Exercise Prescription

Question 1

Exercise Guidelines for Americans

Answer 1

1. avoid inactivity
2. 150 mins/week of moderate intensity exercise or 75 min of vigorous intensity exercise
3. 300 min/week for additional health benefits
4. muscle strengthening activities 2 or more days per week

Question 2

specific guidelines for those with chronic illness

Answer 2

1. should adhere, if possible, to the guidelines for healthy adults
2. these individuals “should engage in regular physical activity according to their abilities and should avoid inactivity”
3. “…should consult their health-care providers to match their physical activity plan to their abilities and health status”

Question 3

guidelines for Older Americans

Answer 3

1. if you cannot do 150 min of moderate activity/week, be as physically active as you can AND
2. should do exercises that maintain or improve balance if they are at risk of falling
3. should determine their level of effort for physical activity relative to their level of fitness

Question 4

list the 4 fundamentals of exercise training

Answer 4

1. frequency
2. intensity
3. time (duration)
4. type (mode)

Question 5

what is the threshold model state?

Answer 5

achieve sufficient physiological challenge to bring about adaptive changes/training effects, reconditioning

Question 6

factors to consider for FREQUENCY

Answer 6

1. aerobic exercise = 3-5x/week
2. initial fitness level moderate this
3. medical treatment may reduce this frequency
4. occurrence of setbacks or complications
5. more than once/day for short period of time if pt is deconditioned
6. fitness status of the pt
7. 3rd party payer

Question 7

how can exercise intensity be expressed?

Answer 7

1. % of VO2 max
2. % of estimated VO2 max
3. % of estimated HR max
4. % of estimated HRR
5. % of 6-min walk distance
6. RPE → 12-14 or 5-6
   
   1. this range can bring about physiological adaptations
7. % of 1RM

Question 8

Tanaka’s equation for HRmax

Answer 8

HR max = 207 - (0.7 * age)

Question 9

what is THR?

Answer 9

target HR range

an expression of desired exercise intensity as a fraction of the HRR

Question 10

define/describe light exercise intensity

Answer 10

1. light intensity
   
   1. 30% - <40% HRR
   2. RPE = 1-3
   3. normal or slight breathing

Question 11

define/describe moderate exercise intensity

Answer 11

1. moderate intensity
   
   1. 40-<60% HRR
   2. RPE = 4-5
   3. elevated breathing

Question 12

define/describe high exercise intensity

Answer 12

1. high intensity
   
   1. 60%-<90% HRR
   2. RPE = 5-7
   3. heavy breathing

Question 13

factors defining exercise intensity

Answer 13

1. age, program goals, exercise capabilities, health status and fitness levels
2. less fit initially, history of being sedentary → start at light intensity, even at the low end of light intensity
3. survivors of MI’s should be at low end of light intensity to minimize risk of MSK injury and cardiac re-injury

Question 14

things to consider with exercise mode?

Answer 14

1. what is available?
2. what does the pt want to do?
3. what is safe for the pt?
4. aerobic and (not or) strength training

Question 15

exercise duration considerations

Answer 15

1. total amount of time spent exercising
   
   1. per session or per week
2. shorter periods, greater frequency
   
   1. 3-10 min/multiple sessions/day
   2. less well fit
3. long term goal → 30 min of continuous activity resulting in 150 min/wk of moderate activity
4. 1x30 min/session, 3-5x/week
5. progress this exercise property first

Question 16

how long should a single exercise session last?

Answer 16

generally at least 10 min

exercise bouts of <10 min may be effective but more data needed

Question 17

progression of exercise via the FITT model

Answer 17

1. can increase any component
2. initially consider increasing duration
   
   1. increase session length by 5-10 min/session per week
3. next progress frequency
4. finally progress intensity
5. progression should be gradual and anticipate setbacks
6. triangulate exercise intensity with RPE info

Question 18

rate of progression depends on what factors?

Answer 18

1. individual’s health status/change in health status
2. physical fitness status
3. training response
4. exercise program goals

Question 19

what is Volume?

Answer 19

how much exercise time is actually spent in the target HR range

monitor and record HR during exercise session

Question 20

list general components of an exercise training session

Answer 20

1. warm-up → 5-10 min (<40% of VO2)
2. stretching → 5-10 min
3. conditioning → variable
4. cool down → 5-10 min

Question 21

T/F: strengthening/resistance training is not an important part of rehab in cancer pts

Answer 21

FALSE

very important

Question 22

recommendations for strength/resistance training in cancer pts

Answer 22

1. ROM, elastic bands than progress to weight equipment (machines)
2. exercise large muscle groups
3. proper form must be taught
4. start with 1 set of 10 reps; RPE of 2-3

Question 23

general considerations for strength/resistance training

Answer 23

1. start at low resistance
2. increase resistance slowly
3. keep work phase short
4. >1:2 ratio work to rest
5. keep number of reps low
6. increase number of sets
7. stair climbing or other activities that use the major muscle groups and use body weight as resistance

Question 24

T/F: conditioning drives prescription?

Answer 24

TRUE

poorly conditioned = 35-55% of 1RM

moderately conditioned = 55-70% of 1RM

progression = increase reps, then increase sets up to 3, then increase weight

Question 25

T/F: strengthening and balance may need to precede aerobic training among frail older adults with chronic disease

Answer 25

TRUE

Question 26

exercise intensity and Beta-Blockers

Answer 26

1. age predicted HRmax - 20 = HRmax
2. use RPE scale → particularly in the older pts
3. equation → 164 - (0.7 * age)