Exercise in Preventive Medicine Flashcards
Discuss several behavioral steps a healthcare provider may suggest to their patients to maintain a healthy diet.
- Behavioral modifications: SMART goals, emotional eating, sleep deprivation Specific Measurable Achieveable Rearding Time specific
- Make easy substitutions, cut out one thing not everything, try and portion control. Etc.
- Diet modifications
- Caloric deficit
List 3 medications that have been approved by the FDA for the treatment of obesity.
- Orlistat (xenical, alli)
- Phentermine-topiramate (qsymia)
- Natrexone-bupropion (contrave)
Describe the ideal candidate for surgical intervention in the treatment for obesity
- BMI > 35 with at least one comorbid condition
- BMI > 40
- Evaluation by gastroenterologist and psychiatrist
Recommend exercise guidelines for a healthy 45 y/o male patient, according to the Physical Activity Guidelines for Americans. Be sure to include the following:
Duration, frequency, and type of exercise=
Aerobic Activity: jogging, yard work, heavy lifting, workout classes, swimming, etc.
150-300 minutes of moderate PA/week
75 minutes of vigorous PA/week or equivalent combination spread throughout the week
Addition of muscle-strengthening activities and provide examples.
Heavy lifting, weight training, heavy yard work, etc.
Muscle strengthening activities at moderate or greater intensity (all major muscle groups) on 2 or more days/week
Difference between moderate-intensity and vigorous-intensity
See quizlet
Explain the mental and physical benefits of exercise.
See quizlet
Determine a list of barriers to participation in physical activity for which a sedentary client might propose.
- Top 3: Time, Energy Motivation
- Inconvenience of exercise, unfamiliarity with equipment, lack of enjoyment from exercise, fear o finjury, bordeom, lack of confidence in abilities, lack of support, etc.
- Pts often need counseling and encouragement to try to understand how they can better overcome their barriers.
Explain how the Social Cognitive Theory may be used to help counsel a patient on participation in physical activity.
- Definition: a behavior theory of human motivation and action. Cognitive, behavioral, and environmental factors will dynamically interact to shape human behavior.
- Cognitive factors: knowledge, expectations, attitudes, motivation, fitness level
- Behavioral factors: skills, practice, self-efficacy
- Environmental factors: social norms, support, access in the community, influence on others
Explain how the Trans-theoretical Theory may be used to help counsel a patient on participation in physical activity.
- Definition: an integrative theory of therapy that assesses a person’s readiness to change a behavior (stages of change)
- 5 stages: Precontemplation, Contemplation, Preparation, action, maintenance
- Patients can exit and re-eneter cycle at any stage
Describe the general principles of PACE (Patient-centered Assessment and Counseling for Exercise) and defend the importance of each.
Patient-Centered Assessment and Counseling for Exercise
- Questionnaire for pts to help physicians better understand how they can counsel patients on increasing physical activity level
- Incorporates concepts from the social cognitive theory and the TTM
- The GOAL is to meet pts where they are at and help them to engage in regular exercise at an itnensity level that is best for them
Decide and explain how recommendations for physical activity in children and adolescents might differ from recommendations for physical activity in adults.
- 60 min of moderate or vigorous physical activity/DAY, including at least 3 days of vigorous PA/week
- 3 days/week and included as part of the 60 min daily of PA; bone-loading activities
- Age 3-5: to improve bone health and weight status
- Age 6-13: to improve cognitive function
Calculate the a) maximum heart rate and b) target heart rate for a 40 y/o female patient. Define the threshold which should be maintained to consider exercise beneficial.
Calculating Maximum Heartrate
Estimated maximum age-related heart rate: 220 - age
EX: 220-40= 180 max hr
Calculating target heart rate
Moderate intensity: 64-76% of maximum level
EX: at 64%–> 180 x 0.64= 112
EX: at 76%–> 180 x 0.76= 136.8
Vigorous intensity: 77-93% of maximum level
EX: at 77%–> 180 x 0.77= 138.6
EX: at 93%–> 180 x 0.93= 167.4
Predict which high-risk patients might pose a definite risk for an adverse outcome from regular exercise and thus require a thorough clinical evaluation prior to starting an exercise regimen.
- Cardiovascular disease
Hypertension, hyperlipidemia, peripheral vascular disease, cerebrovascular disease - Metabolic disease
Diabetes mellitus - Renal disease
- Musculoskeletal issues
Osteoarthritis, osteoporosis, injury - Concerning signs or symptoms at rest or during exercise: pain, discomfort in chest, neck, jaw, arm, or other areas related to ischemia, significant shortness of breath, dizziness, syncope, othropnea, paroxysmal nocturnal dyspnea, ankle edema, tachycardia, palpitations, intermittent claudication, known heart murmur, unusual fatigue
Outline the diagnostic criteria for metabolic syndrome
- Definition: a cluster of conditions that increase the risk of heart disease, stroke, and diabetes
- Major components: high BP, high BG, excess abdominal fat/waist circumference, abnormal lipid levels
- Diagnosis is made if at least 3 of the 5 criteria are met
Glucose: fasting glucose >= 100 or drug treatment for elevated glucose
HDL cholesterol: = 150 or drug treatment for elevated trigs
Obesity: waist >= 102 cm in men and 88 in women
Hypertension: >= 130/85 or drug treatment - Lifestyle modifications to decrease the risk of metabolic syndrome: weight management, exercise, healthy diet, and smoking cessation
- Removal of adipose tissue with liposuction does not decrease risk of heart disease or improve insulin sensitivity.
