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Lifestyle Medicine > Physical Activity > Flashcards

Physical Activity Flashcards

1
Q

Types of exercise?

A

Aerobic / endurance
Strength / resistance
Flexibility (joint)
Balance (static, dynamic)

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2
Q

Aerobic exercise - benefits?

A

Lower
- all cause mortality
- CV disease
- cancer
Better
- sleep, qol

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3
Q

Resistance exercise - benefits?

A

Reduced
- injury, fatigue, body fat, pain
Improved
- BMR, sleep, strength, qol, mental
- BMD
- chol, bgl
- NAFLD

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4
Q

The ROM possible at a joint?

A

Flexibility

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5
Q

What improves flexibility?

A

stretching, yoga, tai chi, pilates

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6
Q

Benefits of flexibility exercises?

A
  • increase muscle length
  • increase rom
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7
Q

Flexibility exercises don’t help with:

A

recovery/soreness
injury prevention
performance

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8
Q

Maintaining body’s equilibrium while stationary or moving?

A

Balance

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9
Q

Benefits of balance exercise?

A

Decrease
- injury from falls 37%
- injuries req medical care 30%
- severe injury falls 43%
- fractures 61%

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10
Q

Physical inactivity is the ? th leading risk factor for global mortality

A

4th

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11
Q

Aerobics Center Longitudinal Study

Low cardioresp fitness was the number ? cause of preventable deaths

A

One (16-17%)

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12
Q

8.3% deaths attributed to physical inactivity, for which age group?

A

> = 40

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13
Q

Years of life lost

A
  • inactive, normal weight (4.7)
  • active, obese (4.5)
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14
Q

What is sedentary behaviour?

A
  • behaviour with <= 1.5 METs (metabolic equivalents of task)
    while seated, reclined, lying
  • independently increases disease risk and mortality
    (even if ppl are physically activity guidelines, but sitting lots too)
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15
Q

What % of ppl achieve recommended amount of physical activity each week?

A

1/3 (33%)

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16
Q

TV viewing increased all cause mortality with what hazard ratio, even in those getting 7 hrs exercise per week?

A

1.5

Equal to ppl who never execised and never watch tv

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17
Q

What is physically active?

A

> = 150 mins of MVPA (moderate to vigorous)

(Or > 0 mins of MVPA)

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18
Q

What is physically inactive?

A

0 mins of MVPA

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19
Q

Can patients meet physical activity guidelines, but still have significantly sedentary behaviour?

A

Yes

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20
Q

How to reduce sedentary time?

A

sitting for < 50 mins at a time with a 5 min movement break

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21
Q

Most benefit gained with how many MET hours per week of physical activity?

A

10-20

(plateaus around 80)

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22
Q

Standing for how many hours is associated with a 10% reduction in mortality?

A

2 hours per day

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23
Q

Nurse Health Study
Risk reduction 0.82
How many hours of MVPA?

A

1.0 - 1.9 hours per WEEK

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24
Q

Is it better to spread out exercise over more than two days?

A

Yes
(HR 0.7 –> 0.65)

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25
Q

How many MET hours and mins is = 150 min of MVPA?

A

8.30 MET hours
500 MET mins

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26
Q

> 65 yo

PA guidelines

A

150 min mod int OR
75 min vigorous int

Strengthen at least 2 times per week
Balance + stretching

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27
Q

Pregnancy + Post Partum

PA guidelines

A

150 min mod int aerobic / wk
- pref spread over week

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28
Q

IHD prevention

Exercise

A

risk reduction 20-30% of primary CAD

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29
Q

T2DM prevention

PA guidelines

A

150 mins / wk mod int
- reduces risk

lowers HbA1c only if PA +dietary asvice

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30
Q

Cancer prevention

Physical activity

A

Reduced risk of
- colon ca (17-3-%)
- breast ca (20-30%)
3-4 hrs MVPA

Also prevents recurrence

31
Q

SPPB (predicts mobility)

Short Physical Performace Battery

A

Gait speed test
Balance test
Chair rise test

32
Q

Best stability improvement in Parkinson’s ?
Stretching
Tai Chi
Resistance ex

A

Tai Chi

33
Q

PA guidelines for Obesity

A

Weight Loss
2-3 kg with > 150 min
5 - 7.5kg with > 225-420 min
(need dietary input)

Weight Maintenance
> 250 min / wk
60-90 min/day
Strength twice / wk (not as helpful as aerobic)
- PA is a strong indicator

34
Q

Aerobic exercise guidelines
3-5 yo
6-17 yo
18-64 yo
> 65 yo
Preg / post partum
Chronic conditions

A

Throughout the day
>60 min per day
150 min mod / 75 min vig
150 min mod
150 min mod, spread
150-300

35
Q

Health benefits of flexibility exercise?

When is it best to do?

A

Unknown

When muscles are warm

36
Q

Who should do balance training?

A

> 65 yo
= 3 times per week

37
Q

What is PAVS?

A

Physical activity vital sign

Days/wk of aerobic PA
x
Mins of aerobic PA
=
Mins of aerobic PA / week

38
Q

Exercise intensity tools?

A
  1. Talk test
  2. Resp rate (breaths/min)
  3. RPE - Rate of perceived exertion
  4. HRR - Heart rate reserve
  5. % max HR
  6. METs
39
Q

Talk test?

A

Very light - can talk/sing
Moderate - can talk, but not sing
Vigorous - cannot talk complete sentence

40
Q

Rate of perceived exertion

A

BORG scale
est max HR / 10

41
Q

Heart rate reserve (HRR)

A

Max HR - Resting HR

Recommended intensity
- 40-85% of HRR

42
Q

% Max HR
Light
Mod
Vig

A

Light : < 63% max hr
Moderate : 64-76% max hr
Vigorous : > 77% max hr

43
Q

METs
Light
Mod
Vig

A

Light : < 3
Moderate : 3 - 5.9
Vigorous : >=6

44
Q

What do physical activity assessment tools measure?

A

Functional capacity
Cardioresp fitness
Muscular fitness
Flexibility
Body Composition

45
Q

Assessment tools for
Functional capacity

A

6 min walk test

8 foot up and go test
- muscular power
- sit to stand from chair, walk 8 feet afap, walk around cone, return, sit down

46
Q

Assessment tools for
Cardioresp fitness

A

VO2 max
- max vol of O2 consumed during
(aerobic power)

Step testing
- 12 inch step, metronome
- steps for 3min to timing and rests for 1 min –> check HR and compare

Rockport fitness walking test
- 1 mile or 1.6km as fast as possible
- then measure HR
- estimate VO2 max with equation

12 min (Cooper) walk/run test
- cover max distance
- estimate VO2 with equation

47
Q

Assessment tools for
Muscular fitness

A

Power
- Vertical jump
- Medicine ball throws
Strength
- 1 rep max
- hand grip strength
Endurance
- bodyweight exercise for time

48
Q

Assessment tools for
Flexibility

A

Sit and reach (hamstrings, low back)
Apley back scratch test (ant should)
Goniometry

49
Q

Assessment tools for
Body Composition

A

BMI
Skinfold thickness (body fat)
BIA (elecrical)
DEXA
Underwater weighing (hydro)

50
Q

What is the 6 min walk test?

A

Measures functional capacity
- walk as far as possible in 6 min
Can stop, rest and resume
- reflective of ADLs

Helpful for patient’s before/after intervention

51
Q

Norms for body fat % for optimal health?

A

10-22% (men)
20-32% (women)

52
Q

Most accurate methods for body composition testing?

A

DEXA
Hydro (underwater)

53
Q

Risk of death during physical activity

A

Rare!
Risk only if
- known disease symptoms
- sudden intense activity
Risk of AMI x 50 higher if vigorous activity in someone usually sedentary

54
Q

Who should get a medical clearance before exercise?

(2015 Rec for Ex Prepart Health Screening from ACSM)

A
  1. Clinically significant disease needing supervised exercise
  2. Uncontrolled medical conditions that req treatment
55
Q

PAR-Q+

A

Physical Activity Readiness Questionnaire for Everyone

  • guides pre-participation (self)
    –> to reduce barriers to exercise and false positive screenings
56
Q

When should ppl have a medical clearance?

A

If they are inactive and have signs or symptoms of CV, metabolic, or renal disease

57
Q

Indications for exercise stress testing (intermediate risk pts)

A
  • symptoms of IHD
  • presents to ED with chest pain
  • syncope, valvular disease, arrhythmia

alt - myocardial perf scan

58
Q

Skill related fitness?

A

agility, coordination, balance, power, reaction time, speed

59
Q

What is 1.0 MET?

A

metabolic rate (amt of O2 consumed) during quiet rest/sitting
– 3.5ml of O2 per kg / min

60
Q

METs
Sleeping
3mph walking
Climbing 2 stairs
Running 17.5 km/h

A

0.9
3
5
18

However this is regardless of fitness level

61
Q

METs

Moderate Int
Vigorous Int

A

3 - 5.9 METs
>= 6 METs

62
Q

FITT-VP Exercise Prescription

A

Frequency
- day per week
Intensity
- light, mod, vig
Time
- mins per session
Type
- aerobic, strength, b, f
Volume
- total
Progression
- advancement, increase

63
Q

3 stages of exercise progression

A

Initial
- mod int, 15-30 mims, 3-4 times per week, 1-6 weeks

Improvement
- int variable, 20% each week

Maintenance

64
Q

Only 23.5% ppl meet both aerobic and strengthening exercise.
T or F?

A

True

65
Q

Prediabetes
- diabetes prevention with lifestyle

RCT (Diabetes Prevention Program Research Group)

A

58% vs 31% diabetes incidence

6.9 v 13.9 NNT to prevent diabetes

66
Q

Resistance exercise can reduce HbA1c by > 0.5% in ppl with diabetes. T/F?

A

True

67
Q

Effect of exercise on mortality outcomes

Meta-analysis of RCTs

A

No diff b/w exercise and drugs for secondary prevention heart disease and prediabetes

Exercise superior if hx of stroke

Exercise inferior for heart failure

68
Q

Exercise vs PCI
in stable CAD

A

Superior event free survival
Improved exercise capacity
Higher HDL
Lower costs

69
Q

BP and exercise

A

Modest but consistent reduction

But less than meds

70
Q

Benefits of exercise after stroke?

A

Mobility and balance
Gait speed
Neuroplasticity

71
Q

Obesity and exercise

A

150min mod int
Build to 250-300 min
- for long term weight loss
Non WB, less pressure on joints
Combine with nutrition

72
Q

Diabetes and exercise

A

> 150 min / wk
Dietary changes
Weight loss 5-7%
Reduce sedentary time
Exercise daily
Aerobic and resistance combined

73
Q

Diabetes on insulin
BGLs for exercise

A

< 100mg/dL - eat a snack before exercise
100-250 - ok to exercise
> 250 - test for ketones

Reduces short acting insulin by 50% around exercise time

Lifestyle Medicine (9 decks)

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