Exercise Testing and Prescription in Older Adults Flashcards
After age 50, muscle mass declines __% per year
Strength decreases __% per year
After 60, muscle strength can decline __% per year
Age related muscle loss is __% in adults 65+ and __% 80+
- 1-2%
- 1.5%
- 3%
- 25%
- 30-50%
Sarcopenia
age-related loss of skeletal muscle mass. Causes include disease, disuse, nutritional deficiencies
cachexia
muscle wasting. May be a component of sarcopenia but does not happen to everyone
(Muscle mass OR Muscle function) is the primary factor underlying age and gender related strength differences
Mass
muscle quality
ratio of strength to mass
Skeletal Muscle Index
ratio of appendicular lean mass relative to height (m)
Intensity of exercise in older adults should be
50-85% HRR
talk test
approximates ventilatory threshold. At point when it gets hard to talk
mode for Ex Rx in older adults
any modality that doesn’t impose excess orthopedic stress
progression of Ex Rx in older adults
limit to 10% per week
Core Exercises
exercises that recruit large muscle groups, multijoint
Assistance Exercises
smaller muscle areas, single joint, “prehab”
Ex Rx frequency in older adults
- beginners
- mod and advances
- whole body 2-3x/wk
- split routines 3-6x/wk
Ex Rx intensity for older adults
- light
- mod
- 40-50%
- 60-70%
Rest periods for resistance exercises
- strength
- power
- hypertrophy
- endurance
-2-5 min
-2-5 min
-30 s-1.5min
-
AIDS
- stage 1
- stage 2
- stage 3
- asymptomatic seropositive HIV; exercise capacity unaffected
- early symptomatic HIV; reduced VO2peak & vent. threshold
- AIDS; dramatically reduced VO2peak, high intensity levels may elicit nervous and endocrine abnormalities
AIDS Ex Rx Aerobic
3-5 days/wk, 40-60% Vo2 or HRR. 10 min initially, progress to 30-60. Include WBing if osteopenia is a concern, avoid high risk and high contact.
*overall goal- improve VO2max over 3-6 mos
SCI O2 consumption
-VO2 peak may decrease as much as __%. Exercise may ____ VO2peak by 10-20%. UE ergometry ____________ compared to LE
-26%, increase, decreases VO2 by approx 1/2
How does quadriplegia effect VO2 compared to paraplegia?
-What happens to HR
- decreases VO2 by 1/2 to 1/3
- HR may be limited to 115-130 bpm
Ex Rx for SCI Aerobic
3-5x/wk. initially 40-60% VO2reserve, then 60-80%. 30 min total. Initially 5-10 min moderate with 5 min active recovery, then 10-20 min w/ 5 min active recovery.
Ex Rx for SCI Resistance
2-4 days/wk, 2-3 sets of 8-12 reps, maximize functional independence
DM
- hyperglycemia
- macrovascular complications
- microvascular complications
- blood glucose >120 mg/dL
- CVD, Cerebrovascular disease, PVD
- retinopathy, nephropathy, neuropathy
Is exercise testing necessary for DM patients?
Not for asymptomatic and low risk. GXT for those >35 with type 1 DM > 15 yrs or type 2 DM?10 yrs who want to do mod-vigorous activity
Ex Rx for DM Aerobic
3-7x/wk, 40-60% VO2 reserve or RPE 11-13, 150 min/wk in 10 min bouts. Lg muscle groups
Ex Rx for DM Resistance
general population guidelines
Chronic Kidney Disease
- dx
- ESRD
- > 45% of those with ESRD have ______
-microalbuminurea, or GFR
Exercise in CKD
low tolerance, low Q, chronic anemia, muscle abnormalities, blunted HR response, excessive BP response, LE fatigue, limited ADLs
Ex Rx for CKD Aerobic
3-5 days/wk, 40-60% Vo2reserve, 20-60 min in as little as 3-5 min bouts
Ex Rx for CKD Resistance
2-3 days/wk>1 set of 10-15 reps @ 70% RM
Ex Rx for cancer
very individualized, pay attention, modify as needed, be informed.
No need for GXT for light intensity ex.
