Which vital signs abnormality should prompt medical clearance before continuing physical therapy?

Which vital signs abnormality should prompt medical clearance before continuing physical therapy?

• A. Oxygen saturation 98%
• B. Systolic BP ≥180 or diastolic BP ≥110
• C. Heart rate 75
• D. Respiratory rate 12

Answer: (B)

The key safety rule is that strikingly elevated blood pressure signals a high cardiovascular risk when proceeding with therapy. If systolic pressure is at or above 180 mmHg or diastolic pressure is at or above 110 mmHg, there is a real chance of adverse events during activity, so the patient should obtain medical clearance before continuing physical therapy. These thresholds reflect the point where exercise could provoke myocardial ischemia, arrhythmias, stroke, or other acute events, making professional assessment essential prior to resuming or increasing activity. In contrast, the other vital signs shown are within normal resting ranges—oxygen saturation at 98% is typical, heart rate at 75 is normal, and a respiratory rate of 12 is normal—so they do not by themselves necessitate medical clearance.

The key safety rule is that strikingly elevated blood pressure signals a high cardiovascular risk when proceeding with therapy. If systolic pressure is at or above 180 mmHg or diastolic pressure is at or above 110 mmHg, there is a real chance of adverse events during activity, so the patient should obtain medical clearance before continuing physical therapy. These thresholds reflect the point where exercise could provoke myocardial ischemia, arrhythmias, stroke, or other acute events, making professional assessment essential prior to resuming or increasing activity.

In contrast, the other vital signs shown are within normal resting ranges—oxygen saturation at 98% is typical, heart rate at 75 is normal, and a respiratory rate of 12 is normal—so they do not by themselves necessitate medical clearance.