Table 2 Summary of exercise recommendation evidence
Symptom | Recommendation | Population |
|---|---|---|
Energy availability | ||
Low energy availability | Modify | ED |
Starvation | * H/I A & AN contraindicated on days when meals are skipped | ED |
Purging | *Contraindicated when hypovlemia is present | ED |
Cardiovascular health | ||
Arrhythmias | EKG, Holter monitoring and exercise testing if arrhythmias persist beyond nutritional restoration | GEN |
Bradycardia | Only supervised & with caution (particularly if under 80% IBW, and purging) | ED |
Tachycardia | Investigate cause prior to engagement | GEN |
Postural tachycardia | Modify | GEN |
Orthostatic hypotension | Unknown   | N/A |
Hypotension | Modify until resolved | ED |
Hypertension | High intensity & volume contraindicated for BP > 200 mm/Hg) | GEN |
Prolonged QT | Unknown | N/A |
Electrolyte abnormalities | ||
Hypokalaemia | Unknown | N/A |
Hypophosphatemia | High intensity & long duration activity contraindicated until rectified | ED |
Hypomagnesemia | High intensity exercise restricted until rectified | GEN |
Hypercarbia | High intensity aerobic and resistance training restricted until rectified | GEN |
Hyponatremia | Correct prior to long or intense activity | GEN |
Biomedical function markers | ||
Hypothermia | Modify | GEN |
Hyperthermia | Contraindicated | GEN |
Blood urea nitrogen & urine specific gravity | *Strength training only when nitrogen levels are normalized | ED |
Transaminase | Modify type and intensity | GEN |
Hypoglycaemia | Contraindicated until resolved | GEN |
Hyperglycaemia | Exercise with caution, contraindicated when > 250 mg/dl | GEN |
Hypohydration | Contraindicated | ED |
Sex hormones | ||
Amenorrhea/functional hypothalamic amenorrhea | Modify *high impact exercise is contraindicated in those with FHA | ED |
Low female sex hormones | Exercise with caution | ED |
Low male sex hormones | Exercise with caution | ED |
Body composition | ||
Body mass index (kg/m2) | Modify *high impact exercise is contraindicated when BMI < 16 kg/m2 *intense endurance or strength training contraindicated when BMI < 13.5 kg/m2 | ED |
Bone mineral density | Activity dependent | ED |
Superior mesenteric artery syndrome | Modify until resolved | ED |
Peripheral edema | High intensity contraindicated | ED |