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ACE > Chapter 12: Working With Participants with Health Considerations > Flashcards

Chapter 12: Working With Participants with Health Considerations Flashcards

1
Q

Exercise Guidelines for Cardiovascular Disease: Points of Emphasis

A

Encourage self monitoring of exercise intensity
Do not exceed the target HR and/or a somewhat hard RPE of 12 to 13 on the 6 to 20 scale, or a 4 to 5 on the 0 to 10 scale.
Focus on the proper breathing patterns.

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2
Q

Exercise Guidelines for Cardiovascular Disease: Modifications

A
  • change exercise order to complete all standing, seated, or floorwork together, as abruptly changing from lying down or seated to standing my elicit orthostatic hypotension, causing dizziness.
  • extend the cool down, as antihypertensive medication may lead to post exercise hypotension
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3
Q

Exercise Guidelines for Cardiovascular Disease: Things to avoid

A

avoid the valsalva manuever
avoid exercises with significant isometric activation hold times, which may elicit a significant rise in BP

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4
Q

Exercise Guidelines for Cardiovascular Disease: Additional Precautions

A

exercise should not continue if any abnormal signs or symptoms are observed, such as angina, dyspnea, lightheadedness or dizziness, pallor, or rapid HR above established targets.
- understand the effects of medication on the heart rate response to exercise

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5
Q

Exercise Guidelines for Asthma: Points of Emphasis

A
  • encourage hydration before, during, and after exercise
  • have participants use the RPE scale and dyspnea scale to monitor exercise intensity
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6
Q

Exercise Guidelines for Asthma: Modifications

A
  • encourage individuals to utilize an extended warm up and cool down
  • if pulmonary exacerbations arise before or during exercise, physical activity should be limited, or intensity reduced until symptoms subside
  • encourage frequent rest periods
  • encourage individuals to use diaphragmatic breathing or pursed-lip breathing
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7
Q

Exercise Guidelines for Asthma: Things to avoid

A
  • avoid or limit exposure to cold, dry, polluted, or high-allergen environments
  • avoid chlorinated pools
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8
Q

Exercise Guidelines for Asthma: Additional Precautions

A
  • remind participants to have medication nearby for use in the event of an asthma episode
  • understand the effects of medication on the heart rate response to exercise
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9
Q

Exercise Guidelines for Osteoarthritis: Points of Emphasis

A
  • perform an adequate warm up
  • start with light aerobic exercise to increase systemic blood flow and body temperature
  • dynamic flexibility exercises should be performed to enhance tissue elasticity and further increase joint lubrication
  • perform activation exercises to target specific areas during the warm up and conditioning segment of the class.
  • incorporate exercises that relate to activities of daily living, such as sit to stand or carrying activities
  • pay attention to each participant’s overall posture and joint mechanics and cue proper techniques for ideal joint alignment
  • perform an adequate cool down
  • teach participants to distinguish between soreness and pain
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10
Q

Exercise Guidelines for Osteoarthritis: Modifications

A
  • reduce volume and intensity if pain is present
  • start with bilateral exercises and advance to unilateral
  • replace isotonic with isometric strengthening
  • reduce load on effected joint
  • change body position to avoid pain
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11
Q

Exercise Guidelines for Osteoarthritis: Things to Avoid

A
  • avoid vigorous exercise during flare ups
  • do not perform high impact activities during inflammation.
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12
Q

Exercise Guidelines for Osteoarthritis: Additional Precautions

A
  • stop exercise if joint pain is too severe
  • water temperature for aquatic exercise should be between 83 to 90 to help relax muscles and reduce pain
  • participants should wear appropriate shoes with good shock absorption and stability
  • understand the effects of medication on the heart rate response to exercise
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13
Q

type 1 diabetes

A

age of onset: usually <35 years
clinical onset: abrupt
family history: not always
body composition: normal or thin
blood insulin levels: reduced or absent
cell insulin resistance: absent or minor
treatment: insulin, diet, exercise

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14
Q

type 2 diabetes

A

age of onset: usually >40 years
clinical onset: gradual
family history: yes
body composition: usually obese
blood insulin levels: normal or increased
cell insulin resistance: present
treatment: weight loss, diet, oral hypoglycemic drugs, insulin

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15
Q

Early Signs and Symptoms of Hypoglycemia

A

shakiness, anxiety, sweating/chills/clamminess, irritability, fast heartbeat, lightheadness, nausea, hunger, loss of skin color, weakness, headache, clumsiness, nightmares

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16
Q

Late/Severe signs of Hypoglycemia

A

blurred vision, confusion, slurred speech, tingling or numbness, drowsiness, seizures, coma, death

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17
Q

Exercise Guidelines for Diabetes: Points of emphasis

A
  • emphasis frequency and duration over intensity
  • ensure that participants understand their own medication management
  • the timing of exercise in relation to taking insulin and carb consumption is particularly important for preventing hypo-and hyperglycemia
  • optimal pre-exercise blood glucose levels are between 90 and 250 mg/dL
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18
Q

Exercise Guidelines for Diabetes: modifications

A

provide time for participants to monitor their blood glucose levels before, during, and after exercise

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19
Q

Exercise Guidelines for Diabetes: things to avoid

A
  • do not perform exercise if blood glucose levels are lower than 70 md/dL
  • avoid vigorous physical activity if blood glucose levels are above 250 mg/dL
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20
Q

Exercise Guidelines for Diabetes: Additional Precautions

A
  • know the signs and symptoms of hypoglycemia
  • encourage self care for the feet
  • be aware of side effects of medications on the heart rate response to exercise
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21
Q

Exercise Guidelines for Obesity: Points of emphasis

A
  • the majority of the time exercising should be at low to moderate to avoid joint stress, injury, and heat intolerance
  • gradual progression of exercise intensity and duration
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22
Q

Exercise Guidelines for Obesity: Modifications

A
  • for individuals with mobility and balance issues, seated exercise is a good options
  • aquatic exercise places less stress on joints
  • recumbent cycling may be more comfortable than a traditional upright bike
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23
Q

Exercise Guidelines for Obesity: Things To Avoid

A
  • running, jumping, and high impact movement not recommended
  • certain supine exercises may cause breathing difficulty
  • not too much lunge or squat work because of knee and back injury
  • avoid body-weight exercises performed on an unstable surface due to balance difficulties for some participants
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24
Q

Exercise Guidelines for Obesity: Additional Precautions

A
  • need high quality fitness shoes
  • skin chafing may occur
25
Q

Exercise Guidelines for Low Back Pain: points of emphasis

A
  • adequate warm up and cool down
  • use proper form
  • maintain neutral posture and an erect torso
  • perform low or nonimpact activities
  • focus on core function and fundamental movement patterns
  • utilize more repetitions of less demanding low back strength and stability exercises to enhance postural endurance and strength
26
Q

Exercise Guidelines for Low Back Pain: Modifications

A
  • when leaning forward to lift or lower an object, always hinge at the hips and bend the knees
27
Q

Exercise Guidelines for Low Back Pain: Things to avoid

A
  • do not work through pain
  • avoid forward head positions in which the chin is tilted up
  • avoid hyperextending the spine in an unsupported position
  • avoid extreme ranges of motion, excessive spinal flexion under load, and abrupt twisting movements
28
Q

Exercise Guidelines for Low Back Pain: Additional precautions

A
  • individuals with low back pain, should consult with a physician and get specific recommendations for exercise
29
Q

Exercise Guidelines for Older Adults: Points of Emphasis

A
  • extended warm up and cool down
  • monitor intensity
  • teach exercises that participants can replicate on their own
  • cognitive exercises may improve reaction time and cognitive function
  • coach participants to control the eccentric phase of a resistance exercise
30
Q

Exercise Guidelines for Older Adults: Modifications

A
  • be mindful of ability to move quickly to floor to seated
  • provided chair exercise options
  • barefoot balance training can be helpful for improving propriception
31
Q

Exercise Guidelines for Older Adults: Things to Avoid

A
  • avoid use of excessive equipment
  • avoid dim lighting in exercise area
32
Q

Exercise Guidelines for Older Adults: Additional Precautions

A
  • ask participants what their limitations are
33
Q

Exercise Guidelines for Osteoporosis: Points of Emphasis

A
  • choose resistance exercises that strengthen the muscles of the hip and spine.
  • choose ROM exercises that improve posture
  • aerobic activity should be weight bearing
  • balance activities should be added to help reduce the risk of falls
34
Q

Exercise Guidelines for Osteoporosis: Modifications

A
  • short bouts of activity interspersed with recovery are preferable to long duration loading
  • multiplanar activity should be encouraged
  • higher loads with fewer repetitions
35
Q

Exercise Guidelines for Osteoporosis: Things To Avoid

A
  • avoid explosive movements or high impact loading if at risk for fractures
  • avoid excessive twisting, bending, or compression of the spine
36
Q

Exercise Guidelines for Osteoporosis: Additional Precautions

A
  • the intensity of each exercise modality that can be tolerated will vary depending on bone status
37
Q

Exercise Guidelines for Youth: Points of emphasis

A
  • light weight equipment
  • develop motor skills to run, jump, kick, throw, and other basic skills
  • focus on physical literacy
  • bone strengthening
  • proper breathing techniques
  • encourage frequent fluid consumption
  • communication when feeling tired, fatigued, pain, or discomfort
38
Q

Exercise Guidelines for Youth: modifications

A
  • children may not be able to measure RPE
  • to increase adherence, gamify exercise sessions
39
Q

Exercise Guidelines for Youth: things to avoid

A
  • caution should be taken when exercising in hot, humid enviornments
40
Q

Exercise Guidelines for Youth: additional precautions

A
  • proper supervision
  • free weight and bodyweight over machines
  • no single maximal lifts or sudden explosive moments
41
Q

Exercise Guidelines for Pregnancy: Points of Emphasis

A
  • extended warm up and cool down
  • RPE to mointor intensity
  • exercise for postural muscles
  • adequate hydration
42
Q

Exercise Guidelines for Pregnancy: Modifications

A
  • reduce intensity, duration, and frequency over the course of pregancy
  • walking and running on a flat surface
  • modify jumping or quick change in direction activities
43
Q

Exercise Guidelines for Pregnancy: Things To Avoid

A
  • after 20 weeks, avoid lying in supine for long periods
  • avoid hot and humid enviornments
  • avoid contact or collision actvities
44
Q

Exercise Guidelines for Pregnancy: Additional Precautions

A
  • some women need snack prior to exercise
  • be aware of warning signs to discontinue exercise
  • low back pain common
45
Q

Exercise Guidelines for Post Partum: Points of Emphasis

A
  • start slowly and gradually increase
  • wear a supportive bra
  • strengthen major muscle groups
  • hydrate
46
Q

Exercise Guidelines for Post Partum: Modifcations

A
  • c sections need more time to heal
47
Q

Exercise Guidelines for Post Partum: things to avoid

A
  • excessive fatigue
  • avoid dehydration
48
Q

Exercise Guidelines for Post Partum: Additional precautions

A
  • stop of unusual pain
  • stop if you see bright red vaginal bleeding
49
Q

Beta Blockers on heart rate response

A

Resting HR: decrease
Exercise HR: decrease
Exercise Capacity: decrease
Comments: dose related respose

50
Q

Angiotensin

A

Resting HR: decrease or no change
Exercise HR: decrease or no change
Exercise Capacity: no change

51
Q

antihypertensives

A

Resting HR: increase, no change, or decrease
Exercise HR: increase, no change, or decrease
Exercise Capacity: no change

52
Q

antihistamines

A

Resting HR: increase
Exercise HR: no change
Exercise Capacity: no change

53
Q

antidepressants

A

Resting HR: increase, no change
Exercise HR: increase, no change

54
Q

Stimulants

A

Resting HR: increase
Exercise HR: increase
Exercise Capacity: increase, no change

55
Q

Caffeine

A

Resting HR: increase
Exercise HR: increase
Exercise Capacity: increase

56
Q

Brochodilators

A

Resting HR: no change
Exercise HR: no change
Exercise Capacity: no change

57
Q

Alcohol

A

Resting HR: no change
Exercise HR: no change
Exercise Capacity: decrease
Comments: do not exercise

58
Q

Nicotine Replacement therapy

A

Resting HR: increase
Exercise HR: increase
Exercise Capacity: no change, decrease

ACE (14 decks)

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