Physical Activity, Reconditioning, and Aerobic Training

Question 1

What is moderate to vigorous physical activity (MVPA)?

Answer 1

MVPA includes exercise, physical activities, and activities of varying intensity levels like moderate and vigorous physical activities.

Question 2

What is the goal of the physical activity guidelines set by the federal government?

Answer 2

To create a healthier nation through increased participation in physical activity.

Question 3

How is daily time typically divided between different activities according to the schematic?

Answer 3

About 8 hours each are spent on sedentary behavior, sleep, and light physical activity, with very little time spent on moderate to vigorous physical activity (MVPA).

Question 4

What is the difference between exercise and physical activity?

Answer 4

Exercise is goal-directed, planned, and structured, while physical activity includes any movement caused by muscles.

Question 5

Why do physical activity guidelines use the term “physical activity” rather than “exercise”?

Answer 5

Many people are not fond of the term “exercise,” and using “physical activity” may encourage broader participation.

Question 6

What are the characteristics of exercise studies compared to physical activity studies?

Answer 6

Exercise studies are typically short, controlled trials focusing on specific exercises and outcomes, while physical activity studies are long-term observational cohort studies.

Question 7

What is the main limitation of observational cohort studies on physical activity?

Answer 7

They can show a relationship between physical activity and outcomes but cannot establish cause and effect.

Question 8

How do exercise and MVPA fit into the ICF model used in physical therapy?

Answer 8

Exercise is often seen in the realm of activity, while physical activity can be considered part of participation.

Question 9

What benefits can meeting the physical activity guidelines provide?

Answer 9

It could prevent 1 in 10 premature deaths, 1 in 8 cases of breast or colorectal cancer, 1 in 12 cases of diabetes, and 1 in 15 cases of heart disease.

Question 10

What is a common reason people exercise, according to the content?

Answer 10

People often exercise to look good and feel better, not primarily to meet public health goals.

Question 11

What percentage of adults meet the physical activity guidelines needed to prevent chronic diseases?

Answer 11

About 50% of adults meet the guidelines for physical activity.

Question 12

How does physical activity participation differ among education levels?

Answer 12

People with a college degree or more have higher participation rates, while those with less than a high school education have lower rates.

Question 13

What trend is observed in physical activity participation over time?

Answer 13

Although there has been some increase, only about 20-25% of adults meet both the aerobic and muscle-strengthening guidelines.

Question 14

What is the difference between physical activity and exercise in terms of study types?

Answer 14

Exercise studies are typically randomized controlled trials, while physical activity studies are more observational and cohort-based.

Question 15

What are two types of activities emphasized in the physical activity guidelines?

Answer 15

Aerobic endurance activities and muscle-strengthening exercises, which contribute to bone health and balance.

Question 16

What is a significant barrier to improving physical activity participation?

Answer 16

Changing behavior and encouraging more participation, especially among those with chronic diseases.

Question 17

How can the medical model serve as a barrier to physical activity?

Answer 17

The medical model often focuses on medications rather than promoting physical activity as part of treatment, which can reduce motivation for exercise.

Question 18

What was the key conclusion from the study on physical activity in patients with type II diabetes and hypertension?

Answer 18

Physicians should prescribe physical activity as seriously as medications, providing evidence-based guidelines for exercise.

Question 19

How does the environment in Denmark support physical activity?

Answer 19

Denmark encourages cycling with facilities like bike racks at train stations, rail systems accommodating bikes, and parks designed for cycling.

Question 20

What is one contrast between Denmark’s environment and that of the United States?

Answer 20

Denmark promotes active transportation like cycling, while the U.S. has a culture of drive-through conveniences, contributing to inactivity.

Question 21

What are the dangers of sedentary behavior as shown in meta-analyses?

Answer 21

High amounts of sitting time are associated with an increased risk of all-cause mortality, even when combined with moderate to vigorous physical activity.

Question 22

How does moderate to vigorous physical activity (MVPA) affect the risks associated with sitting?

Answer 22

MVPA can reduce the risks of sitting, but sitting for long periods still increases the risk of all-cause mortality.

Question 23

What did the study on sitting time and physical activity find about the relationship between activity levels and sitting?

Answer 23

Even highly active individuals have increased risks of mortality if they sit for prolonged periods each day.

Question 24

What is the public health challenge regarding physical activity in the U.S.?

Answer 24

Promoting physical activity is challenging because many people remain inactive, and increased inactivity is associated with higher healthcare costs.

Question 25

What is the estimated economic burden of inadequate physical activity in the U.S.?

Answer 25

Inadequate physical activity costs the government around $117 billion.

Question 26

What role do physical therapists play in promoting physical activity?

Answer 26

Physical therapists are movement specialists and play a crucial role in addressing the consequences of inactivity and encouraging more active lifestyles.

Question 27

What is still unknown about light physical activity according to current evidence?

Answer 27

While light physical activity is considered better than sitting, its specific health benefits are not yet fully understood.

Question 28

Why might observational studies be important for understanding physical activity?

Answer 28

They provide insights into long-term trends and associations between activity levels and health outcomes, despite not establishing cause and effect.

Question 29

How does environment influence physical activity behavior?

Answer 29

Environments that facilitate active lifestyles, like those with accessible cycling infrastructure, encourage more physical activity among residents.

Question 30

What are the physical activity recommendations for adults (18-64 years)?

Answer 30

At least 150 minutes per week of moderate-intensity activity (e.g., brisk walking) and muscle-strengthening activities on 2 or more days per week.

Question 31

What additional recommendation is given for older adults in the physical activity guidelines?

Answer 31

In addition to aerobic and muscle-strengthening activities, older adults should include exercises that improve balance, like standing on one foot.

Question 32

What is the daily physical activity recommendation for children and adolescents?

Answer 32

60 minutes or more of moderate to vigorous physical activity every day, including activities that strengthen muscles and bones.

Question 33

What are the three key aspects of physical activity guidelines?

Answer 33

Intensity (how hard), frequency (how often), and duration (how long)

Question 34

What is absolute intensity in physical activity?

Answer 34

The energy expended during an activity compared to rest, measured in multiples of the energy used while sitting (METs).

Question 35

How is relative intensity different from absolute intensity?

Answer 35

Relative intensity considers an individual’s fitness level and effort, meaning less fit individuals exert more effort for the same activity.

Question 36

What is the MET value range for moderate-intensity activities?

Answer 36

3 to 5.9 METs, meaning the activity is 3 to almost 6 times more intense than resting.

Question 37

How often should moderate and vigorous intensity physical activities be performed?

Answer 37

Moderate activities: at least 5 days per week; Vigorous activities: at least 3 days per week.

Question 38

What is the recommended weekly duration for moderate and vigorous physical activity?

Answer 38

150-300 minutes per week for moderate-intensity or 75-150 minutes per week for vigorous-intensity activities.

Question 39

What is the focus of physical activity for insufficiently active people?

Answer 39

Reduce sedentary behavior first, then gradually increase moderate-intensity activity for the most health benefits.

Question 40

What are some of the health benefits of physical activity according to recent evidence?

Answer 40

Improved bone health and weight status in children, reduced cancer risk, improved cognitive function, and reduced anxiety, depression, and mortality risk.

Question 41

How do physical activity guidelines relate to physical therapy?

Answer 41

They are based on strong evidence, align with the physical stress theory, and are used to set goals, monitor progress, and encourage lifelong activity for patients.

Question 42

What role do physical therapists play in promoting physical activity?

Answer 42

They provide physical activity plans during treatment and discharge, helping patients achieve better long-term health through activity.

Question 43

How does vigorous activity differ from moderate activity in terms of intensity?

Answer 43

Vigorous activity is greater than 6 METs and corresponds to a 7 or 8 on a scale of 0 to 10, making conversation during the activity difficult.

Question 44

What approach should inactive individuals take to begin increasing their physical activity?

Answer 44

Start by reducing sedentary behavior and gradually incorporate moderate-intensity activities, progressing slowly over time.

Question 45

What is deconditioning?

Answer 45

Deconditioning describes physiological changes resulting from prolonged bed rest or a drastic reduction in activity, leading to declines in function.

Question 46

How soon can muscle loss be detected in different immobilization conditions?

Answer 46

Muscle loss can be detected after 7 days in microgravity, 10 days of bed rest, and 10-14 days with limb casting or suspension.

Question 47

What are the consequences of muscle loss during immobilization?

Answer 47

Muscle loss leads to functional declines and cardiovascular changes, such as reduced strength and decreased aerobic capacity.

Question 48

What happens to a person’s function when they fall below the “threshold of independence”?

Answer 48

They may lose the ability to perform activities like getting out of a chair or using the toilet without assistance, often requiring physical therapy.

Question 49

What are some cardiovascular changes associated with bed rest in older adults?

Answer 49

Increased resting heart rate, faster heart rate with activity, reduced stroke volume, and a higher risk of blood clots like deep vein thrombosis.

Question 50

What is orthostatic hypotension, and why is it a concern during bed rest?

Answer 50

Orthostatic hypotension is a drop in blood pressure upon standing, leading to dizziness or fainting, and is a common issue after prolonged bed rest.

Question 51

How does bed rest affect the pulmonary system?

Answer 51

It leads to decreased lung volume, increased respiratory rate, shallow breathing, and higher risk of pneumonia due to reduced air exchange.

Question 52

What are other adverse effects of prolonged bed rest on the body?

Answer 52

Loss of muscle strength, constipation, urinary incontinence, depression, confusion, pressure ulcers, and bone loss.

Question 53

How much time do hospitalized older adults typically spend in bed each day?

Answer 53

Hospitalized older adults spend an average of 17 hours a day lying in bed, leading to significant inactivity.

Question 54

Why is the message “sit up, get dressed, and keep moving” important for hospitalized patients?

Answer 54

It emphasizes the need to reduce bed rest and promote movement to prevent the negative effects of prolonged inactivity.

Question 55

What did a study on stroke patients’ activity levels in hospitals reveal?

Answer 55

Most stroke patients spend their time alone in their bedrooms with limited physical activity, even during formal therapy sessions.

Question 56

How did a study in the Veteran Association hospital measure patient activity levels?

Answer 56

Using accelerometers, the study found that 83% of the hospital stay for older veterans was spent lying in bed.

Question 57

What did a study in Denmark reveal about physical activity levels of hospitalized ambulatory patients?

Answer 57

Even ambulatory patients spent about 17 hours per day lying in bed, with very limited time standing or engaging in higher-level activities.

Question 58

Why is bed rest considered “inactivity on steroids”?

Answer 58

Because it results in profound inactivity, which rapidly accelerates physical decline, particularly in older adults and those with low functional reserves.

Question 59

How does prolonged inactivity during hospitalization impact patients with low functional reserves?

Answer 59

It can push them below the threshold of independence, making recovery more difficult and often requiring intensive rehabilitation.

Question 60

What are the four key components of exercise prescription in physical therapy?

Answer 60

Intensity, duration, frequency, and mode.

Question 61

What is the age-predicted max heart rate formula?

Answer 61

220-age

Question 62

What is the heart rate reserve (HRR) method used for?

Answer 62

It is used to prescribe exercise intensity, accounting for a person’s resting heart rate and fitness level.

Question 63

How is the heart rate reserve calculated?

Answer 63

HRR = Max heart rate (220 - age) - Resting heart rate, then multiply by a percentage (e.g., 50-85%) and add back the resting heart rate.

Question 64

Why is the heart rate reserve method preferred over age-predicted max heart rate for exercise prescription?

Answer 64

It better accounts for an individual’s fitness level and correlates closely with physiological work and oxygen consumption.

Question 65

What is VO2 max?

Answer 65

The maximum amount of oxygen a person can utilize during intense exercise, often used as a measure of aerobic capacity.

Question 66

How does age affect VO2 max and heart rate?

Answer 66

VO2 max and maximum heart rate decline with age due to changes in heart function and muscle mass.

Question 67

What factors can influence VO2 max?

Answer 67

Testing mode (e.g., treadmill vs. cycle), age, sex, body size, composition, and heredity.

Question 68

What is the relationship between heart rate and oxygen consumption during submaximal exercise?

Answer 68

There is a linear relationship, allowing for predictions of VO2 max based on heart rate measurements during submaximal exercise.

Question 69

Why are submaximal exercise tests commonly used in clinical settings?

Answer 69

They are less expensive, safer, and can predict VO2 max using the linear relationship between heart rate and oxygen consumption.

Question 70

What is a nomogram used for in exercise testing?

Answer 70

It helps predict maximal oxygen consumption (VO2 max) based on submaximal exercise test results.

Question 71

What conditions or factors can affect the accuracy of exercise intensity predictions?

Answer 71

Caffeine, sleep, menstrual cycle, medications, and day-to-day variations in heart rate.

Question 72

Why should patients on heart rate-affecting medications avoid predictive heart rate tests?

Answer 72

Medications can alter heart rate, making predictions inaccurate and potentially misleading for exercise intensity.

Question 73

What is the difference between age-predicted max heart rate and heart rate reserve when prescribing exercise?

Answer 73

Age-predicted max is a simpler method, while heart rate reserve provides a more accurate reflection of fitness level by including resting heart rate.

Question 74

How is exercise intensity defined in physical therapy?

Answer 74

Exercise intensity is the level of effort required, typically measured using heart rate, oxygen consumption (VO2), or perceived exertion.

Question 75

What is a metabolic equivalent (MET)?

Answer 75

MET is a measure of energy expenditure, where 1 MET equals 3.5 milliliters of oxygen per kilogram per minute, the amount of energy used while at rest.

Question 76

How does the Compendium of Physical Activities relate to exercise prescription?

Answer 76

It assigns MET values to various activities, helping to estimate their energy expenditure and categorize their intensity.

Question 77

Why is MET considered an absolute measure of intensity?

Answer 77

Because it does not account for an individual’s fitness level when measuring energy expenditure.

Question 78

What is perceived exertion, and how is it measured?

Answer 78

Perceived exertion is how hard a person feels their body is working during exercise, often measured using the Borg scale (6 to 20) or a modified scale (0 to 10).

Question 79

What is the Borg scale, and how is it related to heart rate?

Answer 79

The Borg scale rates perceived effort from 6 (very light) to 20 (very hard), correlating with heart rate (e.g., a rating of 19 may correspond to a heart rate of 190 bpm).

Question 80

Why is perceived exertion useful for patients on beta blockers?

Answer 80

Beta blockers can blunt heart rate responses, making perceived exertion a better indicator of exercise intensity for these individuals.

Question 81

What intensity levels do the physical activity guidelines associate with a 0 to 10 scale?

Answer 81

Moderate intensity corresponds to a 4-6 (40-60% HRR), while vigorous intensity corresponds to a 7-8 (70-80% HRR).

Question 82

What is the recommended minimum duration for a continuous exercise session?

Answer 82

A minimum of 20 minutes per session.

Question 83

How often should exercise be performed according to exercise prescription guidelines?

Answer 83

At least 2 times per week, with many studies suggesting 3 times per week for better outcomes.

Question 84

What types of activities can be used as modes of exercise?

Answer 84

Walking, running, cycling, swimming, rowing, dancing, and any activity that raises the heart rate, including functional exercises like chair rises.

Question 85

How do upper extremity exercises compare to lower extremity exercises in terms of cardiovascular demand?

Answer 85

Upper extremity exercises result in a higher heart rate and oxygen consumption at the same workload compared to lower extremity exercises.

Question 86

What is continuous training in exercise?

Answer 86

A type of exercise where an individual maintains a steady intensity level for a set period, allowing for gradual overload and improved efficiency.

Question 87

What is interval training, and how does it differ from continuous training?

Answer 87

Interval training involves alternating between high-intensity work intervals and lower-intensity recovery periods, resulting in a higher average heart rate.

Question 88

Why is it important that recovery heart rate during interval training does not return to resting levels?

Answer 88

Keeping the heart rate elevated during recovery maintains stress on the cardiovascular system, enhancing the training effect.

Question 89

What are some examples of functional exercises that can be used for interval training?

Answer 89

Walking up and down stairs, repeated chair rises, and whole-body motions like active range of motion exercises.

Question 90

What is a common clinical measure of aerobic capacity and endurance in physical therapy?

Answer 90

The six-minute walk test, where a patient walks back and forth in a corridor for six minutes to measure distance covered.

Question 91

How does the two-minute walk test differ from the six-minute walk test?

Answer 91

It measures distance covered in two minutes instead of six, offering a shorter assessment option.

Question 92

What is the 400-meter walk test used for?

Answer 92

It assesses aerobic capacity in higher-functioning individuals by measuring the time taken to walk a quarter mile.

Question 93

What factors should be considered when developing an exercise program for a patient?

Answer 93

Conditioning status, functional ability, comorbid conditions, activity preferences, accessibility, ability to self-monitor, and personality.

Question 94

What is reserve capacity in terms of aerobic capacity?

Answer 94

It is the remaining capacity for physical activity after accounting for the energy needed for activities of daily living (ADLs) and community independence.

Question 95

How does aging affect reserve capacity?

Answer 95

Aging decreases VO2 max, which reduces reserve capacity and limits the ability to perform additional activities beyond basic daily functions.

Question 96

Why is reserve capacity important for understanding the needs of deconditioned patients?

Answer 96

Reduced reserve capacity means that even basic activities like getting dressed or walking can be very fatiguing for these patients.

Question 97

How does deconditioning affect heart rate response to physical activity?

Answer 97

Deconditioned patients often have an exaggerated heart rate response, meaning their heart rate increases more at a given work level compared to before deconditioning.

Question 98

What is the role of interval training in acute care for deconditioned patients?

Answer 98

Interval training, involving short bouts of activity followed by rest, helps to slowly rebuild aerobic capacity and manage the limited reserve of deconditioned patients.

Question 99

How do comorbid conditions impact exercise prescription?

Answer 99

Conditions like hypertension, diabetes, and joint pain can require adjustments in exercise types, intensity, and monitoring methods to ensure safety.

Question 100

Why is it important to consider a patient’s activity preferences when prescribing exercise?

Answer 100

Tailoring exercises to activities a patient enjoys increases their willingness to participate and adhere to the exercise plan.

Question 101

What type of exercise might be appropriate for a patient who has very low capacity due to deconditioning?

Answer 101

Activities like sitting up, standing, and short walks, performed in intervals with rest, can help rebuild strength and endurance gradually.

Question 102

How do you assess a deconditioned patient’s baseline capacity?

Answer 102

By observing their vital signs’ response to basic movements, such as sitting up or walking a few feet, to gauge their initial exercise tolerance.

Question 103

What can exaggerated heart rate responses in a deconditioned patient indicate?

Answer 103

They suggest that even low levels of physical activity are a significant challenge for the patient’s current physical condition.

Question 104

Why might interval training be more suitable than continuous exercise for certain patients in acute care?

Answer 104

It allows patients with limited endurance to perform brief periods of activity with rest breaks, accommodating their reduced physical capacity.