 Design, agree and adapt a physical activity
programme for adults with chronic
respiratory disease
Mapping Version
Element 1 – D520.1 Design and agree a physical activity programme for
patients/clients with chronic respiratory disease
What you must do
Mapped Against
1
Establish an effective working relationship with your patients/clients and
appropriate health care professionals
2
Collect, record and interpret information about your patients/clients
with chronic respiratory disease using safe, appropriate and recognised
methods
3
Follow the correct procedures and protocols for accepting referrals from
and maintaining ongoing communication with pulmonary rehabilitation
professionals, including those for confidentiality
4
Establish and agree the patient/client’s readiness to participate
5
Plan and agree goals that are appropriate to your client and their current
level of ability
6
Plan and prepare objectives, activities and delivery methods that are
appropriate to your client’s goals and condition
7
Design and agree a programme adapted to your patient/client using
relevant principles of training
8
Assess and manage risk according to appropriate guidelines and protocols
What you must cover
Mapped Against
Information
information
1
2
3
4
5
personal goals
referral form from pulmonary rehabilitation professional
informed consent to participate to transfer medical information
medical history and medication
current and previous physical activity history and preferences
6 social and psychological considerations
Methods
1. reports
2. interview
3. questionnaire
4. observation
Unit D520
Mapping Version
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5. functional assessment
Element 2 – D520.2 Deliver, review and adapt a physical activity programme for
patients/clients with chronic respiratory disease
What you must do
Mapped Against
1
Assess, monitor and manage risk to your patient/client throughout the
programme
2
Manage medical complications and emergencies within the boundaries of
your role until the required medical help is available
3
Deliver planned activities to your patient/client with chronic respiratory
disease, adapting activities according to their individual needs
4
Communicate and consult with your patients/clients on issues to do with
their physical activity programme and progress
5
Provide appropriate attention to your patients/clients with common comorbidities
6
Support your patient/client in a way which will promote sustained change
in physical activity levels
7
Monitor your patient/client’s progress against agreed goals and adapt the
programme accordingly
8
Provide ongoing reports to communicate relevant outcomes to the
appropriate health care professional.
What you must know and understand
Mapped Against
K1 Government policy and published international and national guidelines
for pulmonary rehabilitation (e.g. ERS/ATS and BTS)
K2
Awareness of national agencies and organisations (e.g. GOLD, BLF)
relating to chronic respiratory disease
K3
Relevant medico-legal requirements
K4
How to interact appropriately with pulmonary rehabilitation
professionals, other health care professionals and personnel and
general practitioners, involved in the process of pulmonary
rehabilitation
K5
The information that must be reported on the referral form to
include:

Main diagnosis and significant co-morbidities


Oxygen requirements
Smoking history


Medication
Lung function (FEV1 % predicted and FEV1/FVC (%)

Exercise tolerance (distance achieved, heart rate at rest and post
test/s, breathlessness score pre and post test/s, reason for
termination of test and oxygen saturation)
Unit D520
Mapping Version
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
Pre and post exercise test (e.g. incremental shuttle walk test
(ISWT), 6 minute walk test or endurance shuttle walking test)
(indication as to whether undertaken with or without oxygen)

Exercise completed during pulmonary rehabilitation (frequency,
intensity, type and duration)

Other relevant information (e.g. BODE Index score, if used)
K6
Local protocol that should be followed when dealing with the
patient/client who has been transferred from clinically-based
rehabilitation to ongoing maintenance of exercise behaviour
K7
The importance of an agreed link with a named specialist from the
pulmonary rehabilitation team
K8
Barriers to communication with the referred patient/client and the
communication skills needed to overcome these
K9
How to identify when the patient/client needs to consult health care
professionals
K10 Considerations involved in ongoing maintenance of exercise
behaviour, including respecting inter-professional boundaries and
patient/client confidentiality
K11 Methods of information collection and interpretation, appropriate
storage of confidential records and management processes
encountered in running ongoing maintenance of exercise behaviour
K12 The significance of measurements of lung function and oxygen
saturation and their implications for practice
K13 The respiratory system and the components of respiration
K14 The physiology and pathology of Chronic Obstructive Pulmonary
Disease with consideration for other conditions such as asthma,
bronchiectasis and interstitial lung disease
K15 Causes, presentation, diagnosis and treatment of Chronic Obstructive
Pulmonary Disease with consideration for other conditions such as
asthma, bronchiectasis, interstitial lung disease
K16 The impact of chronic respiratory disease on functional performance
and emotional well-being
K17 How the pathophysiology of respiratory disease contributes to the
altered response to exercise in individuals with respiratory disease
K18 The range of respiratory medications and their exercise
considerations
K19 Oxygen therapy and potential requirements during exercise
K20 Acute responses and chronic adaptations to aerobic and resistance
training and implications for the individual with chronic respiratory
disease
K21 Evidence-based beneficial effects of physical activity on chronic
respiratory disease
K22 Contra-indications to exercise which need to be taken into account
for the patient/client with chronic respiratory disease
K23 Initial assessment including appropriate assessment of exercise level
Unit D520
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using recognised tests, for example the Incremental Shuttle Walk
Test, the Endurance Shuttle Walk Test and One Repetition Maximum
Test
K24 On going screening process prior to each exercise session
K25 How to set up and manage a safe physical activity environment
relevant for a patient/client with chronic respiratory disease
K26 Principles of individual exercise prescription (aerobic and resistance)
for the patient/client with chronic respiratory disease
K27 Evidence-based methods for monitoring intensity e.g. breathlessness
(use of the breathlessness scale and perceived exertion (RPE scale))
K28 Causes and management of breathlessness (e.g. breathing techniques)
K29 Exercise considerations for the patient/client with other medical
conditions/co-morbidities for example:
 Heart failure
 Diabetes (Type 1 and Type 2)
 Hypertension
 Obesity / low weight
 Peripheral Vascular Disease
 Osteoarthritis/Rheumatoid arthritis/osteoporosis
 Depression and anxiety
K30 How to determine and progress physical activity programmes
appropriate to the condition using results from the physical / exercise
assessments, medical information, national guidelines, consultation and
patient/client aims
K31 The motivational processes, models and techniques involved in
behavioural change for the referred patient/client to encourage
beneficial lifestyle changes and providing appropriate support to
sustain such changes
K32 How to communicate and consult effectively with the referred
patient/client about their programme and progress
K33 How to recognise and understand the impact of an exacerbation of
the chronic respiratory disease and adapt the exercise programme
appropriately
K34 How to manage medical complications e.g. angina, arrhythmias, until
the required medical help is available
K35 How to respond safely and appropriately to emergencies e.g.
myocardial infarction, hypoglycaemia until appropriate medical help is
available
K36 The management, evaluation and reporting of information, in verbal
and written formats
K37 How to use and adapt a system for monitoring and recording the
patient/clients progress and updating their physical activity programme
K38 How to evaluate the effectiveness of on-going maintenance of
exercise behaviour
Unit D520
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