Considerations for Clients with Chronic Disease Flashcards
Factors to modify training methods
Characteristics of the disease
Any restrictions that the disease places on clients and how they will respond to exercise
Disease severity
Safety concerns
Activities to emphasize
Activities to avoid
Coronary Artery Disease (atherosclerotic heart disease)
Narrowing of the coronary arteries that supply the heart muscle with blood and oxygen.
Inflammatory response within the arterial walls resulting from an initial injury (high BP, elevated LDL, elevated blood glucose, or other chemical agents
Exercise Guidelines for clients with cardiovascular disease (Cardiorespiratory Training)
Frequency: At least 3, but preferably 5x a week
Intensity: Moderate to vigorous
Time: Eventual goal of 20-60 mins
Type: Rhythmic, large muscle group exercise
Exercise Guidelines for clients with cardiovascular disease (Muscular Training)
Frequency: 2-3 days per week, 48 hrs rest
Intensity: 40-60% 1-RM, 10-15 reps, RPE 11-13
Time: N/A
Type: Various
Blood Pressure in Adults
Normal: <120, <80
Elevated: 120-129, <80
Stage 1 Hypertension: 130-139, 80-89
Stage 2 Hypertension: >140, >90
Lifestyle modifications to manage Hypertension
Weight reduction; BMI 18.5-24.9
Adopt DASH eating Plan
Dietary sodium reduction
Physical Activity
Moderation of Alcohol
Exercise Guidelines for clients with Hypertension (Cardiovascular Training)
Frequency: Most days of the week
Intensity: 40-59% HRR or VO2R, RPE 12-13, or Below VT1
Time: Eventual goal of 30 mins continuous
Type: Rhythmic, large muscle group exercise
Exercise Guidelines for clients with Hypertension (Muscular Training)
Frequency: 2-3 days week
Intensity: 60-80% 1 RM, 40-50% 1RM for older adults/novice
Time: 2-4 sets 8-12 reps
Type: Machine/free weights. Avoid Valsalva manuever
Exercise Guidelines for clients recovering from Stroke (Cardiovascular Training)
Frequency: 3-5 days per week
Intensity: 40-70% HRR, RPE 11-14
Time: Progressively increase from 20-60 mins. Consider multiple bouts through day
Type: Some use of equipment may need modifications
Exercise Guidelines for clients recovering from Stroke (Muscular Training)
Frequency: 2 nonconsecutive days/week
Intensity: 50-70% 1 RM
Time: 1-3 sets of 8-15 reps
Type: Use equipment and exercises that improve safety in those with deficits
Exercise Guidelines for clients with Peripheral Arterial Disease (Cardiovascular Training)
Frequency: 3-5 days/week
Intensity: Moderate, below VT1, do not exceed 3 out of 4 on claudication pain
Time: 30-45 mins, may progress to 60
Type: Weight bearing, walking
Exercise Guidelines for clients with Peripheral Arterial Disease (Muscular Training)
Frequency: At least 2 nonconsecutive days
Intensity: 60-80% 1 RM
Time: 2-3 sets, 8-12 reps
Type: Whole body, emphasize lower limbs if time is limited
Peripheral Arterial Disease
Atherosclerosis of the arteries of the lower extremities. Most common sites are abdominal aorta, and the iliac, femoral, popliteal, and tibial arteries
Dyslipidemia
Undesirable levels of lipids
Low Density Lipoprotein (LDL)
Contains 60-70% of body’s total cholesterol. “Bad” due to role in atherogenesis
Very low density lipoprotein (VLDL)
Major carrier of triglycerides, contains 10-15% of the body’s total cholesterol
Intermediate density lipoprotein (IDL)
Transports a variety of TG fats and cholesterol in the bloodstream and promotes atherogenesis. Formed from the breakdown of VLDL.
High density lipoprotein (HDL)
“Good” cholesterol. Produced in the small intestine and liver and normally contains 20-30% of total cholesterol. Transports lipids to the liver for recycling and removal.
Non-HDL
Total cholesterol minus HDL
LDL Cholesterol Levels (mg/dL)
Optimal: <100
Near/Above optimal: 100-129
Borderline high: 130-159
High: 160-189
Very high: >190
HDL Cholesterol Levels
Low: <40
High: >60
Total Cholesterol Levels
Desirable: <200
Borderline high: 200-239
High: >240
Classification of Triglycerides (mg/dL)
Normal: <150
Borderline high: 150-199
High: 200-499
Very High: >500
Exercise Guidelines for clients with Dyslipidemia (Cardiovascular Training)
Frequency: 5 or more days/week
Intensity: Below, at and above VT1, below VT2. 40-75% HRR
Time: 30-60 mins
Type: Rhythmic large muscle group exercise
