P4. p197-208 Flashcards
What are the effects of resistance exercise & strength training on:
1) BMR
2) Bone mineral density
3) Metabolic: [chol], glucose tolerance
4) Arthritis
5) NAFLD
BR 197
Effects of resistance exercise & strength training on:
1) Increased BMR
2) Improved BMD in early post-menopausal years
3) Improved [chol] & glucose tolerance
5) Decreased pain & disability w arthritis
6) NAFLD dec LIVER lipids despite no change in visceral adiposity or whole body fat mass.
A) Components of a resistance prescription
B) Eg of initiating resistance script
BR 197-198
A) Components
F - Freq - how often
I - Intensity (wrt ability to lift)
R - Repetitions - # of times life weight
S - Sets - # of cycles of repetitions
B) Initiating
F - Q 48hrs (for recovery)
I - 5-6 out of 10
R - 8-12 before fatigue
S - ?
In terms of flexibility exercises:
1) Why do them ?
2) Does stretching before physical actiivty prevent injury ?
3) Effect of daily hip flexor stretching in the elderly
4) Effect of flex exercises in NIDDM (4)
BR 198
In terms of flexibility exercises:
1) Aim is to enhance ability of a joint to move thru its full ROM
2) Mixed evidence wrt stretching warmup & injury prevention
3) Daily hip flexor stretching => inc gait by inc stride length & Peak hip extension during walking.
4) NIDDM w yoga x 3mos: see small but sig improvement in fasting [glu], ppr [glu], HbA1c, BMI
When introducing flexibility exercises
1) Should one warm up first ?
2) Is it OK to bounce during a stretch ?
3) How long should one
- hold each stretch
- total time for one muscle (group)
4) # of repetition
5) “How hard should I push myself ?”
1) Yes - warm up first
2) Don’t bounce
3) Hold for 10-30 sec w total time of 60 secs
4) Do 2-4 repetitions for each muscle group => 60 seconds total for each stretch
5) Goal is to feel some tension but not pain during a stretch.
In terms of balance exercises
1) Why do them ?
2) What are the documented benefits ?
3) Sequence with introduction
4) Quick office assessment
BR 198 & here
In terms of balance exercises
1) Because they improve ones ability to withstand postural sway or destabilizing stimuli
2) Meta-analysis benefits show decrease in falls which:
- 30% dec injuries requiring medical care
- 40% overall & severe injuries
- 60% resulting in fractures
3) Hand-hold support => remove support => stand on an unstable surface
4) Quick asssessment: stand on one foot.
1) What are METs
2) What is the standard resting MET
3) What are MET hours per week ?
4) Give examples of METs for common activities
BR 199
1) MET = metabolic equivalant of a task (compared to standard resting metabolic rate)
2) Std MET = amt of O2 consumed during quiet rest ~ 3.5 ccO2/kg body wt/minute = 1.0 MET
3) MET hours/wk calculate as the sum of (activity) x (MET for activity) x (hr/wk for activity)
4) Light housework = 2, easy biking = 4, serious = 6 (see slide).
1 hr brisk walking ~ 2.5 METs
1) What dose of exercise (METS per week) shows the most benefit ?
2) Is there an effect of lower increases in MET hours per week ?
3) In cohort studies, what are the effects of:
a) Walking > 1 hr/day
b) Non-exercise physical activity/day >= 4h/day
4) Is there a benefit to standing for 2 hrs/day
BR 200
1) Most benefit from 10-20 MET hours/week
2) See decreased mortality with almost any increase in MET hrs/week
3) In cohort studies of Chinese women saw sig HR’s (all cause mortality):
a) Walk > 1 hr/day => HR 0.65
b) Non-exercise > 4hrs/day => HR 0.60
4) Standing 2 hrs/day => 10% reduction in all-cause mortality
(Plateau ~ 40% risk reduction)
In the nurses health study:
1) What were the all-cause mortality benefits of 1-1.9 hrs of moderate-vigorous physical activity /week ?
2) What there much incremental gain at 7 or more hours per week ?
BR 200
In NHS:
1) 1-1.9 hrs/wk mod-vigorous activity => RR 0.82 in all cause mortality (ie approx 10% reduction in mortality for 1 hr/wk [mod exercise])
2) Only slight, non-statistically sig benefits were seen beyond this with 7 or more hers per week.
1) Is there a benefit to low activity vs no activity - what is the threshold for moderate intensity exercise ?
2) Was there a life expectancy benefit with the above ?
BR 200
1) 15 min/day (or 90 min/week)(ie low [activity]) of moderate intensity exercise with RR 0.86 for all-cause mortality
2) Low active group had 3 yrs longer life expectancy vs inactive group.
90 min/wk for a 40 yr old x 40 yrs adds up to 6 mos => gain 3 yrs of life !
- assumes 16 hrs/day
Is there a “Weekend Warrior” benefit ?
a) In men performing physical activity 1-2 days per week ?
b) Is there a possible downside to this ?
BR 201
1) Men performing physical activity 1-2 days per weeks had RR 0.85 vs sedentary men
2) However completing all 150 minutes of physical activity in one day MAY increase risk of injury.
In a young (20 yo) Hispanic male:
How much is the benefit (in hours of life) for one hour of moderate vs vigorous intensity expercise.
BR 202
For a 20 yo Hispanic male:
1 hr moderate intensity exercise => 2.6 hrs life gained
1 hr vigorous exercise => 5.2 hrs life gained
What would be the current recommendation for who should consider High Intensity Interval Training ?
Give an example of how to do it
BR 202
Currently recommended for already fit individuals who are looking to decrease how much time they spend training or to improve cardiovascular conditioning.
Eg swim as fast as you can for 20 seconds, then swim slowly for 10 seconds.
In terms of assessing cardiorespiratory fitness:
1) What is “aerobic power” ?
2) Name 3 ways to test this
3) Describe the following tests:
a) Step Testing
b) Submaximal talk test
c) Rockport fitness walking test
BR 203-204
1) Aerobic power = maximum volume of O2 consumed during exercise.
2a) Step testing
- 12 inch step, metronome & stop watch
- step for 3 min to metronome; rest x 1 min, THEN check HR and compare to standards.
- is EFFECTIVE, validated
2b) Submaximal talk test (for ventialtory threshold)
- occurs when inc [lactate] => met acidosis => inc resp rate to blow off (talking difficult).
- It is the highest level of intensity that can be sustained for 1-2 hours.
- tricky to test - req telemetry, treadmill. Takes 8-16 minutes.
2c) Rockport (shoes)
- complete 1 mile (1.6 km) as fast as possible.
- then record pulse & estimate VO2 w an equation based on gender, age, weight, time to finish course & peak HR.
Mn: Step testing, talking w Rockport shoes
How could one assess:
1) Muscular strength
2) Muscular endurance
BR 204
Strength => difficult to test in a clinic. Need weights or bench/leg press. Best to refer to a medical fitness professional.
Endurance
- assessses ones ability to perform ADLs by testing ability of muscles to perform repeated/sustained contractions until muscle fatigue occurs.
- # of repetitions during 1 minute of squats, push-ups or sit-ups is compared to established norms based on age & sex.
How can one assess flexibility ?
Which parts of the body is this test good/bad for ?
What about subjects with low back pain ?
Is efficacy well documented in the literature ?
BR 204
Use “Sit & Reach test” (SiTREaCH test)
- measures flexibility in the hamstrings & low back
- While standard test is consistent & reproducible, it has only moderate accuracy for hamstring flexibility (reliability r 0.64) & poor accuracy for low back flexibility (reliability r 0.28).
- It is NOT accurate for those w low back pain.
- this type of flexibility is BELIEVED to protect against acute & chronic MSk injuries, risk of falls, postural issues & LBP, however this is NOT well documented in the literature.
