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Kin 311 > Kin 311 Mid Term 2 > Flashcards

Kin 311 Mid Term 2 Flashcards

1
Q

Diabetes and metabolic disorders

A

t1 d - Born with it - result of pancreatic beta cell destruction causing
t2 d - develops due to lifestyle genetics etc and insulin resistence insulin is less effective at facilliating glucose uptake
gestational diabetes - glucose inteolerance onset during pregnancy

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2
Q

glucose measurement

A

Important for the diagnosis of diabetes
important for the monitoring of glucose at rest during and following exercise

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3
Q

Capillary glucose sampling

A

Normal blood glucose
Fasted anything below 5.5mmol/l ot 100mg/dl is normal and unfasted anything below 11.1mmol/L or 200mg/dl is normal

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4
Q

Capillary sampling according to WHO

A

Select clean site with aalc punch skin with deliberate poke prevent repeated punctures
wupe away first drop of blood aviod contamination with tssue fluid or debris
avoid squeezing teh finger too tightly because tgis dilutes the sample with tissue fluid or plasma

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5
Q

Glucose tolerance test

A

Essentially just drink a fuck ton of glucose in a very short period of time like 5 min then track what occurs post 1-5 hours will see a spije in the following hrs then go back to nors
continuous glucose minotring if we take values at intervals we erisk vauable information being left out continous monitoring is better as we capture and can visualize the highs and lows

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6
Q

Glycated hemoglobin

A

Glucose damaged hemoglobin as RBC are freely permeable to glucose molecules and have a life span of 2-3 months fo you can take glucose levels over the preceduing 2-3 months

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7
Q

Advantages and disadvantages of diagnostic tests for diabetes

A

Finger prick adv- Standard easy single sample dis - not stable high variability
2 hour post glucose Adv - standard predicts microvascular complications sample not stanle high variability involnvenient 13 12.15

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8
Q

WHy do we measure PA levels

A

Direct relatipnship with disease endpoints
indirect relationship with disease through the effects of activity on diet or body weight
ability to study PA patterns determinants and barrier in differnt groups
more relevant for a wider segment of pop
evaluate PA interventions

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9
Q

Measuring energy expensiture

A

PA - bodily movement generated by skeletal muscles resulting in energy expenditure ie heat production

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10
Q

What are the 2 enegry expenditure divisions

A

Non exercice activity thermogenesis (NEAT) which are things we dont rly think about but over time could make a difference ie fidgeting blinking etc and the second one is voluntary physical activity

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11
Q

Metabolic cart

A

Measure oxygen used and taken up

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12
Q

Metabolic chamber

A

you live in it and it measures heat energy what is produced can measure over logn periods of time

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13
Q

Doubly labelled water technique

A

Essentially just means having more isotopes of molecules when yo uburn it you metabolise CO@ and hydorgen ions the ratio of oxygen to hydrogen can tell you how metabolically active you are over months

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14
Q

Classifying energy expendtiture (MET)

A

1 met oxy consumed at rest
normalized metabolic demand of a given activity across activities the data for the value of 1 met is 3.5 ml o2 min times kg body weight was done by 1 person

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15
Q

Physcial inactivity

A

An insuffiencent PA level to meet present PA recommendations

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16
Q

Sitting

A

a position in which ones weight is supported by cuttock rather than feet and back is upright you can be sitting sedentarily or you can be doing something else like biking

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17
Q

lying

A

being in a horozontal position on a supporting surface

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18
Q

standing

A

A position in which one has or is miantaining an upright position while supported by ones feet
the common theme with all of these is about what you are doing in the said positions

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19
Q

Sedentary behavior

A

any WAKING behavior charectirsed by a EE of less tha 1.5 mets while in a sitting reclining or lying position STANDING NOT INCLUDED

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20
Q

Moveent behaviors not mutally exclusive

A

you cna be active and sedentary at the same time the best way to mitigate thigs is by minimiznng sedentary behaviors

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21
Q

Weekend warriors

A

Essentially just says it doesnt matter how you get the minutes in as ling as you are getting all the required minutes in

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22
Q

Nethods for assessing PA in activity (PA questionairs pros cons and what are some good ones (International PA 1

A

Pros - self reported mass use cheap
cons - social desireability will be biased to themselves, wont remember everything, familiarity iwth terms
Good ones are the IPAq and the GPAQ
IPAQ - developed over 20 years many valitative studies validity ranges from good to poor depending on outcome activity type and cohort

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23
Q

Subjective assessment method - Pedometer how does it work pros cons what is better

A
  • self report measures of PA
    Step counters - detect vertical accelerations of body record count when vertical acceleration excees threshpld value, so not very good with super slow speeds but accurate for number fo steps taken and distance walked step count better than kilocalorie estimates
    Limitations - less sensitive if tileted away from vertical plane so must be worn properly and also for obese may fail to record steps at slow pace
    whats better is an ankle device which is sensitive enough to detect frail slow shufflunng steps so better accuracy
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24
Q

Acceloerometer how does it wirk pros cons give example of one

A

measure movement based on accleration deceleration any type of moveemtn worn on trunk or limbs provides FIT of PA measures in all 3 planes not very good ith cycling or swimming
good one fore that is the active pal
pros - small data over long periods download data can be worn by different people easy to track
cons - more reasources and time than pedometer, need technical expertise single plane models not accurat for bike swimming
cant deetch incresed activity level from upper body movement carrying laod or surface changes like hills
equasions that estimate EE may not apply to free living situations

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25
Q

Heart rate monitors

A

linearly related to vo2 during submax aerobic activities
good method of PA assessment
very practical in the field
able to store data estimation of FIT of PA for days to weeks
indirect calorimetry is highly correlated with HR monitoring stronger correlation accelerometers vs valoriometry for lifestyle activities
wearing an accelerometer and. HR monitor toegtehr may imrpove EE estimation and classification of time spent in light moderate and hard atcivity
limitations - HR incresed by temp humidity high altitude can result in overest of EE
also influenced by emotional state hydration status type of contraction and amount of muscle mass recruited will afect Hr independent of PA level

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26
Q

Other devices

A

Monitors that use muliple inputs some monitos use a combo of acclerometer and physiological signals to preduct and calculate energy expentidture like the sensewear armband and the actiheart
GPS can provoide accuract assessment of speed ranging from slow walking to rast running and can be sued indoor or outside cant be used for stationary activities like biking physiological sensors embedded into clothing with wearable digital cameral may be useful in future

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27
Q

General PA guidelines

A

0-4 years ofl 180 mins per day of activity and when reach 5 YOA 60 mins of energetic play no screen time for 0-2 2-4 1 hr of screen time
for us 150 mins per week in 10 mins or more bouts
older adults more focus on bone strentthan and muscle building of major muscle groups

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28
Q

What can vo2 predict

A

extreame predictor of all cause morbidity and mortality

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29
Q

First ever lab exercise test

A

Measured. the incresed consumption of vital air sustained during sustained exercise

30
Q

vo2max was introduced 1923 - 1925 what did it demonstrate e

A

oxygen uptake increses linearly with running speed but eventually reaches a maximym which no effort can drive it further up

31
Q

vo2 max

A

important for performing in aerobic sports preduct sucess in ensurance sports indicate the baility to recovery from tasks

32
Q

Assessing aeorbic power

A

gold standard vo2max test defined by the fick equasion which is cardiac output hr times SV times AVo2 difference

33
Q

Absolute vs relative vo2 what is limitation of it

A

absolute is the total vol of oxygen taken up by body
relative - volume of oxygen taken up by the body per unit of bosy weight relative is better
major limitation of it is body comp of the person because oxygen uptake is brought on by sksletal muscle so how much muscle mass a person has limits the test

34
Q
A
35
Q

How are vo2 max tests given what do you increse and what are modifications

A

graded up to opeak levels and those grades generally increse by 2-3 mets each step up to get a new vo2 plateau you increse speed and grade, speed alone is not recommended
slower initial speed for inexperienced or can start with walk and increse speed first then grade after many differnt protocols avaiklible

36
Q

what are end of vo2test criteria

A

volitional exhaustion
rpe of 17+
peak and plateau of less than 150ml/min in oxygen consumption with increse in work rate
respiratory exchange ratio greater than 1.15
achivement of preducted maximum HR
venous lactate concentration of mroe than 8nm

37
Q

what are contraindications to vo2

A

drop in systolic bp of 10mmhg with incerse in workload if measureing or dizziness near fainting
hypertensive response blood pressure more than 250/115mmhg
chest pain or angina
signs of poor perfusions (cyanosis or pallor)
abnormal ECG recording is using or cramping/extreame fatiuge)

38
Q

Peak vs max vo2

A

max /true vo2 - must utilize largest overall muscle mass requires working against gravity and is accomplished on treadmill atleast we think so
peak vo2max - all other exercise machines or modalities

39
Q

how can we check is the test data is valid

A

post gas check (gas analysers)
checking to see if the parameters follow the desired trends ie VE FECO FEO vo2 are close to tehir expected norms just seeing if the increse compared ot norms

40
Q

Variability in vo2max testing

A

at any given point there is about a 3-5 ml/kg/min variance betweeen vo2maxes of a 50ml/kg/min individual there is high evidence that it is reliable

41
Q

vo2max in feild

A

used to be in a car beside individual big bag collecting air at altitude now we have masks that have gas analysers in them

42
Q

What to do if no metabolic cart

A

many things can be used to preduct vo2max max or submax formula to provide predicted max or peak

43
Q

Indirect maximal tests for vo2 max

A

Leger 20 meter shuttle run
bruce continuious progressive extersize to exhaustion 10 percent grade 1.7mph incese every 3. ins time is recorded can use a nonogram which aligns time with vo2 or by using equasions
mod bruce
balke
cooper 12 min
naughton treadmill - exhaustion higher risk individuals 0 grade 1 mph incres speed and grade every 2 ins time is recorded
lots of different equasions for indirect calc of vo2

44
Q

other maximal indirect tests

A

multistage treadmill good estimation of vo2max protocol can be adapted
cycle ergometry which can be discontinous or continuous with max power output and is attained used to estimate vo2 submax

45
Q

Indirect submax tests for vo2

A

mCAFT
YMCA
AStrand
PWN
ACSM
Ebelling
Rockport

46
Q

Why use preductive submax vo2

A

Safe avoids max cardiovascular stress
inexpesnsive less equipment less expertise
mass testing
duration shotrer than max

47
Q

Submax test for preduicting vo2max - what is based on

A

positive linear relationship between power output vo2 and HR
Assumption max HR can be predicted similar in all individuals
Assumption Variability in HR day to day is minimal
Assumption that efficiency of exercise is simlar between individuals at max
best predictive power using HR occurs between HR of 120-170 b/min
preduction may be less accurate above and below these HR

48
Q

Predicting vo2ax by graphing

A

use of metabolic equasions to calculate vo2 for each stag e
plot HR end stage 3rd min only vs calculated vo2 and extrapolate to age preducted HR max
then use the line best fit

49
Q

Ebbeling treadmill test

A

Lots of assumptions uses only one stage uses HR speed speed times age age to dertmine vo2 max from test

50
Q

Rockport 1 mile run

A

male or female 20-69 more appropriate for older and sedentary poulations
one mile track is required
walk as quick as possible measure Hr immediately after test

51
Q

General protocol for measuring vo2 for submax tests and what is critical competency

A

5 min warm-up monitoring HR bp and RPE before, during, and after exercise 1 3 5 min
ability to measure resting an dpost exercise blood pressure and HR resting steady state and post

52
Q

Limitations to submax tests

A

HR factors like anxiety stress caffience talking body position
Achivement of steady state
age preducted maxHR formulas have errors
over and underestimation for athletes sedentary populations and older populations

53
Q

other aerobic assessments (stress tests) and the incremental exercise protocol

A

cardiac function by incresing HR and myocardial contractility
incremental exercise protocol - 12 lead ECG system plus bp measurements subjective symptoms of borg scale angina scale which is chest pain claudication scale, which is another pain scale not for heart and dyspnea scale which is a shortness of breath scale

54
Q

why do we use exercise fro aerobic asessments rather than drigs or meds

A

while drugs can raise BP, HR exercise does everything all at once and includes a number of stressors all at the same time, like increasing bp venous return and also competing oxygen demands of the peripheral muscles that can’t be replicated with meds

55
Q

Why use stress tests

A

prognosis - assessment patients with risk factors
diagnose - those with coronary artery disease and symtoms like chest pain shortness of breath or lightededness
functional - assess a product that may be used to improve coronary artery circulation and to determine a safe level of exercise for rehave and daily living

56
Q

Aerobic capacity def how its measured

A

Total amount of work that can be done using aerobic energy sources - how long cna you go at given intensity
The test needs to be sufficient in duration to determine and predict the limit of aerobic power output validity heavily dependent on hydration glycogen lactate muscle soreness

57
Q

Why measure aerobic capacity

A

Ultra-endurance athletes may have the same vo2 max levels as middle-distance runners, but the latter cannot match the aerobic capacity and may be more important to the individual than other physiological variables used to assess aerobic fitness, especially for exercise prescription capacity, also may have more application to ADLs than power

58
Q

Aerobic capacity testing (boulay method what is the rationale behind it

A

90 min cycle ergometry 10 bpm below AT 60 rpm o rhigher results as kJ/KG the greater the heart rate before reaching AT the greater capacity under the graph as aerobic capacity
the rationale behind it is that vo2max does not predict the max amount of energy that can be generated aerobically
90 min stresses 0 mechnisms related to aerobic energy production and the duration also does not require food and the intensity does not engage anaerobic glycolysis if set below AT reliable but hard to tell if valid as you need to reach exhaustion

59
Q

What are limitations of the boulay aerobic capacity test

A

Length of test requires determination of AT which requires control of resistence
dehydration and cardiovascular drift as well as substrate availibility maybe have a nutroitional requirement
lack of comparable data availible

60
Q

Assessment of the Anaerobic trheshold

A

the exercise vo2 above which anaerobic high every production supplements aerobic high energy production with a consequential lowering of the celular redox state increse in lactate and pyruvate ip ratio and net increse in lactat production at site of anaerobisis
(essentially the pint you reach when anaerobic supplements aerobic system causes more lactate buildup)
and has 2 components lactate and ventilatory thresholdsL

61
Q

Lactate threshold

A

The more fit a person is the later lactate wil start to be produced and they are able to exercise at that greater ntensity before starting lactate production can still have similar vo2s but production will start later
Graded 3-4 mins compared to vo2 tests which are 2-3 moiins as it required times for it to buffer and reach the blood also needs proper equipment
ventilation responds independant to lactate

62
Q

Maximal lactate steady state

A

Essentially max amount of lactate that can be maintained
increses of less than 1mM
requires series of tests at different intensities preceded by a LT test and often requires several days
BLa vs power output or time

62
Q

Single lactate trheshold determination (graphical analysis

A

Single lactate threshold is the point that precededs a sustained chage in bla more than 1mM
regression analysis - interaction of 2 regression lines forces above and below causing an inflection point
d max method - largest deviation between LA vs W curve and the line connected at end points
OBLA- onset blood lactate of 4 mM simple least accurate

63
Q

Ventilatory threshold

A

Graded to near max 2-3 mins

64
Q

vent threshold analysis ways

A

vslope method vco2 vs vo2 pint point they cross
in general LT usually occurs at similar time or preceded VT by one workload higher the higher threshold means you can cruise at a higher intenisty longer

65
Q

Field testing anaerobic threshold

A

Uses repeated intervals of exercise of incresing speed over a predetermined distance and measures HR and actial velocity at the end of each interval
graph HR vs velocty and determine the deflection (breakaway) pont in HR response and products AT

66
Q

PWC 170 test

A

Physcial work capacity 170 heart rate suggeest that a capacity tests
two consequetive 6 min PE cycle ergometer at 5-60 rpm with hr at 120-140 plot HR vs PO and extrapolate to HR of 170 and determines the PO at 170 or PWC at 170 assumes that anaerobic trheshold is at 170 bpm

67
Q

submax ensurance test of aerobic capacity limitations

A

Not long enough to stress AC
variables selected may not indicate AC
possible that some submax ests intensities are higher than AT so are they AC tests like PWC 170 could be above AT in some individuals

68
Q

does Anaerobic threshold actually indicate aerobic capacity

A

if intensity of exercise below AT is considered to be attained primarly through aerobic energy sources and above AT there is an incresed need for energy from anerobic glycolysis than AT may set the upper limit for AC
evidence for it
by defintiion - below AT exercise endurance time is greatly increse and above AT greadtly reduced endurance athelets competing in events stressing the capacity of the aerobic system have higher AT

69
Q
A

Kin 311 (4 decks)

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