Primary prevention, Risk reduction, Deconditioning Flashcards
Exercise dose that will maintain the patient’s conditioning level and prevent deterioration; Intensity is primary to frequency (i.e. better to complete high intensity exercise less frequently than low intensity exercise with increased frequency)
Rehabilitation
Prevention of ischemic heart disease can be prevented & “optimal” cardiovascular health can be achieved through moderate volume of regular physical activity at an intensity of ___METs.
6
What can be done to prevent detrimental effects on the CV system due to bedrest?
- Mobilization and exercise ENHANCE mucociliary transport and airway clearance. RESULT: Improved pulmonary function
- Changes in body position assist in airway clearance to minimize pooling and stagnation of bronchial secretions. RESULT: Decreased risk of atelectasis
What are the effects of bedrest on the CV system?
- Loss of fluid-volume and pressure regulating mechanism
- Decrease in plasma volume
- Diuresis
- Increased hematocrit
- Increased risk for deep vein thrombosis (DVT)– this is PREVENTABLE
What are the effects of bedrest on the pulmonary system?
- Increased work of breathing
- Secondary effect of decrease lung volumes - Functional Residual Capacity = Worse in supine; improved in sitting; Residual Volume; Forced Expiratory Volume
What are the effects of bedrest on the msk system?
- Bedrest Muscle Atrophy - Weakness, Discoordination, Impaired balance
- Excessive strain on ligaments and joints = Joint contracture
- Disuse osteoporosis - Needs to be prevented because once bone loss occurs it is largely irreversible; Increased risk for fracture!
- Limited alternatives to lying in bed result in poor postural alignment, stiffness, soreness - neck pain after ventilator
What are effects of bedrest on other systems?
- Orthostatic hypotension
- Increased risk for skin lesions and decubitus ulcers
- Increased renal load, may lead to dysrhythmia, muscle wasting, weakness, neuropathy, glucose intolerance, and reduced bone density
- Decreased activity of the sympathetic nervous system
- Decreased electrical activity in the brain
- Emotional & behavioral changes, decreased reaction times, sleep disturbance, impaired psychomotor performance
- Decreased insulin sensitivity
- Decreased lymphatic flow and impaired immune system response
- Depression
What are alternatives to bedrest?
- Use of creatively-designed furniture that supports normal physiological functioning. (i.e. stretcher chair) - Kinetic & rotating beds
- Avoid passive positioning whenever possible!
- Active standing > passive standing
- Upright sitting > passive standing
Effects of acute exercise on the CVP system results in increased airway diameter in addition to the following increases:
- Minute alveolar ventilation
- Alveolar ventilation
- Tidal Volume
- Respiratory Rate
- Air flow rates
- Cardiac Output
- Stroke volume
- Heart rate
- Blood pressure
- Rate pressure product (HR + Systolic BP)
Hemodynamic benefits are greater in ____ positions. For those with impaired venous return and myocardial contractility, begin with ________. In those with stroke and other clotting disorders, _______ are associated with minimal increases in platelet activity.
There is no evidence to support this as a risk factor in this population.
upright; moderate-intensity recumbent cycling; moderate levels of activity
What are the effects of exercise on the endocrine system?
- Mobilization and exercise are stimulating
- Increased sympathetic nerve stimulation, which improves processing of sympathetic neurotransmitters
- Many benefits of increase catecholamines, including anti-inflammatory effects
What are the effects of exercise on the central nervous system?
- Arousal due to activation of the reticular activating system
- Parasympathetic inhibition coupled with sympathetic activation to assist with systemic responses to exercise
What are the effects of exercise on the metabolic system?
- Improved sensitivity to insulin
2. Increased growth hormone synthesis
What are the effects of exercise on the immunological system?
- Improves white blood cell production
- Dose-dependence is unknown
- Prolonged exhaustive exercise is associated with compromised immunity
What are the effects of exercise on the psychological system?
- Improved well-being and mood
2. Not well utilized amongst those with mental illness
What are the steps you should take to prepare for mobilization of a patient?
- The patient should be physically prepared.
- The patient’s medication schedule should be reviewed.
- Equipment should be noted and positioned appropriately.
- Move procedures and techniques should be discussed with the team before implementation.
how should you be monitoring the mobilization session?
- Adapt communication needs to the learner
- Assess baseline
- Metabolic response to mobilization and exercise should be monitored
- How? HR, EKG, BP, Rate Pressure Product, Respiratory Rate, RPE, Breathlessness, Pain/discomfort, Fatigue
What are the specific long-term effect of mobilization and exercise on the pulmonary system?
increased respiratory m strength and endurance
What are the specific long-term effect of mobilization and exercise on the CV system?
- Increase myocardial efficiency
- exercise-induced bradycardia
- decr HR and BP
- improved orthostatic tolerance
What are the specific long-term effect of mobilization and exercise on the hematological system?
- increase RBC
2. optimize hematocrit and cholesterol
What are the specific long-term effect of mobilization and exercise on the central nervous system?
- increased sense of well-being
2. increased concentration
What are the specific long-term effect of mobilization and exercise on the NM system?
- improved NM control
- improved postural control
- improved efficiency of movement
What are the specific long-term effect of mobilization and exercise on the msk system?
- improved m vascularization
- increased glycogen storage capacity
- increased biomechanics efficiency
- m hypertrophy
- incr strength, endurance, and leg tensile strength
- maintain bone density
What are the specific long-term effect of mobilization and exercise on the endocrine system?
Increased efficiency of hormone production and degradation to support exercise
What are the specific long-term effect of mobilization and exercise on the immunological system?
increased resistance to infection
What are the specific long-term effect of mobilization and exercise on the integumentary system?
- increased efficiency of skin as heat exchanger and sweating efficiency
- decr skin breakdown
- improved healing
