If INR is greater than 5.0, what should be done?

• A. Light exercise
• B. Moderate exercise
• C. Resistive exercise
• D. No exercise

Answer: (D)

When INR is above 5.0, the blood’s ability to clot is markedly reduced, increasing the risk of spontaneous or provoked bleeding. In rehab, even mild activity can cause trauma to tissues or joints, and with impaired clotting, that can lead to significant bleeding. The safest approach is to refrain from exercise and obtain medical clearance or ensure INR is within the therapeutic range before resuming activity. Once the INR is controlled, gradual, supervised activity can be considered. Activities that involve resistance or contact and any potential for minor injuries should be avoided while the INR remains elevated.