Lectures 12-15 Flashcards
1
Q
Inflammation of one or more joints, causing pain and stiffness that can worsen with age
A
arthritis
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#
3
Q
Arthritis:
Common with other diseases
A
66% overweight/obese
4
Q
Arthritis:
Non-modifiable risk factors
A
- Age
- Gender
- Genetic
5
Q
Arthritis:
Non-modifiable risk factors
- The risk of developing most types of arthritis increases with age
A
Age
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
7
Q
Arthritis:
Modifiable risk factors
A
- Overweight and obesity
- Joint injuries
- Infection
- occupation
8
Q
Arthritis:
Modifiable risk factors
- Excess weight can contribute to both the onset and progression of knee osteoarthritis
A
Overweight and obesity
9
Q
Arthritis:
Modifiable risk factors
- Damage to a joint can contribute to the development of osteoarthritis in that joint
A
Joint injuries
10
Q
Arthritis:
Modifiable risk factors
- Many microbial agents can infect joints and potentially cause the development of specific forms of arthritis
A
Infection
11
Q
Arthritis:
Modifiable risk factors
- Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee
A
Occupation
12
Q
Arthritis Types:
- Most common type
- Wear-and-tear damage to cartilage
- relating to the bones
A
Osteoarthritis
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)
14
Q
Arthritis Types:
- No matter what types, joint _ may follow
A
erosin
15
Q
Arthritis pain areas
A
in the joints, ankle, back, fingers, hands, muscles, neck, or wrist
16
Q
Arthritis pain types
A
can be intermittent or sharp
17
Q
Arthritis pain circumstances
A
can occur while sitting
18
Q
Arthritis ages affected
A
- Some 19-40 years
- Most 41-60 years and 60+
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)
20
Q
Arthritis - Ex testing:
- _ is a termination criteria
A
Inflammation
21
Q
Arthritis - Ex testing:
- The mode of the test should be the _
A
least painful
22
Q
Arthritis - Ex testing:
- Allow time for individuals to _
A
warm-up (at a very light or light intensity level)
23
Q
Arthritis - Ex testing:
- Monitor _
A
pain level
24
Q
Arthritis - Ex programming:
- Mild arthritis (within tolerance) follow _
A
healthy individual guideline (joint-friendly)
25
Arthritis - Ex programming:
- Arthritis with disability or diminished physical functioning follow _
chronic disease guideline
26
Arthritis - Ex programming:
- Ex should include _
- Muscular fitness
- Neuromotor & Balance
- Adequate warm-up & cool down
27
Why is physical activity important for people with arthritis?
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)
28
How to exercise safely with arthritis:
S.M.A.R.T tips
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
29
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
T - talk to a health professional or certified exercise specialist
30
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)
R - recognize safe places and ways to be active
31
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 - activities should be "joint-friendly"
32
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
M - modify activity when arthritis symptoms increase, try to stay active
33
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
S - start low, go slow
34
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 _
long-term pain relief
35
What to do if there is pain during or after exercise with arthritis:
- Tips to help manage pain
- 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
36
Exercise training considerations for arthritis:
- The goal of aerobic exercise is to improve cardiorespiratory fitness with _
little to no joint pain or damage
37
Exercise training considerations for arthritis:
- Pain is the _
- Minimize pain while gradually increase loads as tolerated
major barrier
38
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
low-impact
39
Exercise training considerations for arthritis:
- It is appropriate to start with _ of 10 min (or less if needed)
short bouts
40
Exercise training considerations for arthritis:
- In addition to improving muscular strength and endurance, _ may reduce pain and improve physical function
resistance training
41
Exercise training considerations for arthritis:
- Adequate _ are critical for minimizing pain
warm-up and cool-down periods (5-10 min)
42
FITT for individuals with arthritis:
Aerobic
- Frequency
3-5 days/week
43
FITT for individuals with arthritis:
Aerobic
- Intensity
Moderate (40-59% HRr) to vigorous (>/=60% HRr)
44
FITT for individuals with arthritis:
Aerobic
- Time
150 min/week MPA
75 min/week VPA
or equivalent combination
45
FITT for individuals with arthritis:
Aerobic
- Type
Activities with low-impact joint stress (walking, cycling, swimming, aquatic exercise)
46
FITT for individuals with arthritis:
Resistance
- Frequency
2-3 days/week
47
FITT for individuals with arthritis:
Resistance
- Intensity
60-80% 1-RM
- Initial intensity should be lower (50-60%) for those unaccustomed to resistance training
48
FITT for individuals with arthritis:
Resistance
- Time
Use healthy adult value and adjust accordingly (8-12 reps for 2-4 sets)
- Include all major muscle groups
49
FITT for individuals with arthritis:
Resistance
- Type
Machine or free weights
- Body weight exercises may also be appropriate for select individuals
50
FITT for individuals with arthritis:
Flexibility
- Frequency
Daily
51
FITT for individuals with arthritis:
Flexibility
- Intensity
Move through ROM feeling tightness/stretch without pain
- progress ROM of each exercise only when there is very little or no joint pain
52
FITT for individuals with arthritis:
Flexibility
- Time
Up to 10 repetitions for dynamic movements
- Hold static stretch 10-30 seconds
53
FITT for individuals with arthritis:
Flexibility
- Type
A combination of dynamic and static stretching focused on all major joints
54
Ex Rx for individuals with arthritis:
Individuals with arthritis need to be reassured that exercise is _, fatigue, inflammation and disease activity
not only safe but is generally reported to reduce pain
55
Ex Rx for individuals with arthritis:
In general, recommendations for Ex Rx are consistent with those for _
apparently healthy adults
56
Osteoporosis characterized by _
- Low bone material
- Decrease in bone strength
- Weak and brittle
57
Osteoporosis:
- More than _
- More than 10 million ≥ 50 yr
- 34 million are at risk
54 million
58
Osteoporosis:
- Affects _ in their lives
1 out of every 2 women
59
Osteoporosis:
Ages affected
- Some 41-60yrs
- Most _
60+ yrs
60
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
Osteoporosis
61
(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
Low bone mass
62
Osteoporosis:
Clinically, we use _ to estimate the prevalence
Femur neck or lumbar spine
63
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
Femur neck
64
Osteoporosis:
Clinically, used to estimate the prevalence
- Osteoporosis-related fractures most commonly occur in the hip, wrist or spine
Lumbar spine
65
Osteoporosis - T-score:
Bone density is within 1 SD (+1 or -1) of the young adult mean
Normal
66
Osteoporosis - T-score:
Bone density is between 1 and 2.5 SD below the young adult mean (-1 to -2.5 SD)
Love bone mass
67
Osteoporosis - T-score:
Bone density is 2.5 SD or more below the young adult mean (-2.5 SD or lower)
Osteoporosis
68
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
Severe (established) osteoporosis
69
Osteoporosis Causes:
- Bone is _ that is constantly being broken down and replaced
living tissue
70
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 _
lost faster than it's created
71
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
less likely
72
Osteoporosis Causes:
- Osteoporosis occurs when the _
creation of new bone doesn't keep up with the removal of old bone
73
Osteoporosis Risk Factors
- Sex
- Age
- Race
- Family History
- Body Frame size
- Low calcium intake
- Eating disorders
- Gastrointestinal surgery
74
Osteoporosis Risk Factors:
Women are much more likely to develop osteoporosis than are men
Sex
75
Osteoporosis Risk Factors:
The older you get, the greater the risk of osteoporosis
Age
76
Osteoporosis Risk Factors:
You're at greatest risk of osteoporosis if you're white or of Asian descent
race
77
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
Family History
78
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
Body frame size
79
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
Low calcium intake
80
Osteoporosis Risk Factors:
Severely restricting food intake and being underweight weakens bone in both men and women
Eating disorders
81
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
Gastrointestinal surgery
82
Osteoporosis Symptoms & Complications:
There are typically _ in the early stages of bone loss
no symptoms
83
Osteoporosis Symptoms & Complications
- 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
Osteoporosis Symptoms & Complications:
- A bone fracture occurs much more easily than expected
-- Bone fractures, particularly in the spine or hip, are the _ of osteoporosis
most serious complication
85
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
even if you haven't fallen
86
How does physical activity reduce osteoporosis?
- Resistance means you're working against the weight of another object
- Resistance training helps with osteoporosis because it _
strengthens muscle and builds bone
87
How does physical activity reduce osteoporosis?
- Resistance means you're working against the weight of another object
- Studies have shown that resistance exercise increases _
bone density and reduces the risk of fractures
88
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 _
bone loss and conserves bone tissues, lowering the risk of fractures
89
How does physical activity reduce osteoporosis?
- Exercise also helps reduce the risk of _
falling
90
Ex Testing - osteoporosis
self-guided method, pre-screening & CVD risk factor
91
Ex Testing - osteoporosis:
Mild condition _
senior fitness test
92
Ex Testing - osteoporosis:
Use of _ to assess cardio if walking is painful
cycle leg ergometry
93
Ex Testing - osteoporosis:
Balance testing or fall risk assessment
- Four-stage balance test
- Falls efficacy scale
94
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
Four-stage balance test
95
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
Falls Efficacy Scale
96
Osteoporosis - Effects on the Ex response:
Without bone pain or fractures, there is _ on the Ex response
little effect
97
Osteoporosis - Effects on the Ex response:
Ex reduces risk for osteoporosis by _
- Enhancing bone mass
- Slowing the rate of bone loss
- Reducing the risk for falls via benefits on muscle strength and balance
98
Osteoporosis - Ex Programming:
Mild to moderate follow _
healthy individual guideline
99
Osteoporosis - Ex Programming:
Severe follow _
chronic disease guideline
100
Osteoporosis - Ex Programming:
Ex should include _
- Muscular fitness: endurance and core strength
- Neuromotor
- Balance
- Weight bearing Ex
101
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.
Weight-bearing
102
Osteoporosis - Ex Programming:
- When you do regular _ exercise, your bone adapts to the impact of weight and pull of muscle by building more cells and becoming stronger
weight-bearing
103
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
weight-bearing aerobic exercise
104
FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Frequency
Weight-bearing aerobic activities 3-5 days/week
105
FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Frequency
2-3 days/week
106
FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Intensity
Moderate to vigorous
107
FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Intensity
Moderate (8-12 repetitions) to vigorous (5-6 repetitions)
108
FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Time
30-60 min/day of a combination of weight-bearing aerobic and resistance activities
109
FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Time
30-60 min/day of a combination of weight-bearing aerobic and resistance activities
110
FITT recommendations for individuals at risk for Osteoporosis:
Aerobic
- Type
Weight-bearing aerobic activities (Ex: tennis, stair climbing/descending, walking with intermittent jogging), activities that involve jumping (Ex: volleyball, basketball)
111
FITT recommendations for individuals at risk for Osteoporosis:
Resistance
- Type
resistance exercises (Ex: weight lifting)
112
FITT recommendations for individuals with Osteoporosis:
Aerobic
- Frequency
Weight-bearing aerobic activities 3-5 days/week
113
FITT recommendations for individuals with Osteoporosis:
Resistance
- Frequency
2-3 days/week
114
FITT recommendations for individuals with Osteoporosis:
Aerobic
- Intensity
Moderate intensity
115
FITT recommendations for individuals with Osteoporosis:
Resistance
- Intensity
Moderate intensity in terms of bone loading forces, although some individuals may be able to tolerate more intense exercise
116
FITT recommendations for individuals with Osteoporosis:
Aerobic
- Time
30-60 min/day of a combination of weight-bearing aerobic and resistance activities
117
FITT recommendations for individuals with Osteoporosis:
Resistance
- Time
30-60 min/day of a combination of weight-bearing aerobic and resistance activities
118
FITT recommendations for individuals with Osteoporosis:
Aerobic
- Type
Weight-bearing aerobic activities (Ex: tennis, stair climbing/descending, walking with intermittent jogging), activities that involve jumping (Ex: volleyball, basketball)
119
FITT recommendations for individuals with Osteoporosis:
Resistance
- Type
Resistance exercise (Ex: weightlifting)
120
Special considerations - Osteoporosis:
- Use moderate weight-bearing Ex that does not _
cause or worsen the pain
121
Special considerations - Osteoporosis:
- _ explosive movements or high-impact loading
Avoid
122
Special considerations - Osteoporosis:
- Improve _
Balance
123
Special considerations - Osteoporosis:
- Improve balance
-- strengthen the _ because these are the muscles primarily responsible for balance
quadriceps, hamstrings, and gluteal and trunk muscles
124
Cigarette Smoking in the US:
≥ 480,000 deaths every year, or about _ deaths
1 in 5
125
Cigarette Smoking in the US:
_ deaths due to secondhand smoke
≥ 41,000
126
Cigarette Smoking in the US:
In 2018, 34.2 million U.S. adults were current cigarette smokers
- Of these, 76.1% smoked _
every day
127
Cigarette Smoking in the US:
Current smoking has declined from 20.9% in 2005 to _ in 2018
13.7%
128
A group of lung diseases that block airflow and make it difficult to breath
Chronic Obstructive Pulmonary Disease (COPD)
129
What is COPD?
- Chronic Bronchitis
- Emphysema
- No effective cure for COPD and lung damage can't be reversed
130
COPD - In the US:
- _ leading cause of death
- 16 million Americans (6.4%) have been diagnosed
4th
131
COPD - Ages affected:
- Some 19-40 yrs
- Most _
41-60 and 90+ yrs
132
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
Physical activity
133
COPD - Treatments:
Quitting smoking tobacco
Smoking cessation
134
COPD - Treatments:
Using the large muscle between the lungs and abdomen to inhale and exhale more deeply
Diaphragmatic breathing
135
inflammation of main and smaller bronchi
Bronchitis
136
Bronchitis:
- Very common
- last few days due to cold or infection
- repeated acute may become chronic
Acute
137
Bronchitis:
- serious condition
- due to smoking
- one of the conditions included in COPD
Chronic
138
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
Emphysema
139
COPD:
The _ shows the amount of air breathe out, quickly and forcefully, after a deep breath
FVC
140
COPD:
The FEV1 measurement is recorded during the _ of the FVC test
1st second
141
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
FEV1/FVC
142
COPD:
diagnose COPD if FEV1/FVC ratio falls below _
70%
143
COPD:
If already received a COPD diagnosis, FEV1 score can help determine which _ COPD has reached
stage
144
COPD:
Done by comparing _ value of those individuals similar to you with healthy lungs
FEV1 score to the predicted
145
Ex Testing for COPD
- Self-guided method, pre-screening & CVD risk factor
- Senior fitness test; 6-min walk (supervised)
146
Ex Testing for COPD:
More severe pulmonary disease and in settings that lack exercise testing equipment
- watch intensity
- walking
submaximal cycle ergometer or treadmill
147
Ex Testing for COPD:
Monitor _
dyspnea: difficult breathing or shortness of breath
148
Ex Rx for COPD:
- There are _ guidelines that describe the specific application of the FITT principles
no evidence-based
149
Ex Rx for COPD:
_ exercise training is recommended for individuals in all stages of COPD who are able to exercise
Aerobic
150
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
Resistance training
151
Ex Rx for COPD:
Observation of _ in people with COPD
- lower extremity strengthening and balance training are effective
falls
152
Ex Programming for COPD:
Be flexible, upon _
- conditions
- Dyspnea
153
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
Modifications
154
Ex Training considerations for COPD:
_ intensities
- With mild COPD, intensity guidelines, for healthy older adults are appropriate
Higher
155
Ex Training considerations for COPD:
Higher intensities
- Moderate-to-severe COPD, intensities representing _
> 60% peak work rate
156
Ex Training considerations for COPD:
_ is appropriate for those with severe COPD or very deconditioned
Light intensity aerobic exercise
157
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
dyspnea
158
Ex Training considerations for COPD:
Intensity targets based on percentage of estimated HRmax or HRr may be _
inappropriate
159
FITT recommendations for COPD:
Aerobic exercise
- Frequency
3-5 days/week
160
FITT recommendations for COPD:
Aerobic exercise
- Intensity
Vigorous and light
161
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
Light intensity
162
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
Moderate-severe
163
FITT recommendations for COPD:
Aerobic exercise
- Time
Shorter period of vigorous intensity exercise separated by period of rest (Interval training)
164
FITT recommendations for COPD:
Aerobic exercise
- Type
walking and/or cycling
165
FITT recommendations for COPD:
Resistance and Flexibility exercise
- Follow same FITT principle of Ex Rx for _
healthy adults and/or older adults
166
A condition in which a person's airways become inflamed, narrow and swell, and produce extra mucus, which makes it difficult to breath
Asthma
167
Asthma:
In the US
- 26.5 million, 6 million _
children
168
Asthma:
In the US
- Prevalence is higher in _, and higher in _
≥ 3500 deaths per ye
- children (9.4%) than in adults (7.7%)
- females (9.2%) than males (7.0%)
169
Asthma:
- Symptoms are variable and often reversible, can be controlled
- But the disease itself _
can’t be completely cured
170
We don't know for sure what causes asthma, but we do know that attacks are sometimes triggered by _
- Allergens
- Exercise
- Occupational hazards
- Tobacco smoke
- Air pollution
- Airway infections
171
90% of all asthma patients experience _ during Ex
- An older term is exercise-induced asthma, which wrongly suggests that exercise causes asthma
Exercise-induced bronchoconstriction (EIB)
172
Effects of Ex Training - Asthma:
- _ does not improve airway inflammation
Ex alone
173
Effects of Ex Training - Asthma:
- Symptoms can be provoked or worsened by Ex, and then _
negative cycle
174
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
Negative cycle
175
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
CRF
176
Effects of Ex Training - Asthma:
- Consistent Ex reduces the need for _ to control asthma
medication
177
Effects of Ex Training - Asthma:
- Improvements in _, aerobic capacity, maximal work rate, Ex endurance, and pulmonary minute ventilation (VE) have been noted
days without asthma symptoms
178
Effects of Ex Training - Asthma:
- Overall, Ex training is well tolerated and should be _ in people with stable asthma
encouraged
179
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
Pulmonary function
180
Ex Testing for Asthma:
- Monitor _ (0-10 scale), specially for EIB
-- More likely to have _, wheezing, coughing and other acute symptoms during or after Ex
-- Sufficient warm-up & cool down
dyspnea
181
Ex Testing for Asthma:
- Need medications and _ during Ex
-- prepare inhaler
preventive measures
182
Ex Testing for Asthma:
- The _ may be used in individuals with moderate-to-severe persistent asthma when other testing equipment is not available
6-min walk test
183
FITT Recommendations for Asthma:
Aerobic
- Frequency
3-5 days/week
184
FITT Recommendations for Asthma:
Aerobic
- Intensity
Begin with moderate intensity
- If well tolerated, progress to 60-70% HRr after 1 month
185
FITT Recommendations for Asthma:
Aerobic
- Time
Progressively increase to at least 30-40 min/day
186
FITT Recommendations for Asthma:
Aerobic
- Type
Aerobic activities using large muscle groups such as walking, running, cycling, swimming, or pool exercises
187
FITT Recommendations for Asthma:
Resistance
- Frequency
2-3 days/week
188
FITT Recommendations for Asthma:
Resistance
- Intensity
- strength: 60-70% of 1RM for beginners; >/= 8-% for experienced weight trainers
- Endurance: <50% of 1RM
189
FITT Recommendations for Asthma:
Resistance
- Time
- strength: 2-4 sets, 8-12 reps
- Endurance:
190
FITT Recommendations for Asthma:
Resistance
- Type
Weight machines, free weight, or body weight
191
Ex Rx for Asthma:
FITT recommendations for comprehensive exercise in healthy adults, _ are suitable
adjusted to patient capabilities
192
Ex Programming for Asthma:
Be flexible upon _
- conditions
- Dyspnea
193
Ex Programming for Asthma:
- _ at the beginning period
-- Easier on FITT
Modifications
194
Ex Programming for Asthma:
- Work towards the _
-- Only if FITT is well tolerated
healthy individual guideline
195
FITT Recommendations for Asthma:
Aerobic exercise
- Progression
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
Special considerations for Asthma:
- Use of _ may be necessary before or after Ex
short-acting inhaler
197
Special considerations for Asthma:
- Adjust intensity to avoid _
dyspnea
198
Special considerations for Asthma:
- _ condition individual should limit Ex until symptoms released
Acute
199
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
HR target intensities
