Exercise Testing and Prescription in Older Adults

Question 1

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+

Answer 1

• 1-2%
• 1.5%
• 3%
• 25%
• 30-50%

Question 2

Sarcopenia

Answer 2

age-related loss of skeletal muscle mass. Causes include disease, disuse, nutritional deficiencies

Question 3

cachexia

Answer 3

muscle wasting. May be a component of sarcopenia but does not happen to everyone

Question 4

(Muscle mass OR Muscle function) is the primary factor underlying age and gender related strength differences

Answer 4

Mass

Question 5

muscle quality

Answer 5

ratio of strength to mass

Question 6

Skeletal Muscle Index

Answer 6

ratio of appendicular lean mass relative to height (m)

Question 7

Intensity of exercise in older adults should be

Answer 7

50-85% HRR

Question 8

talk test

Answer 8

approximates ventilatory threshold. At point when it gets hard to talk

Question 9

mode for Ex Rx in older adults

Answer 9

any modality that doesn’t impose excess orthopedic stress

Question 10

progression of Ex Rx in older adults

Answer 10

limit to 10% per week

Question 11

Core Exercises

Answer 11

exercises that recruit large muscle groups, multijoint

Question 12

Assistance Exercises

Answer 12

smaller muscle areas, single joint, “prehab”

Question 13

Ex Rx frequency in older adults

• beginners
• mod and advances

Answer 13

• whole body 2-3x/wk

- split routines 3-6x/wk

Question 14

Ex Rx intensity for older adults

• light
• mod

Answer 14

• 40-50%

- 60-70%

Question 15

Rest periods for resistance exercises

• strength
• power
• hypertrophy
• endurance

Answer 15

-2-5 min
-2-5 min
-30 s-1.5min
-

Question 16

AIDS

• stage 1
• stage 2
• stage 3

Answer 16

• 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

Question 17

AIDS Ex Rx Aerobic

Answer 17

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

Question 18

SCI O2 consumption

-VO2 peak may decrease as much as __%. Exercise may ____ VO2peak by 10-20%. UE ergometry ____________ compared to LE

Answer 18

-26%, increase, decreases VO2 by approx 1/2

Question 19

How does quadriplegia effect VO2 compared to paraplegia?

-What happens to HR

Answer 19

• decreases VO2 by 1/2 to 1/3

- HR may be limited to 115-130 bpm

Question 20

Ex Rx for SCI Aerobic

Answer 20

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.

Question 21

Ex Rx for SCI Resistance

Answer 21

2-4 days/wk, 2-3 sets of 8-12 reps, maximize functional independence

Question 22

DM

• hyperglycemia
• macrovascular complications
• microvascular complications

Answer 22

• blood glucose >120 mg/dL
• CVD, Cerebrovascular disease, PVD
• retinopathy, nephropathy, neuropathy

Question 23

Is exercise testing necessary for DM patients?

Answer 23

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

Question 24

Ex Rx for DM Aerobic

Answer 24

3-7x/wk, 40-60% VO2 reserve or RPE 11-13, 150 min/wk in 10 min bouts. Lg muscle groups

Question 25

Ex Rx for DM Resistance

Answer 25

general population guidelines

Question 26

Chronic Kidney Disease

• dx
• ESRD
• > 45% of those with ESRD have ______

Answer 26

-microalbuminurea, or GFR

Question 27

Exercise in CKD

Answer 27

low tolerance, low Q, chronic anemia, muscle abnormalities, blunted HR response, excessive BP response, LE fatigue, limited ADLs

Question 28

Ex Rx for CKD Aerobic

Answer 28

3-5 days/wk, 40-60% Vo2reserve, 20-60 min in as little as 3-5 min bouts

Question 29

Ex Rx for CKD Resistance

Answer 29

2-3 days/wk>1 set of 10-15 reps @ 70% RM

Question 30

Ex Rx for cancer

Answer 30

very individualized, pay attention, modify as needed, be informed.
No need for GXT for light intensity ex.