Chapter 19-23 Flashcards by Does Not Matter

What is LBP characterized as?

Pain, muscle tension, or stiffness localized below the rib margin and
above the inferior gluteal folds

 Can occur w/ or w/o leg pain

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What is CNSLBP?

Chronic non-specific low back pain (CNSLBP)
 No specific pathology; lasts >12 weeks

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What is CNSLBP associated with?

Often associated with sedentary behavior and low levels of PA due
to intolerance

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What are common comorbitities of CNSLBP?

Common comorbidities include OWOB, metabolic syndrome,
hypertension, and T2D

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How to assess individuals with CNSLBP?

 Treadmill, cycle, and step tests, as well as field tests such as 6MWT
are appropriate for assessment of CRF
 Multi-rep max is probably better than 1-RM for assessing muscular
fitness

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Prescription of exercise for CNSLBP?

 Use guidelines for healthy adults, but consider modifications based
on comfort and activity tolerance
 Bed rest is not recommended; start slow, but get active as soon as you
can!
 Use “two for two” rule for progression of PRT
 Heavy emphasis on posture and technique; modify exercises if pain
worsens
 Consider movement direction preference/bias
 Consider isometric exercises for core to improve stabilization
 If symptoms worsen or new ones develop, stop and refer
 Avoid prolonged sedentary behavior

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What is fibromyalgia?

Chronic pain syndrome that affects the joints, muscles, tendons, and soft
tissue of the body

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What is fibromyalgia thought to be caused by?

Thought to be caused by neurological imbalances in the central nervous
system associated with a heighted pain perception

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Primary triad of fibromyalgia?

Bilateral, widespread musculoskeletal pain above and below the waist
with pain in axial skeleton lasting longer than 3 months
(Described as “diffuse ache” with specific “tender points” along the body)
Fatigue
Sleep disturbances

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Who is fibromyalgia prevalent in?

Higher prevalence among women; often combined with mood disorders

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Testing of people with fibromyalgia?

Suggestions for CRF testing include Åstrand cycle ergometer test,
walking test (5, 6, and 10 min), and shuttle walk test

 Monitor pain and fatigue levels throughout

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What is fibromyalgia marked by?

Typically marked by poor exercise adherence due to pain

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FITT for fibromyalgia?

 F: 1-2 days progressing to 2-3 days per week
 I: 30-39% of HRR progressing to 40-59%; 40-80% of 1-RM
 T: >10 minutes progressing to 30-60; 1 set progressing to 2 of 15-20
reps for endurance
 T: Low-impact; water-based activities are often well-tolerated

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What is rheumatoid arthritis?

 Chronic inflammatory disease primarily affecting synovial joints caused
by autoimmune response
 Marked by “flare-ups” and remissions; more common in women than men

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What can rheumatoid arthritis lead to?

Can lead to rheumatoid cachexia: loss of skeletal muscle with increase in
adiposity, which can result in lower PA levels and functional limitations

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What tests are effective for rheumatoid arthritis?

Functional testing is effective
 TUG test, functional balance tests, grip strength, 30-sec STS, 30 second bicep
curl
 6MWT can be used in place of standard CRF assessments

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What to consider for patients with rheumatoid arthritis?

 Potential limitations for exercise include grip weakness, joint instability,
and mobility restrictions
 Important to constantly monitor RPE and pain during exercise

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What exercises is most effective for rheumatoid arthritis?

 Combined aerobic and RT is most effective
 Water-based aerobic exercise demonstrates great outcomes due to
low joint stress

Resistance training for rheumatoid arthritis?

RT: 1-3 sets, 8-12 reps, 50-80% of 1-RM, 2-3 days per week

What can stretching do for rheumatoid arthritis?

Daily stretching may provide benefits of reduced pain and
increased function

What will regular exercise do for patients with rheumatoid arthritis?

Regular exercise will lessen BMD loss and improve joint health and
body composition

What is cancer?

Uncontrolled cell growth, usually the result of genetic or singlenucleotide mutations that occur because of environmental, lifestyle
and host factors

Common types of cancer?

Most common types are lung, prostate, breast, colon, and rectum

How is cancer classified?

Classified by stage (0-5) depending on types of tumor cells and spread

What can exercise do for cancer patients?

Exercise reduces risk of recurrence, mitigates fatigue, and improves QoL

What do be mindful of when dealing with cancer patients?

Need to be mindful of treatment side effects  Acutely: Pain, fatigue, nausea and vomiting, change in appetite, and localized swelling or lymphedema  Long-term: Changes in cognition, BW and comp, CV health, immune function, and nerve function

When is testing needed for cancer patients?

Testing only needed if fatiguing after low-to-moderate PA  May use testing guidelines for healthy populations

What to do if a clients is on medications that alter heart rate ressponse?

May be on medications that alter HR response; if so, use RPE  12-13 for moderate intensity; 14-17 for vigorous

Resistance training prescription for cancer patients?

RT on 2-3 days per week; start <30% 1-RM with slow progression  Avoid high-impact activities due to fx risk

What exercises can improve ADL for cancer patients?

Consider balance, flexibility, and coordination exercises to improve ADLs

When should exercise be avoided with cancer patients?

Avoid exercise if severe symptoms or side effects are present

What to consider if patient is immune suppressed for exercise?

If patient is immunosuppressed, avoid swimming and consider private facility or space for exercise

What is osteoporosis?

Poor bone strength that leads to increased fx risk

Who is osteoporosis most common in?

Most common in elderly women

Behaviors to improve bone strength and reduce falls?

Behaviors to improve bone strength and reduce falls include  Adequate calcium and vitamin D intake  Regular exercise (slows ↓ BMD, ↑ SMM, ↑ strength and dynamic balance)  Smoking cessation  Avoidance of excessive alcohol intake  Visual correction to decrease risk of falling

What to consider for vertebral osteoporosis?

Consider cycle-based for vertebral osteoporosis  May have balance and breathing issues if spine is compromised

What should test should not be done for clients with osteoporosis?

No maximal strength testing

What is most effective for bone health/

High-intensity WB exercise is most effective for bone health  Balance safety and health considerations  Unaccustomed loading and rest-inserted loading are key

What can clients with osteoporosis start with to progress to weight bearing exercise?

May start with water- and cycle-based activities to improve muscular fitness; progress to WB

Osteoporosis?  Maintain ____ spine and ____ end-range flexion and rotation  ____ explosive or high-impact loading and lifting/lowering heavy weight from floor or overhead  May perform ____ training daily for up to 20 minutes

 Maintain neutral spine and avoid end-range flexion and rotation  Avoid explosive or high-impact loading and lifting/lowering heavy weight from floor or overhead  May perform balance training daily for up to 20 minutes

Forms of ____ ____ that are often comorbid and accompany other chronic diseases

Forms of psychological distress that are often comorbid and accompany other chronic diseases

____ and ____ can have altered autonomic control of CV response (↓ HRV)  May limit CRF testing due to abnormal or inadequate ____ response

anxiety and depression HR

 Exercise may interact with ____ ____  Inform patients that exercise response may be similar to ____ ____  Exercise prescription is same as for ____ ____  Exercise can be equally effective as ____ and ____  Non-adherence is common in individuals with ____

 Exercise may interact with psychoactive medication  Inform patients that exercise response may be similar to anxiety symptoms  Exercise prescription is same as for healthy population  Exercise can be equally effective as pharmacotherapy and psychotherapy  Non-adherence is common in individuals with depression