1. severe symptoms requiring referral to the emergency department. 2. contraindications to exercise (cardiac disease such as diagnosed arrhythmias, on home oxygen, or end stage organ failure). 3. known history of poorly controlled diabetes or hypertension. 4. active neurological or psychiatric illnesses.

1. severe symptoms requiring referral to the emergency department. 2. contraindications to exercise (cardiac disease such as diagnosed arrhythmias, on home oxygen, or end stage organ failure). 3. known history of poorly controlled diabetes or hypertension. 4. active neurological or psychiatric illnesses.

severe symptoms requiring referral to the emergency department. contraindications to exercise (cardiac disease such as diagnosed arrhythmias, on home oxygen, or end stage organ failure). known history of poorly controlled diabetes or hypertension. active neurological or psychiatric illnesses.

severe symptoms requiring referral to the emergency department. contraindications to exercise (cardiac disease such as diagnosed arrhythmias, on home oxygen, or end stage organ failure). known history of poorly controlled diabetes or hypertension. active neurological or psychiatric illnesses.

1. severe symptoms requiring referral to the emergency department. 2. contraindications to exercise (cardiac disease such as diagnosed arrhythmias, on home oxygen, or end stage organ failure). 3. known history of poorly controlled diabetes or hypertension. 4. active neurological or psychiatric illnesses.

1. severe symptoms requiring referral to the emergency department. 2. contraindications to exercise (cardiac disease such as diagnosed arrhythmias, on home oxygen, or end stage organ failure). 3. known history of poorly controlled diabetes or hypertension. 4. active neurological or psychiatric illnesses.