Exam 1 Flashcards
physical activity
any movements from skeletal muscles that substantially increase energy expenditure
movement is typically characterized by …
energy expenditure (kcals)
exercise
planned, purposeful, structured, repetitive movement with a goal in mind to enhance physical fitness
health related components of physical fitness
muscular endurance, muscular strength, flexibility, body composition, & cardiovascular endurance
skill-related components of physical fitness
balance, coordination, reaction time
physical activity domains
HOTEL
H - household
O - occupational
T - transport
E - exercise
L - leisure-time activity
1 MET
energy cost of rest (3.5 ml/kg/min)
< 3 METS
light intensity
3-6 METS
moderate intensity
> 6 METS
vigorous intensity
moderate intensity (verbal explanation)
heart rate increases but can maintain constant conversation
vigorous intensity (verbal explanation)
can only speak in choppy language
karvonen equation
[(max - rest) %] + rest
MODERATE INTENSITY examples
Brisk walk (3 mph)
Water aerobics
Slow biking (<10 mph)
Dancing
Light gardening
VIGOROUS INTENSITY examples
Jogging/running
Lap swimming
Biking > 10 mph
Heavy gardening (digging)
Backpacking
light intensity % HRR or % VO2R
30 -39
moderate intensity % HRR or % VO2R
40 - 59
vigorous intensity % HRR or % VO2R
60 - 89
benefits of regular physical activity and exercise (improvement in cardiovascular and respiratory function)
Increase maximal oxygen uptake (VO2 max)
Increase capillary density
Increase exercise threshold for the onset of disease signs/symptoms
benefits of regular physical activity and exercise (at submaximal intensities)
Lower the myocardial oxygen cost
Decrease heart rate and blood pressure (cardiac stress)
Decrease ventilation
Collectively, physical tasks are easier to accomplish
improves musculoskeletal health
benefits of regular physical activity and exercise (Improve cardiovascular disease risk factors)
Decrease blood pressure (systolic and diastolic)
Increase HDL, decrease triglycerides
Decrease body fat (subcutaneous and visceral)
Improve metabolism
benefits of regular physical activity and exercise (Decrease morbidity and mortality through primary and secondary prevention)
morbidity - state of being unhealthy for a particular disease or situation
mortality - # of deaths that occur in a population
purposes of pre-participation health screening
Identify those with significant medical disease that would prohibit them from exercising until those conditions have been stabilized or removed
Identify those with chronic disease/condition that require a medically supervised exercise program
Identify those at increased risk for disease due to signs and symptoms
Identify any special needs and medical clearance
Safety and liability
Establish rapport (History, Preferences, Build trust)
Overall, risks …. with increasing intensity and …. as the frequency of activity decreases.
increase
decrease
pre-participation screening
Gather information on…
Health/medical history and current medical conditions
Medications
Risk factors, sign/symptoms of disease
Current physical activity habits
Pre-participation Screening Algorithm
Step 1) Classify individuals who do or do not currently participate in regular exercise (in the last 3 months, 3 days per week, 30 minutes moderate)
Step 2) Identify individuals with known CV, metabolic, or renal diseases or those with signs or symptoms suggestive of cardiac, peripheral vascular, or cerebrovascular disease, Types 1 and 2 diabetes mellitus (DM), and renal disease
Step 3) Identify desired exercise intensity
Signs/Symptoms Suggestive of Cardiovascular, Pulmonary, or Metabolic Disease
Pain: discomfort in chest, neck, jaw, arms (ischemia)
Dyspnea - difficult or labored breathing
Syncope - fainting
Orthopnea or paroxysmal nocturnal dyspnea
Ankle edema
Palpitations or tachycardia
Intermittent claudication
Heart murmur
Unusual fatigue or shortness of breath with usual activities
Cardiovascular Risk Factors
Age:
Men 45+
Women 55+
Family History:
MI/surgery or sudden death before 55 in father or other male first-degree relative
MI/surgery or sudden death before 65 in mother or other female first-degree relative
Smoking:
Current
Quit within 6 months
Sedentary Lifestyle:
Not engaged in500-1,000 MET-min of moderate-to-vigorous physical activity or 75-150 min per week of moderate-to-vigorous intensity physical activity
Obesity:
BMI > 30 kg
Waist girth > 102 cm (40 in) for men
Waist girth > 88 cm 38 in for women
- Hypertension *
Systolic > 130 mmHg (at least 2 separate occasions)
Diastolic > 80 mmHg (at least 2 separate occasions)
Antihypertensive medication
Drug to eliminate category, count that category
Dyslipidemia – abnormal fat in the blood
LDL > 130 mg/dL
HDL < 40 mg/dL
Total > 200 mg/dL
Lipid lowering medication
Prediabetes
Fasting glucose > 100 mg/dL
2 hour tolerance test > 140 mg/dL
NEGATIVE risk factor: HDL > 66 mg/dL
This is a good thing!
PULMONARY RISK FACTORS
Asthma
Exercise-induced asthma/bronchospasm
Extreme breathlessness at rest or during exercise
Chronic bronchitis
Emphysema
MUSCULOSKELETAL RISK FACTORS
Acute or chronic pain
Osteoarthritis
Rheumatoid arthritis
Osteoporosis
Inflammation/pain
Low back pain
informed consent
Summary of the background/ purpose(s)
Explanation of the procedures
Description of any and all risks
Description of the benefits
An offer to answer any questions
A statement that the individual is free to withdraw at any time
A statement that the participant is free to refuse to answer specific items or questions
A statement about confidentially
physical examination
Heart Rate/rhythm
Blood Pressure (seated, supine, standing)
Anthropometrics:
Height, weight, BMI, waist:hip ratio, body composition (% fat)
Palpation and auscultation of arteries
Evaluation of the abdomen
Palpation, inspection of lower extremities
Neurologic function (reflexes and cognition)
Inspection of the skin
Heart Rate Regulation (parasympathetic nervous system)
(vagus nerve)
SA and AV node
Slows heart rate (acetylcholine)
Rest: parasympathetic tone
resting heart rate
Common indicator of cardiorespiratory fitness and overall well-being!
Gravity, body works harder while standing
Normal heart rate range? 60-80
Bradycardia?
<60
Tachycardia?
>100
Heart Rate Regulation (sympathetic nervous system)
(cardiac accelerator nerves)
SA and AV node, ventricles
Increases heart rate and contraction force
blood pressure
Force of blood against the walls of the arteries and veins created by the heart as it pumps blood to every part of the body
Not the same throughout body
Measure arterial, heart-level BP
Systolic Blood Pressure (SBP)
Maximum pressure in the arteries when the ventricles contract
Represents left ventricular functioning (key indicator of CV function during exercise)
Diastolic Blood Pressure (DBP)
Minimum pressure in the arteries when the ventricles relax
Reflects the peripheral resistance in the arterial vessels to blood flow
Hypertension – “Silent Killer”
High blood pressure is a major risk factor for stroke, heart attack, heart failure and kidney failure.
Heart must pump harder
Arteries carry blood under greater pressure.
Over time, heart and artery function can decrease, and also impact other organs
lowering blood pressure
Physical activity
Reduce body weight
Diet rich in fruits, vegetables, and low-fat dairy
Reduced sodium consumption
Alcohol in moderation
Medications
Cholesterol
Fat-like substance (lipid), present in cell membranes, a precursor of bile acids and steroid hormones.
low density lipoproteins (LDL)
60–70 percent of the total serum cholesterol
major atherogenic lipoprotein
high density lipoproteins (HDL)
20–30 percent of the total serum cholesterol
very low density lipoproteins (VLDL)
triglyceride-rich lipoproteins
contain 10–15 percent of the total serum cholesterol
FITT-VP principle of exercise prescription
Frequency (how often)
Intensity (how hard)
Time (duration or how long)
Type (mode or what kind)
Total Volume (amount)
Progression (advancement)
how to reduce musculoskeletal injuries
including a warm-up and cool-down, stretching exercises, and gradual progression of volume and intensity.
warm up
“…allows the body to adjust to changing physiologic, biomechanical, and bioenergetic demands…”
Increase heart rate
Increase respiratory rate
Redirect blood flow
Prime metabolic systems
Focus or getting mentally dialed in
cool down
Blood pooling
Delayed onset muscle soreness
Recovery (metabolism, hormones, blood circulation, temperature)
Aerobic exercise is recommended on 3–5 day/week for most adults, with the frequency varying with the intensity of exercise.
Improvements in cardiorespiratory fitness are lowered with exercise frequencies more than 3 day/week and commonly plateau in improvement with exercise done more than 5 day/week.
Vigorous intensity exercise performed more than 5 day/week might increase the incidence of musculoskeletal injury
