What monitoring approach is advised for clients on beta blockers during exercise?

• A. Rely exclusively on heart rate monitoring to set intensity.
• B. Use RPE scale or work rates based on prior testing rather than HR responses.
• C. Ignore any monitoring during exercise.
• D. Remove all monitoring and rely on patient self-report.

Answer: (B)

Beta blockers blunt the heart rate response to exercise, so using heart rate to set intensity isn’t reliable. The best approach is to guide intensity with the rating of perceived exertion (RPE) or with fixed work rates based on prior testing. RPE provides a consistent sense of effort that remains valid even when the heart rate response is blunted, and pre-determined work rates from a baseline test give a known, safe workload for that individual. Relying on heart rate alone can lead to inappropriate intensity, and skipping monitoring or relying only on patient self-report removes important safeguards. Using RPE or prior-tested work rates keeps exercise safer and appropriately challenging for someone on beta blockers.