Module 1 Flashcards
Indicate which of the following points were made in “Morbidity and Mortality Weekly Report”. 2014;63(18):407-13:
Select ALL correct answer/s from the below:
A) In the United States, one in 8 adults aged 18 – 64 years has a serious limitation in their hearing, vision, cognition or mobility;
B) Those who are inactive are 25% more likely to have chronic disease than those who get the recommended amount of aerobic physical activity each week
C) 80% are inactive, meaning they do not get any aerobic physical activity
D) Approximately 44% of adults who saw a doctor or other health professional in the past 12 months received a physical activity recommendation and were more likely to be active than those who did not receive a recommendation
A & D
Indicate which of the following were identified in “Morbidity and Mortality Weekly Report” (2014;63(18):407-13) as being barriers to physical activity participation for people with disabilities:
Select ALL correct answer/s from the below:
A) Lack of knowledge of the benefits of physical activity.
B) Physical or emotional barriers to participating in fitness and recreation activities.
C) Lack of training in accessibility and communication among fitness and recreation professionals.
D) Limited information about accessible facilities and programs.
E) Physical barriers in the built or natural environment.
B, C, D, E
If a person who is currently completing less than 30 minutes of moderate intensity activity per week increases the amount of physical activity they are completing to 40 minutes per week, they will reduce their relative risk of all-cause mortality by more than a than a person who is currently meeting National Physical Activity Guidelines (150 minutes of moderate intensity activity per week) who increases to 160 minutes per week.
In the box below state whether this is true or false, and then briefly explain your answer.
This is true. The relationship between moderate physical activity and all-cause mortality rates is negatively curvilinear, indicating that the rate of reduction for all-cause mortality decreases as the amount of time spent participating in moderate physical activity increases.
You have just concluded a community-based intervention for an elderly person who had a stroke five years previously. The aim of the intervention was to improve health and functioning. At the commencement of the intervention your client was completely sedentary, but by the conclusion of the intervention they were meeting with a neighbour four evenings a week to go for a slow-paced 20 minute walk. A colleague criticises this outcome because “your client is not meeting physical activity guidelines and is therefore not going to accrue a health benefit”.
What evidence could you cite to defend the health benefit of your intervention?
To defend the health benefit of this intervention, you could cite the Australian Physical Activity Guidelines, which state that any increase in physical activity is beneficial, and sedentary adults can gradually work up to meet full guidelines. Additionally, the American Heart Association’s recommendations for stroke survivors support that four 20-minute walks per week can help reduce cardiovascular risk, improve daily functioning (ADLs), and build stamina for longer exercise. Research also shows that even smaller amounts of activity than the guidelines recommend can lower mortality and reduce the risk of serious health conditions, demonstrating that this intervention still provides significant health benefits.
A colleague of yours writes a report on a client in which they state:
“My client’s ability to walk is impaired”.
Is this statement consistent with the language of the ICF?
If not, why not?
How should it be changed so that it is consistent with the ICF?
No it’s not consistent with the language of the ICF.
The term “impair” refers to problems with body structures or functions. An example of an impairment could be reduced vision or reduced muscle tone. As walking is not a body structure or function, it is not appropriate to say it is impaired.
Walking could be classes as an “activity” in the ICF frameworks, therefore we would say they are having an activity limitation in the context of walking. “My client’s ability to walk is limited”.
The figure above is presented in a paper by Zhu et.al. Entitled “Does intensive rehabilitation improve functional outcome of patients with traumatic brain injury (TBI)? A randomised controlled trial” (Brain Injury, 21: 681-690, 2007).
Briefly describe the data presented in the figure and discuss 4 (four) potential practical implications for professional practice in exercise science/exercise physiology.
The figure above is presented in a paper by Kreisel et.al. entitled “Pathophysiology of stroke Rehabilitation: the natural course of clinical recovery, use-dependent plasticity and rehabilitative outcome” (Cerebrovascular Disease, 23: 243-255, 2007).
In your own words, describe the data presented in the figure and discuss two (2) potential practical implications for professional practice in exercise science/exercise physiology.
After the initial 28 days, motor ability appears to plateau irrespective of stroke severity at a new maximum. This indicates that the capacity for us as exercise professionals to improve a stroke patient’s moto capabilities is reduced after that initial 28 days.
1. Exercise interventions after the initial stages of recovery should focus on treating and managing co-morbidities that could arise form new motor impairments.
2. Exercise interventions should focus on helping the patient’s capitalise on the period in which they can improve their motor ability the most. Should help improve their rate of absolute degree of motor recovery.
Vicki is a 23 year old woman with spastic diplegic cerebral palsy. She has a flexion pattern of hypertonicity in her legs which limits range of movement at the hips, knees and ankles. She also has increased tone in her upper limbs but they are less affected than her legs. In relation to vision, she has difficulty with depth perception. She walks as her primary means of locomotion but cannot run, has difficulty climbing stairs and cannot walk carrying a load of more than 3kg. She lives mostly independently (cooking, cleaning, self care) but she cannot do her weekly shopping by herself and so each week a paid support worker goes with her to assist.
Using the ICF framework, identify Vicki’s impairments, activity limitations and participation restriction.
Impairments: Impaired vision (depth perception), impaired ROM at hips, knees, and ankles, increased muscle stiffness in limbs.
Activity Limitations: Running ability limited, ability to climb stairs limited, ability to walk with load >3kg limited.
Participation restrictions: Unable to go shopping without support worker.
There is very strong evidence that exercise is effective in reducing morbidity and mortality in Type 2 diabetes mellitis by improving glycemic control and insulin sensitivity. Conversely, there is little or no evidence that exercise will promote neurological recovery in chronic spinal cord injury.
With this background, explain how the aims of an exercise intervention would differ for the two cases below.
A person who is sedentary and who has newly diagnosed Type 2 Diabetes Mellitis.
The goal of an exercise program should be designed to treat and manage their T2D by improving their glycemic control and insulin sensitivity. Secondary, exercise will serve to reduce the incidence of inactivity-related co-morbidities. The program should seek to help the patient move towards the physical activity guidelines and reduce the effects their new conditions has on their QOL.
There is very strong evidence that exercise is effective in reducing morbidity and mortality in Type 2 diabetes mellitis by improving glycemic control and insulin sensitivity. Conversely, there is little or no evidence that exercise will promote neurological recovery in chronic spinal cord injury.
With this background, explain how the aims of an exercise intervention would differ for the two cases below.
A person who is sedentary and who has a complete spinal cord injury at T5 acquired 10 years ago.
The goal of an exercise program fro this patient should not focus on treating or managing their condition, but instead try and help them reach physical activity guidelines to reduce the changes of co-morbidities common with inactivity occurring and improve their physical function given their neurological constraints.
