Exercise and lifestyle medicine

Question 1

Physiological benefits of exercise

Answer 1

hyperlipidaemia, T2DM, osteoarthrotos, osteoporosis, back pain, CF, COPD

Question 2

Psychological benefits of exercising

Answer 2

anxiety, stress, memory, depression, schizophrenia

Question 3

CVS impacts exervise

Answer 3

• Increased sympathetic activity to SAN, decreased PS activity (increased HR)
• Increased sympathetic nerve = increased contractions of myocardium (increased SV)
• Increased SV and ejection increase BP

Question 4

Why does HR increase during exercise

Answer 4

Increased sympathetic to SAN

Question 5

Why does SV increase during exercise

Answer 5

increased sympathetic = increased contraction

Question 6

Why does CO increase during exercise

Answer 6

HR x SV

Question 7

What happens to systolic BP when you exercise

Answer 7

SV and ejection increase = increased systolic BP

Question 8

Why does diastolic BP increase only a little when you exercise

Answer 8

When heart fills, pressure in major arteries is influenced by SVR
Decreased DVR remains low after exercise

Question 9

Why does blood flow decrease to abdo organs when you exercise

Answer 9

Increased sympathetic nerve (a1) constricts arterioles in abdo organs and kidneys

Question 10

Why does blood flow to brain remain the same in exercise

Answer 10

autoregulation of brain arterioles

Question 11

post-exercise hypotension

Answer 11

• Persistent vasodilation results in low SVR following exercise (low catecholamines, increase in local vasodilatory factors)
• Reduced CO (decreased sympathetic activity and increased parasympathetic)
• Improved baroreceptor reflex sensitivity - new lower set point
• Re-distribution of blood to periphery (reflex vasodilation of skin arterioles due to increased body temp)

Question 12

Why is exercise important in old age

Answer 12

Improves bone and muscle strength - reduced risk of falls and fragility fractures

Question 13

Which type of exercise has the most benefits

Answer 13

moderate - vigorous exercise

Question 14

exercise guidance 19-64

Answer 14

• 2 days a week muscle strengthening
• 2.5 hours a week of moderate intensity - walking or cycling
• 75 mins vigorous intensity (running)

Question 15

Psychological affects of exercis

Answer 15

Endogenous neurotropic release and opioid release = antidepressants
Acute stress stimulated SAM and HPA axis (cortisol) = improved reaction to stress
Increased neurogenesis in hippocampus (linked to pre-frontal cortex)

Question 16

Exercise guidance 65+

Answer 16

• 2.5 hours of moderate aerobic activity
• Muscle strength, balance and flexibility 2 days per week
• Weight bearing activities = good bone health

Question 17

NICE guidelines depression exercise

Answer 17

Nice guidance exercise in depression: group exercise 3x a week with mild/moderate depression of up to 1hr over 10-14 weeks