exercise biochemistry in clinical populations Flashcards
what does exercise biochemistry in clinical population investigate?
- changes in biochemical reactions during exercise
what is exercise described as?
- physiological stress
- pulls at the energy end as needs increased ATP
what happens to the metabolic processes if you are physically inactive?
- become less sufficient
- energy put in (food) blocks up the processes causing diseases
what are metabolic processes affected by?
- factors such as age
what are the three things we assess when looking at someone with a health condition?
- specific cell process
- organ health
- whole body health
what are the four factors that are examined?
- function
- size
- blood flow
- cell activity
relate the four factors examined to muscle health
- function= produce contractions
- size= dependent on response to training
- blood flow= oxygen and nutrient flow
- activity = ATP
what is sarcopenia?
- progressive and generalised muscle disorder whereby there is a loss of muscle mass and function
what increases sarcopenia?
- age
what is frailty defined as?
- clinical syndrome in which 3+ of the criteria are present
what are the criteria’s of frailty ? (5)
- un- intentional weight loss
- self- reported exhaustion
- weakness (grip strength)
- slow walking speed
- low physical activity
what has been frailty been argued to be?
- normal ageing
what does frailty cause high risks for?
- falls, disabilities, hospitalization, and mortality
what are people with frailty considered? what ability does it relate to?
- considered psychologically weak; disease of the brain
- relates to our ability to move around so can be defined as disease of the muscle
what are the measures of frailty?
- Garmin device
- blood sample (how responsive vessels were to BP changes)
- sit to stand test
- 6- minute walk test
what is the most common test for frailty?
- short physical performance battery
- handgrip strength, balance, chair stand and gait speed
what else do frailty measures investigate? what question does this raise?
- impact on anxiety, depression, fatigued, motivated and how vital they felt
- do underlying biochemical changes affect psychological status ?
what is frailty linked to?
- cardiovascular disease, diabetes and dementia
what is the UK biobank?
- large collection of data whereby people have donated their data from studies to a bank so others can access and review data
what risk was found in those with pre- frail and frail compared to non- frail?
- study found a higher risk of dementia in pre- frail and frail individuals> non- frail
By preventing frailty, how many dementia cases could be prevented?
- 9% of dementia cases prevented
what is the harzard ratio?
- measure of an effect of an intervention on an outcome of interest over time
what is the effect of frailty on diabetes?
- associated with incident DM in older community dwellers
- independent risk factor for morbidity and mortality in older DM patients
what is the effect of diabetes on frailty?
- linked to incident frailty
- predicts transition to higher- frailty level
- vascular complication of DM & malnutrition lead to functional decline
what are the 5 shared pathophysiology between frailty and diabetes?
- sarcopenic obesity
- hormonal & metabolic changes
- chronic inflammation
- oxidative stress
- mitochondrial dysfunction
what happens if the muscle is less able to function?
- muscle becomes less sensitive to glucose
- so movement is impacted
what does mitochondrial dysfunction affect?
- affects respiration so less ATP produced causing oxidated stress
what causes oxidated stress? can it be beneficial?
- occurs when oxidation and reduction are no longer in balance
- oxidative reactions can’t be suppressed
- can be beneficial to cause adaptations to exercise
what can continued oxidated stress cause?
- cell dysfunction
- this combined with mitochondrial dysfunction and chronic inflammation explains many diseases
what are biomarkers?
- biological markers that represent changes happening
how can you access information using biomarkers?
- from a blood sample
what are the most reliable biomarkers?
- stable
- quick to measure
what are common biomarkers? why are these easy to test?
- cholesterol, glucose, triglycerides
- within particular range in a healthy individual
what would be the ideal assessment for dementia? what is the limitation?
- brain biopsy
- dangerous as may lead to death
how is dementia assessed safely ? what is the limitation?
- brain fluid assessed
limitation= blood brain barrier filters the blood
what other assessment may you carry out to assess dementia? linked to spine
- lumbar puncture
- as brain fluid is exchanged with cerebrospinal fluid
- invasive
what happens if you leave a blood sample on the bench after you’ve taken it into a tube?
- natural clotting process of the blood will cause RBCs to clot at the bottom
what happens after the RBCs clot at the bottom?
- tube is left with a serum sample
- see through
what does the sample undergo and what layer forms?
- undergoes centrifugation
- white blood cells and platelets from a little later between the RBCs and plasma
what are biological sample described as? what does this require?
- complex mixtures
- requires separation techniques to allow the assessment of individual components
what do separation techniques rely on? what can they be separated based on?
- rely on using the properties of the separate components
- separated based on mass and change
what are the common separation techniques ?
- spectrophotometry
- mass spectroscopy
- chromatography
- western blotting
what is HBA1C? what should the level be below?
- biomarker used to measure average blood glucose levels to assess type 2 diabetes across 2-3 months
- should be below 42 mmol/ mol
what is HBA1C known as? what does this allow?
- known as glycated haemoglobin as sticks to RBCs meaning it is stable and accurate
- results aren’t affected by factors like eating
what is psychosis ?
- severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality
when is psychosis mainly diagnosed?
- at the age of 18-25
what are positive symptoms?
- symptoms that are added on
e.g., hallucinations, delusions
what are negative symptoms?
- taken away
e.g., lack of interest/ motivation
what are the benefits of intervening during the first episode of psychosis?
- may prevent the development of schizophrenia
- schizophrenia = complicated mental health problem
what is PANSS? what symptoms should be reduced and what should be increased?
- positive and negative symptom score
- positive reduced (no delusions)
- negative increased (gain vitality and motivation)
what was studied to investigate effect of exercise intensity?
- V02 max and HR max desired to capture people in moderate intensity range around 50-70%
- imaging used to demonstrate changes in the brain
why were levels of metabolic change, cytokines and inflammation studied relating to schizophrenia?
- showed that negative symptoms were much more associated with biochemical markers
- if individuals is inflamed then their immune system is behaving as if they’ve got an infection
- controlling inflammation w exercise reduced negative symptoms
when are questionnaire measures used?
- used alongside physiological measures to probe if biochemical changes have an effect on quality of life and if interventions affects quality of life
what are the 6 domains of functioning covered by WHODAA?
- cognition: understanding & communicating
- mobility : moving & getting around
- self- care : hygiene, dressing, eating & staying alone
- getting along w other people
- life activities: domestic responsibilities, leisure, work & school
- participation in community activities
what does WHOQUOL assess?
- individuals’ perceptions of their position in life in context of the culture and value systems in relation to goals, expectations, standards and concerns
how many settings was WHOQUOL developed in?
- developed in 15 cultural settings
- tested in 37 settings
- 29 language versions
what is involved in the physical health domain of WHOQUOL?
- mobility, daily activities, functional capacity, energy, pain, sleep
what is involved in psychological domain of WHOQUOL?
- self- image, negative thoughts, positive attitudes, self- esteem, learning ability, concentration, religion
what does interdisciplinary studies describe?
- how physiology and psychology can help us to understand health and disease
