General mid term 1 Flashcards
What is cceps definition of fitness
a set of attributes that are either health and performance related
What is the American college of sport medicine definition
Set of attributes or charectistics that relate to their ability to perform that are usually separated into health and skill related componenets
How is the CCEp and americal college of sport medicines definitions of fitness difference
The CCEP definition is saying that attributes are plastic and always changing while the american college of sport medicine is stating that these attributes are static and relate to how someone performs on a task
Health related fitness - Mortality and morbidity definitions … what can glucose numbers give us
Mortality - Occcurance of death
Morbidity - occurance of illness
For example glucose can give us infomration about the chance of morbidity in subsequence years
Health definitions WHO and CCEP
WHO - a complete state of physical mental and social wellbeing not merely an absense of disease
CCEP - combinatuion of social physical and phycological dimensions positive health is associated with capacity to enjoy life and withstand challenge not just absense of disease
does performance have to be related to sport
no ie firefighter
Assessment 4 Purposes
Identify strength and weakness
provide baseline for prescreiption and rehab
feedback for evaluating effectiveness of program ie does it work for that population
compairision to the norms what does that number mean
Conducting assessment (3 things)
Assessment, measurement, evaluation
assessment is like what tool or protiocal you are using to test
measurement is the actual value like 70 inch vert and evaluation is compairing that value oto other norms or standard ie that is above average for that group
6 things needed to conduct assesment
variables measured specific and relevant, valid, reliable, tests administered at the appropriate time and regular intervals assessment is controlled you are not influencing results, rights are respected and results must be communicated directly and in written and verbal form
what is a good assessment 5 things
safe, valid relaible practical and conducted in professional manner
what can assesments do
objective measured of health and performance in relation to peer group ie other athletes identify odds or chance of sucess within domain r a particular health outcome
what cant assessments do
provide absolute predictions
Why is statistics imporant
predictive utility
How do we calculate how representative SD is of the full population and how many SD is about 95% of pop
Standard error and 2 SD
What is the coeff of variation also called Relative SD
percent value or deviation to see if the devation of a group is large is the SD is 5 with a range of 900 its small but if the sd is 10 with a range of 20 it is large
What are the factors influencing variability (name 4)
Biological variability - inherent physiological and psychological fluctuations of the individual ie circadian rhythms mood etc
Technical variability - precision and accuracy of th einstruments
testing accuracy - instructions and manner of administering test
enviromental variability - temp and humidity
Validity why is it important example
how much a test measured what its supposed to measure use it everyday like balance tests to test sobriety is not very valid but a sim to real life may be
Reliability - and why its imporant
How consistent a test is at measuring the same thing every time like a preg test abutuallly testing pregnancy and sayng you are pregnany you dont want tumor screensing to give you false positives like type 1 erros and false negative like type 2 erros
Two types of validity and both of their 2 subsections give examples
Content related - face validity which is doe sit measure what it appears to measure - weakest form difficult to quantify established by judge ie swim
Construct validity - does test capture related underlying theoretical concepts like a maximal graded exercise test that tests your vox is also representative of your overall cardiorespiratory fitness
Criterion related
concurrent validity - does the test give outcomes similar to related other tests that try to measure the same thing ie does max hr test on a bike equal a max hr test on a treadmill
preductive reliability - does the test allow you to preduct some other varibel of outcome of interest ie body fat from skin folds
Errors 2 types
systematic error - errors that can be based on bias learning fatiuges situations that result in a unidirectional chance in scores on repeat testing like a run test you will do wose on the second round
Random error - imprecision biological variability may in a random manner both increse and decrese test scores on repeat testing
Testing reliability 3 types explian all
Intrarater- 1 thing that tests 2 or more measures cant use pearson method as different values will come up depending on data orientation
interrater - testing the same measure between 2 or more testers 2 machines testiing the same thing
test retest - repeated testing on two or more occasions used to test the reliability of the technique
Correlation
important for predictuve validity and decribes strength of relationship between 2 variables of interest does not describe pattern of relationship and cant quantify it
Regression
Describes the numerical relationship between two variables linear line of best bit not always linear multiple factors may be known to be correleted influencing the relationship of interest ie speed hr and sex all known to be correlated which all influence VO2 max
Bland altman analysis exmaple
- figureing out if metric compares to a gold standard test example here; outcome from paq and outcome from gold stand y axis is the gold - the metric and the x is teh average you have the mean which is how different the 2 decives are if we know one of them is on average 2 less we can account for that but if we just shift the graph up you would still have values different from the actual and your will be over or under estimating then based on that you can determine if its a good measuer ie if the sd is 20 off a range of 100 ists very bad but if its 1-2 off then its good use knowledge systems to help
Risk what is it and give the 2 types and explain them
Used to represent the effect of an intervention on a particular outcome odds ratio OR and risk rations which both influence exposure or treatment in separate ways but are not related and they also normalize the occurance of an outcome due to exposure in reference to a control group commonly used in medicine
odds ratio
what are the odds something ocurs given a particular exposure of intervention compared to control offds exposure a/b / non exposure c/d
Risk ratio
more intuitive gives you the percent value of how much something is biggger a / a plus b / c /c plus d times 100
Meta analysis
pool data for larger sample size determines validity
Informed concent (tri policy council 5 things
consent given voluntarily
consent can be withdrawn anytime
concent shall be informed
if withdrawn occurs data can also be requested to be withdrawm
should address confidentiallity
informed consent other notes (5 things)
Read understood signed prior to administration of. any appraisal
self explanatory describes nature of the appraosal items that will be undertaken and outlines client responsibilities
assent form for under age
encourage dialouge to ensure client fully understands process
not a waiver does not absolve appraiser from negligence
what is a waiver 4 things
signed statement relinquishing some level of rights
an ettempt to cover any accident that may occur
must adhere to the same issues as consent form
does not absolve appraiser from negligence
what is negligence and what are 4 things that are common allegations of negligence
omission that causes harm to another person (does or fails to do something that causes harm,
personal trainer failed to consider pre existing injuries or medical conditions when developing the program, provide approproate types of exercise or tests, limit the weights lifted or length of the cardio exercise, properly supervise client
from a liability perspective (negligence) 4 things
be professional
pre screening actions and intentions are important
pre screening paperwork is important
dont make it up as you go
from a risk mitigation perspective (negligence) 4 things
ask before you do
explain before you do
listen and answer questions
get acknowlegdment from participants
why is pre screening better than referral to provider
unnessary referral to health care provider places unnessary financial and other burdens on the individual and the health care system
Health screening (how to what what is it doing) 4 things
identify and exclude indviduals with medical contraindications to exercise
identidy indviduals at incresed risk for disease because of age symtoms and or other risk factors
those who should undergo a medical prior to testing or stanting an exercise program
identify those that you are not qualifies to work with (scope of practise
Scope of practise name a coupel organizations and what is it
CSEP CEP CPT ACSM NCSA defines the procedures actions and processes that are permitted for a liceanse and outline the responsibilities and limitations for a certificate
Get active questionaire 7 things
2page
all age
parental assessment
valid for 6 months
includes concussion in health
general assessment of PA guidelines
self assessment model
What other questionaire are outl there
pregnancy one and also one for individuals with physical limitations or disabilities which was made at the u of a
what are the basic physiological assessment part of the pre screen
Heart rate identify cardiac irregularities
blood pressure to identify hyper or hypotension
what instructions do you give to the indvidual doing the test pre screeening
no alchohol for 6 hrs prior no caffience for 2 hours prior no food for 2 hours prior no smoking for 2 hours prior no exercise for 6 hours prior
what is the cut off for heart rate and bp to proceed with screening
heart rate above 99 bpm rest 5 min if still over then stop and refer
for bp systolic over 160 or diastol above 90 rest 5 min if still over refer
other considerations about bp why it could be high
white coat hypertension wherre you normally have normal bp except in doc office could be a sign of cardiovascular risk shoul dnot be ignored
what step is after the pre screen and the risk for differing populations
Secondary risk assessment
What is the secondary risk assessment definition and when is it important 4 things
provides health fitness, clinical exercise and health care professionals with important information for the development of an individuals prescription
important when making decisions for the level of medical clearance required if needed
the need for pre-testing
the level of supervision for exercise training and program
scope of practise
How risk assessment work
Add up all the cardiovascular risk factors and teh point tally
Non modifiable risk factors main 2 explain them
Age - men over 45 and women over 55 due to menopause est and progesterone help block cardiovascular risk
Family history - myocardial infraction, coronary revascularization or sudden death from father before 55 or a first degree male relative or 65 for mother or first degree female relative
Non modifiable risk factors others
Ethnicity - ie african american and Indigenous
where you were born environment you grew up in exposure in utero or early life altitude
Modifiable risk factors 6 things
Hypertension - SBP over 140 or over or DBP 90 or over measured on 2 seperate occasions or while taking enti hypertensive meds
Smoking - current smoker or quit within last 6 months or contact with second hand smoke evidence shows even after 5-9 years there is still an elevated risk
dislipidemia - LDL above 130 or HDL below 40 or on lipid lowereing meds or if total serum cholesterole is above 200 mmhg there is an exception to this rule tho which is then called a negative ris factor and that is when the HDL concentration is super high meaining it cancelles out any LDL concentration and that value is if the HDL is above 60
Prediabetes - impaired fasting blood glucose of 100 5.6-6.9 or over or impaired glucose tolerance of 140 of above confirmed by 2 seperate occasions impaired ability to clear glucose from system
obesity - BMI over 30 or waist girth above 102 cm for men and 88 cm for women
sedentary lifestyle - not meeting recommended 30 mins moderate activity 3 times a week
What should occur if you are missing a value or test
should be counted as a risk factor anyways and 1 point added, except for prediabetes which we can test for without the tests which is age above 45 and bmi over 25 or age below 45 and bmi above 25 if true count as pt
ACSM risk stratification
low risk any below 2 asymptomatic
moderate risk above 2 asymptomatic
high risk individuals with one or more sogns or symtoms or known cardiovascular pulmonary or metabolic disease
What other tool is also used for the secondary risk assessment
Austrailia SMA sport med slightly different factors like if indvidual reaches 150 min activity per week then subtract pt they also make it more open so its up to clinician even if they are moderate risk the clinican has final say
What are tertiary other health assessment factors
medications is the biggest one especially in older adults ofr things like beta bloickers that slow HR because if you dont know if they have taken them the study becomes very unvalid
other things like high cortisol pregnancy exercise history or injury.
afterload and what affects it stroke and cardiac work
Elevated bp increses afterload in the heart, afterload is the pressure the heart needs to vercome to eject blood during systole stroke work is SV times MAP and cardiac work is SW times HR
explain blood pressure cuffs and what occurs if arm is over or under heart
first sound is systole no sound is diastole pressure of systole is usually underestimated due to timing of contractins and the bp going down and pressure of the diastole is usually overestimated beacause of that same reason lower the heart rate the more under or over estimation occurs
Bp considerations
seated uncrossed legs relaxed no talking cuff at level of heart and bracial artery
inflated 30 mmhg above systole
deflated at 2-3mmhg or slower if low HR
repeated tests separated by atleast 1 min
Bp methods
Bp cuff
Blood pressure menometer which calibrates thecuff measuring mm hg
iv needle measure artirial pressure and goes into the artirial cannula
hydrostatic pressure
increse or decrese of about .8 mmhg per cm the farther you are away from heart if hand above head you are decresing pressure meaning you are underestimating the pressure if below heart it is overestiating pressure and has a higher pressure
pressure is density of blood times gravity times height
Explain ECG/EKGs
graph is the machine gram is the tracing
measures the electircal activity of the heart along different vectors and used to asses basci abnormalities of the heart CPT cant use for any purposes but CEP can use to measure and track but cnat diagnose
12 lead system (directional vectors) with 10 electrodes
a lead is essentially a 2 terminal system from axix to provide a different view or tracing of the hearts electrical activity goes from negative to positive always provides info from superior inferior left right and posterior anterior
Explain the lead system
3 means leads RA LA LL and a ground at RL if the electrodes are switched you will get a negative wave form
lead 1 runs from RA to LA lead 2 runs from RA to LL and lead 3 from LA to LL which are called bipolar leads
After bipolar leads you have augmented unipolar leads which use two electrods to createa null point which is compared to the 3rd electride
LL and LA combine to RA
RA and LL combine to go to LA
RA and LA combine to go to LL or Augmented vector leg
those are called limb leads
after that you have precordial leads which are 6 leads that go around the apec of the heart and are unipolar measure the change in electrial potential aliong a vector from the heart towards an electrole AVR is the only vector that will give you an negative prominent R wave
Exmaple all the cycles waves segemnts
p - atria depolarization
QRS - ventricle depolarizaion
t- ventricle repolar
u- rare repolar of purkinhe
RR- 1 heart beat
j point- transition between QRS complex and teh ST segemnt
Pr interval - .12-.20 sec less than 2.5mm in size
QRS interval .07-.11 sec 6-30mm in size
st segment - ventricle refractory period smoke and gradual
QT interval - half distance of the RR interval
Reading the grids
Large and small squares - large squares are .2 secs and small is 0.04 sec standard chart recorder speed is 25mm/sec
to calculate Heart beat it is 1500/ number of small boxes between RR
Arrhythmias
Tachycardia - Rapid beating greater then 100 b /min in untrained adult
bradycardia - less than 60 beats per min at rest and symtomatic is less than 50
arrhythmia refers to abnormal rate rhythm or cinduction of electrical imoulses in the heart carse is multifaceded as there are several types and is related to fever dehydration shock hormaonal imbalances setress heart failure etc
Premature ventricular contraction
Caused by depolarization of ventricle before atria can contract absense of the p wave before another QRS complex
extra beats ccur under influence of autorhythmic cells other than the SA node the QRS complex and T waves will look abnormal compared to a normal ECG need to be treated when they occur at a rate of more then 6 per min
Sinus pause no p wave failue of SA node firing
Ultrasound what is a CRGS and a CRCS what do exams include
Canadian registered generalist sonographer and canadian registered cardiac. sonographer
examsns include neck thyroid arteries breast tisues abdomomen pelvis scroteum heart
Advantages to ultrasound 4
Inexpensive, non invasive, no ionizing radiation, rule out soft tissue abnormalities
Ultrasound technologists what do they do
work in clinic or hospital
review requisitions
review relevant patient medical history
conduct ultrasound exams
write technical impression reports for radiologist
How does ultrasounds work Piezoelectric effect signal time and signal strength
electric crytal is deformed by electricity to produce ultrasonic sound wave based on how long crystal takes to return and and sound interprets on screen
electrical to acoustic transformation and then a acoustic to electrical transformation
the signal time is the location of pixel on acoustic line and the signal strength is the brightness of the pixel
what is an acoustic impedance
describes a tissues resistence to the passage of ultrasound and is the reason we cant see past bone and why we need medium gel
Dopple effect, what is it and what is an ultrasound transducer how does it all work what is doppler shift
a change in frequency due to motion of a sound source receiver or reflector transducer is the sound source you get from red blood cells reflecting surface which determines speed of blood flow
shift is the difference between transmitted and received frequency, falls in audible range its the reason you can use it to hear fetal heart rate
Reading and ultrasound
if holding transfuser vertical in longituional place left side is superior towards head right is inferior towards feet top is anteriorr skin fat muscle closest to you and bottom are the deeper structures
holding it in transverse plane horozontal patient right is on left of image patient left is on right of image
Describing ultrasound
Heterogenous - clearer
homogenous - denser
anechoic black fluid filled
hypochonic- darker relative to structure
hyperchonic brighter relative to structure
Why might you be ordered to go in for an appt
Gestational diabetes, hypertension
weight gain too much too little
reduced fetal movement
complication in prior preg
advanced maternal age
many reasons we can see bones in fetal as they havent calsified enough to not be able to see them
The ultrasound Machine
2 d imagining
freeze and still stored photos
PW and CDI pulsed wave and colour doppler
clip store
depth
caliper ABD calc
TCGs- time gain compensation
Ultrasound transducers
Based on needs highest frequence as possible to get clearest resolution but poor penetration used for thyroid breast scrotum lower frequency you cna penetrate further used for adult abdomoment and pelvic exams
Machines come in all shapes and siezes ie computer ones
less powerful more portable
ICU patients.
ENS FAST scans - Focused assessent with sonography and thinsg like internal bleeding
Acoustuc window cardiac scanning
parasternal - long axis - saggital view left ventricle atrium aorta
short axis - correspond transverse plane, level of aorta capullar muscles etc assessing for wall motion septal defects valve regurgitation and anatomy pericardial effusion and measures for wall thickness chaber size aortic root diameter tricuspid valve regurgitation or pulmonary artery velocity
acoustic window which to measure from which window
apical
visually wall motion and regurgitation
measure atrium size in ap4 and 2
ventricle size in diastyole and systole ejection fraction in ap 4 and 2
velocity of blood through mitral valve ap4 and aortic valve in ap5
tricuspid regurgitation ap4 and velocity of mitral annuli in ap4
Ichemic heart disease
- Coronary artery disease leads to
congestive heart failue
Respiatory Assessment - pulmonary function testing
Used to identify breathing difficulties at rest and during exercise assessed with spirometer measures volume static and flow which is dynamic
for exact same body comp females have smaller lungs
Definitions of Respiratory things
TV IRV ERV TLC RLV fVC IC FRC
Tidal vol - normal breathign in plus ex
Inspiratory reserve vol maximal in at end of tidal
Expiratory reserve vol - maximal expiration at end of tidal expiration
Total lung capacity vol in lungs after max inspiration
Residual lung vol - vol in lungs after max expiration
forced vital capacity - max vol expired after max inspiration
Inspiratory capacity - max vol inspired following tidal expiration
functional residual capacity - vol in lungs after tidal expiration
Dynamic vent flow and volumes (graph) rest and at exercise
rest is a circle during exercise has a expiration then a slope which is influenced by resistance in airways
Spirometry
Inspiration followed by a maxmim expiration exited in 1 sec which is your FEV1 should be about 70-80 percent of total, at the start of expiration is heavily influenced by traechea and primary bronci
After 1 sex you exhale for a futher 6 FVC slope of graph is how much resistence you have narrow airways means more resistence things like asthma influeces values if you dont get within 80% of normal values you need a follow up
Spirometer considerations
Seated position unless obese nose clips used
Forceful as long as possible encouragement
end test criteria no more exhale or plateaus at .025l/s
repeat 2-3 times with 203 mins of recovery
select two best performances that are withing 150 ml for both FVC and FEV1
if not within then continue with additional tests up to 8 times and take highest values
men and women equsions are differnt because men and women lung volumes are different and lung volumes decline with age
if normal exeeds prediced or is within 10% you are good so if predicted is 77 and you measure 74 you are within 96% predicted meaning ou are good
What is exercise spirometry used for how is it done
investigate breathing difficulties during or following exercise ie exercise induced broncospasm
Perform resting FVC test then do a exercise test of 6-8 mons duration at 80-90 percent of HR max then perform post exercise FVC tests at 5-10-15-20 mins
Called a eucapncic voluntary hyperventilation test designed to mimic an exercise challange tiodal vol fixed at 85% of TLC breathign ratae fixed at 30 bpm
loooking for a change in FEV1 that is greater or equal to 10 percent of previous values
If drops more than 10 percent indcation of exercise induced broncospasm narrowign of bronci due to smoth muscle contraction induced by heavy exercise breathing cold dry air
drops more than 15 percent indication of exercise infduced asthma more common in winter and aquatic sports due to water treatment plans
What is COPD and types
Chornic obstructed pulmonary disease
emphysema - pink puffer - break down of alveolar membrane bigger alveoli popcorn lungs are similar but bigger caused by smoking
Chonic bronchitis - blu ebloater - onstructpn of bronchi from chemicals like asbestos
Chonic lung damage - also casued by things liek smoking and chemicals and its when particles get trapped in alveolui trigger an inflammatory response which then dissolves the alveolar septum
COPD pathophysiology air trapping
breakdown and loss of lung tissue and structure
narrowing and compression of small airways
airway obstruction (mucus) more difficulty moving air
More COPD can means your lungs are actually larger this is becuase it causes remoddleing of the lungs because of airway reistence, where breathign at larger lung volumes becuase you cant get rid of it all so your tidal volume gets larger over time causing remoddeling and leads to larger resideual volumes and less tidal usuable volume
Spirometry graphs
more dropoff on graph meanas more airway resistence but there is no differnce in inspiration only expiration as airway pulled open during inspiration menas an opening of resistence that drops as you open
if there is a different inspiration it is indicative of a reistence of airflow outside thorax.
what is anthrpometrics
science deals with emasurement of zie weight and proportion of body like BMI somatotyping waist hip ratio body typing
what is weight bias and stigma 2
preconceived belives about a persons lifestyle diet PA etc judements on a persons weight
stigma is the social implication carried by a person who is a victum or prejudice and weight bias
what tools do you use to assess your own potential weight bias
BAOP - beliefs about opese persons scale
ATOPS attitudes about obese persons scaled
Assessment of individuals with big bodies
private space large gowns study armless chair large blood cuffs wide base scale more tham 350 lbs
Sensitivity and privacy
use common sense protect confidentiality no judgement over 30 bmi dont need skin folds do you need to measure weight for an acute visit
Stadiometer measures height
nearest .5cm
Weight scale
measures to nearest 1kg
BMI what is it normalized values and stages
Metric understand life expectancy developed by adolphe quetee kg/m2 age independent same for both sex
used to screen for some health considerations butdoes not indicate current health
underweight is below 18.5 normal is 18.5 - 25 overweight is above 25 and obese is above 30
for men linear relationship between body fat and bmi women curvilinear relationship some expections are skiny fat and yoked poeple
stages 0-1 no or mild signs does not emet clinical criteria for admission 2 is moderate symptoms limitations 3-4 unlikely to work with sig or sever symtoms or impairments not good for active idndividuals or athletes especially strength trained can also be infliuenced by ethnicity
Waist circumfernce
where fat is stored apple or pear shaped there are two measures WHO uses the narrowest point of the waist and NIH Meaures illiac crest NIH is 102 or women with 88 WHO obses is above 110 and women is above 105
Other measures of anthropology waist/hip ratio
waist hip ratio accounts for differnce in overall body size index of relative fat distribution greater the ratio higher the viceral fat in proportion to lower body and increse risk of diease men over .89 and women over .78 considered health risk and .5 is healthy forulas to predict body fat percent bit are not recommended
children is anthropetry
Standardized growth can be calculated with respect to population
based means percent represent where a value places with respect to entire distribution
both are useful for identifying relationship to cohort ie same age
What are considerations of waist circumference
MEasurement of bony landmarks
consistent techniques to not compress it while overlapping tape
frequent inspection of the tape for stretch or wear
Body comp Compartment models def assumptions
Techniques to measure body fat and lean body mass or fat free mass direct is chemical or cadaver analysis indirect lab based like dexa and doubly indirect is fiels based like skin folds can separate into fat mass and fat free mas but can also get into water protein bone mineral content glycogen etc assumptions are fat density of .9g/ml and ffm has a density of 1.1 g/ml lean body mass includes essential fat where as FFM fat is removed entirely the more body compartments accounted for the les error
Hydrostatic weighting archemedies prinicble what do you need to know and what technique do you use
Any object imersed in fluid is boyues up by a force equal to the weight of the lfuid displaced by object ie the force of the fluid that was displaced acts on the object that displaced it know residual vol of air density of water which vaires with temp but 4 degrees is 1 trapped air in GI approx 100 dry and submerged body weight min clothing min trapped air
technique is body of water thermometer water density table calculator weight to assist full end expiration and submersion for 5-10 secs repeat 5-10 times
there is about a 5% absolute error between formulas for a 25% relative error across formulas
Hydrostatic weighting limitations
constant density of body fat and LBM 19% relative error in body fat
assumption of magnitude of trapped air GI tract lung body cavity 8 percent relative error in body fat reduction based on variability in lung vol alone
variability in body mass determination in air things like hydration dehydration nutrition
number of trials performed best if 9-10 are done
Bod pod
same as hydrostatic weighing but used air validity of .94 and reliability of .96
DEXA
dual energy x ray absorbption assumes a 3 compartment model ie lean soft tissue fat soft tissue and bone low radition scan reliability of .9-.99 and validity id .90 error is less than 3 percent
limitations to DEXA
Expensive
cant be used in certain populations ie pregancy
certain size individuals
cant use metallic implants
MRI
Closest thing to gold standard uses magnitism not radiation most acurate body comp very expensive and limited access limited for size of individual too
Skin folds
approx 5% error can preduct body fat directly or entered into formulr to predict body density then FAT .99 reliability and .92 validity
dont do if BMI over 30
BIA
bioelectrical impedance easy and fast electrical current greater resistence to flow greater fat can also preduct total body water content
assume : no eat or drink 4 hours no exercise 12 hours must urinate within 30 mins
no alc for 48 hrs no diuretic type medications within 7 days no testing at certain days of menstral cycle validity is questionaly reliability can be good under controlled conditions manufacturs use differnt formulas for determining it
Near infared interactance
validity questionable good reliability measures optical density for near infared light for bicep fast absorbed light and LBM reflects it sensor measures difference of light omittd underestimating body fat up to 10 ercent and is worse in obese clints
What do CCEP and AFLCA recommend to use for anthropometry
BMI and waist circumerence to evealuatie anthropometrics as opposed to body comp
Research assessment pyramid
Correlative to both descriptibe and causative and necessitive to causitive and descriptuve
What does causitive measure
sometihn gthat causes somethign else nessestive and causitive are tricky to test for in humans
Response to hypoxia
Fight or flight response
regulation plasticity and adaptation along the sympathetic neurovascular cascade
sympathetic nerve activity (microneurogenic)
neurotransmitter release (blood samples)
Receptor sensitivity (phenylephrine)
vascular outcomes blood pressure flow resistence and artirial stiffness
go from direct to indirect
Neurovascular health lab
Caustive blood samples like catecholemines neuropeotides influenced by factors like volume blood flow release uptake etc
Microneurography
2 needles one of which goes directly into the nerve to record the system and considered the gold standard
in the nerve there is myelinated and unmyelinated neurons which are red in color and spotty andyou want information from them
spiked in graph are action potentials firing
Sympathetic nervous system (what can you see on the graph)
graph readins can see the burst frequency by the constant up and down the burst amplitude which is how strong it is and the burst probability
what are the 2 types of low oxygen called
Hypoxia which is low oxygen availibility and hypoxaemia which is low o2 in the blood itself impairing ability to take up and circulate oxygen
Envrioment in terms of oxygen (altitude)
reduction in enviromental availibility as you go up in altitude the pressure goes down and the less oxygen you have going in
how do we respond to enviromental hypoxia
high altitude - considered 1500-3000 AMS symptoms usually start around 2500meters and generally begins with headaches and altered night vision
very high altitude 3000-5000 tingling sensations, headaches, fatigue and other indications of altitude sickness will usually begin to occur from about 2500 onwayds
extreme altitude over 5000m many expirience uncconsciousness at this altitude if not properly acclimated there are only few mountain ranges in the world that reach this altitude
Death zone - anything over 8000m oxygen concentration at this altitude is so low that your cells do not have enough oxygen to build new tissue and your body will continually withier away until death
how to measure hypoxia and hypoxaemia
barometer - partial pressure of oxygen around the individual is measured to the degree of hypoxaemia, bas weather at the same altitude the pressure will drop which is important to know
can also use a gas analyzer and mass spectrometer
pulse oximetry - measures wavelengths of light absorbed by RBCs how much light is absorbed vs how much comes back determins oxygen if you need something stornger you can use it on the brain which is the same idea
also use a near infared spectrometer
Short term responses to acclimation to altitude
linear progression from Max vo2 which is out maximal work to an increse in altitude and a decline of VO2 going up to 4300 m decreses vo2 max by 25 percent and going up to 7440 m decreses by 60 percent, to compare going up to everest means you are eesentially at your vo2max at rest
Performance at altitude
at altitude any aerobic activity declines however short distance gets better becuase of decresed air resistence so you get faster
it would require you to pump 180L of blood per min to transport enough o2 which is inefficeint RBCs carry hemoglobin
Oxygen transport
hemocrits from hemoglibin go up at altitude to try and compensate for teh difference of amount of blood you need to pump per min
AMS
Acute mountain syndrome and the lake louise scale
key hallmark of AMS is headache but it is also charecterised by GI issues fatiuge and dizziness but you must have a headache for it to be classified as AMS
the underlying cause of AMS is not known and you cant predict who will develop AMS
Guidelines for ascent
Proper mediacation diamox
take a one day break every 1000m elevation
never sleep more than 500m above where you slept before you can climb more but dont spend the nigh
avoid respiratory depressants like alcohol
if unwell dont go higher
go down if you get worse
Long term adaptations to altitude
Sherpa people - ethnic group go by sherpa indigenous groups all reside at altitude for over 25000 years
for example Racing mt everest normal people completed in 5 48 sherpa demolished it in 3 hrs
Andrean populations
Have a higher RBC count most studied high altitude population
rely on incresed hemoglobin to sustain oxygen delivery
prone to chrnic mountain sickness which is charecterised by excessive RBC
develops over time and blood becomes super thick and sluggish hard to move
Chronic mountain sickness
Qunghai
must have incresed hemoglobin 21 in men 19 in females acccompanies with any of the following breathlessness palpitations sleep distrubance cyanosis dialation of veins headaches etc
What is the auscultation method
listening to bodily sounds through stethoscope
