Module 12: Physical Activity and Exercise Prescription Flashcards
Define physical activity
All leisure and non-leisure body movement produced by the skeletal muscles and resulting in an increase in nrg expenditure.
Define exercise
A type of activity that is planned, structured, and done to improve at least one aspect of physical fitness (aerobic, strength, flexibility, muscular endurance, etc.).
Define physical fitness
A set of attributes that are either health-related or performance/skill related. Health-related fitness comprises those components of fitness that exhibit a relationship with health status. Performance/skill related fitness involves those components of fitness that enable optimal work or sport performance.
Define fatness
The relative or absolute amount of fat cells on your body as estimated by skin caliper, DEXA and other measures and associated with measures such as BMI and waist circumference.
What are the 6 different ways to measure physical activity? Rank then in terms of precision and ease of assessment by drawing a diagram
Most precise and least easy of assessment:
- Room calorimetry
- Doubly labeled water
- Indirect calorimetry
- HR monitoring
- Movement sensors
- Questionnaires
Describe how you would conduct a questionnaire to measure PA? Pros and cons?
During consultation with patient you may try to get an idea of weekly exercise levels using the FITT principle. FITT stands for:
1) Frequency - How often you exercise?
2) Intensity - How hard you work during exercise?
3) Time - How long you exercise during each session?
4) Type - The type of exercise you do?
Questionnaire results:
- Fairly Reliable
- Poor Validity
- Almost useless in children
- Try to use a validated tool
1) Minnesota Leisure-time PA
2) IPAQ
Describe how to use activity monitors to measure PA and pros and cons?
- Accelerometers’ data log movement over multiple days.
- Worn on waist or arm.
- Extensively validated.
- Gives information on volume, intensity and patterns of activity.
- Raw data is entered into an algorithm to estimate kcals, Mets or other energy measure.
Describe how to use HR monitors to measure PA and pros and cons?
- Good linear relationship between nrg expenditure and HR
- Can be data logged over time to see activity patterns.
- Require individual calibration due to inter-individual variation in resting HR, and rate response to activity.
What are the 4 different ways to measure aerobic fitness? Rank them in validity and easy of assessment
Most valid and least ease of assessment:
- Maximal oxygen consumption
- Maximal exercise test (stress test)
- Field tests: 6 min run test
- Sub max exercise testing
According to the American College of Sports Medicine (ACSM), what are the 1) relavent clinical considerations 2) exercise testing 3) exercise prescription and training for individuals with DIABETES?
1) relavent clinical considerations (ACSM recommends a medical exam and a clinical exercise testing for individuals with diabetes (and other metabolic diseases for that matter) particularly when attempting to participate in a moderate (40-60% VO2 Max) and vigorous (>60% VO2 Max):
- Presence of any diabetes related complications.
- Lab findings particularly for hemoglobin 1AC, glucose, lipids and the amount of protein urea.
- BP
- Body weight and BMI.
- Medication use and timing.
- Exercise history (if any).
- Nutritional Plans (if any) including timing, amount and type of most recent food intake.
- Presence of medical conditions (other than diabetes).
2) exercise testing (cardiovascular, strength, and ROM):
a) Cardiovascular
- Mode: Treadmill and/or leg/arm ergometer.
- Specific Measures: Peak VO2 Max, heartrate, blood pressure and 12 lead Electrocardiogram (ECG)
- Special Considerations: special consideration to the following areas/ findings:
- > Chest pain (which could be a sign of ischemia to the heart triggered by atherosclerosis).
- > Arrangements should be made to patients with peripheral vascular problems such as using cycle ergometer mode.
- > Hypoglycemia considerations which means that blood glucose should be tested before the test.
b) Strength
- Mode: Machine weights, dynamometer.
- Specific Measures: strength and power.
- Special Considerations: special consideration to the following areas/ findings:
- > 1RM should not be considered if the patient is sedentary or has severe disease.
- > No resistance type of training for individuals with ocular complications such as retinopathy.
c) Range of Motion (ROM)
- Mode: Goniometer, sit and reach.
- Specific Measures: ROM for major muscle groups.
- Special Considerations: special consideration to the following areas/ findings:
NA
3) Exercise Prescription and training
a) Aerobic
- Frequency: 3-5 per week.
- Intensity: 50-70% of maximal aerobic capacity.
- Type: Walking, cycling, swimming.
- Time: 20-60 min.
- Note on progression: depends on baseline fitness, age, weight, health status and goals.
- Considerations: special consideration to the following areas/ findings:
- > Timing of medications (such as insulin).
- > Including warmup and cool down time.
- > Assessment of footwear (considering the possible complications like an ulcer and the peripheral neuropathy.
- > Adequate hydration.
- > Adequate blood glucose monitoring.
b) Resistance training
- Frequency: 2x/week
- Intensity: About 60% of 1 RM.
- Type: Free weights, machines, elastic bands.
- Time: 10-15 reps per set. One or two sets per activity.
- Note on progression: As tolerated.
- Considerations: special consideration to the following areas/ findings:
- > Same as above.
c) Range of Motion
- Frequency: Post aerobic session.
- Intensity: NA
- Type: static stretch.
- Time: 10-30 secs per exercise of each muscle group.
- Note on progression: As tolerated.
- Considerations: special consideration to the following areas/ findings:
- > Same as above.
According to the American College of Sports Medicine (ACSM), what are the 1) relavent clinical considerations 2) exercise testing 3) exercise prescription and training for individuals with HTN?
1) relevant clinical considerations (ACSM recommends assessing secondary forms of HTN, assessing factors that could influence therapy and determining if end organ damage is present.
2) Exercise testing
- graded exercise test in a useful screening tool for hypertensive patients
- ACSM doesn’t recommend mass exercise testing to identify patients with high risk of developing HTN cause of exaggerated BP response.
- Exercise testing with an ECG usually done for HTN patients with an additional risk factor for cardiac disease, males above 45 years of age and females above 55 years of age.
- Exercise testing should NOT be used in patients with high BP, any pressure equal to and greater than 200/110 mmHg
3) Exercise Prescription and Training
a) Aerobic
- Frequency: 3-7 days per week.
- Intensity: 40-70% of VO2 max
- Type: Walking, jogging, cycling.
- Time: 30-60 min.
- Considerations: special consideration to the following areas/ findings:
- > Antihypertensive medications use.
- > Test should not be administered BP equal to and greater than 200/110 mmHg.
b) Resistance
- Frequency: 2-3 days per week.
- Intensity: 40-60% of 1 RM
- Type: 8-10 exercises for major muscle groups.
- Time: 1 set of 10-15 reps.
- Considerations: special consideration to the following areas/ findings:
- > Same as above.
According to the American College of Sports Medicine (ACSM), what are the
1) relavent clinical considerations
2) exercise testing
3) exercise prescription and training
for individuals with HYPERLIPIDEMIA/DYSLIPIDEMIA?
2) exercise testing
a) Cardiovascular
- Mode: Treadmill/ cycle ergometer.
- Specific Measures: HR, BP, and ECG
- Special Considerations: special consideration to the following areas/ findings:
- > Antihyperlipidemic medication side effects.
b) Strength
- Mode: Free weights, machine weights.
- Specific Measures: 1 RM
- Special Considerations: special consideration to the following areas/ findings:
- > Same as above.
c) ROM
- Mode: static stretching.
- Specific Measures: ROM at major joints.
- Special Considerations: special consideration to the following areas/ findings:
- > Same as above.
3) exercise prescription and training
a) Aerobic
- Frequency: 3-5 days per week.
- Intensity: 40-70 VO2 max
- Type: Walking, jogging, cycling, swimming.
- Time: 40-60 min.
- Considerations: special consideration to the following areas/ findings:
- > The presence of additional CV risk factors.
- > Antihyperlipidemic medication side effects.
b) Resistance
- Frequency: 2-3 days per week.
- Intensity: 1 set of 8015 reps to fatigue.
- Type: free weights, machine weights, elastic band.
- Time: 8-10 different exercises for major muscle groups.
- Considerations: special consideration to the following areas/ findings:
- > Same as above.
c) ROM
- Frequency: 4-7 days a week.
- Intensity: stretch to end of range of motion without pain.
- Type: Static
- Time: 15-30 seconds per stretch.
- Considerations: special consideration to the following areas/ findings:
- > NA
