Exercise in Chronic Disease and Disability Flashcards
AIDS
Progressive destruction of CD4 or T-helper cells -> immunosupression
AIDS Effects
Increased susceptibility to infection
Decreased food consumption
Loss of lean body mass
Advanced tissue wasting
AIDS Complications
CV/Met abnormalities Chronic diarrhea Anemia Muscle wasting Peripheral neuropathy
Stage 1 AIDS
Asymptomatic seropositive HIV
Exercise capacity unaffected
Stage 2 AIDS
Early symptomatic HIV
Reduced VO2 peak and ventilatory threshold
Stage 3 AIDS
Dramatically reduced VO2 peak
High intensity levels may elicit nervous and endocrine abnormalities
Aerobic Training with AIDS Frequency
3-5 days/wk
Aerobic Training with AIDS Intensity
40-60% VO2 or HRR
Aerobic Training with AIDS Time
10 min -> 30-60 min
Aerobic Training with AIDS Type
Individual
Include WB
Avoid high risk/contact
Aerobic Training with AIDS Goal
Improve aerobic capacity over 3-6 mos
Resistance Training with AIDS Frequency
2-3 days/wk
Resistance Training with AIDS Intensity
10-12 rep
2-3 set
50% 1 RM
Resistance Training with AIDS Goal
Improved muscle strength, power and endurance over 3-6 mos
AIDS Special Considerations
STRICT adherence to precautions
Use standard contraindications for exercise
Supervise symptomatic and comorbidities in individuals
SCI Complications
Paresis Atrophy Spasticity Impaired skin integrity Autonomic dysreflexia Respiratory dysfunction Bowel/bladder dysfunction Orthostatic hypotension
Autonomic Dysreflexia
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
Oxygen Consumption
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
SCI Special Considerations
Depression TBI Improvements may be small Closely monitor vitals Abdominal binders, TED or compression may be beneficial
Aerobic Training with SCI Frequency
3-5 days/wk
Aerobic Training with SCI Intensity
40-60% VO2 reserve and progress to 60-80% of VO2 reserve
Aerobic Training with SCI Time
30-60 min
Mod 5-10 min with 5 min active recovery
Vig 10 20 min with 5 min active recovery
Aerobic Training with SCI Type
Arm or w/c ergometer
Swimming
Adapted aerobics
FES
Aerobic Training with SCI Goals
Increase active muscle mass and strength
Maximize overal strength for functional independence
Improve efficiency of manual W/C propulsion