Table 3.

Safety Check for Exercise Training in CORE

Normal testing

CPET71

Resting BP ≤160/90 mm Hg*

Normal BP response to exercise

No inducible ischemia

No atrial or ventricular arrhythmias

Maintain normal O2 saturations

No symptoms†

6-min walk test72

Resting blood pressure ≤160/90 mm Hg*

Maintain normal O2 saturations

Laboratory studies

Absence of severe anemia (<8.0 g/dL)

Absolute neutrophil count >500 mm3

Platelet count >50 000/μL

No baseline symptoms

Acute nausea during exercise

Vomiting within 24 h

Disorientation

Blurred vision

Ongoing cancer complications

Acute infection

Acute metabolic disease‡

New-onset lymphedema

Mental or physical impairment to exercise

Initial wound healing after surgery

Bone or brain metastasis§

Displays exercise knowledge

Understands functions of aerobic and resistance equipment

Demonstrates correct form on equipment

Understands perceived exertion and heart rate goals; performs exercise accordingly

BP indicates blood pressure; CORE, cardio-oncology rehabilitation; and CPET, cardiopulmonary exercise testing.

^*If elevated, recheck after 5 minutes. If still elevated, then reschedule CPET after patient is seen by provider to adjust BP medications.

^†Symptoms such as dyspnea, chest pain, or dizziness or other cardiac symptoms during exercise deemed abnormal by supervising physician.

^‡Examples include abnormal thyroid function, uncontrolled diabetes mellitus, and electrolyte abnormalities.

^§For patients with bone or brain metastases, a plan in CORE needs to include a consultation with oncology rehabilitation to establish a patient-specific safe exercise plan.