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NASM-CPT > Chapter 16: Chronic Health Conditions and Physical or Functional Limitations > Flashcards

Chapter 16: Chronic Health Conditions and Physical or Functional Limitations Flashcards

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1
Q

obesity

A

the condition of subcutaneous fat exceeding the amount of lean body mass

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2
Q

diabetes

A

chronic metabolic disorder, caused by insulin deficiency, which impairs carbohydrate usage and enhances usage of fat and protein

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3
Q

hypertension

A
  • high blood pressure
  • consistently elevated arterial blood pressure, which, if sustained at a high enough level, is likely to induce cardiovascular or end-organ damage
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4
Q

Valsalva maneuver

A

a maneuver in which a person tries to exhale forcibly with a closed glottis (windpipe) so that no air exits through the mouth or nose as, for example, in lifting a heavy weight. the Valsalva maneuver impedes the return of venous blood to the heart

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5
Q

osteopenia

A

a decrease in the calcification or density of bone as well as reduced bone mass

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6
Q

osteoperosis

A

condition in which there is a decrease in bone mass and density as well as an increase in the space between bones, resulting in porosity and fragility

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7
Q

arthritis

A

chronic inflammation of the joints

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8
Q

osteoarthritis

A

arthritis in which cartilage becomes soft, frayed, or thins out, as a result of trauma or other conditions

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9
Q

Rheumatoid arthritis

A

arthritis primarily affecting connective tissues, in which there is a thickening of articular soft tissue, and extension of synovial tissue over articular cartilages that have become eroded

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10
Q

cancer

A

any of various types of malignant neoplasms, most of which invade surrounding tissues, may metastasize to several sites, and are likely to recur after attempted removal and to cause death of the patient unless adequately treated

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11
Q

restrictive lung disease

A

the condition of a fibrous lung tissue, which results in a decreased ability to expand the lungs

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12
Q

chronic obstructive lung disease

A

the condition of altered airflow through the lungs, generally caused by airway obstruction as a result of mucus production

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13
Q

intermittent claudication

A

the manifestation of the symptoms caused by peripheral arterial disease

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14
Q

peripheral arterial disease

A

a condition characterized by narrowing of the major arteries that are responsible for supplying blood to the lower extremities

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15
Q

what ages does “youth” include

A

6-20

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16
Q

although a group of children or adolescents may be the same age, their response to exercise can vary considerably as a result of individual differences in…………..

A

growth, development, and physical matruation

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17
Q

current recommendations state the children and adolescents should get _____ or more of physical activity daily

A

60 minutes (1 hour)

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18
Q

children and adolescents should engage in ____, _____, and ____ activities daily to improve their health and reduce their risk of developing chronic disease

A

aerobic, muscle-strengthening, and bone-strengthening activities

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19
Q

true or false: NASPE recommends that children ages 5=12 get up to 60 minutes of exercise daily

A

TRUE

-in response to the growing problem of obesity and diabetes in American children

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20
Q

peak oxygen uptake in children vs. adults

A
  • adjusted for body weight, peak oxygen consumption is similar for young and mature males, and slightly higher for young females compared to mature females
  • a similar relationship also exists for force production, or strength
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21
Q

submaximal oxygen demand (or economy of movement) in children vs. adults

A

-children are less efficient and tend to exercise at a higher percentage of their peak oxygen uptake during submaximal exercise compared with adults (submaximal oxygen demand is higher)

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22
Q

why is the term “peak oxygen uptake” more appropriate than “VO2max” for children?

A

because children to not typically exhibit a plateau in oxygen uptake at maximal exercise

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23
Q

levels of glycolytic enzymes in children vs. adults

A

-children do not produce sufficient levels of glycolytic enzymes to be able to sustain bouts of high-intensity exercise

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24
Q

thermoregulatory systems in children vs. adults

A

-children have immature thermoregulatory systems, including both a delated response and limited ability to sweat in response to hot, human environments

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25
Q

VO2 peak is similar to adults - implication of exercise compared with adult

A

able to perform endurance tasks relatively well

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26
Q

VO2 peak is similar to adults - considerations for health and fitness

A

physical activity of 60 minutes on most or all days of the week for elementary school children, emphasizing developmentally appropriate activities

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27
Q

VO2 peak is similar to adults - considerations in sport and athletic training

A

progression of aerobic training volume should not exceed 10% per period of adaptation (if weekly training volume was 200 minutes per week, increase to 220 minutes before further increases in intensity)

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28
Q

submaximal oxygen demand is higher in children - implication of exercise compared with adult

A

greater chance of fatigue and heat production in sustained higher-intensity tasks

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29
Q

submaximal oxygen demand is higher in children - considerations for health and fitness

A

moderate to vigorous physical activity for adolescents, for a total of 60 minutes 3 or more days of the week or 3 days per week if vigorous

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30
Q

submaximal oxygen demand is higher in children - considerations in sport and athletic training

A

intensive anaerobic exercise exceeding 10 seconds is not well tolerated (if using stage II or III training, provide sufficient rest and recovery intervals between intense bouts of training)

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31
Q

glycolytic enzymes are lower in children - implication of exercise compared with adult

A

decreased ability to perform longer duration (10-90 seconds), high-intensity tasks

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32
Q

glycolytic enzymes are lower in children - considerations for health and fitness

A

resistance exercise for muscular fitness:

  • 1-2 sets of 8-10 exercise
  • 8-12 reps per exercise
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33
Q

glycolytic enzymes are lower in children - considerations in sport and athletic training

A
  • resistance exercise should emphasize proprioception, skill, and controlled movements
  • repetitions should not exceed 6-8 set for strength development or 20 for enhanced muscular endurance
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34
Q

sweating rate in children - implication of exercise compared with adult

A

decreased tolerance to environmental extremes, particularly heat and humidity

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35
Q

lower absolute sweating rate in children - considerations for health and fitness

A

2-3 days per week, duration of 30 minutes, with added time for warm-up and cool-down

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36
Q

lower absolute sweating rate in children - considerations in sport and athletic training

A

2-3 days per week, with increases in overload occurring through increases in reps first, the resistance

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37
Q

vigorous exercise in hot, humid environments should be restricted for children to less than __ minutes, including frequent rest periods

A

30

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38
Q

true or false: resistance training is not safe for children and adolescents

A

FALSE

-research has clearly demonstrated that resistance training is both safe and effective in children and adolescents

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39
Q

resistance training for health and fitness conditioning in youth results in a lower risk of ___ when compared with many popular sports

A

injury

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40
Q

what are the most common injuries associated with resistance training in youth?

A
  • sprains (injury to ligament)

- strains (injury to tendon or muscle_

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41
Q

what are injuries in youth during resistance training usually attributable to?

A
  • lack of qualified supervision
  • poor technique
  • improper progression
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42
Q

true or false: children and adolescents can gain significant levels of strength as a result of resistance training beyond that normally associated with growth and development

A

TRUE

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43
Q

untrained children can improve their strength by an average of ___% after 8 weeks of progressive resistance training

A

30-40

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44
Q

resistance training in youth has been shown to improve…

A
  • motor skills such as sprinting and jumping
  • body composition
  • bone mineral density
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45
Q

improvements in strength and performance after a resistance training program in youth appear to be owing to ___ versus muscular hypertrophy

A

neural adaptations

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46
Q

what is one of the most important aspects to consider when designing and implementing exercise training programs for youth?

A

make it safe and fun

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47
Q

as America’s population ages, we are faced with dealing with issues such as…

A
  • mortality
  • longevity
  • quality of life
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48
Q

typical forms of degeneration associated with aging include…

A
  • osteoporosis
  • arthritis
  • arthritis (osteoarthritis)
  • low-back pain (LBP)
  • obesity
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49
Q

mode of exercise for youth

A

walking, jogging, running, games, activities, sports, water activity, resistance training

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50
Q

frequency of exercise for youth

A

5-7 days of the week

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51
Q

intensity of exercise for youth

A

moderate to vigorous cardiorespiratory exercise training

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52
Q

duration of exercise for youth

A

60 minutes per day

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53
Q

movement assessment for youth

A
  • overhead squats
  • 10 push-ups (if 10 cannot be performed, do as many as can be tolerated)
  • single-leg stance (if can tolerate, perform 3-5 single-leg squats per leg)
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54
Q

flexibility for youth

A

follow the flexibility continuum specific for each phase of training

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55
Q

resistance training for youth

A
  • 1-2 sets of 8-12 repetitions at 40-70% on 2-3 days per week
  • phase 1 of OPT model should be mastered before moving on
  • phases 2-5 should be reserved for mature adolescents on the basis of dynamic postural control and a licensed physician’s recommendation
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56
Q

special considerations for youth

A
  • progression for the youth population should be based on postural control and not on the amount of weight that can be used
  • making exercise fun!
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57
Q

normal physiologic and functional changes associated with aging include reductions in the following:

A
  • maximal attainable heart rate
  • cardiac output
  • muscle mass
  • balance
  • coordination (neuromuscular efficiency)
  • connective tissue elasticity
  • bone mineral density
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58
Q

blood pressure tends to be higher at rest and during exercise with age, which is the result of…

A

either natural causes, disease, or a combination of both

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59
Q

is arteriosclerosis a normal physiologic process of aging, or a result of disease?

A

normal

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60
Q

what does arteriosclerosis result in?

A

arteries that are less elastic and pliable, which in turn leads to greater resistance to blood blow and thus higher blood pressure

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61
Q

what is atherosclerosis a result of?

A

poor lifestyle choices (smoking, obesity, sedentary lifestyle, etc.)

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62
Q

what does atherosclerosis result in?

A

restricted blood flow as the result of plaque buildup within the walls of arteries, thus leading to increased resistance and blood pressure

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63
Q

peripheral vascular disease refers to plaques that form in any peripheral artery, typically those of the…

A

lower leg

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64
Q

prehypertensive blood pressure levels

A

between 120/80 and 139/89

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65
Q

hypertensive pressure levels

A

above 140/90

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66
Q

degenerative processes associated with aging can lead to a decrease in the functional capacity of older adults, including potentially significant reductions in….

A

muscular strength and endurance, cardiorespiratory fitness, and proprioceptive neural responses

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67
Q

what is one of the most important and fundamental functional activities affected with degenerative aging?

A

walking

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68
Q

the decreased ability to move freely in one’s own environment not only reduces the physical and emotional independence of an individual, it also can lead to any increase in __________

A

the degenerative cycle

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69
Q

the ability or inability to perform normal activities of daily living (ADLs) such as bathing, eating, housekeeping, and leisure activities can be measured to help determine the __________ of an individual

A

functional status

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70
Q

before initiating any exercise training, older adults must complete a _______ and _____

A

Physical Activity Readiness Questionnaire (PAR-Q) and movement assessment such as the overhead squat, sitting and standing from a seated position, or a single-leg stance

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71
Q

why is flexibility assessment and training an important consideration with older adults?

A

because they tend to lose the elasticity of their connective tissue, which reduces movement and increases the risk of injury

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72
Q

what kind of flexibility training is advised for seniors?

A
  • SMR and static stretching, provided there is a sufficient ability to perform the necessary movements
  • otherwise, simple forms of active or dynamic stretching can be recommended to help get the client to start moving their joints during the warm-up period
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73
Q

what cardiorespiratory stages are appropriate for seniors?

A

stages I and II

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74
Q

mode of exercise for seniors

A

stationary or recumbent cycling, aquatic exercise, or treadmill with handrail support

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75
Q

frequency of exercise for seniors

A

3-5 days per week of moderate-intensity activities or 3 days per week of vigorous-intensity activities

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76
Q

intensity of exercise for seniors

A

40-85% of VO2 max

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77
Q

duration of exercise for seniors

A

30-60 minutes per day or 8-10 minute bouts

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78
Q

movement assessments for seniors

A

push, pull, OH squat, or sitting and standing into a chair, single-leg balance

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79
Q

flexibility for seniors

A

SMR and static stretching

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80
Q

resistance training for seniors

A
  • 1-3 sets of 8-20 repetitions at 40-80% on 3-5 days per week
  • phase 1 of OPT model should be mastered before moving on
  • phases 2-5 should be based on dynamic postural control and a licensed physician’s recommendation
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81
Q

special considerations for seniors

A
  • progression should be slow, well monitored, and based on postural control
  • exercises should be progressed if possible toward free sitting (no support) or standing
  • make sure the client is breathing in normal manner and avoid holding breath as in a Valsalva maneuver
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82
Q

maximal oxygen uptake, maximal exercise heart rate, and measures of pulmonary function will all decrease with increasing age - implications of health and fitness training

A
  • initial exercise workloads should be low and progressed more gradually to 3-5 days per week
  • duration = 20-45 minutes
  • intensity = 45-80% of peak
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83
Q

percentage of body fat will increase, and both bone mass and lean body mass will decrease with increasing age - implications of health and fitness training

A

resistance exercise is recommended, with lower initial weights and slower progression (for example, 1-3 sets of 8-10 exercises, 8-20 reps, session length = 20-30 minutes)

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84
Q

balance, gait, and neuromuscular coordination may be impaired - implications of health and fitness training

A
  • exercise modalities should be chosen and progressed to safeguard against falls and foot problems
  • cardio options include stationary or recumbent cycling, aquatic exercise, or treadmill with handrail support
  • resistance options include seated machines, progressing to standing exercises
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85
Q

there is a higher rate of both diagnosed and undetected heart disease in the elderly - implications of health and fitness training

A

knowledge of pulse assessment during exercise is critical, as is monitoring for chronic disease signs and symptoms

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86
Q

pulse irregularity is more frequent - implications of health and fitness training

A

careful analysis of medication use and possible exercise effects

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87
Q

what is the fastest growing health problem in America?

A

obesity

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88
Q

__% of Americans older than age 20 are overweight

A

66

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89
Q

approximately __% of Americans are obese

A

34

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90
Q

what is obesity associated with?

A

a variety of chronic health condition’s, as well as emotional and social problems

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91
Q

body mass index is used to estimate ____

A

healthy body weight ranges based on a person’s height

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92
Q

what is BMI defined as?

A

total body weight in kilograms divided by the height in meters squared

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93
Q

true or false: BMI is helpful in developing weight loss goals

A

FALSE
-because BMI does not actually measure body composition, other techniques such as skin-fold or circumference measurements may be performed to assist in developing realistic weight loss goals and to help provide feedback to clients

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94
Q

true or false: assessing body fat using skinfold calipers is the best option for obese individuals

A

FALSE

-it can be a sensitive situation

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95
Q

although BMI is not a perfect measurement, it does provide reliable values for…..

A

comparison and goal setting

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96
Q

normal BMI

A

18.5-24.9

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97
Q

overweight BMI

A

25-29.9

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98
Q

obese BMI

A

> 30

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99
Q

what fraction of adults in the US have a BMI of 25 or greater?

A

2/3

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100
Q

what fraction of adults in the US have a BMI of 30 or greater?

A

1/3

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101
Q

true or false: the risk of chronic diseases increases in proportion to the rise in BMI in both adults and adolescents

A

TRUE

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102
Q

what is the primary problem regarding obesity?

A

obesity (too many calories consumed and too few expended)

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103
Q

it has been suggested that adults who remain sedentary throughout their life span will lose approximately __ pounds of muscle per decade, while simultaneously adding __ pounds of fat per decade

A

5, 15

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104
Q

the average adult will experience a __% reduction in fat-free mass (FFM) between the ages of 30 and 80

A

15

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105
Q

true or false: body fat is an age-related problem

A

FALSE

-it relates to the number of hours individuals spend exercising per week

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106
Q

it has been shown in sedentary individuals that daily-activity levels account for more than __% of the variability of body-fat storage in men

A

75

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107
Q

what is one of the most important factors related to long-term successful weight loss?

A

regular physical activity and exercise

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108
Q

true or false: obese and morbidly obese clients have unique problems associated with exercise

A

TRUE

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109
Q

true or false: heavier individuals exhibited worse balance, slower gait velocity, and shorter steps, regardless of their level of muscular strength

A

TRUE

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110
Q

exercise training for obese clients should focus primarily on what?

A

energy expenditure, balance, and proprioceptive training to help them expend calories and improve their balance and gait mechanics

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111
Q

by performing exercises in a proprioceptively enriched environment (controlled, unstable), the body is forced to…

A

recruit more muscles to stabilize itself, potentially expending more calories

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112
Q

for effective weight loss, obese calories should expend ___ calories per exercise session, with a minimum weekly goal of ___ calories of energy expenditure from combined physical activity and exercise

A

200-300, 1250

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113
Q

the initial energy expenditure goal of 1250 calories per week should be progressively increased to ___ calories per week

A

2000

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114
Q

true or false: resistance training can gradually be added to any exercise program designed to promote weight loss, but sustained long-term aerobic endurance activities will always remain a priority

A

TRUE

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115
Q

true or false: circuit-style resistance training, when compared with walking at a fast pace, produces nearly identical caloric expenditure rates in the same given time span

A

TRUE

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116
Q

why is resistance training an important component of any weight-loss program?

A

because it helps increase lean body mass, which eventually results in a higher metabolic rate and improved body composition

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117
Q

true or false: the same exercise training guidelines for apparently healthy adults can be used when designed aerobic and resistance training programs for obese clients

A

TRUE

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118
Q

fitness assessments for obese clients

A

pushing, pulling, and squatting assessments

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119
Q

for obese clients, resistance training exercises for assessment or training may be best performed with ____ from a ____ position

A

cables, exercise tubing, or body weight from a standing or seated position

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120
Q

true or false: a single-leg squat is more appropriate than a single-leg balance assessment for obese clients

A

FALSE

-using a single-leg balance assessment may be more appropriate than a single-leg squat for obese clients

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121
Q

what position should flexibility exercises be performed from for obese clients?

A

standing or seated position

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122
Q

true or false: SMR is highly recommended for obese clients

A

FALSE

-SMR should be used with caution and may need to be avoided or performed at home

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123
Q

why is core and balance training important for obese clients?

A

because they lack balance and walking speed, both of which are important to exercise

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124
Q

why must personal trainers use caution when placing an obese client in a prone or supine position?

A

because these obese individuals are prone to both hypotensive and hypertensive responses to exercise

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125
Q

which phases are appropriate for the obese population?

A

phases 1 and 2

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126
Q

what should personal trainers lookout for in obese clients performing resistance training exercises?

A
  • ensure that the client is breathing correctly
  • ensure that the client avoids straining during exercise or squeezing bars too tightly, which can cause an increase in blood pressure
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127
Q

obesity is a unique chronic disease because it also affects a person’s sense of _____ and _____

A

emotional well-being and self-esteem

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128
Q

true or false: obesity can alter the emotional and social aspects of a person’s life as much as it does the physical aspects

A

TRUE

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129
Q

what will help create trust between the client and professional and assist the client in adhering to a weight-loss and exercise program?

A

personal trainers must be very aware of the psychological aspects of obesity when training obese clients to ensure that the client feels socially and emotionally safe

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130
Q

true or false: machines are a good option for obese individuals

A

FALSE
-machines are often not designed for obese individuals and may require a significant amount of mobility to get in and out

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131
Q

what kind of exercise modalities are best for obese clients?

A

dumbbells, cables, or exercise tubing exercises

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132
Q

why should SMR be used with caution in obese clients?

A
  • obese clients may not feel comfortable rolling or lying on the floor
  • may be better done in privacy
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133
Q

it is recommended that obese clients engage in _____ to decrease orthopedic stress

A

weight-supported exercise (such as cycling or swimming)

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134
Q

___ is often both a preferred activity for many obese clients and one that is easily engaged and adhered to

A

walking

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135
Q

things to consider when working with obese clients

A
  • exercise positions
  • locations in the training facility that offer greater privacy
  • choice of exercise equipment
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136
Q

obese clients may have other comorbidities (diagnosed or undiagnosed) including hypertension, cardiovascular disease, or diabetes - considerations for health and fitness

A

initial screening should clarify the presence of potential undiagnosed comorbidities

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137
Q

maximal oxygen uptake and ventilatory (anaerobic threshold) is typically reduced in obese clients - considerations for health and fitness

A
  • consider testing and training modalities that are weight-supported (such as cycle ergometer, swimming)
  • if a client does not have these limitations, consider a walking program to improve compliance
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138
Q

coexisting diets may hamper exercise ability and result in significant loss of lean body mass for obese clients - considerations for health and fitness

A
  • initial programming should emphasize low intensity, with a progression in exercise duration (up to 60 minutes as tolerable) and frequency (5-7 days per week), before increases are made in intensity of exercise
  • exercise intensity should be no greater than 60-80% of work capacity, with weekly caloric volume a minimum of 1250 kcal per week and a progression to 2000, as tolerable
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139
Q

measures of body composition (hydrostatic weighing, skin0fold calipers) may not accurately reflect degree of overweight or obesity - considerations for health and fitness

A

BMI, scale weight, or circumference measurements are recommended as measures of weight loss

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140
Q

mode of exercise for obese clients

A

low-impact or step aerobics (such as treadmill walking, rowing, stationary cycling, and water activity)

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141
Q

frequency or exercise for overweight clients

A

at least 5 days per week

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142
Q

intensity of exercise for obese clients

A
  • 60-80% of maximum heart rate
  • use the talk test to determine exertion
  • stage I cardiorespiratory training progressing to stage II (intensities may be altered to 40-70% of maximal heart rate if needed)
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143
Q

duration of exercise for obese clients

A

40-60 minutes per day, or 20-30 minute sessions twice each day

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144
Q

assessment for obese clients

A
  • push, pull, squat

- single-leg balance (if tolerated)

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145
Q

flexibility for obese clients

A
  • SMR (only if comfortable to client)

- flexibility continuum

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146
Q

resistance training for obese clients

A
  • 1-3 sets of 10-15 repetitions on 2-3 days per week

- phases 1 and 2 will be appropriate performed in a circuit-training manner (higher repetitions such as 20 may be used)

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147
Q

special considerations for obese clients

A
  • make sure your client is comfortable: be aware of positions and locations in the facility your client is in
  • exercises should be performed in a standing or seated position
  • may have other chronic diseases; in such cases a medical release should be obtained from the individual’s physician
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148
Q

type 1 diabetes

A
  • insulin-dependent diabetes
  • the body does not produce enough insulin
  • younger individuals
  • hyperglycemia or hypoglycemia
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149
Q

type 2 diabetes

A
  • non-insulin dependent diabetes
  • the body cannot respond normally do the insulin that is made
  • associated with obesity
  • hyperglycemia
150
Q

diabetes is associated with a greater risk for…

A

heart disease, hypertension, and adult-onset blindness

151
Q

what is type 2 diabetes strongly associated with?

A

an increase in childhood and adult-onset obesity (particularly abdominal obesity)

152
Q

true or false: some individuals with type 2 diabetes cannot manage their blood glucose levels and do require additional insulin

A

TRUE

153
Q

who is type 1 diabetes typically diagnosed in?

A

children, teenagers, or young adults

154
Q

with type 1 diabetes, specialized cells in the pancreas called ____ stop producing insulin, causing blood levels to ___

A

beta cells, rise

155
Q

hyperglycemia

A

high levels of blood sugar

156
Q

how do individuals with type 1 diabetes control for high levels of blood sugar?

A

they must inject insulin to compensate for what the pancreas cannot produce

157
Q

exercise ____ the rate at which cells utilize glucose

A

increases

158
Q

if an individual with type 1 diabetes foes not control his or her blood glucose levels before, during, and after exercise, blood sugar levels can drop rapidly and cause a condition called ____

A

hypoglycemia

159
Q

hypoglycemia

A

low blood sugar

160
Q

what does hypoglycemia lead to?

A

weakness, dizziness, and fainting

161
Q

what are the primary components prescribed for individuals with type 1 diabetes?

A

insulin, proper diet, and exercise

162
Q

individuals with type 2 diabetes usually produce adequate amounts of insulin; however, their cells are resistant to the insulin, leading to _________

A

hyperglycemia (high blood sugar)

163
Q

chronic hyperglycemia is associated with a number of disease associated with damage to the ______

A

kidneys, heart, nerves, eyes, and circulatory system

164
Q

true or false: individuals with type 2 diabetes experience the same fluctuations in blood sugar as those with type 1 diabetes

A

FALSE

165
Q

what are the most important goals of exercise for individuals with either type of diabetes?

A

glucose control

166
Q

what is the most important goal of exercise for individuals with type 2 diabetes?

A

weight loss

167
Q

how can exercise training help with glucose control and weight loss?

A

it has a similar action to insulin by enhancing the uptake of circulating glucose by exercising skeletal muscle

168
Q

exercise improves a variety of glucose measures, including…

A

tissue sensitivity, improved glucose tolerance, and even a decrease in insulin requirements

169
Q

why must caution be taking when prescribing walking to clients with diabetes?

A

it is important to prevent blisters and foot microtrauma that could result in foot infection

170
Q

why should special care be taken with respect to giving advice to clients with diabetes regarding carbohydrate intake and insulin use?

A

to reduce the risk of a hypoglycemic or hyperglycemic event

171
Q

why should special care be given to SMR in clients with diabetes?

A

SMR may be contraindicated for anyone with peripheral neuropathy (loss of protective sensation in feet and legs)

172
Q

what phases are appropriate for clients with diabetes?

A

phases 1 and 2

173
Q

true or false: plyometric training may be inappropriate for clients with diabetes

A

TRUE

174
Q

mode of exercise for clients with diabetes

A

low-impact activities (such as cycling, treadmill walking, low-impact or step aerobics)

175
Q

frequency of exercise for clients with diabetes

A

4-7 days per week

176
Q

intensity of exercise for clients with diabetes

A
  • 50-90% of maximum heart rate
  • stage I cardiorespiratory training (may be adjusted to 40-70% of maximal heart rate if needed) progressing to stages II and II based on a physician’s approval
177
Q

duration of exercise for clients with diabetes

A

20-60 minutes

178
Q

assessment for clients with diabetes

A
  • push, pull, OH squat

- single-leg balance or single-leg squat

179
Q

flexibility for clients with diabetes

A

flexibility continuum

180
Q

resistance training for clients with diabetes

A
  • 1-3 sets of 10-15 repetitions 2-3 days a week

- phases 1 and 2 of the OPT model (higher repetitions such as 20 may be used)

181
Q

special considerations for clients with diabetes

A
  • make sure client has appropriate footwear and have client or physician check feet for blisters or abnormal wear patterns
  • advise client or class participant to keep a snack (quick source of carbohydrate) available during exercise, to avoid sudden hypoglycemia
  • use SMR with special care and licensed physician’s advice
  • avoid excessive plyometric training, and higher-intensity training is not recommended for typical client
182
Q

blood pressure

A

the pressure exerted by the blood against the walls of the blood vessels, especially the arteries

183
Q

what does blood pressure vary with?

A
  • strength of the heartbeat
  • the elasticity of the arterial walls
  • the volume and viscosity of the blood
  • a person’s health, age, and physical condition
184
Q

hypertensive measurement

A

> 140 / >90

185
Q

prehypertensive measurement

A

between 120/80 and 135/85

186
Q

normal blood pressure

A

less than 120.80

187
Q

common causes of hypertension

A
  • smoking
  • a diet high in fat (particularly saturated fat)
  • excess weight
188
Q

health risks of hypertension

A

increased risk for stroke, cardiovascular disease, chronic heart failure, and kidney failure

189
Q

methods of controlling hypertension

A
  • antihypertensive medications
  • regular physical activity
  • diet
  • smoking cessation
190
Q

research has shown that exercise can have a modest impact on lowering elevated blood pressure by an average of ___ mm Hg for both systolic and diastolic blood pressure

A

10

191
Q

true or false: low to moderately intense cardiorespiratory exercise has been shown to be just as effective as high-intensity activity in reducing blood pressure

A

TRUE

192
Q

individuals with hypertension frequently take medications that alter what?

A

the heart rate response to exercise, in most cases blunting the heart rate response to exercise, thus invalidating prediction equations or estimates of training heart rate

193
Q

supine or prone positions can often ____ blood pressure

A

increase

194
Q

what kinds of stretching are easiest and safest for clients with hypertension?

A

static and active

195
Q

why may SMR may be contraindicated for clients with hypertension?

A

it requires lying down

196
Q

for clients with hypertension, cardiorespiratory endurance training should focus on what stage?

A

stage I, and progress only after a physician’s approval

197
Q

true or false: plyometric training is recommended for clients with hypertension

A

FALSE

-use plyometric training with care for this population

198
Q

what position should resistance training be performed in for clients with hypertension?

A

a seated or standing position

199
Q

what phases are appropriate for clients with hypertension?

A

phases 1 and 2

200
Q

programs for clients with hypertension should b e performed in a ___ or ___ training system to distribute blood flow between the upper and lower extremities

A

circuit-style of Peripheral Heart Action (PHA)

201
Q

personal trainers should always ensure that clients with hypertension….

A
  • try and breath normally
  • avoid the Valsalva maneuver
  • avoid over gripping (squeezing too tightly) when using exercise equipment
202
Q

personal trainers should monitor clients with hypertension carefully when ________, as they may experience dizziness

A

rising from a seated or lying position

203
Q

mode of exercise for clients with hypertension

A
  • stationary cycling
  • treadmill walking
  • rowers
204
Q

frequency of exercise for clients with hypertension

A

3-7 days per week

205
Q

intensity of exercise for clients with hypertension

A
  • 50-85% of maximal heart rate
  • stage I cardiorespiratory training progressing to stage II (intensities may be altered to 40-70% of maximal heart rate if needed)
206
Q

duration of exercise for clients with hypertension

A

30-60 minutes

207
Q

assessment for clients with hypertension

A
  • push, pull, OH squat

- single-leg balance (squat if tolerated)

208
Q

flexibility for clients with hypertension

A

static and active in a standing or seated position

209
Q

resistance training for clients with hypertension

A
  • 1-3 sets of 10-20 repetitions 2-3 days per week
  • phases 1 and 2 of the OPT model
  • tempo should not exceed 1 second for isometric and concentric portions (e.g. 4/1/1 instead of 4/2/1)
  • use circuit or PHA weight training as an option, with appropriate rest intervals
210
Q

special considerations for clients with hypertension

A
  • avoid heavy lifting and Valsalva maneuvers: make sure client breathes normally
  • do not let client overgrip weights or clench fists when training
  • modify tempo to avoid extended isometric and concentric muscle action
  • perform exercises in a standing or seated position
  • allow client to stand up slowly to avoid possible dizziness
  • progress client slowly
211
Q

blood pressure response to exercise may be variable and exaggerated, depending on the mode and level of intensity, in clients with hypertension - considerations for health and fitness, sport, and athletic training

A
  • a program of continuous, lower-intensity (50-85% of work capacity) aerobic exercise is initially recommended
  • frequency an duration parameters should be at a minimum 3-5 days per week, 20-45 minutes per day, with additional increases in overall volume of exercise if weight loss is also desired
212
Q

despite medication, hypertensive clients may arrive with preexercise hypertension - considerations for health and fitness, sport, and athletic training

A
  • resistance exercise should consist of a Peripheral Heart Action or circuit-training style
  • avoid Valsalva maneuvers (holding breath), emphasize rhythmic breathing and a program design for muscular fitness (e.g., 1-3 sets of 8-10 exercises, 10-20 reps, 2-3 days per week)
213
Q

hypertension is frequently associated with other comorbidities, including obesity, cardiovascular disease, and diabetes - considerations for health and fitness, sport, and athletic training

A
  • screening for comorbidities is important
  • exercise should target a weekly caloric goal of 1500-2000 kcal, progressing as tolerable, to maximize weight loss and cardio protection
214
Q

some medications, such as beta-blockers, for hypertension will attenuate the heart rate at rest and its response to exercise - considerations for health and fitness, sport, and athletic training

A
  • for clients taking medications that will influence heart rate, do not use predicted maximal heart rate or estimates for the exercise
  • instead, use actual heart rate response or the Talk test
  • accepted blood pressure contraindications for exercise include an SBP of 200 mm Hg and DBP of 115 mm Hg
215
Q

what is the leading cause of death and disability?

A

coronary heart disease (CHD)

216
Q

CHD is caused by ______, which leads to narrowing of the coronary arteries and ultimately angina pectoris, myocardial infarction, or both

A

atherosclerosis (plaque formation)

217
Q

angina pectoris

A

chest pain

218
Q

myocardial infarction

A

heart attack

219
Q

causes of CHD

A
  • cigarettes smoking
  • poor diet
  • physical inactivity
220
Q

the emphasis of treating CHD is centered on…

A

improving the internal lining of the coronary artery, called plaque “stabilization”

221
Q

CHD treatment

A
  • medical management: pharmaceuticals

- aggressive lifestyle intervention: eating better, getting more exercise, smoking cessation, stress reduction

222
Q

true or false: clients must be able to find and monitor their own pulse rate or use an accurate monitor to stay below their safe upper limit of exercise

A

TRUE

223
Q

true or false: the heart rate response to exercise will vary considerably from age-predicted formulas in clients with CHD , and will often be higher

A

FALSE

-it will often be lower

224
Q

benefits of exercise for clients with CHD

A
  • lower risk of mortality (death)
  • increased exercise tolerance
  • muscle strength
  • reduction in angina and heart failure symptoms
  • improved psychological status and social adjustment
225
Q

true or false: there is evidence that heart disease may be slowed (or even reversed) when a multifactor intervention program of intensive education, exercise, counseling, and lipid-lowering medications are used, as appropriate

A

TRUE

226
Q

true or false: plyometric training is not recommended for clients with CHD in the initial months of training

A

TRUE

227
Q

mode of exercise for clients with CHD

A

large muscle group activities, such as stationary cycling, treadmill walking, or rowing

228
Q

frequency of exercise for client with CHD

A

3-5 days/week

229
Q

intensity of exercise for clients with CHD

A
  • 40-85% of maximal heart rate reserve
  • the talk test may also be more appropriate as medications may affect heart rate
  • stage I cardiorespiratory training
230
Q

duration of exercise for clients with CHD

A

5-10 minutes of warm-up, followed by 20-40 minutes of exercise, followed by 5-10 minutes of cool-down

231
Q

assessment for clients with CHD

A
  • push, pull, OH squat

- single-leg balance (squat if tolerated)

232
Q

flexibility for clients with CHD

A

static and active in a standing or seated position

233
Q

resistance training for clients with CHD

A
  • 1-3 sets of 10-20 repetitions 2-3 days per week
  • phases 1 and 2 of the OPT model
  • tempo should not exceed 1 second for isometric and concentric portions (e.g., 4/1/1 instead of 4/2/1)
  • use circuit or PHA weight training as an option, with appropriate rest intervals
234
Q

specific considerations for clients with CHD

A
  • be aware that clients may have other diseases to consider as well, such as diabetes, hypertension, peripheral vascular disease, or obesity
  • modify tempo to avoid extended isometric and concentric muscle action
  • avoid heavy lifting and Valsalva maneuvers: make sure client breathes normally
  • do not let client overgrip weights or clench fists when training
  • perform exercises in a standing or seated position
  • progress exercise slowly
235
Q

in clients with CHD, resistance training should not be started until the client has been exercising without problems for __ months

A

3

236
Q

the nature of CHD may result in a specific level of exercise, above which it is dangerous to perform - considerations for health and fitness, sport and athletic training

A
  • the upper safe limit of exercise, preferably by heart rate, must be obtained
  • heart rate should never be estimated from existing prediction formulas for clients with heart disease: consult their physician
237
Q

clients with CHD may not have angina (chest pain equivalent) or other warning signs - considerations for health and fitness, sport and athletic training

A

clients must be able to monitor pulse rate or use an accurate monitor to stay below the upper safe limit of exercise

238
Q

between the underlying disease and medication use, the heart rate response to exercise in clients with CHD will nearly always vary considerably from age-predicted formulas, and will almost always be lower - considerations for health and fitness, sport and athletic training

A

although symptoms should always supersede anything else as a sign to decrease or stop exercising, some clients may not have this warning system, so monitoring of heart rate becomes increasingly important

239
Q

CHD clients may have other comorbidities (such as diabetes, hypertension, peripheral vascular disease, or obesity) - considerations for health and fitness, sport and athletic training

A

screening for comorbidities is important and modifications to exercise may be made based on these diagnoses

240
Q

peak oxygen uptake (as well as ventilatory threshold) is often reduced in clients with CHD because of the compromised cardiac pump and peripheral muscle deconditioning - considerations for health and fitness, sport and athletic training

A

-the exercise prescription should be low intensity, to start, and based
on recommendations provided by a certified exercise physiologist or
physical therapist with specialty training
-aerobic training guidelines should follow, at minimum, 20–30 minutes 3–5 days per week at 40–85% of maximal capacity, but below the upper safe limits prescribed by the physician
-a weekly caloric goal of 1,500–2,000 kcal is usually recommended, progressing as tolerable, to maximize cardio protection
-resistance training may be started after the patient has been exercising asymptomatically and comfortably for >3 months in the aerobic exercise program
-a circuit-training format is recommended, 8–10 exercises, 1–3 sets of
10–20 reps per exercise, emphasizing breathing control and rest as needed between sets

241
Q

what is a precursor to osteoperosis?

A

osteopenia

242
Q

type 1 (primary) osteoporosis

A

associated with normal aging and is attributable to a lower production of estrogen and progesterone, both of which are involved with regulating the rate at which bone is lost

243
Q

type 2 (secondary) osteoporosis

A

caused by certain medical conditions that can disrupt normal bone reformation, including alcohol abuse, smoking, certain diseases, or certain medications

244
Q

true: the actual proteins in bone are altered in osteoporosis

A

TRUE

245
Q

why is type 2 osteoporosis most prevalent in postmenopausal women?

A

-because they have a deficiency in estrogen

246
Q

bone resorption

A

removal of old bone

247
Q

bone remodeling

A

formation of new bone

248
Q

what leads to a decrease in bone mineral density?

A

bone resorption & remodeling

249
Q

what does osteoporosis commonly affect?

A

the neck of the femur and the lumbar vertebrae, placing the core in a weakened state

250
Q

peak bone mass

A

the highest amount of bone mass a person is able to achieve during his or her lifetime

251
Q

new bone formation occurs as result of…

A

stress placed on the musculoskeletal system

252
Q

risk factors that influence osteoporosis

A
  • peak bone mass
  • lack of physical activity
  • smoking
  • excess alcohol consumption
  • low dietary calcium intake
253
Q

what is required to maintain consistent bone remodeling?

A

remaining active enough to ensure adequate stress is being placed on the body

254
Q

mode of exercise for individuals with osteoporosis

A

treadmill with handrail support

255
Q

frequency of exercise for individuals with osteoporosis

A

2-5 days per week

256
Q

intensity of exercise for individuals with osteoporosis

A
  • 50-90% if maximal heart rate

- stage I cardiorespiratory training progressing to stage II

257
Q

duration of exercise for individuals with osteoporosis

A

20-60 minutes per day or 8-10 minute bouts

258
Q

assessment for individuals with osteoporosis

A

push, pull, overhead squat, or sitting and standing into a chair (if tolerated)

259
Q

flexibility for individuals with osteoperosis

A

static and active stretching

260
Q

resistance training for individuals with osteopersosis

A
  • 1-3 sets of 8-20 repetitions at up to 85% on 2-3 days per week
  • phases 1 and 2 of the OPT model should be mastered before moving on
261
Q

special considerations for individuals with osteoporosis

A
  • progression should be slow, well monitored, and based on postural control
  • exercises should be progressed if possible toward free sitting (no support) or standing
  • focus exercises on hips, thighs, back, and arms
  • avoid excessive spinal loading on squat and leg press exercises
  • make sure the client is breathing in a normal manner and avoid holding breath as in a Valsalva maneuver
262
Q

maximal oxygen uptake and ventilatory threshold is frequently lower in clients with osteoporosis, as a result of chronic conditioning - considerations for health and fitness, sport and athletic training

A

typical exercise loads prescribed are consistent with fitness standards: 40-70% of maximum work capacity, 3-5 days per week, approximately 20-30 minutes per session

263
Q

gait and balance may be negatively affected in clients with osteoporosis - considerations for health and fitness, sport and athletic training

A

physiologic and physical limitations point to low-intensity, weight-supported exercise programs that emphasize balance training

264
Q

chronic vertebral fractures may result in significant lower-back pain in clients with osteoporosis - considerations for health and fitness, sport and athletic training

A
  • for clients with osteopenia (and no contraindications to exercise), resistance training is recommended to build bone mass
  • loads >75% of 1RM have been shown to improve bone density, but clients must be properly progressed to be able to handle these loads
  • a circuit-training format is recommended, 8-10 exercises, 1 set of 8-12 reps per exercise, with rest as needed between sets
265
Q

age, disease, physical stature, and deconditioning may place the osteoporosis client at risk for falls - considerations for health and fitness, sport and athletic training

A
  • for clients with severe osteoporosis, exercise modality should be shifted to water exercise to reduce risk of loading fracture (if aquatic exercise is not feasible, use other weight-supported exercise, such as cycling, and monitor signs and symptoms)
  • reinforce other lifestyle behaviors that will optimize bone health, including smoking cessation, reduced alcohol intake, and increased dietary calcium intake
266
Q

true or false: individuals who participate in resistance training have a higher bone mineral density than those who do not

A

TRUE

267
Q

resistance training has been shown to improve bone density by no more than __%

A

5

268
Q

it has been estimated that a __% increase in bone mineral density is necessary to offset fractures

A

20

269
Q

higher intensities (__%) are needed to stimulate bone formation

A

75-85

270
Q

it appears that ___ (rather than the number of repetitions) is the determining factor in bone formation

A

load

271
Q

it generally takes about __ months of consistent exercise at relatively high intensities before any effect on bone mass is realized

A

6

272
Q

2 most common types of arthritis

A
  1. osteoarthritis

2. rheumatoid arthritis

273
Q

osteoarthritis is caused by the degeneration of ___

A

cartilage within joints

274
Q

some of the most commonly affected joints in osteoarthritis are in the…

A

hands, knees, hips, and spine

275
Q

the lack of cartilage as a result of osteoarthritis results in what?

A

wearing on the surfaces of articulating bones, causing inflammation and pain at the joint

276
Q

rheumatoid arthritis is a degenerative joint disease in which the body’s immune system mistakenly….

A

attacks its own tissue (in this case, tissue in the joint or organs)

277
Q

some of the most commonly affected joints in rheumatoid arthritis are in the…

A

hands, feet, wrists, and knees

278
Q

what is rheumatoid arthritis typically characterized by?

A

morning stiffness, lasting more than half an hour, which can be both acute and chronic, with eventual loss of joint integrity

279
Q

pain persisting for more than __ after exercise is an indication that the exercise should be modified or eliminated from the routine

A

1 hour

280
Q

exercises of higher intensity or involving higher repetitions are to be avoided to decrease ___

A

joint aggravation

281
Q

clients taking oral corticosteroids, particularly over time, may have….

A

osteoporosis, increased body mass, and, if there is a history of gastrointestinal bleeding, anemia

282
Q

steroids increase ___ risk

A

fracture

283
Q

research indicates that people exhibiting osteoarthrosis have a decrease in ____ and ____

A

strength and proprioception

284
Q

what is a strong predictor of osteoarthrisis?

A

loss in knee-extensor strength

285
Q

patients with osteoarthrosis exhibit increased ____ of knee extensors, and were not able to effectively activate their knee-extensor musculature to optimal levels

A

muscle inhibition

286
Q

symptoms of arthritis are heightened through inactivity as a result of ___ and ____

A

muscle atrophy and lack of tissue flexibility

287
Q

mode of exercise for individuals with arthritis

A

treadmill walking, stationary cycling, and low-impact of step aerobics

288
Q

frequency of exercise for individuals with arthritis

A

3-5 days per week

289
Q

intensity of exercise for individuals with arthritis

A
  • 60-80% of maximal heart rate

- stage I cardiorespiratory training progressing to stage II (may be reduced to 40-70% of maximal heart rate if needed)

290
Q

duration of exercise for individuals with arthritis

A

30 minutes

291
Q

assessment for individuals with arthritis

A
  • push, pull, overhead squat

- single-leg balance of single-leg squat (if tolerated)

292
Q

flexibility for individuals with arthritis

A

SMR and static and active stretching

293
Q

resistance training for individuals with arthritis

A
  • 1-3 sets of 10-12 repetitions 2-3 days per week
  • phase 1 of OPT model with reduced repetitions (10-12)
  • may use a circuit or PHA training system
294
Q

special considerations for individuals with arthritis

A
  • avoid heavy lifting and high repetitions
  • stay in pain-free ranges of motion
  • only use SMR if tolerated by the client
  • there may be a need to start out with only 5 minutes of exercise and progressively increase, depending on the severity of conditions
295
Q

maximal oxygen uptake and ventilatory threshold are frequently lower in arthritis clients as a result of decreased exercise associated with pain and joint inflammation - considerations for health and fitness, sport and athletic training

A
  • multiple sessions or a circuit format, using treadmill, elliptical trainer, or arm and leg cycles, are a better alternative than higher-intensity, single-modality exercise formats
  • the usual principles of aerobic exercise training apply (60-80% peak work capacity, 3-5 days per week)
  • duration of exercise should be an accumulated 30 minutes, following an intermittent or circuit format, 3-5 days per week
296
Q

medications may significantly influence bone and muscle health in arthritis clients - considerations for health and fitness, sport and athletic training

A

incorporate functional activities in the exercise program whenever possible

297
Q

tolerance to exercise may be influenced by acute arthritic flare-ups - considerations for health and fitness, sport and athletic training

A

awareness of the signs and symptoms that may be associated with acute arthritis flare-ups should dictate a cessation or alteration of training, and joint pain persisting for more than 1 hour should result in an altered exercise format

298
Q

rheumatoid arthritis results, in particular, in early morning stifness - considerations for health and fitness, sport and athletic training

A

avoid early morning exercise for clients with rheumatoid arthritis

299
Q

evaluate for presence of comorbidities in arthritis clients, particularly osteoporosis - considerations for health and fitness, sport and athletic training

A
  • resistive exercise training is recommended, as tolerable, using pain as a guide
  • start with a very low number of repetitions and gradually increase to the number usually associated with improved muscular fitness (e.g., 10-12 reps, before increasing weight, 1 set of 8-10 exercises, 2-3 days per week)
300
Q

positive benefits of exercise in the treatment of cancer

A
  • improved aerobic and muscular fitness
  • retention of lean body mass
  • less fatigue
  • improved quality of life
  • positive effects on mood and self-concept
  • reduce cellular risks associated wit cancer
  • improve exercise tolerance
301
Q

medications used by clients with cancer can result in substantial adverse effects, such as…

A

peripheral nerve damage, cardiac and pulmonary problems, skeletal muscle myopathy (muscle weakness and wasting), and anemia, as well as frequent nausea

302
Q

mode of exercise for individuals with cancer

A

treadmill walking, stationary cycling, rowers, low-impact or step aerobics

303
Q

frequency of exercise for individuals with cancer

A

3-5 days per week

304
Q

intensity of exercise for individuals with cancer

A
  • 50-70% of maximal heart rate reserve

- stage I cardiorespiratory training progressing to stage II (may be reduced to 40-70% of maximal heart rate if needed)

305
Q

duration of exercise for individuals with cancer

A

15-30 minutes per session (may only start with 5 minutes)

306
Q

assessment for individuals with cancer

A
  • push, pull, overhead squat

- single-leg balance (if tolerated)

307
Q

flexibility for individuals with cancer

A

SMR and static and active stretching

308
Q

resistance training for individuals with cancer

A
  • 1-3 sets of 10-15 repetitions 2-3 days per week
  • phases 1 and 2 of the OPT model
  • may use a circuit or PHA training system
309
Q

special considerations for individuals with cancer

A
  • avoid heavy lifting in initial stages of training
  • allow for adequate rest intervals and progress client slowly
  • only use SMR if tolerated by the client- avoid SMR for clients undergoing chemotherapy or radiation treatments
  • there may be a need to start with only 5 minutes of exercise and progressively increase, depending on the severity of conditions and fatigue
310
Q

exercise at ____ intensities for moderate durations appears to have a more positive effect on the immune system (when compared with higher intensities for longer durations)

A

low to moderate

311
Q

the majority of observed disparities in athletic performance between men and women are explained by differences in…

A
  • body structure
  • muscle mass
  • lean to fat body mass ratio
  • blood chemistry
312
Q

those already engaged in an exercise program before pregnancy may continue with moderate levels of exercise until __________, when a logical reduction in activity is recommended

A

the third trimester

313
Q

the gradual growth of the fetus can alter the ___ of pregnant women

A

posture

314
Q

things to avoid in later stages of pregnancy

A
  • prone or supine positions
  • hip abduction or adduction
  • uncontrolled twisting motions of the torso
315
Q

women in the childbearing period are more vulnerable to….

A

nausea, dizziness, and fainting

316
Q

pregnant women should immediately stop exercising if they experience nausea, dizziness, or fainting, along with any…

A

abdominal pain (or contractions), excessive shortness of breath, or bleeding or leakage of amniotic fluid

317
Q

changes that occurred during pregnancy may persist for ______ after pregnancy

A

a month to a month and a half

318
Q

postnatal women should be encouraged to reeducate.

A
  • posture
  • joint alignment
  • muscle imbalances
  • stability
  • motor skills
  • recruitment of the deep core stabilizers such as the transverse abdominis, internal oblique, and pelvic floor musculature
319
Q

in pregnant women, SMR should not be performed on…

A

varicose veins that are sore, or on areas where there is swelling (such as the calves)

320
Q

appropriate precautions can minimize the risks of exercise during pregnancy, including…..

A

increased blood circulation, thermoregulatory changes, or decreased oxygen supply

321
Q

mode of exercise for pregnant women

A

low-impact or step aerobics that avoid jarring motions, treadmill walking, stationary cycling, and water activity

322
Q

frequency of exercise for pregnant women

A

3-5 days per week

323
Q

intensity of exercise for pregnant women

A

stage I and only enter stage II on a physician’s advice

324
Q

duration of exercise for pregnant women

A
  • 15-30 minutes per day
  • there may be a need to start out with only 5 minutes of exercise and progressively increase to 30 minutes, depending on the severity of conditions
325
Q

assessment for pregnant women

A
  • push, pull, overhead squat

- single-leg squat or balance

326
Q

flexibility for pregnant women

A

static, active stretching and SMR

327
Q

resistance training for pregnant women

A
  • 2-3 days per week, using light loads at 12-15 repetitions

- phases 1 and 2 of the OPT model are advised (use only phase 1 after first trimester)

328
Q

special considerations for pregnant women

A
  • avoid exercises in prone or supine position after 12 weeks of pregnancy
  • avoid SMR on varicose veins and areas of swelling
  • plyometric training is not advised in the second and third trimesters
329
Q

contraindications include persistent bleeding into 2nd or 3rd trimester, medical documentation of incompetent cervix or intrauterine growth retardation, pregnancy-induced hypertension, preterm rupture of membrane, or preterm labor during current or prior pregnancy - considerations

A

screen carefully for potential contraindications to exercise

330
Q

decreased oxygen available for aerobic exercise in pregnant women - considerations

A

low-moderate intensity aerobic exercise (40-50% of peak work capacity) should be performed 3-5 days per week, emphasizing non-weight bearing exercise (e.g., swimming, cycling), although certain treadmill or elliptical training modes may be preferred and are appropriate

331
Q

posture can affect blood flow to uterus during vigorous exercise in pregnant women - considerations

A

avoid supine exercise, particularly after first trimester

332
Q

even in the absence of exercise, pregnancy may increase metabolic demand by 300 kcal per day to maintain energy balance - considerations

A

advise adequate caloric intake to offset exercise effect

333
Q

high-risk pregnancy considerations include individuals older than age of 35, history of miscarriage, diabetes, thyroid disorder, anemia, obesity, and a sedentary lifestyle

A

-there are no published guidelines for resistance,
flexibility, or balance training specific to pregnancy
exercise
-provided exercise intensity is below the aerobic prescription of 40–50% of peak work capacity, with careful attention to special
considerations and contraindications described, adding these components may be helpful
-for resistance training, if cleared by the physician,
a circuit-training format is recommended, 1–3 sets
of 12–15 reps per exercise, emphasizing breathing
control and rest, as needed, between sets
-advise clothing that will dissipate heat easily during exercise
-postpartum exercise should be similar to pregnancy guidelines, as physiologic changes that occur during pregnancy may persist for up to 6 weeks

334
Q

major obstructive lung diseases

A
  • asthma
  • chronic bronchitis
  • emphysema
335
Q

what are obstructive lung diseases characterized by?

A

chronic inflammation and airway obstruction via mucus production

336
Q

cystic fibrosis

A

a genetic disorder that is characterized by excess mucus production

337
Q

impairments during exercise due to chronic lung disease

A
  • decreased ventilation

- decreased gas exchangeability (resulting in decreased aerobic capacity and endurance and in oxygen desaturation)

338
Q

dyspnea

A

shortness of breath

339
Q

clients with lung disease experience…

A

fatigue at low levels of exercise and often have shortness of breath

340
Q

those with emphysema are frequently ______ and may exhibit ______

A

underweight, overall muscle wasting with hypertrophied neck muscles (which are excessively used to assist labored breathing)

341
Q

those with chronic bronchitis are _______

A

oversight and barrel-chested

342
Q

the use of ____ cardiorespiratory and resistance training exercises seem to be best tolerated in those with lung disease

A

lower body

343
Q

upper extremity exercises place an increased stress on…

A

the secondary respiratory muscles that are involved in stabilization the upper extremities during exercise

344
Q

true or false: the Peripheral Heart Action training system is highly recommended for those with lung disease

A

FALSE

-may need to avoid upper body exercises

345
Q

in some clients, inspiratory muscle training can specifically improve ____

A

the work associated with breathing

346
Q

mode of exercise for individuals with lung disease

A

treadmill walking, stationary cycling, steppers, and elliptical trainers

347
Q

frequency of exercise for individuals with lung disease

A

3-5 days per week

348
Q

intensity of exercise for individuals with lung disease

A
  • 40-60% of peak work capacity

- stage I

349
Q

duration of exercise for individuals with lung disease

A

work up to 20-45 minutes

350
Q

assessment for individuals with lung disease

A
  • push, pull, overhead squat

- single-leg squat or balance

351
Q

resistance training for individuals with lung disease

A
  • 1 set of 8-15 repetitions 2-3 days per week
  • phase 1 of the OPT model is advised
  • PHA training system is recommended
352
Q

flexibility for individuals with lung disease

A

static and active stretching and SMR

353
Q

special considerations for individuals with lung disease

A
  • upper body exercises cause increased dyspnea and must be monitored
  • allow for sufficient rest between exercises
354
Q

lung disease frequently is associated with other comorbidities, including cardiovascular disease - considerations

A

screen for presence of other comorbidities

355
Q

a decrease in the ability to exchange gas in the lungs may result in oxygen desaturation and marked dyspnea at low workloads - considerations

A
  • if possible and properly trained, ascertain the level of oxygen saturation using a pulse oximeter
  • pulse oximetry values should be above 90% and certainly above 85%: values above this level are a contraindication to continued exercise, regardless of symptoms
356
Q

chronic deconditioning results in low aerobic fitness and decreased muscular performance in clients with lung disease - considerations

A
  • the aerobic exercise prescription should be guided by the client’s shortness of breath
  • workloads of 40-60% of peak work capacity 3-5 days per week, 20-45 minutes as tolerable, may be achievable
  • intermittent exercise with frequent rest breaks may be necessary to achieve sufficient overall exercise duration
357
Q

upper extremity exercise may result in earlier onset of dyspnea and fatigue than expected, when compared with lower extremity exercise - considerations

A
  • upper extremity exercise should be programmed carefully and modified, based on fatigue
  • resistance training can be helpful; use conservative guidelines
  • circuit training in a PHA format is recommended (8-10 exercises, 1 set of 8-15 reps per exercise), emphasizing breathing control and rest as needed between sets
358
Q

lung disease clients may have significant muscle wasting and be of low body weight (with a BMI <18)

A

if the client is very thin, be certain to recommend adequate caloric intake to offset exercise effects

359
Q

lung disease clients may be using supplemental oxygen

A
  • trainers may not adjust oxygen flow during exercise; it is considered a medication
  • if a client experiences unusual dyspnea or has evidence of oxygen desaturation during exercise, stop exercise immediately and consult with the client’s physician
360
Q

what is intermittent claudication characterized by?

A

limping, lameness, or pain in the lower leg during mild exercise resulting from a decrease in blood supply (oxygen) to lower extremities

361
Q

what is the primary limiting factor for exercise in a client with peripheral arterial disease?

A

leg pain

362
Q

exercise for peripheral arterial disease should induce symptoms, causing a stimulus that increases _____

A

local circulation

363
Q

the health and fitness professional must differential between true intermittent claudication versus what?

A

similar leg complaints associated with deconditioning

364
Q

mode of exercise for individuals with PAD

A

treadmill walking is preferred, also stationary cycling, steppers, and elliptical trainers

365
Q

frequency of exercise for individuals with PAD

A

3-5 days per week working up to everyday

366
Q

intensity of exercise for individuals with PAD

A

50-85% of maximal heart rate

367
Q

duration of exercise for individuals with PAD

A

work up to 20-30 minutes

368
Q

assessment for individuals with PAD

A
  • push, pull, overhead squat

- single-leg squat or balance

369
Q

flexibility for individuals with PAD

A

static and active stretching

370
Q

resistance training for individuals with PAD

A
  • 1-3 sets of 8-12 repetitions 2-3 days per week, and slowly increasing up to 12-20 reps
  • phase 1 of the OPT model is advised
371
Q

special considerations for those with PAD

A
  • allow for sufficient rest time between exercises
  • workout may start with 5-10 minutes of activity
  • slowly progress client

NASM-CPT (21 decks)

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