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ACE Personal Trainer > Chapter 13 - Considerations for Chronic Disease > Flashcards

Chapter 13 - Considerations for Chronic Disease Flashcards

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1
Q

Chronic conditions that general exercise guidelines apply to.

A

The general guidelines apply to conditions such as uncomplicated coronary artery disease, hypertension, dyslipidemia (blood lipid disorder), diabetes, MetS (metabolic syndrome), asthma, cancer, and osteoarthritis

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2
Q

Modifications to exercise programs for someone with a chronic disease should be based on:

A
  1. Characteristics to the disease
  2. Restrictions that the disease places on someone
  3. Disease severity
  4. Activities to emphasize
  5. Activities to avoid
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3
Q

Three factors that would dramatically reduce chronic disease

A

Smoking, Physical Activity, Poor diet

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4
Q

Information a PT should gather from a client’s physician

A 
Medical release (permission to exercise)
Exercise limitations - HR limitations
Exercise guidelines
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5
Q

SOAP Notes

A

A way to document client progress. Documents patterns of self image vs actual performance.
Subjective - client observations of status, description of symptoms, challenges w/program, progress made
Objective - Measurements taken, exercise & nutrition log (include date)
Assessment - Summary of client status based on S and O
Plan - Description of next steps based on assessment

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6
Q

PT Responsibility When Working with Clients Who Have Chronic Disease

A

Expand knowledge and skills through continuing education and close communication with healthcare professionals

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7
Q

Nutrition Statistics Regarding Chronic Disease

A

45% of deaths caused by heart disease, type 2 diabetes, and stroke were attributable to dietary habits. (US study)

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8
Q

Recovery from a cardiac event (MI, procedure, surgery, angioplasty, stent)

A

Recovery is almost always improved with an appropriate exercise program. Avoid Valsalva maneuver. Stop exercise if angina, dyspnea, lightheadedness, dizziness, pallor, or rapid HR.

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9
Q

Description of low-risk CAD clients (Cardiovascular Disease)

A
  1. Uncomplicated clinical course in hospital
  2. No evidence of resting or exercise induced ischemia
  3. Functional capacity >=7 METS after 3 wks post treatment
  4. Normal ventricular function (ejection fraction >50%)
  5. No resting or exercise induced arrhythmias
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10
Q

FITT Recommendations for Clients with Cardiovascular Disease

A

Frequency - cardio 3-5days/wk, strength 2-3days/wk
Intensity - moderate to vigorous, moderate
Time - cardio goal of 20-60 min w/warm up and cool down, no specific duration for strength
Type - Rhythmic large muscle groups, various exercises for strength one set initially

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11
Q

Two types of hypertension

A

Essential or Primary Hypertension - most prevalent, no know cause
Secondary Hypertension - caused by another disease such as kidney disease

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12
Q

Lifestyle Changes to Manage Hypertension

A
  1. Maintain normal bodyweight (5-20 mm/Hg)
  2. Adopt DASH eating pattern (dietary approaches to stopping hypertension) (8-14 mm/Hg)
  3. Dietary sodium reduction (2-8 mm/Hg)
  4. Physical activity (4-9 mm/Hg)
  5. Moderation of alcohol (2-4 mm/Hg)
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13
Q

FITT Recommendations for Clients with Hypertension

A

Frequency - cardio every day preferable, strength 2-3 days/wk
Intensity - cardio RPE 12-13, strength 40-50% or 60-80% 1-RM
Time - 30min, 2-4 sets, 8-12 reps
Type - rhythmic large muscle , free weights or machines no Valsalva maneuver

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14
Q

Stroke definition

A

Stroke occurs when the blood supply to the brain is compromised by a blocked vessel (ischemic stroke) or when a blood vessel bursts in the brain (hemorrhagic stroke). Number one cause of disability globally.

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15
Q

Signs of Stroke

A

FAST - Face drooping, arm weakness, speech difficulties, time to call EMS

  1. Sudden numbness or weakness in arms, legs, face
  2. Sudden confusion or trouble speaking or understanding others
  3. Trouble seeing in one or both eyes
  4. Sudden walking problems, dizziness, loss of balance or coordination
  5. Sudden sever headache with no known cause
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16
Q

FITT Recommendations for Clients with Stroke

A

Follow same guidelines as CAD & Hypertension
Frequency - cardio 3-5days/wk strength 2days/wk
Intensity - light to vigorous RPE 11-14, 50-70% 1-RM
Time - 20-60min/day multiple bouts ok, 1-3 sets, 8-15 reps
Type - consider cognitive ability, consider safety

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17
Q

Peripheral Artery Disease PAD definition & considerations

A

Atherosclerosis of the arteries of the lower extremities. Most prominent risk factors are smoking and diabetes. Causes pain due to ischemia or lack of blood flow to the muscle. Pain is brought on by exercise and sometimes at rest. Medical evaluation required before exercise. Proper foot care important.

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18
Q

FITT Recommendations for PAD

A

Frequency - cardio 3-5 days/wk, >=2days/wk
Intensity - moderate, 60-80% of 1-RM
Time - 30-45min, 6-8 exercises 2-3 sets 8-12 reps
Type - weight bearing, whole body-large muscles-lower muscles

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19
Q

FITT Recommendations for Dyslipidemia

A

Frequency - cardio >=5 days/wk, 2-3days/wk
Intensity - below VT2, 50-85% of 1-RM
Time - 30-60min, 6-8 exercises 2-4 sets 8-12 reps or more for endurance
Type - rhythmic large muscle, variety

20
Q

Exercise considerations for Dyslipidemia

A

Decreasing total and LDL cholesterol involves exercise of at least 250-300 minutes per week, expending approx 2,000 cal/week. Definition - undesirable levels of lipids

21
Q

Lipid definition

A

A group of organic compounds that are oily to the touch and insoluble in water. Includes fatty acids, oils, waxes, sterols, triglycerides (TG). They are a source of stored energy and a component of cell membranes.
Cholesterol is manufactured in liver and transported in plasma while attached to protein.

22
Q

Lipid Types

A

LDL - low density lipids-bad- 60-70% of body chol.
VLDL - very low- carrier of TG, 10-15% of body chol.
IDL - Intermediate, similar to LDL, from VDL breakdown
HDL - high density, good, 20-30% of body chol
Non-HDL - Total cholesterol minus HDL

23
Q

Cholesterol Classifications - LDL

A 
<100 -      Optimal
100-129 - Near Optimal
130-159 - Borderline High
160-189 - High
>190    -   Very High
24
Q

Cholesterol Classifications - HDL & Total

A 
HDL - low <40, high >=60
Total Cholesterol
<200 -     desirable
200-239 borderline high
>=240     high
25
Q

Triglyceride (TG) Classifications

A

<150 desirable
150-199 borderline high
200-499 high
>=500 very high

26
Q

FITT Recommendations for Diabetes

A

Frequency - cardio 3-7 days/wk, 2-3days/wk
Intensity - mod to vigor, below VT2, 50-85% of 1-RM
Time - 150min/wk, 6-8 exercises 1-3 sets 8-10 reps
Type - rhythmic large muscle, variety

27
Q

Type 1 Diabetes Considerations

A

With advances in insulin delivery systems, persons with type 1 diabetes can eat and exercise just a a person without the disease.

28
Q

Characteristics of Type 1 Diabetes

A 
Onset <35 years
Abrupt onset
Family history not always
Normal to thin body composition
Reduced or absent blood insulin
Absent or minor cell insulin resistance
Treatment - Insulin, diet &/or exercise
29
Q

Characteristics of Type 2 Diabetes

A

Onset >40 years
Gradual
Family history - yes
Usually obese (central type) body composition
Normal or increased blood insulin
Present- cell insulin resistance
Treatment - Weight loss, drugs, insulin, diet

30
Q

FITT Recommendations for Metabolic Syndrome (MetS)

A

Frequency - cardio >=5 days/wk, 2-3days/wk
Intensity - below VT1, 50-85% of 1-RM
Time - 30-60min/day, 8-10 exercises 1-3 sets 8-10 reps
Type - rhythmic large muscle, variety

31
Q

MetS definition

A

A cluster of conditions that increases a person’s risk for developing heart disease, type 2 diabetes and stroke. Identified by the presence of 3 or more of these:
Elevated Waist Circumference W - >35in, M - >40in
Elevated TG >=150 or on drug treatment
Reduced HDL w,<50, m<40 or on drug treatment
Increased BP - >= 130/85
Elevated fasting glucose - >= 100mg/dL or on drug treatment

32
Q

Asthma Considerations

A

In general, people with asthma should be able to participate in regular exercise and sports with minimal restrictions if properly medicated.

  1. Always have rescue medication
  2. Drink plenty of fluids
  3. Avoid asthma triggers - heat or cold
  4. Utilize prolonged warm up and cool down
  5. Start with low intensity and gradually increase
  6. PT should closely observe client for EIB
  7. Activate EMS if medication isn’t helping
  8. Mid to late morning workouts may be better
  9. If well controlled, client can use regular guidelines for exercise
33
Q

FITT Recommendations for Asthma

A

Frequency - cardio 3-5 days/wk, 2-3days/wk
Intensity - initially below VT1, 50-85% of 1-RM
Time - increase to at least 30-40min/day, 8-10 exercises 1-3 sets 8-10 reps
Type - rhythmic large muscle, variety

34
Q

FITT Recommendations for Bronchitis and Emphysema

A

Frequency - cardio at least 3-5 days/wk, 2-3days/wk
Intensity - mod to vigor, 50-85% of 1-RM
Time - 20-60min/day intermit., 2-4 sets 8-12 reps
Type - walking/cycle/upper body, variety

35
Q

Cancer Stats

A

Cancer is the second leading cause of morbidity and mortality worldwide. Cancer death has declined 27% in the past 10 years. Lifetime risk of cancer for women is 38%, for men 41%. Exercise helps reduce risk.

36
Q

FITT Recommendations for Cancer

A

Frequency - cardio 3-5 days/wk, 2-3days/wk
Intensity - mod to vigor, 30% of 1-RM and increase 5% increments
Time - 150min/wk mod or 75min vigor, >=1 sets 8-12 reps
Type - prolonged rhythmic large muscle, variety

37
Q

American Cancer Society Guidelines for Cancer

A
  1. Aim for a healthy weight
  2. Regular physical activity including cardio & strength, avoid inactivity
  3. Nutrition - avoid processed meats & red meat, 2.5 cups fruit/veggies per day, whole grains, limit alcohol
38
Q

Osteoporosis Considerations

A

Characterized by low bone mass and disrupted microarchitecture. Defined as Bone Mineral Density (BMD) that is >=2.5 deviations below mean. Affects more women than men. Hip fractures are caused by falls 90% of the time. Common areas for fracture are hip, vertebrae and wrist. One in two women will break a bone due to osteoporosis and 1 in 4 for men.

39
Q

Osteopenia Definition

A

1-2.5 deviations below mean for BMD

40
Q

Osteoporosis Nutrition

A

Calcium and Vitamin D
Vitamin D aids calcium absorption
If calcium is inadequate it gets resorbed from the bones
Excessive alcohol is detrimental to bone health

41
Q

FITT Recommendations for Osteoporosis

A

Frequency - cardio 4-5 days/wk, 1-2 to 2-3days/wk
Intensity - mod some to vigor, adjust so 2 reps are challenging - high intensity if tolerated
Time - 20min progress to 60min, start at 1 sets 8-12 reps then 2 sets no more than 8-10 exercises
Type - weight bearing, emphasize balance, gait, function movement

42
Q

FITT Recommendations for Arthritis

A

Frequency - cardio 3-5 days/wk, 2-3days/wk
Intensity - light to mod, 50-80% of 1-RM
Time - 150min/wk mod or 75/wk vigor, 2-4 sets 8-12 reps
Type - low impact large muscle, variety within pain free ROM

43
Q

Arthritis Considerations

A
  1. People with arthritis have higher rates of depression & anxiety
  2. People with diabetes are almost twice as likely to have arthritis
  3. Having arthritis increases risk of developing CVD
  4. Higher uric acid with gout is linked to higher risk of hypertension
  5. Obesity increases risk of OA due to higher load on joints
  6. Obesity is also associated with RA and lupus
  7. Higher in women than men
44
Q

Arthritis OA cause

A

Overuse, trauma, obesity, or degeneration of joint cartilage that takes place with age.

45
Q

Arthritis RA cause

A

RA is an autoimmune disease in synovial tissue and progresses to an erosion of articular cartilage and bone. More disabling than OA and causes greater deformity. Exercise is integral part of treatment.

ACE Personal Trainer (13 decks)

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