Module 1: Lecture Notes Flashcards
What percentage of Americans do not engage in the recommended amt of phys activity?
80%
What % of Americans are physically inactive?
43%
What are the benefits of regular activity?
- Improvement in cardio-respiratory function
- Reduction in cardiovascular disease risk factors
- Decrease in morbidity (disease) and mortality (death)
- Decreased anxiety and depression; improved cognitive health
- Dose-response for health/fitness benefits
What percentage of Americans have high blood pressure/hypertension?
33%
What did people die of in 1900s? What do people die fo today?
infectious diseases
cardiovascular disease
What is health?
A state of complete physical, mental, social well-being; not merely the absence of disease
How can one be healthy via exercise?
30 minutes of moderate intensity activity on most, if not all, days of the week (expend about 150kcal)
What is the recommended exercise level?
3 to 5x/week of moderate (300 mins) to vigorous (150 mins) aerobic exercise; Strength, stretch > 2x/week
Who benefits the most from exercise?
Those who are inactive
Can you be healthy but not physically fit? Can you be physically fit but not healthy?
Yes
Yes
What are the health related components of physical fitness?
− Cardio-Reparatory Endurance
− Body Composition
− Muscular Strength and Muscular Endurance
− Flexibility and Balance
Is exercise always safe?
There is an increased risk of sudden cardiac death during vigorous exercise
- But, this risk is much lower among those who are regularly active
- Overall risk is low when weighed against benefits of exercise
Risk of cardiac events during exercise testing in mixed subject population
- 6 per 10,000 maximal tests due to MI (heart attack), dysrhythmia, or death
For submaximal testing, the risk is extremely low
What are the two values of exercise testing?
Functional and Diagnostic
What is are functional values of exercise testing?
- Assess CR endurance; other attributes of fitness
- Basis for exercise prescription
- Monitor progress
- Useful for education and motivation
What is are diagnostic values of exercise testing?
- Along w/ other data (med hx, phys exam, lab tests, signs/symptoms during exercise test)
- Limited value in apparently healthy populations - can get false positives (some evidence of cardiovascular changes that do not mean much)
What is Cardio-Respiratory Endurance (CR-E)?
the ability of the body to perform prolonged large muscle dynamic exercise at moderate to high levels of intensity
In cardiorespiratory endurance, what is -take in- -deliver- and -use-?
take in: lungs
deliver: heart
use: muscle cells
What is VO2 max?
maximum oxygen consumption
What are the 3 metabolic processes during exercise?
immediate, non-oxidative, and oxidative
Which 2 metabolic processes do not use oxygen?
immediate stores and anaerobic or non oxidative metabolism
What is the immediate stores?
ATP and CP, ATP lasts 3-5 seconds, and CP contributes it phosphate which can last up to 10-12 seconds
What is anaerobic or nonoxidative metablism?
glucose –> pyr acid –> LA –> 2ATP
lasts 2 minutes
What is aerobic or oxidative metabolism?
intensity low-moderate, rate of ATP production slow but prolonged
What happens to marathon runners when they “hit the wall”?
They ran out of glucose, NOT fat
What is pulmonary ventilation?
intake of air through lungs to pulmonary capillaries into the heart
What is fR?
frequency of respiration, breaths per minutes
What is VT?
Tidal volume
What is VE?
Pulmonary or minute ventilation
What is the equation for fR, VT, and VE?
fR (breaths/min) x VT (L/breath) = VE (L/min)
What is HR, SV, and CO?
HR = heart rate SV = stroke volume CO = cardiac output
What is Q?
amount of blood pumped by the heart per minute
What is the relationship of HR, SV, and Q?
HR * SV = Q
Average HR vs Fit HR graph
Fit HR resting is lower, but max HR is the same
Graph of SV over WL VO2
Fit people achieve a higher SV than unfit people
Graph of Q over WL VO2
Fit person has a higher CO or Q
What is the VO2 equation?
VO2 = Q * (a-v O2difference) where a is emptied to muscle and v is left to return to heart
What is the rationale behind health screening?
- To identify risk, dependent on subject’s heath/medical status and their physical activity/exercise goals
- Select appropriate exercise-based assessments
What are the components to informed consent?
− Purpose and Explanation of Test
− Risks and Discomforts
− Responsibilities of the Participant
− Benefits to be Expected
− Inquiries: Any other questions other than what is listed on this form?
− Use of Medical Records: Confidential document
− Freedom of Consent: At any point, they can also remove their consent
What are the two categories of contraindications to exercise testing?
Relative and Absolute
What is a relative contraindication?
Not as bad as absolute, benefits of exercise testing may outweigh the risks
What is an absolute contraindiciation?
Everything under this list is unstable, and should be taken into considering when administering exercise tests
What is the PAR-Q+ questionnaire?
The Physical Activity Readiness Questionnaire for Everyone:
Assess for a problem before exercise
What is the Health Status Questionnaire (HSQ)?
Questionnaire for exercise professionals/providers to fill out after client has exercised
S/SSX (signs and symptoms)
What is CVD?
Cardiovascular disease: are diseases of the heart and blood vessels; includes coronary artery disease, heart attack, stroke, heart failure
What is the leading cause of death in the US?
CVD
What is the main cause of CVD?
coronary artery disease (heart’s own blood supply)
What are the steps of atherosclerosis?
• Step 1: Injury of some kind to the endothelial lining of the blood vessel (fatty streak)
o Possible injuries: smoking, high blood pressure, cholesterol
• Step 2: Platelets rush in and begin to aggregate (over years) start to form and form slowly
• Step 3: Smooth muscle cells being proliferating (purple layer start to form on top)
• Step 4: Cell necrosis (cells die) and the rupture of the plaque
o All the plaque contents dump out and could possibly obstruct the entire vessel, causing a thrombus
What is ischemia?
The economics of health, where oxygen supply is not matched up with oxygen demand (oxygen supply < oxygen demand)
What are the manifestations of heart disease?
- angina pectoris
- stroke
- myocardial infarction
- arrhythmias
What is angina pectoris?
chest pain
What is myocardial infarction?
heart attack, irreversible cellular death of myocardial tissue (no necessarily deadly if only small section suffered)
What is a stroke?
Pieces of plaque break free, travel to the brain, and block blood vessels that supply blood to the brain
What are arrhythmias?
irregular heart beats, which can be normal if it is one every few, but if there are many going on it is abnormal
What are major risk factors for CVD that cannot be changed?
age, gender, genetics (family history)
What are major risk factors that can be changed?
Tobacco use, high blood pressure, unhealthy cholesterol levels, obesity, pre-diabetes, physical inactivity
What are the specific CVD risk factors with age?
Men over 45 years, women over 55 years (men and women dies the same, women is later onset)
What are the specific CVD risk factors with family history?
Father or brother with CVD before age 55, mother or sister with CVD before age 65
What are the specific CVD risk factors with tobacco use?
3x as many smokers die of CVD than lung disease
What are the specific CVD risk factors with high blood pressure?
130+ or 80+
What are the specific CVD risk factors with total cholesterol?
Total: >200mg%
LDL: >130 mg%
HDL: <40 mg%
What are LDLs?
Low density lipoproteins, vehicles in which cholesterol travels around in bloodstream
What are HDLs?
High density lipoproteins, “garbage trucks” of the bloodstream that gets rid of unnecessary cholesterol
What are the specific CVD risk factors with obesity?
Body Mass Index > 30 kg/m^2
Waist Circ > 102 cm (m) and 88 cm (f)
WHR > 0.95 (m) and 0.86 (f)
What are the specific CVD risk factors with pre-diabetes?
FBS (fasting blood sugar) > 100 mg%
Normal FBS: 60-90
What are the specific CVD risk factors with physical inactivity?
Not participating in at least 30 minutes of moderate-intensity physical activity at least 3 days a week for at least 3 months
What are the ways to diagnose CVD?
Exercise stress test with electrocardiogram (ECG)
Echocardiogram, angiogram
What are the possible treatments of ischemia?
RESTORE:
- Angioplasty and Stent: Insertion of balloon and wire stent to widen artery
- Coronary Artery Bypass Graft: redirect mammary artery to normalize blood flow, can take vein from leg and sew it on to aorta and attack it past blockage
LOWER DEMAND:
- exercise training, certain cardiac medications that lower HR and/or BP
What are the pertinent signs and symptoms for CVD?
angina palpitations (irregular heart beats) shortness of breath (dyspnea) syncope (fainting) ankle edema, swelling in ankles intermittent claudication (cramping in butt/legs)
What is the bottom line for exercise testing? Overall summary.
All individuals wishing to initiate a physical activity program should complete Pre-Assessment Screening procedures
Determine:
Recognition of known C-V, metabolic, renal diseases and presence of major signs/symptoms suggestive of dz
Currently exercising regularly?
Recommendations for medical clearance and level of exercise intensity
What should the instructions to clients be for an exercise test?
Avoid food (but still eat earlier in the day), alcohol, caffeine, or tobacco within 3 hours of test
Be well-rested, avoid exercise that day
Wear comfortable, loose-fitting clothing
Continue medications as prescribed
What order should the testing be performed in to ensure the least interference?
Obtain resting measurements first Body composition test Test for cardio-respiratory endurance Assessment of muscular fitness (strength, endurance) Flexibility test
What are different measurements of C-R fitness?
Field tests (1 mile walk, 1.5 mile run, etc.) Submaximal tests (2 min step test, YMCA bike test) Maximal tests (treadmill)
What are advantages to field tests?
- large numbers can be tested at one time
- little equipment needed
What are the disadvantages to field tests?
- may require an all-out effort
- unmonitored
- lack of motivation may influence accuracy
What are advantages to submaximal tests?
reasonably accurate prediction of VO2 max at a lower cost, reduced risk, less time/effort by subject
What are the disadvantages to submaximal tests?
estimated MHR may introduce error
What are advantages to maximal tests?
Truer measure of VO2 max (from metabolic calculations or direct measurement)
Increasing sensitivity in diagnosing CAD
What are disadvantages to maximal tests?
Discomfort of volitional fatigue
May require MD supervision
What does each letter of FITTE stand for?
F-frequency I-intensity T-time T-type of activity E-enjoyment
What is the I in FITTE? What are the HR reserve and RPE do you want to be at when exercising?
50-85% of heart rate reserve
RPE (somewhat hard) 12-14
What is the purpose of warm up and cool down?
WU: prepare heart/muscles for exercise
CD: circulate blood, reduce soreness, time to stretch
What is the first T in FITTE?
time should be 20-60 minutes of continuous activity
duration dependent upon intensity where young men jogged 4x per week and injury was at 52% with 60 minutes
What is the second T in FITTE?
type of activity should be continuous rhythmic activity involving large muscle groups
- Weight bearing exercise (dependent on your body weight): walk, jog, stairs
- Orthopedically forgiving exercise: cycle, swim, row
What is the target heart rate calculation equation?
(MaxHR-RestHR)%intensity + RestHR
What are the steps to using the target heart rate calculation equation?
- Estimate your Max HR, 220-age = MHR
- Measure your Rest HR (RHR)
- Subtract your RHR from your MHR = Heart Rate Reserve (HRR)
- Multiply your HRR by selecting an appropriate range between 50% - 85%
- Add back you RHR to these answers
What is the F in FITTE?
frequency should be 3-5 days per week
Young men from a study did 40 min jog for 20 weeks found that injury significantly increase between 4 and 6 days a week
What are some statistics about the E in FITTE?
80% of Americans aren’t exercising the recommended level, and 20% of sedentary
50% who begin exercise program dropout within first 6 months
What are some way to put the E in Exercise?
Set goals Choose appropriate time/location Vary activities Exercise buddy Track progress Reward yourself Have fun!
