Interventions Flashcards
Physical Stress Theory
Tissue needs at least 60% max capacity to change (60% HRmax or 60%RM = appropriate exercise dose).
Dose Response Theory
Negative effects of inactivity are WORSE than potential adverse effects of high intensity.
ACSM General Guidelines (moderate intensity)
150min/wk mod intensity:
3.0 to 5.9 METs
5-6 RPE (1-10 scale)
13-14 RPE (6-20 scale)
ACSM General Guidelines (high intensity)
75min/wk high intensity:
6+ METs
7-8 RPE (1-10 scale)
16-17 RPE (6-20 scale)
Integumentary: pressure relief guidelines
1in or more of material btwn surface & bony prominence.
Integumentary: compression guidelines
Venus ulcer: 30-40mmHg.
Arterial ulcer: NONE!
Exercise Considerations for DM
Mod intensity, 50%RM, 15-20 reps.
Hyperglycemia: >80% HRmax, >300 Glucose.
Hypoglycemia: insulin peak 2-5hrs after inject.
Exercise Considerations for Shingles
Low-mod intensity.
Too intense can further immunocompromise.
Exercise Considerations for Urinary Incontinence
90/90 into wall
Monster walk
Clamshells
200 PFM contractions every day
Exercise Considerations for RA
Remission = high intensity WB.
Active flare = mod intensity.
Exercise Considerations for Cancer
Remission = 60-80% RM.
Active = 40-60% RM.
Flexibility: stretch should be sustained for…
60 sec
How often should we reassess RM?
Every 2-4 weeks
60% 1RM = how many reps?
15
80% 1RM = how many reps?
8
Appropriate dose = how many RIR?
2-4
Appropriate dose = what % 1RM?
60-80%
Progress by ___% if in the 40-60% RM range
10%
Progress by ___% if in the 60-80% RM range
5%
Why train power in the older adult?
Type 2 fibers are declining. Power decreases before strength decreases.
Also better functional outcomes.
Power parameters
40% 1RM
Faster speed
3-6 reps
Efficient way to incorporate endurance, strength, and power
Set 1 = AMRAP (endurance)
Set 2 = strength
Set 3 = power
Exercise Considerations for OA or DJD
Acutely inflamed = isometrics.
Not acutely inflamed = high intensity WB.
Exercise Considerations for LBP
Extensor strength (Multifidus) IMPORTANT!
Stabilization exercises - e.g., seated isometric trunk rotation
Exercise Considerations for Osteoporosis
AVOID: flex, manips, dry needling.
Trunk ext strength important.
Teach hip hinge = bend w/o trunk flex.
Plyo can stimulate osteoblasts.
Exercise Considerations for Joint Replacements
Pre-hab
High intensity
Exercise Considerations for Hip Fx
Fear avoidance, balance confidence - seen a lot longer than hip replacements bc of this
Exercise Considerations for Foot Pain
Proper footwear = thumb-width space btwn side of met head & edge of shoe
Cardiopulm: overall goal of interventions
Chest expansion
Cardiopulm: exercise parameters
60-80% HRmax
20-60min continuous
Mode should work multiple large muscle groups (e.g., bicycling, dancing)
Cardiopulm: warmup must be at least ___ and why?
3min
Stiffer blood vessels, slower O2 exchange, decreased SNS output.
Exercise Considerations for COPD
Diaphragmatic breathing - allows lung recoil, easier to expel air out.
Diaphragm is flatter/weaker with barrel chest.
Exercise Considerations for CHF
Aerobic + resistance.
Cooldown SUPER important to avoid sudden drop in venous return.
When to STOP exercise (6)
- Failure to return to baseline in 5min.
- DBP drops 10-20mmHg.
- SBP >210-240mmHg.
- DBP >110mmHg.
- HR drops >10bpm.
- HR rises >50bpm with low level activity.
Exercise Considerations for PD
Stretch flexors
Strengthen extensors
What is necessary for neuroplasticity?
High intensity
Multimodal
Exercise Considerations for Chronic Pain
Moderate intensity (60-70%) - enough to get moving but avoid pain worsening.
Eccentrics = more DOMS.
Limit passive modalities - no actual tissue pathology, so won’t do anything.
Exercise Considerations for Falls
Multimodal
GAIT TRAINING
Appropriate assist device - using inappropriate device can actually increase falls.
Fall Recovery progression
- Prone<>stand & supine<>stand.
- Omission of 1 limb (e.g., get up without using R arm).
- Omission of ipsilateral UE/LE.
Recommended frequency for aerobic
3-5x/wk
Recommended frequency for balance
1-7x/wk
Recommended frequency for stretching
2-7x/wk
Recommended frequency for strength
3x/wk