Absolute Contra-indications:
- Unstable angina, arrhythmia, hypertension or heart failure
- Acute embolus/infarct, acute systemic infection with fever
- Dissecting aneurysm
- Acute myocarditis or pericarditis
Discontinue exercise if there are adverse cardiorespiratory signs or symptoms: moderately severe angina, dizziness or pre-syncope, cyanosis or pallor – Call for urgent medical assistance
| Relative Contra-indication Gain physician clearance | Exercise modification |
|---|---|
| Platelets <20 × 10^9/L | • Functional mobility exercises only • Minimise fall or impact risk • Emphasise normal breathing (avoid Valsalva manoeuvre) monitor bruising and bleeding |
| Haemoglobin <80 g/L | • Low to moderate intensity only |
| White blood cell <2•0 × 10^9/L: | • Avoid group exercise • Light to moderate intensity exercise only • Reinforce importance of sanitisation and hand-washing • Clean all equipment before use |
| Neutrophils <1•5 × 10^9/L | • Avoid group exercise • Light to moderate intensity exercise only • Reinforce importance of sanitisation and hand-washing • Clean all equipment before use |
| Blood glucose <5•5 mmol/L | • Recommend 5–30 g carbohydrate consumption before exercise |
| Resting Blood pressure Systolic blood pressure >200 mmHg or diastolic blood pressure >110 mmHg after two measurements, 5 min apart | • Seek medical review and clearance • If medically cleared - monitor for signs and symptoms • Repeat blood pressure measurements frequently during session |
| Resting heart rate 120 bpm after two measurements, 5 min | • Seek medical review and clearance • If medically cleared - exercise as tolerated • Monitor closely |
| Resting O2 saturation ≤88% | • Discontinue exercise if desaturation to this level occurs during a session • 88-94% Exercise as tolerated, monitor signs and symptoms of fatigue and exertion, repeat SpO2 |
| Sudden or severe pain, swelling or dysfunction | • Avoid exercise of the affected region • Doctor’s clearance required to resume exercise of the affected region or if general exercise exacerbates symptoms |
| Recent surgical intervention | • Adhere to post operative surgical instructions regarding movement and lifting restrictions • Monitor wound healing and dressings |
Source: Adapted from Santa Mina et al. Lancet Oncol 2018
Printable Safety Reference Guide for Exercise for People with Cancer