exercise

Question 1

Who requires medical clearance?

Answer 1

asymptomatic with disease who does not usually exercise will require clearing between moderate and vigorous exercise.

Asymptomatic with disease who do usually exercise do not need clearance for mod exercise but do before vigorous activity.

Any symptomatic patient requires clearance for all exercise.

Question 2

NNHANES -3 (1988-1994) study and results?

Answer 2

only 33% with HTN councelled on PA

71% who were councelled decreased BP by 3-4mmHg

Question 3

Meta-analysis of office based physical activity councelling?

NNT?

Answer 3

13 papers
primary care
NNT = 12

Question 4

5 As?

Answer 4

ask
advice
agree
assist
FU

Question 5

Who are exercise stress tests used for?

Answer 5

intermediate pts e.g CP but negative Trop/HF with risks of syncope

1/10,000 - death

CI: mi 2 days ago, HTN emergencies, decomp HF, unstable angina, severe AS, aortic dissection, uncont. arrthymias.

Question 6

ARCT?

Answer 6

1. P.A councelling - small effect in older patients
2. councelling and Px - greatest effect

6 months later, 7 day recall

Older pt >50 years - double mod-vig PA - increased by 131 minutes
Younger patients - increased PA by just 31.5mins (7% chance of meeting guidelines)

Question 7

Activity counselling trial?

Answer 7

54 practices
3-4 mins PA advice

99% had advice
63% little or no increase in length
83% said it was as asset

Question 8

ACSM exercise programme?

Answer 8

1. Initial stage: 1-6 weeks - Moderate intensity (40-60% HRR), start 15 mins and progress to 30 mins,
   3-4 TIMES/WEEK
2. Improvement stage: 4-8 months - after target duration and frequency achieved, INCREASE INTENSITY

increase HR by no more than 5% every 6th session
increase duration by no more than 20% each week until 20-30 minute continuous mod-vig activity

3. Maintenance stage - reached goal, at least 0th percentirl in all health fitness

Question 9

HRR?

Answer 9

MAX HR - resting HR

max HR = 220- age

Question 10

What conditions require med clearance?

Answer 10

metabolic and renal

pulm disease - not needed, if uncontrolled may need to make accomodations

Question 11

Grip strength

Answer 11

indicator of mortality and functionality in elderly

Question 12

1 rep max indicator of?

Answer 12

muscle strength

Question 13

Muscular fitness correlates with?

Answer 13

<3 reps of a task prior to fatigue

Question 14

Subcut is proportional to?

Answer 14

total amount of body fat

Question 15

Calliper skin fold thickeness accuracy?

Answer 15

within 3.5%

Question 16

Flexibility test?

Answer 16

3 x sit and reach - checks lower back/hamstring flexibility

lower back - poor accuracy

Question 17

ACSM medical screening questions x 3? Groups?

Answer 17

1. current level of PA
2. desired level?
3. signs/symptoms of renal/metabolic disease?

Group 1 - clinically sig disease, benefit from med supervised programmes
Group 2 - uncontrolled med condition, needs TX/control before exercising

Question 18

ACSM recommended questionaire?

Answer 18

PAR-Q+ for everyone

Question 19

Medical screening death rates?

Answer 19

1/1.5million - men - vig

1/36.5million - females - mod-vig

Question 20

METs
1 MET
Sleeping?
2 flight stairs?
3mph walk?
running at 10mph?

Answer 20

METs - no good for intensity, absolute 
1 met - sitting 
sleeping - 0.9 
3pmh walk - 3 mets
run 10mph - 18 
2 stairs - 5 mets

Question 21

At work amount are METs per week beneficial?

Answer 21

10-20 METS/week most benefits
mortality decreases with any increase in MET hrs
Beneficial effect - plateau at 80 hrs

Question 22

Standing effect on mortality?

Answer 22

standing 2 hours = 10% decrease in all cause mortality

Question 23

Shanghai women’s health study?

Answer 23

87, 143 females 
40-70 yrs
FU 5.7 yrs 
1.  walk >1 hr/day = hazard ratio 0.65
2. 4 or more non-exercise P.A days = hazard ratio 0.60

20-40% risk reduction in the most active in both groups
health benefits from purposeful and non-exercise PA

Question 24

METs in mod and vig activity?

Answer 24

mod - 3-5.9

vig - >6

Question 25

Nurse’s health study?

Answer 25

significant decrease in all cause mortality with 1-1.9hrs of mod-vig P.A/week (risk reduction 0.82)

> 7hrs/week only slight decrease which is non-statiscially sig benefits (RR 0.82)

Question 26

Donnelly 2009 - dose response and magnitude of weight loss?

Answer 26

<150 mins - minimal loss
>150 mins/wk - modest loss - 2-3kg
>225-420 mins/wk - 5 - 7.5kg

PA - strong predictor of long-term weight maintenance

Question 27

Weekend warrior?

Answer 27

decreases all cause mortality in men

Question 28

Flack 2018 - 36 obese/OW?

Answer 28

1 Mile walk/run - burns 100 cals
high energy - lost 2.6kg over 12 weeks
low evergy - 0.8kg

Question 29

Aerobic guidelines for:
3-5yrs
6-17 yrs
18-64 yrs 
>65 yrs 
preg/PP
adults and chronic disease

Answer 29

3-5yrs - throughout the day, adults help imagination
6-17 yrs - 60mins mod/day, vig 3 x week
18-64 yrs - 150 mins mod/week, 75 mins vig act
>65 yrs as above
preg/PP as above, vig not CI if done before preg
adults and chronic disease - as above

Question 30

Strength guidelines:
3-5yrs
6-17 yrs
18-65yrs

Answer 30

3-5yrs - nil
6-17 yrs - 1 hour 3 x week
18-65yrs - 2-3/week (healthy - 1 set 8-12 reps, older/frail - 1 set 10-15 reps)
> 65 yrs - x2/week
adults and chronic diease - 2-3/week or as poss

Question 31

Flexibility guidelines?

Answer 31

health benefits unproven
2-3 x per weeks
10 mins per, 10-30 secs
2-4 reps each

dynamic, ballistic, static

Question 32

Balance guidelines?

Answer 32

no speific amount as per PAGA

3/week