heart failure

1. Introduction:
As a basic grade occupational therapist, I frequently encounter people for whom exercise tolerance is the limiting factor of occupational performance. Usually, this is due to physical de-conditioning secondary to inactivity, but occasionally it is due to pathology. This can often be obvious in people with pulmonary or cardiovascular impairments, but less obvious for those with neurological or renal pathology. Reflecting on my undergraduate occupational therapy training, it has not informed me of how best to manage these people as patients. If I knew no better, I might be hesitant to stress people with cardio-pulmonary pathology for fear of straining their already compromised organs. I might just issue loads of equipment and re-organise tasks to reduce occupational stress. Luckily, from previous experience I know that peripheral physiological adaptations contribute grately to increased performance capacity, and can therefore reduce the overall daily load placed on a compromised heart or lungs. When cleaning out my hard-drive this weekend I found a piece of work I did 9 years ago that has influenced my own physical training and the way I have viewed people with reduced exercise tolerance since. I thought I might as well share it here before deleting it along with the rest of my junk.