Introduction to Physical Activity and Health Flashcards

1
Q

What do physical therapists do?

A
  • assess/improve function
  • decrease pain
  • combination of these activities
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2
Q

Overarching Prevailing Principle of PT

A
  • balance physiological stress of disease, injury, therapeutic intervention
  • with patient’s ability to recover
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3
Q

The Problem

A
  • life in 21st century US: marked by prevailing poor nutrition, physical inactivity, and poor fitness
  • current US activity levels: 23% of adults report exercising vigorously; greater than or equal to 50% VO2max for 20+ minutes 3+ times/week
  • 38% of adults report fully sedentary lifestyles
  • inactivity disparities worse based on race, socioeconomic status, disability
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4
Q

Inactivity and the Obesity Epidemic-Definitions

A
  • obesity: BMI greater than or equal to 30
  • BMI: measure of adults weight in relation to height
  • adults weight in kilograms divided by height in meters
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5
Q

The Impact of Inactivity on Physiology

A
  • people today don’t just look different, they are different
  • activity–>physiological adaptation, cessation of activity–>physiological adaptation, “acute” inactivity, “chronic” inactivity
  • “use it or lose it”
  • this presents challenges: decreased quality of life for the individual, increase in health-care associated costs for individual, taxpayers, business, etc
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6
Q

Challenge of Understanding Inactivity vs. Aging

A
  • early research in aging: emphasized average age-related losses and neglected the substantial heterogeneity (treated everyday like they were the same) of older persons
  • the effect of the aging process itself were exaggerated
  • the modifying effects of diet, exercise, personal habits, and psychosocial factors were underestimated
  • “usual vs. successful aging”
  • point: some disease processes parallel consequences of inactivity
  • counter point: some diseases are obviously related to inactivity-studies on younger subjects also inform; elderly show percent increases equal to much younger subjects
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7
Q

Inactivity and Cognitive Function

A
  • impact on inactivity on the nervous system are particularly extreme in the elderly
  • linked to decreased function: performance on intellectual tests; verbal fluency, color discrimination, reversible figures
  • disrupted EEG pattern of sleep
  • increased incidence of depression, anxiety, and irritability
  • changes reversible with activity/exercise
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8
Q

Inactivity and GI System

A
  • decreased motility with inactivity
  • increased incidence of obesity
  • disruption of hunger and satiety
  • changes reversible with activity/exercise
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9
Q

Inactivity and Integumentary System

A
  • decreased thermoregulatory capacity: decreased oral and skin temperature, increased clinical relevance in the elderly
  • increased incidence of skin breakdown with BR
  • changes reversible with activity/exercise
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10
Q

Inactivity and Cardiovascular System

A
  • increased vitals at given sub max load
  • with BR: increased HR after 1 week, decreased total blood volume, increased risk of orthostatic hypotension
  • changes reversible with activity/exercise
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11
Q

Inactivity and Respiratory System

A
  • decreased oxygen delivery to working tissues
  • decreased reserve capacities
  • oxygen demand exceeds supply
  • exacerbates: decreased cilial efficacy in aging for removing waste products, decreased mechanical function
  • changes reversible with activity/exercise
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12
Q

Inactivity and Musculoskeletal System

A
  • decreased balance and coordination
  • decreased bone mineral density and metabolic function
  • decreased muscular strength and endurance
  • increased formation of connective tissues adhesions–>contractures
  • changes reversible with activity/exercise
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13
Q

Interventions Aimed at Inactivity

A
  • community-based health and wellness programs
  • clinically-based therapeutic interventions: strengthening, AROM, cardiovascular, transfer training, gait training
  • most inactivity-related frailty can be largely reversed in relatively short time frames
  • key is to optimize the training stimulus!
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14
Q

The Solution

A
  • numerous calls for increased physical activity and fitness levels
  • Physical Activity and Health: A Report of the Surgeon General
  • NIH Consensus Conference on Physical Activity and Cardiovascular Health
  • Health and Medical Organizations (AHA, ACSM)
  • Dietary Guidelines for the Nation
  • Healthy People 2020
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15
Q

Healthy People 2020

A
  • national health goals
  • increase span of “healthy” life
  • eliminate health disparities
  • increase access to information and services for all people
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16
Q

Physical Activity and Health: A Report of the Surgeon General

A
  • recommendations include
  • people of all ages include a minimum of 30 minutes of physical activity of moderate intensity (such as brisk walking) on most, if not all, days of the week
  • acknowledge that for most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or of longer duration”
17
Q

ASCM Guidlines

A
  • American College of Sports Medicine
  • general recommendations include
  • aerobic activity (5d/wk or more moderate intensity exercise; 3d/wk or more vigorous intensity exercise
  • muscle strengthening activity: 2d/wk
  • flexibility activity: at least 2 d/wk
  • balance exercises: for frequent fallers or those with mobility impairment, 2-3 d/wk
18
Q

Practical Application in Exercise Prescription

A
  • clear, consistent scientific evidence that physical activity
  • improves: function of the body’s systems, fitness, health, wellness
  • reduces risk of disease states such as: MI, stroke, metabolic syndrome, diabetes, cancer, osteoporosis, obesity
  • but how does one appropriately apply this science in individual cases?
19
Q

General Adaptation Syndrome

A
  • popularized by the work of Hans Selye
  • described as: “a common residual (psychoneurophysiological) response that is nonspecific in regard to its cause”
  • “elicited with such diverse agents as cold, heat, x-rays, adrenaline, insulin, tubercle, bacilli, or muscular exercise)
20
Q

Stages of GAS

A
  • the alarm stage
  • the resistance or adaptation stage
  • the stage of exhaustion
  • selye argued that the stage of exhaustion marked the onset of certain diseases of adaptation
  • examples include: repetitive motion injuries, coronary heart disease, cancer, diabetes
21
Q

The Essence of Successful Exercise Prescription

A
  • the role of stressors:
  • lifestyle associated disease
  • overuse
  • fatigue
  • depression
  • lowered immunity
  • burnout
  • injury
  • poor general fitness
  • the role of recovery:
  • “it’s not how much training you can do, it’s how much training your body can accommodate”
  • carries over from athletics to all areas of exercise and testing and
22
Q

Gross Factors Affecting Physiological Recovery

A
  • genetics
  • diet
  • quantity and quality of sleep
  • general health
  • age
  • sex
  • spiritual health
  • occupation
23
Q

Specific Factors Affecting Recovery

A
  • physiological: i.e. VO2max
  • biomechanical: i.e. limb status
  • psychological: i.e. motivation level
  • epidemiological: i.e. pima indians
  • sociological: i.e. neighborhood safety
  • financial: i.e. intervention costs
24
Q

Professional Self-Assessment

A
  • we each must:
  • consider GAS
  • balance stress and recovery
  • manage this client’s PT
25
Q

Take Home Messages

A
  • many health conditions are linked to the lifestyle of an increasingly sednetary society
  • physical therapy programs provide a great opportunity for health professional to educate, and serve, the public
  • a strong knowledge base in exercise physiology plays an important role in providing such client care
  • theory such as GAGS suggest that stressors: come from many sources, play a large role in the disease process
  • successful PT balance stress and recovery in their clients