Chapter 14 Flashcards
What is atherosclerotic heart disease?
The narrowing of the coronary arteries that supply the heart muscle with blood and oxygen.
What is ischemia?
an inadequate blood supply to an organ/part of body, particularly the heart
What does metabolic equivalent mean?
It refers to the energy you use at rest compared to the energy used during exercise.
A value of 7 METs is 7 x the energy used at rest.
How many sets/reps should those with CAD start on and how often?
One set of 12-15 reps using 8-10 exercises that target major muscle groups 2x a week.
What level on the 6-20 RPE scale should those with CAD not exceed?
11-14
What signs signal termination of session?
angina dyspnea lightheadedness/dizziness pallor rapid HR above established targets
How do you know a client is hypertensive?
Their BP reads as 140/90 or they take antihypertensives.
How much activity should prehypertensive and hypertensive individuals participate in?
at least 30 mins of regular activity for at least 5 days a week
What resistance training is recommended for prehypertensive/hypertensive clients?
Those using low to moderate resistance and high reps as opposed to heavy lifting
What type of exercise/contraction should be avoided for pre/hypertensive clients?
Isometric exercises
What two medications can alter heart rate response and cause orthostatic hypotension and post exercise hypotension?
beta blockers
calcium channel blockers
An exercise session should be discontinued if the SBP or DBP rises to ______ or ____ mmHg or if the SBP fails to _________.
250 or 115
or if the SBP fails to increase.
What are the warning signs of a stroke?
- sudden numbness or weakness of face, arms, legs
- confusion or trouble speaking/understanding others
- trouble seeing
- walking problems, dizziness or loss of balance and coordination
- severe headache with no known cause
What duration of walking should someone with PVD start at and progress to?
They should start with 20-30 mins and progress to 30-60 mins.
Where is cholesterol manufactured in the body and what foods is it prominent in?
It is manufactured by the liver and found in dairy products, meat and eggs.
What is an effective means of improving lipid profiles in many people?
The combination of exercise and dietary changes that lower body weight.
What fasting plasma glucose levels suggests diabetes and prediabetes?
Diabetes = > or equal to 126mg/dL Prediabetes = 100-125 mg/dL
What pre-exercise blood glucose levels should signal you to avoid/postpone exercise?
If the pre-exercise glucose is greater than 300 mg/dL alone or over 250 mg/dL with ketosis.
Most Type 1 Diabetes clients can comfortably exercise at an intensity between 55-75% of capacity or at an RPE of __ to __.
11-14
What are the exercise guidelines for Type 1 Diabetics?
To allow 5-10 mins of proper warm up and cool down.
To progress to 30 mins or more of exercise at an RPE of 11-14 on the 6-20 scale.
What are the exercise guidelines for Type 2 Diabetics?
To allow 5-10 mins of proper warm up and cool down.
To perform aerobic exercise at low-moderate intensity/11-16 RPE for 40-60 mins 5 or 6 days a week.
Low-mod resistance training consisting of 8-12 reps for 8-10 different exercise 2x a week is also recommended.
What is metabolic syndrome characterized by?
abdominal obesity dyslipidemia increased BP insulin resistance prothrombotic state proinflammatory state
The AHA and NHLBI recommend that metabolic syndrome can be identified with 3 or more of what components?
- elevated waist circumference (men ≥ 40 inches / women ≥ 35 inches)
- elevated triglycerides (≥ 150 mg/dL)
- reduced HDL cholesterol (men < 40 mg/dL / women < 50 mg/dL)
- increased BP 130/85
- elevated fasting blood glucose (≥ 100 mg/dL)
What is the primary treatment objective for metabolic syndrome?
To reduce the risk for developing cardiovascular disease and type 2 diabetes.
ACSM recommends that overweight and obese individuals should accumulate how many mins of physical activity per week?
200-300 mins
At what intensity should a deconditioned individual with METS begin at and progress to? And how frequently?
They should begin at a low intensity and gradually progress to moderate levels such as 40-75% of VO2 reserve or an RPE of 9-13.
They should begin with a frequency of 3-5 times a week.
What are the general guidelines for asthmatic clients?
- to have asthma medication at all times
- to drink plenty of fluids before, during and after exercise to prevent dehydration
- avoid asthma triggers
- utilize prolonged warm ups/cool downs
- gradually increase intensity
- constantly observe for early asthma attack symptoms
- exercise in mid-late morning
In the case of breast cancer, what does walking 3-5 hours per week show to decrease the risk of?
a relapse by 50%
What is the goal of exercise in the treatment of cancer? (5)
- maintain and improve cardiovascular conditioning
- prevent musculoskeletal deterioration
- reduce symptoms such as nausea/fatigue
- improve mental health
- improve overall quality of life
What will patients undergoing chemotherapy and/or radiation potentially be more susceptible to and what does that mean exercise wise?
They are more susceptible to anaemia and will require a reduced exercise intensity
What should a training protocol for a cancer patient center around?
The protocol should center on aerobic activities, light strength training and stretching as well as recreational activities.
What should resistance training with a cancer patient look like?
You should utilize light weights with 10-15 reps.
What should resistance training with a breast cancer patient that has undergone axillary lymph node removal look like?
They should perform 10 reps initially and any arm exercises should be swapped for other body parts to allow for recovery.
What intensity should cancer patients start at?
Light to moderate or 9-13 on the 6-20 RPE scale.
What duration should cancer patients start at?
They should start with 3-5 min intervals with frequent rest breaks and progress to 10 min intermittent bouts and then to 30-40 mins of accumulated exercise.
Resistance training is an important component to preventing osteoporosis, what intensity should clients perform?
A higher-intensity strength training regime with 8 rep max will derive the most benefit to bones.
What movements may some osteoporotic clients need to avoid?
- spinal flexion, crunches and rowing machines
- jumping and high-impact aerobics
- trampolines and step aerobics
- abducting/adducting legs against resistance
- pulling on the neck with hands behind head
What frequency, intensity, duration should arthritis clients focus on?
Frequency should be 3-5 times a week whereas they should focus on increasing duration rather than intensity.
A short duration of 3-10 mins starting at 9-13 RPE gradually progressing to 30 mins at 11-15.
Strength training with clients who have arthritis should focus on?
increasing reps rather than weight, from 2-3 reps to 10-12.
Why might arthritic clients benefit from isometric exercises?
because they strengthen the joint structure but put less stress on the joint itself
What guidelines should clients with a hip replacement follow?
- lift the knee no higher than hip level or 90 degree flexion
- keep toes straight ahead, no ‘pigeon’ or ‘duck’ toes
- no adduction past midline
- focus on leg/hip abduction, lateral movements and strengthening
what are common symptoms of fibromyalgia?
aches and pains similar to flu like exhaustion multiple tender points stiffness decreased exercise endurance fatigue muscle spasms paresthesis / tingling
What type of exercise is best recommended for those with fibromyalgia?
Aerobic exercise, warm-water exercises and low-impact exercises at low-moderate intensities
What should the intensity, duration and frequency of exercise be for those with fibromyalgia?
Intensity should be low-moderate at around an RPE of 9-13 for a goal of 150 mins per week through 3-5 regular activities a week.
What should the rest period be for those with chronic fatigue?
1:3 meaning you rest for every 3 minutes where you have exercised for 1
What mode, frequency, intensity and duration is recommended for those with chronic fatigue?
Activities of daily living, walking or low-impact exercises are recommended with low-intensity.
They should begin with multiple 2-5 min exercise periods followed by 6-15 mins rest and gradually increase to 30 mins of total activity.
Their frequency should be 3-5 days with adequate rest between.
What types of training are of most importance for a program for those with low back pain?
cardiorespiratory training, resistance training and basic core exercises
What should be avoided for people with low back pain?
unsupported forward flexion
twisting at the waist with turned feet
lifting both legs simultaneously in prone/supine positions
rapid movements such as twisting, forward flexion or hyperextension
Is muscular endurance or strength best recommended for low back pain? And how is it performed?
muscular endurance should utilize higher reps with lower resistance and proper technique throughout.
it should also be supplemented with aerobic exercise to improve cardiovascular health.
how often should you perform low back exercises?
daily
What exercises can be used daily for enhancing low back pain?
- cat camel
- modified curl up
- bird dog
- side bridge
how often should obese/overweight clients exercise to maximize caloric expenditure?
5-6 days a week
What forms of estimating training intensity are suited for older individuals?
using the RPE scale or the talk test as MHR declines with age
How often and for how long should older adults perform exercise?
- They should perform moderate intensity aerobic activity for a minimum of 30 mins 5 days per week or vigorous activity of 20 mins for 3 days.
- They should perform muscle-strengthening activities twice a week with 8-10 exercises of 10-15 reps for all major muscle groups.
- They should also perform flexibility activities for 10 mins 2 days of the week.
Generally at an RPE of 11-13
What exercises could older individuals perform to help increase balance?
backward walking sideways walking heel walking toe walking standing from sitting tai chi
How long should adolescents perform daily physical activity for?
60 mins
What modes of exercise should adolescents perform?
Aerobic exercise daily as well as muscle-strengthening activities such as climbing trees, tug of war.
Why are children more at risk to heat related illnesses?
due to their higher ratio of body surface area to mass, lower exercise economy, diminished sweat capacity and lower cardiac output
How often should children drink during exercise?
every 15-20 mins
why should pregnant women take particular note of the ambient temperature prior to exercise?
because exercise increases body temperature and pregnancy affects a women’s ability to dissipate heat therefore cold weather could result in hyperthermia.
How often can pregnant women whom were previously active exercise in their first trimester?
for up to 30-40 mins 3-4 days a week as tolerated
How often can pregnant women whom were inactive previously exercise in their first trimester?
they should begin slowly with 15 mins of low-intensity and increase to 30 mins
How often should pregnant women exercise in their 2nd and 3rd trimesters?
they should gradually reduce the intensity, duration and frequency to 30 mins below
What exercises must be avoided by pregnant women?
- extensive jumping, hopping, skipping, bouncing or running
- deep knee bends, full sit ups, double leg raises, straight leg toe touches
- bouncing while stretching
- activities where falling is likely
Why should exercise in the supine position be discouraged after the 1st trimester of pregnancy?
due to fetal hypoxia
