Exercise in Chronic Disease and Disability Flashcards

1
Q

AIDS

A

Progressive destruction of CD4 or T-helper cells -> immunosupression

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2
Q

AIDS Effects

A

Increased susceptibility to infection
Decreased food consumption
Loss of lean body mass
Advanced tissue wasting

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3
Q

AIDS Complications

A
CV/Met abnormalities
Chronic diarrhea
Anemia
Muscle wasting
Peripheral neuropathy
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4
Q

Stage 1 AIDS

A

Asymptomatic seropositive HIV

Exercise capacity unaffected

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5
Q

Stage 2 AIDS

A

Early symptomatic HIV

Reduced VO2 peak and ventilatory threshold

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6
Q

Stage 3 AIDS

A

Dramatically reduced VO2 peak

High intensity levels may elicit nervous and endocrine abnormalities

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7
Q

Aerobic Training with AIDS Frequency

A

3-5 days/wk

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8
Q

Aerobic Training with AIDS Intensity

A

40-60% VO2 or HRR

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9
Q

Aerobic Training with AIDS Time

A

10 min -> 30-60 min

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10
Q

Aerobic Training with AIDS Type

A

Individual
Include WB
Avoid high risk/contact

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11
Q

Aerobic Training with AIDS Goal

A

Improve aerobic capacity over 3-6 mos

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12
Q

Resistance Training with AIDS Frequency

A

2-3 days/wk

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13
Q

Resistance Training with AIDS Intensity

A

10-12 rep
2-3 set
50% 1 RM

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14
Q

Resistance Training with AIDS Goal

A

Improved muscle strength, power and endurance over 3-6 mos

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15
Q

AIDS Special Considerations

A

STRICT adherence to precautions
Use standard contraindications for exercise
Supervise symptomatic and comorbidities in individuals

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16
Q

SCI Complications

A
Paresis
Atrophy
Spasticity
Impaired skin integrity
Autonomic dysreflexia
Respiratory dysfunction
Bowel/bladder dysfunction
Orthostatic hypotension
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17
Q

Autonomic Dysreflexia

A
Risk of SCI above T6
Due to kinked catheter, tight clothing
Could lead to malignant HTN
Sit them up, find cause and get help
Disruption of sympathetic innervation may limit HR to 115-130
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18
Q

Oxygen Consumption

A

VO2 peak may decrease by 26%
UE estimates VO2 by 1/2 compared to LE ergometry
Quadriplegia reduces VO2 values by 1/2-1/3 compared to paraplegia
May experience fatigue before achieving sufficient CV capacity

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19
Q

SCI Special Considerations

A
Depression
TBI 
Improvements may be small
Closely monitor vitals
Abdominal binders, TED or compression may be beneficial
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20
Q

Aerobic Training with SCI Frequency

A

3-5 days/wk

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21
Q

Aerobic Training with SCI Intensity

A

40-60% VO2 reserve and progress to 60-80% of VO2 reserve

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22
Q

Aerobic Training with SCI Time

A

30-60 min
Mod 5-10 min with 5 min active recovery
Vig 10 20 min with 5 min active recovery

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23
Q

Aerobic Training with SCI Type

A

Arm or w/c ergometer
Swimming
Adapted aerobics
FES

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24
Q

Aerobic Training with SCI Goals

A

Increase active muscle mass and strength
Maximize overal strength for functional independence
Improve efficiency of manual W/C propulsion

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25
Q

Flexibility Training with SCI Goals

A

Improve/maintain ROM
Prevent contracture
Prevent injury

26
Q

Resistance Training with SCI Frequency

A

2-4 days/wk

27
Q

Resistance Training with SCI Intensity

A

2-3 x 8-12

28
Q

Resistance Training with SCI Type

A

Weight machines or free weights

Wrist weights if hand impaired

29
Q

Resistance Training with SCI Goals

A

Increase strength and muscle mass
Maximize functional independence
Facilitate w/c propulsion

30
Q

Diabetes

A

Chronic metabolic disease
Absolute (Type I)
Relative (Type II)
Hyperglycemia (blood glucose > 120 mg/dL)

31
Q

Diabetes Complications (Macrovascular)

A

CVD
CVA
PVD

32
Q

Diabetes Complications (Microvascular)

A

Retinopathy
Nephropathy
Neuropathy

33
Q

Benefits of Exercise

A
Improves insulin sensitivity
Improves lipid profile
Reduces blood pressure
Promotes weight loss
Increases strength
Improves well-being
34
Q

ACSM 2014 Guidelines

A

Testing not necessary for asymptomatic and low risk individuals
GXT with EKG conducted in those >35 years old or with type I DM > 15 years or type II DM > 10 years who want to begin moderate to vigorous intensity exercise
CVD risk factors assessed annually

35
Q

Aerobic Training with DM Frequency

A

3-7 d/wk

36
Q

Aerobic Training with DM Intensity

A

40-60% VO2 reserve or 11-13 RPE

>60% - improved glycemic control

37
Q

Aerobic Training with DM Time

A

150 min/wk in >10 min bouts

38
Q

Aerobic Training with DM Type

A

Emphasize large muscle groupes

39
Q

Resistance Training with DM

A

General guidelines apply in absence of retinopathy and other complications
Adjust parameters as needed

40
Q

Retinopathy

A

Avoid vigorous intensity active and resistance training

Have doctor clear

41
Q

Peripheral Neuropathy

A

Enforce regular foot checks

Limit WBing activities

42
Q

Autonomic Neuropathy

A

Monitor BP and HR closely

43
Q

Nephropathy

A

No restrictions for tolerable moderate activity

44
Q

DM Special Considerations

A

Closely monitor blood sugar (>250 or

45
Q

CKD Diagnosis

A

Microalbuminuria

GFR rate

46
Q

CKD

A

Loss of function reduces clearance of metabolic waste

47
Q

End-stage Renal Disease

A

GFR

48
Q

CKD Complications

A
Metabolic Acidosis
LVH
Secondary hyperparathyroidism
PRN
Elevated triglycerides and decreased HDLs
49
Q

ESRDj Complications

A
CHF
Cardiomegaly
Effusion
Dysrhythmias
Renal osteodystrophy
Peritonitis
50
Q

CKD Management

A

Dialysis
Kidney transplant
Medications

51
Q

CKD Exercise

A
Low tolerance
Blunted HR response
Excessive BR responce
Lower extremity fatigue
Limited ADLs
52
Q

Aerobic Training with CKD Frequency

A

3-5x/wk

53
Q

Aerobic Training with CKD Intensity

A

40-60% VO2 reserve or RPE 11-13

54
Q

Aerobic Training with CKD Time

A

20-60 minutes

In as little as 3-5 minute bouts

55
Q

Aerobic Training with CKD Type

A

Walking
Cycling
Swimming

56
Q

Aerobic Training with CKD Progression

A

Increase duration in 3-5 min weekly increments

57
Q

Resistance Training with CKD Frequency

A

2-3 days/wk

58
Q

Resistance Training with CKD Intensity

A

1 set of 10-15 reps @ 70%

Don’t want to do 1 RM

59
Q

Resistance Training with CKD Type

A

Weigh machines or free weights

60
Q

CKD Special Considerations

A
Avoid post-dialysis
Exercise during 1st half of dialysis
Be aware of AV fistula
Spontaneous avulsion fractures may occur
Could work out as early as 8 days post-op