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Physiology > Exercise referral > Flashcards

Exercise referral Flashcards

1
Q

What is an exercise referral?

A

Specific and formalised programme whereby a medical professional refers a patient to a fitness programme

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2
Q

How long do exercise referral programmes last?

A

Usually around 12 weeks of supervision

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3
Q

What specificities should be thought about for the programme?

A

Specific to the needs of the client

Specific to the desired health outcome

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4
Q

What are the different types of referral programmes?

A 
Cardiac rehab
Falls prevention
Exercise after stroke
Pulmonary rehab
Mental health and wellbeing
Cancer rehabilitation 
Weight management
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5
Q

Other than exercise, what other areas might be included in referral programmes?

A 
Nutrition
Education
Cognitive Exercise
Smoking cessation
Counselling
Home exercise
Telephone/home visits
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6
Q

What are the main purposes of exercise referral classes?

A 
To:
increase PA behaviours
Reduce sedentarism 
Create sustained health behaviour change
Improve health and quality of life
Reduce problems associated with inactivity
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7
Q

What are the benefits of exercise referral?

A

Supervised exercise
Exercise is tailored to needs
Exercise can alleviate symptoms
Allows similar individuals to exercise together
Increase confident and adherence
Instructors have specialised knowledge
- to design programmes
- to educate patients to produce positive change
- educate patients on their condition/medication

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8
Q

What occurs in phase 1 of cardiac rehab (CR)?

A

Treatment, medication, reassurance, information, family support (in the hospital)

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9
Q

What occurs in phase 2 of CR?

A

Support from health professionals, possible counselling, and begin focus on lifestyle and behaviour change (at home)

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10
Q

What occurs during phase 3 of CR?

A

A 12 week hospital based exercise programme (physio/cardiac nurse), health talks, nutrition, smoking cessation,
Adaptation and maintenance of lifestyle changes

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11
Q

What is phase IV CR?

A

A community based exercise programme which focuses on returning to normal living and the individual takes responsibility for their exercise
Long term maintenance of PA and lifestyle change

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12
Q

What types of exercise can be completed at phase IV?

A

Aerobic, LI - MI resistance training

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13
Q

How is exercise intensity monitored in phase IV?

A

Borg scale

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14
Q

What types of exercises are undertaken at cardiac rehab?

A

Shuttle walks, bicep curls, leg swings, hamstring curls, lateral raises, front raises, upright row, twists, step ups, knee drives

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15
Q

What is the goal for a CR warm up?

A

To prevent arrhythmias and ischaemia

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16
Q

What pre activity assessment is undertaken before CR?

A

HR and BP

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17
Q

What is the main goal of the exercise component of CR?

A

To improve functional and endurance capacity and improve BP and blood lipids

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18
Q

What is the main goal for the cool down component in CR?

A

To reduce risk of arrhythmias and hypotension

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19
Q

Why should floor exercises be avoided in CR?

A

Can be difficult to get up (risk of falls)

Postural hypotension

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20
Q

What types of exercise should be avoided in CR?

A

Floor exercises, HI, Valsalva (lifting heavy weights), intensive isometric exercises, competitive exercises,

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21
Q

What factors would stop a patient being referred to phase IV CR?

A 
Unstable angina
BP >180/100
Resting HR >100
Uncontrolled atrial/ventricular arrhythmias
Unstable diabetes
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22
Q

How can you be referred to phase IV?

A

Graduation for phase III or GP referral

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23
Q

What is BACPR?

A

British association for cardiovascular prevention and rehabilitation

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24
Q

What cardiac conditions have people experienced at CR classes?

A

MI
Stable angina
Heart failure
Valve replacements

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25
Q

What is the content in the warm up of CR?

A

15 minutes
Pulse raiser (avoid stationary positions)
Walking combined with mobility stretches

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26
Q

What does the circuit format allow in CR?

A

Multiple options
Socialisation
Instructor to circulate
Participants work at own level

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27
Q

What are the main considerations for a CR class?

A 
Staff-patient ratio
Room temperature and humidity
Supervision
Psychological impact (fear of exercise, education/support and encouragement)
Patients have different abilities
28
Q

What drugs are used for the management of heart diseases?

A 
Statins
Anti coagulants
ACE inhibitors
Beta blockers
Diuretics
GTN spray
29
Q

What are the side effects of statins?

A

Muscle pain
Headache
GI upset

30
Q

What are the considerations for using statins?

A

Aching legs - limit exercise tolerance

31
Q

What are statins?

A

Drugs - lower the level of low-density lipoprotein (LDL) cholesterol in the blood

32
Q

What are anti coagulants?

A

Medicines that help prevent blood clots

33
Q

What are the side effects of anti coagulants?

A

Haemorrhages(from external damage - cuts)

Internal bleeding

34
Q

What considerations should be thought out for anti coagulant use with exercise?

A

Care with equipment to avoid injury

35
Q

What are ACE inhibitors?

A

Drugs used to treat heart failure and high blood pressure

36
Q

What are the side effects of ACE inhibitors?

A

Dry cough
Dizziness/weakness
Hypotension

37
Q

What considerations for exercise are required for ACE inhibitors?

A

Rapid changes in posture/abrupt cessation of exercise will increase risk of hypotension

38
Q

What are beta blockers?

A

Drugs prescribed for angina, high BP and heart attacks (work by decreasing the activity of the heart)

39
Q

What are the side effects of beta blockers?

A

Lower pulse
Lower BP
Dizziness
Tiredness

40
Q

What are the considerations for exercise with beta blockers?

A

Rapid changes in posture/abrupt cessation of exercise will increase risk of hypotension
HP will be lowered by 10-30bpm
Use RPE scales when monitoring intensity

41
Q

What are diuretics?

A

Medication for hypertension and used for heart failure. They help your body get rid of extra water and salt

42
Q

What are the side effects of diuretics?

A

Tiredness

Muscle weakness/cramps

43
Q

What are the considerations for exercise with diuretics?

A

Avoidance of dehydration
Increased potential for hypotension
Aching legs/tiredness
Regular trips to toilet

44
Q

What is GTN spray?

A

A reliever for angina

45
Q

What are the side effects of GTN spray?

A

Hypotension
Facial flushing
Headaches
Dizziness

46
Q

What are the considerations for exercise with GTN spray?

A

Rapid changes in posture/cessation of exercise will increase risk of hypotension
Improved exercise tolerance

47
Q

What is stable and able?

A

A falls prevention exercise programme, utilising chair based and standing exercises

48
Q

What does stable and able aim to improve?

A

Lower body strength
Balance
Posture
Gait and walking confidence

49
Q

What effects the participants altered gait in stable and able classes?

A 
Muscle/ joint pain
Muscular imbalances
Reduced motor function
Previous joint replacements 
Reduced ROM and flexibility 
Short stride length
Postural effects - kyphosis, head forward
Increased lateral sway
Limited floor clearance 
Walking aids
50
Q

How are participants referred to stable and able classes?

A

Physios, self referral

51
Q

What are the main components of the stable and able class?

A

Seated mobility exercises for ankle (walking) and trunk (rotation)
Gentle pulse raising
Standing work

52
Q

What strength exercises are undertake at stable and able?

A

Seated:
Leg extension
Leg curl

Standing:
Leg raises
Heel raises
Toes raises

Squats
Stand to sit

Resistance bands
Pulls
Outer thigh
Wrist strengthener

53
Q

What balance exercises are undertaken at stable and able?

A 
Single leg stand
Tandem stand
Side step
Backwards walk
Heel/toe walking
Walk and turn
54
Q

What are the considerations for stable and able classes?

A 
Movement through the building
Transition of seat to stand
Visual/hearing problems
Spacing of participants
Various speeds of participants
55
Q

What conditions/diseases may stable and able participants have?

A

Dementia, osteoporosis, diabetes, stroke, heart disease, arthritis, hearing/visual impairments

56
Q

What are the symptoms of dementia?

A

Impaired memory
Increased risk of falls
Alteration in ability to sequence tasks

57
Q

What are the considerations for exercise with dementia?

A

Difficulty following instructions and remembering exercises from week to week

58
Q

What is osteoarthritis?

A

Wear and tear of joints

59
Q

What are the symptoms of osteoarthritis?

A

Pain
Swelling
Stiffness

60
Q

What are the considerations for exercise with osteoarthritis?

A

Pain feels worse with exercise
Limited exercise capacity
May need to take analgesia prior to exercise

61
Q

What is diabetes?

A

Impaired production/ reduced insulin

62
Q

What are the effects of insulin?

A

Weight loss
Thirst
Frequent urination

63
Q

What are the exercise considerations for diabetes?

A

Impaired feet/altering balance

Should carry juice for exercise

64
Q

What is osteoporosis?

A

Low bone density

65
Q

What are the effects of osteoporosis?

A

Increased risk of fractures

Pain

66
Q

What are the exercise considerations for osteoporosis?

A

Increased risk of fractures with a fall
Use of hip protectors
Limited ROM (avoid forced range)

67
Q

What are the main medications associated with an increased risk in falls?

A 
Sleeping tablets
Antidepressants
Antipsychotics
Diuretics
Vasodilators

Physiology (3 decks)

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