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Ex Phys > Chapter 17/21: Exercise for Special Populations COPY > Flashcards

Chapter 17/21: Exercise for Special Populations COPY Flashcards

1
Q

signs and symptoms of diabetes

A

polydipsia, polyuria, unexplained weight loss, infections and cuts slow to heal, blurry vision, fatigue

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2
Q

for type 1 diabetics, what happens if they do not inject adequate insulin before exercise?

A

show in increase in plasma glucose

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3
Q

effects of normal insulin levels on liver glucose release, glucose uptake by muscle, and BG levels

A

increased liver glucose release, increase glucose uptake by muscle, BG levels remain constant

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4
Q

effects of hypoinsulinemia on liver glucose release, glucose uptake by muscle, and BG levels

A

increased glucose release from liver, less of an increase of glucose uptake my muscles, so BG levels increase

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5
Q

effects of hyperinsulinemia on liver glucose release, glucose uptake by muscle, and BG levels

A

increased glucose uptake by muscles, less of an increase in liver glucose release, leading to decreased BG levels

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6
Q

major concern for type 1 diabetics during exercise

A

hypoglycemia, may result in insulin shock

GLUT 4 receptors increase; if normal insulin injections too this could cause a major drop in BG

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7
Q

what lowers the odds of exercise-induced hypoglycemia?

A

regular exercise schedule

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8
Q

Explain why exercise might complicate the life of a person with type 1 diabetes, while being
a recommended and primary part of a program with someone with type 2 diabetes

A

Exercise for type 1 will drop blood glucose via glut 4 translocation and if this is in conjunction with insulin injections, they run the risk of hypoglycemia

For type 2 the main issue is insulin resistance, so glut 4 translocation helps reduce resistance and control blood glucose

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9
Q

How a person with diabetes responds to exercise when blood glucose is “in control”
compared to when it is not.

A

ketone bodies would stay at a level just above normal vs. dramatically increases

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10
Q

at what fasting glucose level should a type 1 diabetic avoid exercising?

A

fasting glucose > 300 mg/dl

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11
Q

when should a type 1 diabetic ingest carbs?

A

glucose < 100 mg/dl

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12
Q

where should the insulin injection site be for type 1 diabetics?

A

away from working muscle to prevent increased rate of uptake and hypoglycemia

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13
Q

relationship between exercise and type 2 diabetes

A

exercise is a primary treatment (treats obesity, helps control BG and reduce insulin resistance, helps treat CVD risk factors)

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14
Q

can a combo of diet and exercise eliminate need for diabetic drugs for type 2 diabetics?

A

yes

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15
Q

how does exercise improve glucose uptake?

A

muscle contraction causes translocation of GLUT-4 transporters to the cell surface

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16
Q

describe how blood glucose and insulin levels change in type 2 diabetics when they exercise vs not exercising

A

type 2 diabetics who exercise show a decrease in blood glucose levels with less of a spike in insulin compared to diabetics who don’t exercise (during an OGTT)
* became more insulin sensitive

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17
Q

different ways airway is restricted in asthma

A

1) contraction of smooth muscle of airways
2) swelling of mucosal cells
3) hypersecretion of mucus

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18
Q

how is asthma diagnosed?

A

using pulmonary-function testing which assesses vital capacity and forced expiratory volume

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19
Q

define vital capacity

A

maximal volume of air expelled after maximum inhalation

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20
Q

define forced expiratory volume

A

volume of air expired in 1 second during maximal expiration

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21
Q

asthma triggers

A

allergens, exercise, stress, cool/dry climates

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22
Q

describe the asthma response to triggers

A

plasma cells produce IgE antibodies which attach to mast calls lining bronchial tube —> mast cells release inflammatory mediators

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23
Q

what is exercise-induced asthma caused by?

A

cooling and drying of respiratory tract which triggers release of chemical mediators and airway narrowing

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24
Q

if properly controlled, does EIA impair performance?

A

no

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25
Q

how is EIA diagnosed?

A

strenuous running at 85-90% of max HR, if forced expiratory volume (FEV) decreases by 10% or more, EIA is indicated

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26
Q

why is there less of a decrease in FEV for asthmatic-swimming compared to asthmatic-running or cycling?

A

Breathing in humid air = no drying

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27
Q

strategies for preventing an asthma attack during exercise

A

1) warmup (15 mins at 60% of VO2max)
2) performance short-duration exercise
3) use a mask or face mask in cold weather

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28
Q

treatment of EIA

A

B2-agonist in case of attack during exercise, or other medications
* B2-agonist causes smooth muscle relaxaton and vasoodilation = increasing airways

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29
Q

how do B2-agonists affect performance?

A

inhaled B2-agonists do not improve performance (too low of a dose) but ingested salbutamol (B2-agonists) does improve strength, anaerobic power, and endurance (10-20x inhaled dose)

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30
Q

normal BP

A

systolic < 120 and diastolic < 80

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31
Q

elevated BP

A

systolic between 120-129 and diastolic < 80

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32
Q

stage 1 hypertension

A

systolic 130-139 or diastolic 80-89

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33
Q

stage 2 hypertension

A

systolic > 140 or diastolic > 90

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34
Q

prevalence of hypertension

A

1/3 of U.S adults, and prevalence increases with age

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35
Q

how does hypertension affect vascular endothelium?

A

hypertension damages the endothelium, which predisposes the individual to atherosclerosis and other vascular pathologies

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36
Q

how does hypertension affect afterload?

A

increases afterload which leads to left ventricular hypertrophy, which is an important cause of heart failure

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37
Q

nonpharmacological treatments for hypertension

A

lose weight, limit alcohol intake, reduce sodium intake, eat diet rich in fruits and veggies, stop smoking, exercise

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38
Q

recommended exercise prescriptions for those with hypertension

A

frequency: aerobic exercise on most, if not all, days of the week (dont want resistance = spike in bp)
intensity: moderate
duration: 30-60 mins of continuous or intermittent (min of 10 min bouts) aerobic activity
mode: primarily aerobic exercise supplemented by resistance exercise

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39
Q

how does strength change with exercise in children? what does the extent of muscular development depend on?

A

increases as muscle mass increases with age, the extent of muscular development depends on relative maturation of the nervous system (need signals to continue muscle growth)

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40
Q

how is thermoregulation different for children?

A

children have increased surface area:mass ratio so they have greater conductive heat loss and gain, they also have less evaporative heat loss leading to a slower heat acclimation

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41
Q

how is blood pressure different in children?

A

lower resting and submax blood pressure than adults (relative to body size), they have smaller hearts and lower peripheral resistance during exercise

42
Q

how are heart rate & stoke volume different in children? what affect does this have on cardiac output?

A

higher HR, which almost compensates for the lower SV (smaller heart and lower BV), which results in a slightly lower cardiac output than an adult

43
Q

how do children compensate for the slightly lower cardiac output?

A

a-vO2 difference increases to compensate and maintain oxygen consumption

44
Q

how does absolute VO2 max change with age in boys and girls?

A

increases with age

45
Q

how does relative VO2 max change with age for boys and girls?

A

relative VO2max remains steady with boys, but decreases with age for girls
* boys produce more testosterone —> encourages lean muscle mass (which consumes more O2)
* females produces estrogen which encourages more fat mass (doesn’t consume oxygen)

46
Q

how does lung function change with age in children?

A

lung volume and peak flow rate increase with age

47
Q

how does children’s economy differ from adults?

A

child’s O2 consumption per kilogram is greater than adults (bad economy), but with age, skills improved and stride lengthens

48
Q

how does endurance running pace change in children with age? why? occurs regardless of what?

A

endurance running pace increases with age because of better economy of effort, regardless of VO2 max changes or training status

49
Q

how does anaerobic performance in children compare to in adults?

A

children limited in anaerobic performance because of low muscle mass

50
Q

how does the glycolytic capacity in children compare to that in adults?

A

children have a lower glycolytic capacity (less muscle glycogen, less glycolytic enzyme activity, and lower blood lactate)

51
Q

how do the resting stores of ATP-PCr compare in children and adults?

A

similar in children and adults

52
Q

pros and cons of strength training in children

A

historically controversial with concerns about damage to articular cartilage, epiphyseal growth plate, and muscle-tendon insertion

but, weight lifting is safe when proper technique and can promote muscular strength and bone density

53
Q

2 physiological adaptations children experience with aerobic training

A

1) improvement in VO2 max - similar to adults
2) performance increases due to improved running economy

54
Q

3 physiological adaptations in children due to anaerobic training

A

1) higher resting PCr, ATP, glycogen
2) higher PFK activity
3) higher maximal blood lactate

same adaptations as adults

55
Q

how does early specialization in one sport affect lifelong fitness?

A

reduces the “fun” physical activities, which leads to reduced lifelong physical activity

56
Q

cause of sudden cardiac death during exercise in young adults

A

congenital heart defects, not exercise
Abnormal, lethal heart rhythms

57
Q

females’ responses to training are similar to males, with one exception, what is the exception?

A

thermoregulation is impaired during the luteal phase of menstrual cycle (due to increased basal temp)

58
Q

athletic amenorrhea

incidence of amenorrhea in female athletes versus the general population

A

cessation of menstruation
* 12-69% of female athletes
* 3% in general populations

59
Q

3 potential causes of athletic amenorrhea

A

1) amount of training: linear relationship - greater miles of running = greater incidence of amenorrhea
2) psychological stress
3) low energy availability

60
Q

describe anorexia nervosa

A

extreme steps to reduce body weight (starvation, exercise, laxative use) which causes excessive weight loss, amenorrhea, and even death

61
Q

why would the body want to cease menstruation in female athletes?

A

allows the body to divert more resource to survival and key cellular mechanisms rather than reproduction

62
Q

describe anorexia nervosa

A

extreme steps to reduce body weight (starvation, exercise, laxative use) which causes excessive weight loss, amenorrhea, and even death

63
Q

Warning signs of anorexia nervosa

A
  • rapid weight loss
  • mood swings
  • excessive exercise
  • avoiding food-related activities
  • wearing baggy clothes
  • preoccupation with food, calories, or weight
64
Q

describe anorexia bulimia

A

pattern of overeating followed by vomiting which leads to damaged teeth and esophagus

65
Q

Warning signs of bulimia

A
  • noticable weight loss
  • depressive mood
  • excessive concern about weight
  • strict dieteing followed by binges
  • bathroom visits after meals
  • increased critisism of body
66
Q

female athlete triad

2 major causes of osteoporosis

A

1) estrogen deficiency due to amenorrhea
2) inadequate calcium intake due to eating disorders

67
Q

how does the bone mineral content of female runners compare to untrained females?

A

female runners have a higher bone mineral content

68
Q

female athlete traid

A

the inner play of low energy availability, mentral dysfunction, and low bone minderal density

69
Q

describe RED-S

A

relative energy deficiency in sports: newer version of the female triad - applies to both men and women
* has more components

70
Q

treatment of RED-S

A

Primary objective = increase energy availability
1) increase energy intake and reduce energy expenditure
2) nutritional counseling and psychotherapy if practicing restrictive eating behaviors

71
Q

how does recovery from RED-S progress? (when does each component recovery)

A

recovery of energy status happens first (days to weeks), then recovery of menstrual status (months), then recovery of bone mineral density (years)

72
Q

3 reasons why female athletes are at a higher risk of certain knee injuries compared to men

A

1) fluctuation in hormones during menstrual cycle may compromise ACL strength and/or proprioreceptor feedback
2) knee anatomy (may be due to greater joint laxity)
3) dynamic neuromuscular imbalance (imbalanced strength, proprioception, and landing biomechanics)

females at a 3.5x higher risk of non-contact ACL injury

73
Q

major adaptations to pregnancy

A

Cardiovascular: increase in plasma volume, cardiac output, stroke volume, and heart rate
Lungs: increase in tidal volume and minute ventilation

74
Q

exercise recommendations during pregnancy

A

regular endurance exercise poses little risk to the fetus and is beneficial to the mother, but pregnant women should consult their physician before beginning an exercise program

75
Q

exercise during pregnancy reduces the risk of

A

gestational diabetes and preeclampsia

76
Q

how do training adaptations differ during pregnancy?

A

1) absolute VO2 max is increased or maintained due to increased cardiac output & O2 capacity
2) combo of training and pregnancy results in greater adaptations that training alone due to plasma volume increase

77
Q

ASCM/CDC specific exercise recommendation for pregnant women

A

30 min/day of moderate-intensity activity on most, preferably all days

78
Q

how should intensity be determined for exercising pregnant women?

A

Rate of perceived exertion (12-14), heart rate (may not be best) and “talk test”

79
Q

how should body temp be maintained for pregnant women while exercising?

A

limit body temp increases to less than 1.5 degrees celsius (aquatic exercise recommended)
* prevents hypothermia

80
Q

how should exercising pregnant women maintain hydration?

A

consume fluids at regular intervals (every 15 mins)
* monitor by measuring body weight

81
Q

how should training change as pregnancy advances?

A

reduce intensity and volume as pregnancy advances

82
Q

what sort of exercises should pregnant women avoid?

A

supine exercises
* avoid pressure on abdomen

83
Q

why is exercising into old age an unusual pattern?

A

natural tendency to be sedentary, unmotivated

84
Q

potential motivating factors for older people to engage in physical activity

A

be fit enough to play with grandkids, maintain independence, social incentive

85
Q

how does endurance performance change as you age?

A

endurance performance declines after age 60

mainly caused by decline in VO2max

86
Q

how does VO2 max change with age?

A

declines about 1% per year

87
Q

what two factors don’t really change with age?

A

exercise economy and lactate threshold

88
Q

how does training affect the decline in VO2 max as you age?

A

training can slow but not prevent the decline in VO2 max

89
Q

how does weight change with age?

A
  • from age 25-45, decreased physical activity and increased caloric intake causes weight gain
  • older than 65, loss of body mass and appetite causes weight loss
90
Q

Height changes with age

A

decrease begins at 35-40 due to
* compression of intervertebral discs
* Poor posture
* Later on, due to osteopenia and osteoporosis

91
Q

Major body composition changes with age

A
  • increase in body fat content
  • Decrease in fat-free mass (muscle and bone mass)
92
Q

4 factors contributing to decreased fat-free mass starting around age 40

A

1) decreased muscle and bone mass
2) sarcopenia (decreased protein synthesis)
3) lack of activity
4) decreased growth hormone & IGF-1

93
Q

2 factors contributing to loss of strength with age

A

1) lower level of activity
2) sarcopenia (loss of muscle mass)

94
Q

3 defining characteristics of sarcopenia

that explain why it leads to loss of strenght with age

A

1) decrease in muscle size (both type I and II)
2) decrease in number of fibers (both type I and II)
3) greater reduction in type II fibers with aging - type I are used daily

95
Q

how does exercise affect reflexes in older people?

A

exercise preserves reflex response time so that active older adults are approx equal to young active people

96
Q

how does motor unit activation change with age? how does exercise prevent this?

A

motor unit activation decreases; exercise retains maximal recruitment of muscle

97
Q

how does bone mineral content change with age?

A

decrease; bone resorption > bone synthesis due to a lack of weight bearing exercise

98
Q

why is osteoporosis more common in women?

A

due to lack of estrogen

99
Q

recommendations for exercise to maintain bone health

A

frequency: weight bearing 3-5 times/week, resistance 2-3
intensity: moderate to high bone loading
duration: 30-60 mins/ day
mode: weight-bearing, jumping, resistance

100
Q

What type of training is most effective to increase muscle strength

A

Resistance training is most effective for maintaining muscular strength
- combination of resistance and balance trianing can reduce risk of falls

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