EXERCISE MANAGEMENT Flashcards
Exercise management principles of SOAP
Formulating the (P)lan!
- exercise prescription
- exercise prescription must have short and long term plans
- understand risks vs benefits
- potential risks: symptoms increase, falling, injury, pain, fatigue, disease, symptoms, etc
SMART stands for?
Specific, measure, actionable, realistic, time
Explain “S” from SMART.
Goals must be specific and clearly defined.
“I should exercise more” vs. “I should exercise 20 min each session, 3 days per week”
Explain “M” from SMART.
Goals must use real endpoints to measure success.
“I should increase my walking capacity” vs “should increase my walking capacity by 20% and endurance by 20% in 2 months”
Explain “A” from SMART.
Outline specific steps that will enable you to successfully complete your goal.
“I want to be able to…” vs. “I want to. And so, I will achieve this by walking shorter distances 4 days a week; a 500m walk at a slower speed and 300-400m at a faster speed.”
Explain “R” from SMART.
Realistic
Goal that your participant has a good chance to achieve. (Increased self-efficacy)
Explain “T” from SMART.
Time oriented.
A time frame for the accomplishment of a goal is provided. (Deadlines help participants achieve their goals)
WHat does your participant have more control over?
BEHAVIOURAL actions (like walking 3x a week) versus OUTCOME-ORIENTED goals like (losing 15 lbs)
Exercise prescription is both: ______ and _______
art and science
What is the science of exercise prescription?
tests, measurements, collection, analysis of exercise data
What is the art of exercise prescription?
FINE TUNING the exercise program to meet individuals NEEDS while observing their physical limitations. (personality preferences, motivation etc)
What is the exercise-dose response?
What is the dose-response relationship of exercise training for each disease and disability?
What is ACTION from the exercise dose response?
Medicines: type of chemical
Exercise: family of exercise (the type, ex: aerobic training)
What is DOSE from the exercise dose response?
Medicines: function of bioavailability
Exercise: function of intensity and duration
What is HALF-LIFE (lasting effect) from the exercise dose response?
Medicines: Metabolism of the medicine
Exercise: Length of time for recovery from an exercise session
What is the benefit of decreasing the dose of either medication or exercise?
Increasing the frequency!
SO its better to take low doses of meds and just take them more often during the week.
SO its better to do low intensity low duration and just do more exercise more often int he week.
From the exercise dose graph, what section do we try to keep our participants in?
“sweet spot”
In participants with chronic disease and disability, we try to avoid:
HARMFUL DOSE
Why do we try to avoid harmful dose?
can cause relapse
What should we learn to balance with exercise dose-response relationship?
frequency, intensity, duration type of exercise time to recovery
Manipulating which variable is usually most stressful for older adults having disability or chronic disease?
intensity
Exercise involves which 2 types of risk?
Disease-dependant risk
Activity dependant risk
What is disease-dependant risk?
risks that are inherent (existing permanently ins omeone) because of the presence of the disease
EX HEART ATTACK, SUDDEN DEATH, STROKE. Risk? Exacerbation of symptoms
What is the activity dependent risk?
Risk that may occur (injury) because of the participation in physical activity.
EX ANKLE SPRAIN, FALLS, ETC
Which is the more important type of risk?
Disease-dependant
Falling no big deal, vs heart attack, big deal!
Costs of PA include:
Time Energy Money Transportation Adapted equipment SYMPTOMS CAN INCREASE
Benefits of PA include:
Improvement in physical and or functional performance
regression of disease
aging decline
quality of life
Guildelines for spinal cord injury are appropriate guidelines for which populations??
Acute spinal cord injury, those who are pregnant, have an active infection, susceptible to autonomic dysreflexia, chronic medical condition beyond spinal cord injury
What is autonomic dysreflexia?
Dangerous clinical syndrome that develops in individuals with spinal cord injury, resulting in acute, uncontrolled hypertension.
Autonomic dysreflexia develops in those with a neurologic level of spinal cord injury….. where?
AT or ABOVE the 6th thoracic vertebral level (T6).
What does autonomic dysreflexia cause?
Imbalanced reflex sympathetic discharge, leading to hypertension
What happens if autonomic dysreflexia is left untreated?
Causes seizures, retinal hemorrhage, pulmonary edema, renal insufficiency, myocardial infarction, cerebral hemorrhage, and death.
explain what happens in the body with autonomic dysreflexia.
A strong sensory input (not necessarily noxious) is carried intot he spinal cord VIA intact peripheral nerves. The most common origins are bladder and bowel. This strong sensory input travels up the spinal cord and evokes a massive reflex sympathetic response.
Autonomic dysreflexia values for increased systolic and diastolic are?
systolic - 250-300mmHg
diastolic - 100-120mmHg
PA guidelines for adults with SCI vs ACSM: AEROBIC [How often?]
2 times per week
ACSM: 3 to 5 times per week
PA guidelines for adults with SCI vs ACSM: STRENGTH TRAINING [How often?]
2 times per week
ACSM: 2 to 4 times per week
PA guidelines for adults with SCI vs ACSM: AEROBIC [How much?]
at least 20 minutes per aerobic session
ACSM: 20-60 min per session
PA guidelines for adults with SCI vs ACSM: STRENGTH TRANING [How much?]
3 sets of 8-10 reps
ACSM: 2-3 sets of 8-10 reps
SAME
PA guidelines for adults with SCI vs ACSM: AEROBIC [How hard?]
Mod - vigorous
PA guidelines for adults with SCI vs ACSM: AEROBIC [How to?]
upper lower and whole body exercises
PA guidelines for adults with SCI vs ACSM: STRENGTH TRAINING [How to?]
Free weights, elastic bands, cable pulleys, weight machines, functional electrical stimulation
Which professionals should you approach before you ebgin your exercise prescription if you are newly injured, pregnant or prone to autonomic dysreflexia or have other medical conditions?
doctor
PT
qualified exercise professional
Benefits of PA for SCI
better endurance for w/c easier transfers in and out of chair enhanced selfcare and mobility better overall health and QofL more energy more social interaction with others
Being active can have other benefits: less pain lower risk of stress lower risk of depression reduced cholesterol and fats in blood improved ability to regulate blood glucose decreases risk for diabetes better sleep
3 things you can do to not back out of your own goals and stick to them!
use action cues - ex: if you gotta go swimming after work, place goggles beside your computer
focus on first stages of getting ready - focus on dressing up and leaving the house instead of the plans for the day
make exercise plans with others - to motivate
The “Action” plan is critical for?
increased adherence
3 simple steps in writing an action plan
1 - choose an appropriate length of time to plan (weekly calendar) 2 - choose exercises to meet aerobic and endurance training recommendations 3 - add this into your calendar: WHAT activities? WHERE are you doing them? WHEN will you do them? HOW LONG will it take to do it? HOW HARD will it be?
Obstacles to exercise
no time
physical barriers
lack of support
i cant
If you have pressure sores from exercise (for SCI), what should you do?
shift body every 10-15 min
consider equipping wheelchair
Why should you stay cool during exercise for SCI?
sweating may be inhibited below the level of injury so might not know your level of heat temp
spray yourself with spray bottle
If you think you’re expressing AD, what should you do?
remain sitting up
Relationship between PA and parkinsons
if you exercise, you improve strength, flex, balance, symptoms and sense of well being
PARKINSONS: Consult doctor before starting an exercise program, especially if you have other health issues OR are above the age of ____
60
PARKINSONS: medications should be taken…
on time
PARKINSONS: warm up is how long?
3-5 min
before and after exercise
PARKINSONS: exercise should start with (shorter/longer) periods of exercise and gradually (decrease/increase).
shorter,
increase
