Aging and Activity Tolerance CH2 Flashcards
The older adult experiences decreased elastic recoil of the lungs, loss of flexibility in the thorax (rib cage soft tissue) and decreased height of intervertebral discs which affects their vital capacity and residual
volume of breathing.
How does this affect their energy cost with breathing, respiratory rate, depth of breathing/tidal volume, oxygensaturation and respiratory muscles?
- ability to deliver oxygen efficiently gets compromised
What simple equation is used to calculate a healthy individuals recommended target HR for aerobic conditioning exercise?
Why is a different equation used for older adults?
Max HR = 220 - Age
- recommended between 60-80%
RPP = HR x SBP
- rate pressure produce gives clearer impression of relative work
- because afterload on the heart increases with age so HR alone cannot reflect the work older patients experience
-
What combined effects on the older population requiring orthotic or prosthetic intervention, can lead to vulnerability if exercise or activity is too physically demanding?
- age related changes in cardiovascular and cardiopulmonary systems
- the high incidence of cardiac and pulmonary pathologies
- deconditioning impact of bed rest and inactivity
Regarding the Signs and Symptoms of Exercise Intolerance:
-At which level of O2 saturation should exercise be discontinued?
-What values of heart rate at rest are considered cautionary to aerobic exercise?
discontinue @ <86%
caution with HR <40bpm or >130
What is recommended for the patient to do before any functional activity or training session to improve the EDV (end-diastolic volume) which facilitates minimizing effects the of age-related preload problems thus improving work capacity?
gentle repetitive LE warm up exercises
- ankle pumps, knee flex/ext
Which RPE Scale has both a linear and a ratio scale and is an effective indicator of level of physiological exertion with exercise or strenuous physical activity?
Borg Scales: Rating of Perceived Exertion
Regarding standard exercise testing protocols for assessing the condition of the cardiovascular system and exercise tolerance of older adults, what is an alternative test that can be performed if a patient isn’t safe to perform treadmill testing because of balance and severe muscle weakness?
one mile walk test and 6 minute walk test
or
seated step test
With Physical Performance Training, what is “an effective strategy to improve cardiopulmonary response to exercise and activity for older patients who are deconditioned by bed rest, acute illness, or sedentary
life-style?”
a warm up with continuous alternating movements for LARGE muscle groups (LE)
- to facilitate preload and SV
-What does much of the energy cost of walking come from?
muscular work performed to keep the COM moving forward with minimum displacement
Self-selected walking speed…….reflects the overall __________ and ____________ __________ of an ________________.
- overall HEALTH and FUNCTIONAL STATUS of an individual
Walking speed is recognized as a _____________ __________ that not only captures _____________ ____________ but also can be used to predict” what?
- as a vital sign
- captures current function
- predicts risk of functional decline, adverse health events, morbidity, Length of stay, discharge
Which Index uses HR and walking speed to determine the energy cost of walking and is more appropriate to use with older adults esp those with heart disease being managed by medications that blunt HR
response?
RPP (Rate Pressure Product)
or
PCI (Physiologic Cost Index)
How do you calculate the PCI of a patient?
PCI = (HR walking - HR resting)/Walking speed
On what conditions has the PCI assessment been used?
(no need to memorize these, just be aware of the breadth of the conditions)
- assess effect of ADs
- evaluate impack on neuromuscular stim
- assess outcome of orthopedic surgery
True or False: The energy cost of walking with an orthosis is increased in patients with neuromuscular conditions
FALSE because walking with an orthosis results in a slower speed
