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Ex Rx for Individuals with Chronic Disease > Lectures 12-15 > Flashcards

Lectures 12-15 Flashcards

1
Q

Inflammation of one or more joints, causing pain and stiffness that can worsen with age

A

arthritis

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2
Q

Arthritis: In the Us
- 54.4 million
- 1 out of every 4 US adults
- _ cause of disability
- Approx. 67 million by 2030

A

1#

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3
Q

Arthritis:
Common with other diseases

A

66% overweight/obese

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4
Q

Arthritis:
Non-modifiable risk factors

A
  • Age
  • Gender
  • Genetic
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5
Q

Arthritis:
Non-modifiable risk factors
- The risk of developing most types of arthritis increases with age

A

Age

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6
Q

Arthritis:
Non-modifiable risk factors
- Most types of arthritis are common in women; 60% of people with arthritis are women
- Gout is more common in men

A

genetic

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7
Q

Arthritis:
Modifiable risk factors

A
  • Overweight and obesity
  • Joint injuries
  • Infection
  • occupation
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8
Q

Arthritis:
Modifiable risk factors
- Excess weight can contribute to both the onset and progression of knee osteoarthritis

A

Overweight and obesity

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9
Q

Arthritis:
Modifiable risk factors
- Damage to a joint can contribute to the development of osteoarthritis in that joint

A

Joint injuries

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10
Q

Arthritis:
Modifiable risk factors
- Many microbial agents can infect joints and potentially cause the development of specific forms of arthritis

A

Infection

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11
Q

Arthritis:
Modifiable risk factors
- Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee

A

Occupation

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12
Q

Arthritis Types:
- Most common type
- Wear-and-tear damage to cartilage
- relating to the bones

A

Osteoarthritis

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13
Q

Arthritis Types:
- Autoimmune disease
- Immune system mistakenly attacks the lining of the joint (synovial membrane, protects and lubricates joints)
- Eventually destroy cartilage and bone within the joint
- No effective cure

A

Rheumatoid arthritis (RA)

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14
Q

Arthritis Types:
- No matter what types, joint _ may follow

A

erosin

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15
Q

Arthritis pain areas

A

in the joints, ankle, back, fingers, hands, muscles, neck, or wrist

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16
Q

Arthritis pain types

A

can be intermittent or sharp

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17
Q

Arthritis pain circumstances

A

can occur while sitting

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18
Q

Arthritis ages affected

A
  • Some 19-40 years
  • Most 41-60 years and 60+
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19
Q

Arthritis - Ex testing

A
  • Self-guided method & pre-screening algorithm.
  • Senior fitness test; gait speed test (most individuals with arthritis tolerate treadmill walking)
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20
Q

Arthritis - Ex testing:
- _ is a termination criteria

A

Inflammation

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21
Q

Arthritis - Ex testing:
- The mode of the test should be the _

A

least painful

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22
Q

Arthritis - Ex testing:
- Allow time for individuals to _

A

warm-up (at a very light or light intensity level)

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23
Q

Arthritis - Ex testing:
- Monitor _

A

pain level

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24
Q

Arthritis - Ex programming:
- Mild arthritis (within tolerance) follow _

A

healthy individual guideline (joint-friendly)

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25
Q

Arthritis - Ex programming:
- Arthritis with disability or diminished physical functioning follow _

A

chronic disease guideline

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26
Q

Arthritis - Ex programming:
- Ex should include _

A
  • Muscular fitness
  • Neuromotor & Balance
  • Adequate warm-up & cool down
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27
Q

Why is physical activity important for people with arthritis?

A

Participating in joint-friendly activity can improve arthritis pain, function, mood, and quality of life
- Joint-friendly physical activities are low-impact (walking, biking, swimming)

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28
Q

How to exercise safely with arthritis:
S.M.A.R.T tips

A

S - start low, go slow
M - modify activity when arthritis symptoms increase, try to stay active
A - activities should be “joint-friendly”
R - recognize safe places and ways to be active
T - talk to a health professional or certified exercise specialist

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29
Q

How to exercise safely with arthritis: SMART
- Your doctor is a good source of information about physical activity
- Healthcare professionals and certified exercise professionals can answer questions about how much and what type of activity matches abilities and health goals

A

T - talk to a health professional or certified exercise specialist

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30
Q

How to exercise safely with arthritis: SMART
- Safety is important for starting and maintaining an activity plan
- Exercise classes may be a good option
- Find safe places to be active (walk in an area where the sidewalks or pathways are level and free of obstructions well-lighted and are separate from heavy traffic)

A

R - recognize safe places and ways to be active

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31
Q

How to exercise safely with arthritis: SMART
- Chose activities that are easy on the joints like walking, bicycling, water aerobics, or dancing
- These activities have a low risk of injury and do not twist or “pound” the joints too much

A

A - activities should be “joint-friendly”

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32
Q

How to exercise safely with arthritis: SMART
- Arthritis symptoms, such as pain, stiffness, and fatigue, may come and go and you may have good days and bad days
- Try to modify activity to stay as active as possible without making symptoms worse

A

M - modify activity when arthritis symptoms increase, try to stay active

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33
Q

How to exercise safely with arthritis: SMART
- When starting or increasing physical activity, start slow and pay attention to how your body tolerates it
- People with arthritis may take more time for their body to adjust to a new level of activity
- If you are not active, start with a small amount of activity, for example, 3 to 5 minutes 2 times a day
- Add activity a little at a time and allow enough time for your body to adjust to the new level before adding more activity

A

S - start low, go slow

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34
Q

What to do if there is pain during or after exercise with arthritis:
It’s normal to have some pain, stiffness and swelling after starting a new physical activity program
- It may take 6-8 weeks for joint to get used to new activity level, but sticking with the activity program will result in _

A

long-term pain relief

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35
Q

What to do if there is pain during or after exercise with arthritis:
- Tips to help manage pain

A
  • Until pain improves, modify physical activity program by exercising less frequently or for shorter periods of time
  • Try a different type of exercise that puts less pressure on the joints
  • Do proper warm-up and cool-down before and after exercise
  • Exercise at a comfortable place - should be able to carry on a conversation
  • Make sure you have good fitting, comfortable shoes
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36
Q

Exercise training considerations for arthritis:
- The goal of aerobic exercise is to improve cardiorespiratory fitness with _

A

little to no joint pain or damage

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37
Q

Exercise training considerations for arthritis:
- Pain is the _
- Minimize pain while gradually increase loads as tolerated

A

major barrier

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38
Q

Exercise training considerations for arthritis:
_ aerobic activities do not put stress on the joints and include brisk walking, cycling, swimming, water aerobics, light gardening, group exercise classes, and dancing

A

low-impact

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39
Q

Exercise training considerations for arthritis:
- It is appropriate to start with _ of 10 min (or less if needed)

A

short bouts

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40
Q

Exercise training considerations for arthritis:
- In addition to improving muscular strength and endurance, _ may reduce pain and improve physical function

A

resistance training

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41
Q

Exercise training considerations for arthritis:
- Adequate _ are critical for minimizing pain

A

warm-up and cool-down periods (5-10 min)

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42
Q

FITT for individuals with arthritis:
Aerobic
- Frequency

A

3-5 days/week

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43
Q

FITT for individuals with arthritis:
Aerobic
- Intensity

A

Moderate (40-59% HRr) to vigorous (>/=60% HRr)

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44
Q

FITT for individuals with arthritis:
Aerobic
- Time

A

150 min/week MPA
75 min/week VPA
or equivalent combination

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45
Q

FITT for individuals with arthritis:
Aerobic
- Type

A

Activities with low-impact joint stress (walking, cycling, swimming, aquatic exercise)

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46
Q

FITT for individuals with arthritis:
Resistance
- Frequency

A

2-3 days/week

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47
Q

FITT for individuals with arthritis:
Resistance
- Intensity

A

60-80% 1-RM
- Initial intensity should be lower (50-60%) for those unaccustomed to resistance training

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48
Q

FITT for individuals with arthritis:
Resistance
- Time

A

Use healthy adult value and adjust accordingly (8-12 reps for 2-4 sets)
- Include all major muscle groups

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49
Q

FITT for individuals with arthritis:
Resistance
- Type

A

Machine or free weights
- Body weight exercises may also be appropriate for select individuals

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50
Q

FITT for individuals with arthritis:
Flexibility
- Frequency

A

Daily

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51
Q

FITT for individuals with arthritis:
Flexibility
- Intensity

A

Move through ROM feeling tightness/stretch without pain
- progress ROM of each exercise only when there is very little or no joint pain

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52
Q

FITT for individuals with arthritis:
Flexibility
- Time

A

Up to 10 repetitions for dynamic movements
- Hold static stretch 10-30 seconds

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53
Q

FITT for individuals with arthritis:
Flexibility
- Type

A

A combination of dynamic and static stretching focused on all major joints

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54
Q

Ex Rx for individuals with arthritis:
Individuals with arthritis need to be reassured that exercise is _, fatigue, inflammation and disease activity

A

not only safe but is generally reported to reduce pain

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55
Q

Ex Rx for individuals with arthritis:
In general, recommendations for Ex Rx are consistent with those for _

A

apparently healthy adults

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56
Q

Osteoporosis characterized by _

A
  • Low bone material
  • Decrease in bone strength
  • Weak and brittle
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57
Q

Osteoporosis:
- More than _
- More than 10 million ≥ 50 yr
- 34 million are at risk

A

54 million

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58
Q

Osteoporosis:
- Affects _ in their lives

A

1 out of every 2 women

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59
Q

Osteoporosis:
Ages affected
- Some 41-60yrs
- Most _

A

60+ yrs

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60
Q

is defined as a bone mineral density (BMD) value that is > 2.5 standard deviation units below the mean BMD value for a young adult reference group

A

Osteoporosis

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61
Q

(osteopenia, a milder reduction in BMD) is defined as a BMD value between 1.0 and 2.5 SD units below the mean value for a young non-Hispanic white female reference group

A

Low bone mass

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62
Q

Osteoporosis:
Clinically, we use _ to estimate the prevalence

A

Femur neck or lumbar spine

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63
Q

Osteoporosis:
Clinically, used to estimate the prevalence
- It has a larger percentage of soft bone than the rest of femur
- This makes it more vulnerable to a fracture

A

Femur neck

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64
Q

Osteoporosis:
Clinically, used to estimate the prevalence
- Osteoporosis-related fractures most commonly occur in the hip, wrist or spine

A

Lumbar spine

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65
Q

Osteoporosis - T-score:
Bone density is within 1 SD (+1 or -1) of the young adult mean

A

Normal

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66
Q

Osteoporosis - T-score:
Bone density is between 1 and 2.5 SD below the young adult mean (-1 to -2.5 SD)

A

Love bone mass

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67
Q

Osteoporosis - T-score:
Bone density is 2.5 SD or more below the young adult mean (-2.5 SD or lower)

A

Osteoporosis

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68
Q

Osteoporosis - T-score:
Bone density is more than 2.5 SD below the young adult mean, and there have been one or more osteoporotic fractures

A

Severe (established) osteoporosis

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69
Q

Osteoporosis Causes:
- Bone is _ that is constantly being broken down and replaced

A

living tissue

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70
Q

Osteoporosis Causes:
- When young, body makes new bone faster than it breaks down old bone, so bone mass increases
- Most people reach peak bone mass by their early 20s.
- As people age, bone mass is _

A

lost faster than it’s created

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71
Q

Osteoporosis Causes:
- The higher your peak bone mass, the more bone you have “in the bank” and the _ you are to develop osteoporosis as you age

A

less likely

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72
Q

Osteoporosis Causes:
- Osteoporosis occurs when the _

A

creation of new bone doesn’t keep up with the removal of old bone

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73
Q

Osteoporosis Risk Factors

A
  • Sex
  • Age
  • Race
  • Family History
  • Body Frame size
  • Low calcium intake
  • Eating disorders
  • Gastrointestinal surgery
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74
Q

Osteoporosis Risk Factors:
Women are much more likely to develop osteoporosis than are men

A

Sex

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75
Q

Osteoporosis Risk Factors:
The older you get, the greater the risk of osteoporosis

A

Age

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76
Q

Osteoporosis Risk Factors:
You’re at greatest risk of osteoporosis if you’re white or of Asian descent

A

race

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77
Q

Osteoporosis Risk Factors:
having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father experienced a hip fracture

A

Family History

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78
Q

Osteoporosis Risk Factors:
Men and women who have small body frames tend to have a higher risk because they may have less bone mass to draw from as they age

A

Body frame size

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79
Q

Osteoporosis Risk Factors:
A lifelong lack of calcium plays a role in the development of osteoporosis
- Contributes to diminished bone density, early bone loss and an increased risk of fractures

A

Low calcium intake

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80
Q

Osteoporosis Risk Factors:
Severely restricting food intake and being underweight weakens bone in both men and women

A

Eating disorders

81
Q

Osteoporosis Risk Factors:
Surgery to reduce the size of your stomach or to remove parts of the intestine limits the amount of surface area available to absorb nutrients including calcium

A

Gastrointestinal surgery

82
Q

Osteoporosis Symptoms & Complications:
There are typically _ in the early stages of bone loss

A

no symptoms

83
Q

Osteoporosis Symptoms & Complications

A
  • Back pain, caused by a fracture or collapsed vertebra
  • Loss of height over time
  • A stooped posture
  • A bone fracture occurs much more easily than expected
84
Q

Osteoporosis Symptoms & Complications:
- A bone fracture occurs much more easily than expected
– Bone fractures, particularly in the spine or hip, are the _ of osteoporosis

A

most serious complication

85
Q

Osteoporosis Symptoms & Complications:
- A bone fracture occurs much more easily than expected
– In some cases, spinal fractures can occur _
– The bones that make up your spine can weaken to the point that they may crumple, which can result in back pain, lost height and a hunched forward posture

A

even if you haven’t fallen

86
Q

How does physical activity reduce osteoporosis?
- Resistance means you’re working against the weight of another object
- Resistance training helps with osteoporosis because it _

A

strengthens muscle and builds bone

87
Q

How does physical activity reduce osteoporosis?
- Resistance means you’re working against the weight of another object
- Studies have shown that resistance exercise increases _

A

bone density and reduces the risk of fractures

88
Q

How does physical activity reduce osteoporosis?
- Osteoporosis is characterized by the loss of calcium in a person’s bones, which makes them more likely to fracture
- Exercising regularly reduces the rate of _

A

bone loss and conserves bone tissues, lowering the risk of fractures

89
Q

How does physical activity reduce osteoporosis?
- Exercise also helps reduce the risk of _

A

falling

90
Q

Ex Testing - osteoporosis

A

self-guided method, pre-screening & CVD risk factor

91
Q

Ex Testing - osteoporosis:
Mild condition _

A

senior fitness test

92
Q

Ex Testing - osteoporosis:
Use of _ to assess cardio if walking is painful

A

cycle leg ergometry

93
Q

Ex Testing - osteoporosis:
Balance testing or fall risk assessment

A
  • Four-stage balance test
  • Falls efficacy scale
94
Q

Ex Testing - osteoporosis:
Balance testing or fall risk assessment
- Try and stand in each of the 4 positions for 10 seconds, can hold arms out, or move body to help keep balance but don’t move your feet
1. Stand with your feet side-by-side
2. Place the instep of one foot so it is touching the big toe of the other foot
3. Tandem stand: Place one foot in front of the other, heel touching toe
4. Stand on one foot

A

Four-stage balance test

95
Q

Ex Testing - osteoporosis:
Balance testing or fall risk assessment
- Scale from 1 to 10, with 1 being very confident and 10 being not confident at all, how confident are you that you can do the following activities without falling?
– Take shower/bath
– Reach into cabinets/closets
– Walk around the house
– Prepare meals not requiring carrying heavy/hot objects
– Get in/out of bed
– Answer the door/phone
– Get in/out of a chair
– Getting dressed/undressed
– Personal grooming
– Getting on/off the toliet

A

Falls Efficacy Scale

96
Q

Osteoporosis - Effects on the Ex response:
Without bone pain or fractures, there is _ on the Ex response

A

little effect

97
Q

Osteoporosis - Effects on the Ex response:
Ex reduces risk for osteoporosis by _

A
  • Enhancing bone mass
  • Slowing the rate of bone loss
  • Reducing the risk for falls via benefits on muscle strength and balance
98
Q

Osteoporosis - Ex Programming:
Mild to moderate follow _

A

healthy individual guideline

99
Q

Osteoporosis - Ex Programming:
Severe follow _

A

chronic disease guideline

100
Q

Osteoporosis - Ex Programming:
Ex should include _

A
  • Muscular fitness: endurance and core strength
  • Neuromotor
  • Balance
  • Weight bearing Ex
101
Q

Osteoporosis - Ex Programming:
- _ describes any activity you do on your feet that works your bones and muscles against gravity
- Bone is living tissue that constantly breaks down and reforms.

A

Weight-bearing

102
Q

Osteoporosis - Ex Programming:
- When you do regular_ exercise, your bone adapts to the impact ofweightand pull of muscle by building more cells and becoming stronger

A

weight-bearing

103
Q

Osteoporosis - Ex Rx:
Currently, little evidence exists regarding the optimal exercise regime for individuals with or at risk for osteoporosis
- In general, _ in combination with some form of high-impact, high-velocity, high-resistance training is considered the best choice for with population

A

weight-bearing aerobic exercise

104
Q

FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Frequency

A

Weight-bearing aerobic activities 3-5 days/week

105
Q

FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Frequency

A

2-3 days/week

106
Q

FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Intensity

A

Moderate to vigorous

107
Q

FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Intensity

A

Moderate (8-12 repetitions) to vigorous (5-6 repetitions)

108
Q

FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Time

A

30-60 min/day of a combination of weight-bearing aerobic and resistance activities

109
Q

FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Time

A

30-60 min/day of a combination of weight-bearing aerobic and resistance activities

110
Q

FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Type

A

Weight-bearing aerobic activities (Ex: tennis, stair climbing/descending, walking with intermittent jogging), activities that involve jumping (Ex: volleyball, basketball)

111
Q

FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Type

A

resistance exercises (Ex: weight lifting)

112
Q

FITT recommendations for individuals with Osteoporosis:
Aerobic
- Frequency

A

Weight-bearing aerobic activities 3-5 days/week

113
Q

FITT recommendations for individuals with Osteoporosis:
Resistance
- Frequency

A

2-3 days/week

114
Q

FITT recommendations for individuals with Osteoporosis:
Aerobic
- Intensity

A

Moderate intensity

115
Q

FITT recommendations for individuals with Osteoporosis:
Resistance
- Intensity

A

Moderate intensity in terms of bone loading forces, although some individuals may be able to tolerate more intense exercise

116
Q

FITT recommendations for individuals with Osteoporosis:
Aerobic
- Time

A

30-60 min/day of a combination of weight-bearing aerobic and resistance activities

117
Q

FITT recommendations for individuals with Osteoporosis:
Resistance
- Time

A

30-60 min/day of a combination of weight-bearing aerobic and resistance activities

118
Q

FITT recommendations for individuals with Osteoporosis:
Aerobic
- Type

A

Weight-bearing aerobic activities (Ex: tennis, stair climbing/descending, walking with intermittent jogging), activities that involve jumping (Ex: volleyball, basketball)

119
Q

FITT recommendations for individuals with Osteoporosis:
Resistance
- Type

A

Resistance exercise (Ex: weightlifting)

120
Q

Special considerations - Osteoporosis:
- Use moderate weight-bearing Ex that does not _

A

cause or worsen the pain

121
Q

Special considerations - Osteoporosis:
- _ explosive movements or high-impact loading

A

Avoid

122
Q

Special considerations - Osteoporosis:
- Improve _

A

Balance

123
Q

Special considerations - Osteoporosis:
- Improve balance
– strengthen the _ because these are the muscles primarily responsible for balance

A

quadriceps, hamstrings, and gluteal and trunk muscles

124
Q

Cigarette Smoking in the US:
≥ 480,000 deaths every year, or about _ deaths

A

1 in 5

125
Q

Cigarette Smoking in the US:
_ deaths due to secondhand smoke

A

≥ 41,000

126
Q

Cigarette Smoking in the US:
In 2018, 34.2 million U.S. adults were current cigarette smokers
- Of these, 76.1% smoked _

A

every day

127
Q

Cigarette Smoking in the US:
Current smoking has declined from 20.9% in 2005 to _ in 2018

A

13.7%

128
Q

A group of lung diseases that block airflow and make it difficult to breath

A

Chronic Obstructive Pulmonary Disease (COPD)

129
Q

What is COPD?

A
  • Chronic Bronchitis
  • Emphysema
  • No effective cure for COPD and lung damage can’t be reversed
130
Q

COPD - In the US:
- _ leading cause of death
- 16 million Americans (6.4%) have been diagnosed

A

4th

131
Q

COPD - Ages affected:
- Some 19-40 yrs
- Most _

A

41-60 and 90+ yrs

132
Q

COPD - Treatments:
Aerobic activity for 20-30 minutes, 5 days a week improves cardiovascular health
- If injured, pursuing an activity that avoids the injured muscle group or joint can help maintain physical function while recovering

A

Physical activity

133
Q

COPD - Treatments:
Quitting smoking tobacco

A

Smoking cessation

134
Q

COPD - Treatments:
Using the large muscle between the lungs and abdomen to inhale and exhale more deeply

A

Diaphragmatic breathing

135
Q

inflammation of main and smaller bronchi

A

Bronchitis

136
Q

Bronchitis:
- Very common
- last few days due to cold or infection
- repeated acute may become chronic

A

Acute

137
Q

Bronchitis:
- serious condition
- due to smoking
- one of the conditions included in COPD

A

Chronic

138
Q
  1. Inner walls of the alveoli weaken and rupture
  2. one larger alveoli instead of many small ones
  3. Reduce the surface area for gas exchange
  4. Amount of O2 that reaches vessel reduced
  5. Old air becomes trapped
  6. No room for fresh (O2-rich) air to enter
  7. Short of breath (dyspnea
A

Emphysema

139
Q

COPD:
The _ shows the amount of air breathe out, quickly and forcefully, after a deep breath

A

FVC

140
Q

COPD:
The FEV1 measurement is recorded during the _ of the FVC test

A

1st second

141
Q

COPD:
_ ratio represents the percentage of your lung capacity that you can expel in one second. The higher your percentage, the larger your lung capacity and the healthier your lungs

A

FEV1/FVC

142
Q

COPD:
diagnose COPD if FEV1/FVC ratio falls below _

A

70%

143
Q

COPD:
If already received a COPD diagnosis, FEV1 score can help determine which _ COPD has reached

A

stage

144
Q

COPD:
Done by comparing _ value of those individuals similar to you with healthy lungs

A

FEV1 score to the predicted

145
Q

Ex Testing for COPD

A
  • Self-guided method, pre-screening & CVD risk factor
  • Senior fitness test; 6-min walk (supervised)
146
Q

Ex Testing for COPD:
More severe pulmonary disease and in settings that lack exercise testing equipment
- watch intensity
- walking

A

submaximal cycle ergometer or treadmill

147
Q

Ex Testing for COPD:
Monitor _

A

dyspnea: difficult breathing or shortness of breath

148
Q

Ex Rx for COPD:
- There are _ guidelines that describe the specific application of the FITT principles

A

no evidence-based

149
Q

Ex Rx for COPD:
_ exercise training is recommended for individuals in all stages of COPD who are able to exercise

A

Aerobic

150
Q

Ex Rx for COPD:
_ is the most potent intervention to address the muscle dysfunction seen in COPD and should be an integral part of the Ex

A

Resistance training

151
Q

Ex Rx for COPD:
Observation of _ in people with COPD
- lower extremity strengthening and balance training are effective

A

falls

152
Q

Ex Programming for COPD:
Be flexible, upon _

A
  • conditions
  • Dyspnea
153
Q

Ex Programming for COPD:
_ needed at the beginning period
- COPD patients are unable to sustain 20-30 mins of Ex
- Bouts of 5-10 mins until adaptation

A

Modifications

154
Q

Ex Training considerations for COPD:
_ intensities
- With mild COPD, intensity guidelines, for healthy older adults are appropriate

A

Higher

155
Q

Ex Training considerations for COPD:
Higher intensities
- Moderate-to-severe COPD, intensities representing _

A

> 60% peak work rate

156
Q

Ex Training considerations for COPD:
_ is appropriate for those with severe COPD or very deconditioned

A

Light intensity aerobic exercise

157
Q

Ex Training considerations for COPD:
To determine intensity, _ ratings of between 3 and 6 on the CR10 scale may be used
- correspond with 53% and 80% of VO2peak

A

dyspnea

158
Q

Ex Training considerations for COPD:
Intensity targets based on percentage of estimated HRmax or HRr may be _

A

inappropriate

159
Q

FITT recommendations for COPD:
Aerobic exercise
- Frequency

A

3-5 days/week

160
Q

FITT recommendations for COPD:
Aerobic exercise
- Intensity

A

Vigorous and light

161
Q

FITT recommendations for COPD:
Aerobic exercise
- Intensity
– _ training results in improvements in symptoms, health-related quality of life, and performance of ADL, whereas vigorous intensity training has been shown to result in greater physiologic improvements

A

Light intensity

162
Q

FITT recommendations for COPD:
Aerobic exercise
- Time
– _ COPD may be able to exercise only at a specified intensity for a few minutes at the start of training

A

Moderate-severe

163
Q

FITT recommendations for COPD:
Aerobic exercise
- Time

A

Shorter period of vigorous intensity exercise separated by period of rest (Interval training)

164
Q

FITT recommendations for COPD:
Aerobic exercise
- Type

A

walking and/or cycling

165
Q

FITT recommendations for COPD:
Resistance and Flexibility exercise
- Follow same FITT principle of Ex Rx for _

A

healthy adults and/or older adults

166
Q

A condition in which a person’s airways become inflamed, narrow and swell, and produce extra mucus, which makes it difficult to breath

A

Asthma

167
Q

Asthma:
In the US
- 26.5 million, 6 million _

A

children

168
Q

Asthma:
In the US
- Prevalence is higher in _, and higher in _
≥ 3500 deaths per ye

A
  • children (9.4%) than in adults (7.7%)
  • females (9.2%) than males (7.0%)
169
Q

Asthma:
- Symptoms are variable and often reversible, can be controlled
- But the disease itself _

A

can’t be completely cured

170
Q

We don’t know for sure what causes asthma, but we do know that attacks are sometimes triggered by _

A
  • Allergens
  • Exercise
  • Occupational hazards
  • Tobacco smoke
  • Air pollution
  • Airway infections
171
Q

90% of all asthma patients experience _ during Ex
- An older term is exercise-induced asthma, which wrongly suggests that exercise causes asthma

A

Exercise-induced bronchoconstriction (EIB)

172
Q

Effects of Ex Training - Asthma:
- _ does not improve airway inflammation

A

Ex alone

173
Q

Effects of Ex Training - Asthma:
- Symptoms can be provoked or worsened by Ex, and then _

A

negative cycle

174
Q

Effects of Ex Training - Asthma:
- Symptoms contribute to reduced participation in sports and PA and ultimately to deconditioning and lower CRF
- With deconditioning, the downward cycle continues with asthma symptoms being triggered by less intense PA and subsequent worsening of Ex tolerance

A

Negative cycle

175
Q

Effects of Ex Training - Asthma:
- The Ex improves _, which means that, at any given level of Ex, the person uses less of the maximum O2 that be taken in by the body. This decreased use of O2 reduces the likelihood of an Ex-induced attack

A

CRF

176
Q

Effects of Ex Training - Asthma:
- Consistent Ex reduces the need for _ to control asthma

A

medication

177
Q

Effects of Ex Training - Asthma:
- Improvements in _, aerobic capacity, maximal work rate, Ex endurance, and pulmonary minute ventilation (VE) have been noted

A

days without asthma symptoms

178
Q

Effects of Ex Training - Asthma:
- Overall, Ex training is well tolerated and should be _ in people with stable asthma

A

encouraged

179
Q

Ex Testing for Asthma:
- Self-guided method, pre-screening algorithm & CVD risk factor
- Senior fitness test; FITNESSGRAM
- _ (before and after Ex)
- Submaximal cycle ergometer or treadmill:
– Watch intensity!
– Walking

A

Pulmonary function

180
Q

Ex Testing for Asthma:
- Monitor _ (0-10 scale), specially for EIB
– More likely to have _, wheezing, coughing and other acute symptoms during or afterEx
– Sufficient warm-up & cool down

A

dyspnea

181
Q

Ex Testing for Asthma:
- Need medications and _ during Ex
– prepare inhaler

A

preventive measures

182
Q

Ex Testing for Asthma:
- The _ may be used in individuals with moderate-to-severe persistent asthma when other testing equipment is not available

A

6-min walk test

183
Q

FITT Recommendations for Asthma:
Aerobic
- Frequency

A

3-5 days/week

184
Q

FITT Recommendations for Asthma:
Aerobic
- Intensity

A

Begin with moderate intensity
- If well tolerated, progress to 60-70% HRr after 1 month

185
Q

FITT Recommendations for Asthma:
Aerobic
- Time

A

Progressively increase to at least 30-40 min/day

186
Q

FITT Recommendations for Asthma:
Aerobic
- Type

A

Aerobic activities using large muscle groups such as walking, running, cycling, swimming, or pool exercises

187
Q

FITT Recommendations for Asthma:
Resistance
- Frequency

A

2-3 days/week

188
Q

FITT Recommendations for Asthma:
Resistance
- Intensity

A
  • strength: 60-70% of 1RM for beginners; >/= 8-% for experienced weight trainers
  • Endurance: <50% of 1RM
189
Q

FITT Recommendations for Asthma:
Resistance
- Time

A
  • strength: 2-4 sets, 8-12 reps
  • Endurance: </= 2 sets, 15-20 reps
190
Q

FITT Recommendations for Asthma:
Resistance
- Type

A

Weight machines, free weight, or body weight

191
Q

Ex Rx for Asthma:
FITT recommendations for comprehensive exercise in healthy adults, _ are suitable

A

adjusted to patient capabilities

192
Q

Ex Programming for Asthma:
Be flexible upon _

A
  • conditions
  • Dyspnea
193
Q

Ex Programming for Asthma:
- _ at the beginning period
– Easier on FITT

A

Modifications

194
Q

Ex Programming for Asthma:
- Work towards the _
– Only if FITT is well tolerated

A

healthy individual guideline

195
Q

FITT Recommendations for Asthma:
Aerobic exercise
- Progression

A

after the 1st month, increase intensity to approx 70% VO2peak, the time of each exercise session to 40 min/day and frequency to 5 day/week

196
Q

Special considerations for Asthma:
- Use of _ may be necessary before or after Ex

A

short-acting inhaler

197
Q

Special considerations for Asthma:
- Adjust intensity to avoid _

A

dyspnea

198
Q

Special considerations for Asthma:
- _ condition individual should limit Ex until symptoms released

A

Acute

199
Q

Special considerations for Asthma:
- Caution is suggested in using _ based on prediction of HRr and HRmax because of the wide variability in their association with ventilation and the potential HR effects of asthma control medications

A

HR target intensities

Ex Rx for Individuals with Chronic Disease (9 decks)

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