Exercise Recommendations, Benefits And Contraindications

Question 1

What are the physical activity recommendations for infants <1y?

Answer 1

Should be physically active several times a day in a variety of ways, if not yet mobile to include 30 minutes of tummy time

Question 2

What are the physical activity recommendations for toddlers 1-2y?

Answer 2

> 180 minutes a day in a variety of physical activities

Question 3

What are the physical activity recommendations for pre schoolers 3-4y?

Answer 3

> 180 minutes a day in a variety of physical activities, to include 60 minutes of mod-vigorous activity

Question 4

What are the PA recommendations for children and young people ?

Answer 4

Average of 60 minutes a day of moderate to vigorous activity in a variety of types and intensities to develop movement skills, muscle fitness and bone strength.
Minimise sedentary time and break up periods of not moving

Question 5

What are the PA recommendations for disabled children?

Answer 5

20 minutes a day. Do challenging but manageable strength and balance activity 3 times/week.

Question 6

What are the PA recommendations for adults?

Answer 6

> 150 minutes a week mod-vig.
Physically active every day
Strength >2days per week
Minimise sedentary time

Question 7

What are the PA recommendations for older adults >65y?

Answer 7

> 150 minutes of mod activity, building up from current levels
Participate daily
If already active can do vig exercise
Balance/ strength 2x/week
Break up long periods of sitting even if by standing

Question 8

What are the PA recommendations for disabled adults?

Answer 8

> 150 mod intensity / week
Strength and balance 2x/week
Reduce sedentary time

Question 9

What are the PA recommendations for pregnancy?

Answer 9

> 150 mins mod intensity/ week
Strength 2x/ week
Start gradually

Question 10

What are the PA recommendations for post partum women?

Answer 10

> 150 mins mod / week
Start pelvic floor exercises ASAP and continue daily
Build back up to strength 2x/ week

Question 11

How much can PA reduce all cause mortality?

Answer 11

Up to 30% reduction

Question 12

What are the cardiovascular benefits of PA in adults?

Answer 12

50%reduction in HTN
25% reduction in CVD
Increased oxygen uptake
Improved vascular endothelial function
Decreased minute ventilation
Decreased myocardial oxygen consumption
Decreased heart rate and blood pressure at a given intensity
Increased capillary density
Increased exercise threshold
Decreases total peripheral resistance
Increased serum HDL
Reduced triglycerides
Reduced total body and visceral fat

Question 13

What are the metabolic effects of PA in adults?

Answer 13

50% reduction in T2DM
10% reduction in obesity

Question 14

What are the Respiratory benefits of PA in adults?

Answer 14

Symptom improvement of asthma and COPD
Decreased hospital admission time

Question 15

What are the MSK benefits of PA in adults?

Answer 15

21% reduction in falls and frailty
40% reduction in osteoporosis
25% reduction in joint and back pain

Question 16

What are the effects on cancer risk of PA in adults?

Answer 16

Up to 25% reduction in breast, colon cancer

Question 17

What does pre participation screening of PA involve ?

Answer 17

Current and past medical history, drug history, family history, lifestyle factors, special circumstances eg pregnancy, red flags. Questionnaires such as PAR Q +

Question 18

What are the absolute cardiovascular complications of PA?

Answer 18

MI <2 days
Unstable angina
Uncontrolled cardiac arrhythmia with haemodybamic compromise
Active endocarditis
Symptomatic severe aortic stenosis
Decompebsated heart failure
Acute myocarditis or pericarditis
Suspected dissecting aneurysm

Question 19

What are some relative contraindications of PA in adults?

Answer 19

Known obstructed left main coronary artery stenosis
Moderate to severe aortic stenosis with uncertain relationship to symptoms
Tachyarrhythmias with uncontrolled ventricular rates
Acquired or advanced complete heart block
Recent stroke or TIA
Resting hypertension >200/110
Significant anaemia
Uncorrectee Hyperthyroidism
Electrolyte imbalance

Question 20

What are the metabolic effects of PA in children?

Answer 20

Improved serum lipid profile and glucose, Decreased insulin resistance
Improved body composition
Reduced visceral and intra hepatic fat
Maintenance of healthy weight

Question 21

What effect does PA gave on bone health in children?

Answer 21

Improved bone mineral density and bone structure with weight bearing/ impact activity- 90% of peak bone mass is achieved by 18y so optimising this in adolescence is protective against osteoporosis in adulthood.

Question 22

What effect does PA have on cognition and mental health in children?

Answer 22

Improved cognitive function and academic outcomes
Improved memory and executive function
Reduced depression
Improved sleep

Question 23

How can children incorporate PA into their lives ?

Answer 23

In recreation, at school, PE, travel, helping with household jobs, reduce screen time and sedentary time.

Question 24

What are the absolute contraindications to PA in pregnancy?

Answer 24

Severe Respiratory disease
Severe heart disease
Uncontrolled type 1 diabetes
Placental abruption
Vasa previa
Severe pre eclampsia
Cervical insufficiency
Intrauterine growth restriction
Active preterm labour

Question 25

What are the relative contraindications to PA in pregnancy?

Answer 25

Mild Respiratory disease
Congenital or acquired heart disease
Well controlled type 1 diabetes
Mild pre eclampsia
Preterm premature rupture of membranes
Placenta previa after 28 weeks
Symptomatic severe eating disorder
Multiple nutrient deficiencies
Untreated thyroid disease
Moderate/ heavy smoking in presence of comorbidities

Question 26

What PA activities should pregnant women avoid

Answer 26

Avoid excessive heat and humidity eg hot yoga and vigorous activities in these conditions especially in first trimester
Exercising at high altitude
Scuba diving
Contact activities

Question 27

Why are pregnant women at higher risk of injury?

Answer 27

Hormone related changes lead to ligaments laxity so a thorough warm up and cool down is recommended

Question 28

Is there any evidence of increased risk of miscarriage, stillbirth, complications of delivery or effect on birth weight as a result of PA?

Answer 28

No

Question 29

What are some of the benefits to pregnant women of PA?

Answer 29

Reduced risk of preterm birth
Improved maternal health and recovery after delivery
Reduced labour and delivery complications
Less body pain, back pain after delivery
Decreased risk of GDM, improved control of GDM if develops
Reduced gestational weight gain- higher maternal BMI between pregnancy is associated with higher risk of complications in subsequent pregnancy
Decreased post partum weight gain
Decreased risk of hypertensive disorders eg pre eclampsia
Reduce depression during and after pregnancy
Improved sleep

Question 30

What factors in elderly people make then more susceptible to injury?

Answer 30

Sarcopenia, lower bone mineral density, degeneration of connective tissues and skin quality, reduced balance and coordination, cognitive impairment

Question 31

How does our physiology change in older age ?

Answer 31

Reduced maximum heart rate and cardiac output, higher blood pressure, lower maximal aerobic capacity (therefore exercise at a relatively higher intensity), higher residual lung volume, lower viral capacity, increased work of breathing, Decreased lung perfusion quality, reduced glucose tolerance, longer recovery time

Question 32

What are some of the benefits of PA in older adults?

Answer 32

Reduced morbidity and mortality
Improved strength, balance and flexibility
Mitigates against age related deterioration
Increased independence
Reduced progression of disability
Decreased risk of falls
Prevents osteoporosis
Reduced cognitive impairment and dementia
Reduced social isolation
Reduced depression

Question 33

What factors may affect PA in disabled adults ?

Answer 33

The level of spinal cord lesion and if it is complete or incomplete
Increased risk of conditions that may increase injury risk eg spasticity, joint contracture, pressure ulcers
Increased risk of depression and cardiovascular risk factors

Question 34

What is autonomic dysreflexia?

Answer 34

In people with a spinal lesion at T6 or above there Is a lack of sympathetic response below the level of the lesion which leads to severe hypotension and morbidity and mortality if not treated - can be triggered by simple things like UTIs

Question 35

What are the benefits of PA in people with disability?

Answer 35

Improved walking, strength and upper extremity function.
Improved health related quality of life
Improve vascular function in paralysed limbs
Reduced shoulder pain

Question 36

How does MS affect PA?

Answer 36

Fatigue - but improves with fitness
Reduced exercise tolerance
Maximal aerobic capacity, heart rate and blood pressure response to activity reduced
Lower muscle strength and power
Issues with hydration- people may limit fluid intake to manage urinary symptoms
Short term memory loss
Risk of hyperthermia
Side effects of medications

Question 37

How does PA affect MS ?

Answer 37

Improved physical function, strength and balance, endurance, walking speed. Mobility and cardiorespiratory fitness
Reduced fatigue
Improved cognitive function

Question 38

What effect might parkinsonism disease have on PA?

Answer 38

Side effects of medications
Cognitive impairment
Increased falls risk and impaired balance

Question 39

What are the benefits of PA in parkinsons disease

Answer 39

Improved motor function, mobility, endurance, reduced gait freezing and walking speed
Improved cognitive function
Improved quality of life