Special Populations

Question 1

1. What age range is prepubecent for boys/girls?
2. Describe VO2 max adaptions compared to that of adults
3. How does Max HR change throughout childhood?
4. Vigous max HR for this group that is not uncommon?
5. Relationship between childhood and hypertrophy?
6. What 2 adaptions produce strength gains for this group?
   
   1. _ adaptations
   2. _ _adaptations
      
      1. _ _composition
      2. _ _ performance
      3. _ _ coordination
      4. _ _density

Answer 1

1. Prepubescent = boys 6-13, girls 6-11
2. VO2 max adaptations less noticeable than in adults
3. Max HR doesn’t change much throughout childhood
4. Vigorous workout can produce max HR over 200 bpm
5. Children lack sufficient levels of androgens for hypertrophy
6. Strength gains from
   
   1. Neural adaptations
   2. Intrinsic muscle adaptations
      
      1. Muscle fiber composition
      2. Motor skill performance
      3. Muscular grouping coordination
      4. Myofibrillar packing density

Question 2

What age group is considered adolecent?

What age group is considered older adults?

Answer 2

• Adolescent = Boys 13-17, Girls 11-17
• Older adults = 50+

Question 3

What 4 exercise measurements are greater in children?

What 8 exercise measurements are greater in adults?

1. Absolute VO2
2. Relative VO2
3. Exercise recovery
4. Exercise lactate
5. Glycolitic activity
6. Aerobic performance
7. cardiac output
8. Max HR
9. Stroke Volume
10. Tidal volume
11. Breathing frequency
12. Muscular performance

Answer 3

• Childen > Adults
  
  1. Max heart rate
  2. Breathing frequency
  3. Relative VO2
  4. Exercise recovery
• Children < Adults
  
  1. Stroke volume
  2. Cardiac output
  3. Tidal volume
  4. Absolute VO2
  5. Glycolytic activity
  6. Exercise lactate
  7. Aerobic Performance
  8. Absolute muscle strength

Question 4

• What should be done with older adults prior to program design?
• Exercise order if AET+ RT in same session?
• What are 2 benefits fo AET? (include 2 % increase stats)
  
  • Standard cardio = increase VO2 by _%
  • High intensity = increase VO2 by _%
• What are 9 benefits to RT? (7↓ + 2↑) (4 disease, pain, mental, metabolic function, cell organelle function)

Answer 4

• Check with client physician for guidlines and training modifications
• Warm up + AET + RT + static stretching
• Older adults recieve greatest benefit to AET than any other group
  
  1. VO2
     
     • Standard cardio = increase VO2 by 17%
     • High intensity = increase VO2 by 25%
  2. Reduced risk of diseases that increase with age
• RT benefits
  
  1. ↓ Colon cancer
  2. ↓ Type 2 diabetes
  3. ↓ Arthritis
  4. ↓ Osteoporosis
  5. ↓ Lower back pain
  6. ↓ Muscle loss and Metabolic rate reduction
  7. ↓ Depression
  8. ↑ mitochondiral function
  9. ↑ functional abilities

Question 5

AET guidelines for seniors:

• General:
  
  • Frequency
  • Intensity
    
    • Acceptable range
    • Ideal %
  • Duration
• Folks with poor cardio fitness
  
  • Duration and intensity
• ASMC recommendations
  
  • Moderate
  • Vigorous
• 2 Beginner recommendations for programming
  
  • Start with and progress to
  • Combining intensities

Answer 5

• General
  
  • Frequency = 2-5x week
  • Intensity
    
    • Acceptable range = 60-90% MHR
    • Ideal % = 75% MHR
  • Duration = 20-60 min
• Folks with poor cardio fitness
  
  • 5-10 minutes @ 40% MHR
• ASMC recommendations
  
  • Moderate
    
    • 30 min (e.g. walking) 5 x week)
  • Vigorous
    
    • 20 min (e.g. jogging) 3 x week
• 2 Beginner recommendations for programming
  
  1. start with lower intenisty for longer duration (30 min @ mod intensity), progress to 20 min @ vigorous intensity
  2. Combine vigorous and moderate=
     
     1. Vigorous Monday Fiday
     2. Moderate Wednesday Saturday

Question 6

Give RT guildeines for older adults

• Intensity
  
  • Acceptable low intensity
    
    • _-_% (_-_ reps)
  • Recommended
    
    • _-_% (_-_ reps)
  • Acceptable low intensity
    
    • _-_% (_-_ reps)
  • Beginner recommendations
    
    • _-_% (_-_ reps)
• Load progression %
• Frequency
• Rest
  
  • _-_
• Speed of movement
  
  • _-_ per rep
• Movement selection
  
  • _ and _ joint movements that target the _/_ muscle groups
• Breathing (2)

Answer 6

• Intensity
  
  • Acceptable low intensity
    
    • 60-65% (14-16 reps)
  • Recommended
    
    • 70-80% (8-12 reps)
  • Acceptable low intensity
    
    • 85-90% (4-6 reps)
  • Beginner recommendations
    
    • 60-75% (10-15 reps)
• Load Progression = 5%
• Frequency
  
  • 2-3 non consecutive days per week
• Rest
  
  • 2-3 minutes
• Speed of movement
  
  • 4-6 seconds per rep
• Movement selection
  
  • Single and multiple joint movmeents that target the major/large muscle groups
• Breathing
  
  • Inhale eccentric, exhale concentric
  • No Valsalva maneuver

Question 7

• What are age children generally read for exercise participation?
• What 5 signs/symptoms require medical examination for children?
• What are children @ higher risk for?

Answer 7

• 7-8 (rec sport age)
• Signs/symptoms of known disease
  
  1. Asthma
  2. Cystic fibrosis
  3. Cerebral Palsy
  4. Diabetes
  5. Obesity
• Higher risk of heat-related illness b/c not efficient at heat dissipation

Question 8

Detail sample exercise lesson for children

1. _ warm up with _
   
   • 5-10 minutes
2. _ preparation (review _ and demonstrate _)
   
   • _ minutes
3. Fundamental _ training _
   
   • _-_minutes
   • _-_ stations with _ , _exercises, etc.
4. _ and _
   
   • _ min
5. _ and _
   
   • _ minutes

Answer 8

1. Dynamic warm up with medicine all
   
   • 5-10 minutes
2. Movement preparation (review daily lesson and demonstrate technique)
   
   • 5 minutes
3. Fundamental integrative training circuit
   
   • 20-25 minutes
   • 8-12 stations with agility ladder, bodyweight exercises, etc.
4. Games and activities
   
   • 5 min
5. Cooldown and review
   
   • 5 minutes

Question 9

Detail RT program design for children covering:

• Warm-up
  
  • _-_ minutes dynamics
• Sets and reps
  
  • Start @ _-_ sets of _-_ reps
• Beginner intensity
  
  • _-_%1RM
• Muscles targeted by exercises
  
  • _, _, and _
• Resistance increase
  
  • _-_%
• Training sessions per week
  
  • _-_ _ days
• Cool down
  
  • using _
• how to optimize gains and prevent boredom
  
  • _

Answer 9

• Warm-up
  
  • 5-10 minutes dynamics
• Sets and reps
  
  • Start @ 1-3 sets of 6-15 reps
  • Reps
• Beginner intensity
  
  • 40-60%1RM
• Muscles targeted by exercises
  
  • Upper, lower, and midsection
• Resistance increase
  
  • 5-10%
• Training sessions per week
  
  • 2-3 non consecutive days
• Cool down
  
  • using less intense calisthenics and static stretching
• how to optimize gains and prevent boredom
  
  • Vary program

Question 10

• Children aerobic games and skill building
  
  • Frequency
  • Intensity
• Static and dynamic flexibility
  
  • Frequency
  • Movement guidelines
  • Muscle groups

Answer 10

• Children aerobic games and skill building
  
  • Frequency = daily
  • Intensity = moderate to vigorous with rest and recovery as needed
• Static and dynamic flexibility
  
  • Frequency ≥ 2-3 x week
  • Movement Guidelines
    
    • Controlled movments throughout full ROM
  • Muscle groups
    
    • All muscle groups

Question 11

What are 7 exercise benefits for children? 4 ↓ 3 ↑

Answer 11

1. ↓ Obesity
2. ↓ type 2 diabetes
3. ↓ elevated blood lipids
4. ↓ sports related injuries
5. ↑ mood
6. ↑ confidence
7. ↑Motor skills

Question 12

What are 7 benefits of AET for older adults? 3 ↑ 4 ↓

Answer 12

1. ↑ caloric expenditure ↓ risk of disease
2. ↑ VO2 Max
3. ↑HDL cholesterol
4. ↓ Total cholesterol
5. ↓LDL cholesterol levels
6. ↓triglyceride levels
7. ↓ resting blood pressure

Question 13

What are 10 disease/symptoms in older adults that are reduced/alleviated with AET? (metabolic, cardiovascular, skeletal, mental, terminal diseases)

Answer 13

1. High blood pressure
2. Type 2 diabetes
3. Obesity
4. Cardiovascular disease
5. Stroke
6. Osteoporosis
7. Certain types of cancer
8. Psychological stress
9. Poor sleep
10. Poor digestion

Question 14

What are 11 benefits of RT for older adults?

• Disease risk
• Composition
• BP
• Blood lipids
• vascular system
• __ cancer
• Psychological
• Pain
• Muscular changes with age
• Skeletal changes with age
• ___ function

Answer 14

1. ↓ risk of CVD and premature mortality
2. ↓ bodyfat
3. ↓ resting blood pressure (systolic, diastolic, or both)
4. Improves Blood lipid profiles
   
   1. ↓ Total cholesterol
   2. ↓LDL cholesterol levels
   3. ↓triglyceride levels
   4. ↑HDL cholesterol
5. Enhances vascular condition à improved circulation and arterial blood flow
6. ↓ risk colon cancer b/c speeds up digestion
7. ↓Depression
8. ↓ Low back pain
9. ↓ Muscle loss/metabolic rate reduction
10. ↓ Bone loss
11. ↑ Mitochondrial function via circuit strength training

Question 15

• What is typical muscle loss rate for older adults who do not RT?
• What are typical bone loss rates for older adults who do not RT?

Answer 15

• Adults ≥ 50, no RT = 5-10% muscle mass loss per decade
• Adults ≥ 50, no RT = 10-30% bone mass loss per decade

Question 16

What are 8 conditions that prohibit all exercise for prenatal clients?

• 1 BP
• 1 membrane
• 2 premature labor risks
• 1 Disease
• 1 placenta location/time
• 1 dialation
• 1 bleeding

Answer 16

1. Pregnancy induced hypertension (pre-eclampsia)
2. Ruptured membranes
3. Multiple birth pregnancy that ↑ risk of premature labor
4. Premature labor during current pregnancy
5. Significant heart disease or restrictive lung disease
6. ​Placenta that blocks cervix after 26 weeks
7. A cervix that dilates ahead of schedule (incompetent cervix)
8. Persistent bleeding after 12 weeks

Question 17

What are 10 relative contraindication for pregnant clients to exercise that require doctor evaluation prior to exercise?

• 4 poorly controlled diseases
• 2 BMI
• 1 lifestyle history
• 1 unevaluated condition
• 1 uterine condition
• severe __
• Heavy __
• one pulmonary conidtion
• 1 type of limitation

Answer 17

1. Poorly controlled type 1 diabetes, seizures, hypertension, hyperthyroidism
2. Morbid obesity
3. Extremely low BMI (<12kg/m²)
4. History of very sedentary lifestyle
5. Unevaluated maternal cardia dysrhythmia
6. Intrauterine growth restriction in current pregnancy
7. Severe anemia
8. Heavy smoking
9. Chronic bronchitis
10. Orthopedic limitations

Question 18

What are conditions that require discontinuing exercise and medical advice during pregancy?

• 5 cardio/respiratory symptoms
• 4 prenation conditions

Answer 18

1. headache/unexplained diziness
2. chest pain
3. Dyspenia before exertion
4. muscle weakness
5. calf pain/swelling
6. decreased fetal movement
7. amnotic fluid leakage
8. bloody discharge from vagina
9. preterm labor

Question 19

• Exercises in what position are prohibited for prenatal clients?
  
  • What modifications should be done for abdominals?
  • For chest?
• What breathing contraindicatiosn for prenatal cleints?
• How does pregnancy affect oxygen avaiablity/use?

Answer 19

• No supine exercise after 1st trimest
  
  • Curldowns or lying ab exercises
  • Vertical chest press machines or wall pushups
• No valsalva maneuvor or breath holding during exercise
• Pregnant use more O2 at rest and have less available for aerobic activity

Question 20

What are post menopausal recommenations for RT?

• Frequency
  
  • _-_ x week
• Duration
  
  • _ (unit of time)
• Intensity
  
  • _%1RM

Answer 20

2-3 days
45 minutes
High intensity = 80% 1RM

Question 21

What are 2 mechanical changes (gravity/joint) during pregnancy and how can be acommodated?

Answer 21

• Changes in center of gravity → use machines instead of free weights
• Joint laxity increases during pregnancy → use slow controlled movement

Question 22

What are 2 metabolic changes that occur during pregnancy. (substrate use during exercise and caloric need)

Answer 22

• Pregnant clients use carbs @ higher rate during exercise
• Daily caloric need = + 300

Question 23

How does pregnancy affect thermoregulatory system? (metabolic/heat?)

Answer 23

Increase in metabolic rate and heat prodoction, esp. during 1st trimester

Question 24

What are 8 benefits unique to prenatal exercise?

• 4 conditions during pregnancy
• 3 labor/labor recovery/interventions
• 1 post postpartum benefit

Answer 24

1. ↑ energy reserves
2. ↓ preeclampsia
3. ↓ gestational diabetes
4. ↓ backaches, bloating, swelling, and constipation
5. ↑ recovery from labor
6. ↓ Shorter active phase of labor and less pain
7. ↓ need obstetric interventions
8. ↑ return to pre-pregnancy weight, strength, and flexibility levels

Question 25

what are 3 benefits of postpartum exercise?

Answer 25

1. Quick return to pre-pregnancy fitness levels
2. ↓ postpartum depression
3. ↑ VO2 max

Question 26

Prenatal exercise recommendations

• Aerobic
  
  • Mode
  • 2 answers Frequency, intensity volume
    
    • Option 2 has beginner and progression references
  • Beginning program recommendations
• Resistance training
  
  • Mode
  • Frequency
  • Intensity
  • Volume
• Flexibility
  
  • Frequency, intensity, volume
• How to resume postpartum?
  
  • How long do pregrnancy conditions last asfter birth?

Answer 26

• Aerobic
  
  • Mode: dynamic, rythmic activites to reduce joint stress
    
    • Walking, cycling, swimming
  • Frequency, intensity, volume
    
    1. 3-5 days @ RPE 13-14, minimum 150 min/week
    2. Begin 15 minutes @ moderate intensity per day, progress to progress to 30 min accumulated 3-7 days week
• Resistance training
  
  • Mode:
    
    • Machine or freeweight (no supine position)
    • Avoid isometric contractions
  • Frequency
    
    • 2-3 x week, no more than 5
  • Intensity
    
    • 60-80% 10RM
  • Volume
    
    • 12-15 Reps not to fatigue
• Flexibility
  
  • Frequency, intensity, volume
    
    • Daily
    • Stretch below discomfort threshold b/c increased joint elasticity
    • Hold stretch 10-30 seconds
• How to resume postpartum?
  
  • Gradually
  • Morphologic and physiologic changes from pregnancy can last 4-6 weeks postpartum

Question 27

Beginning RT program osteoporosis:

• Warm up: mode, intensity
• RT exercises
  
  • Training split?
  • %1RM
  • Reps
  • Sets
• Spine Specific exercises, reps and sets
  
  • 2 _ press-up _-up (sup/prone?)
  • 3 _ flex or extension? (spine region)

Answer 27

• Warm up: mode, intensity
  
  • Treadmill, stationary bike, stair climber, 50% MHR 5-10 min
• RT exercises and intensity
  
  • Alternate upper and lower exercises
  • 40-60%1RM
  • 15-20 Reps
  • 1-2 sets
• Spine Specific exercises
  
  • Prone Press-up
    
    • 15-20 reps 1-2 sets
  • Prone press-up and quad stabilization
    
    • 15-20 reps 1-2 sets
  • Thoracic extension on foam roller
    
    • 8-10 reps 1 set
  • Thoracic extension with pectoral stretch
    
    • 20s hold 5 reps
  • Thoracic extension in prone position
    
    • 10s hold 5 reps

Question 28

What is difference between:

• State/Trait anxiety
  
  • What nervos system is involved?
• Depression is the result of lowered levels of what 2 things? What type of chemical are they?

Answer 28

• State anxiety = acute
  
  • Actual stress-related process
  • Apprehension/threat + ↑ physiological arousal, mediated by autonomic nervous system
• Trait anxiety = chronic
  
  • Probability that given person is going to perceive situations as threatening
• Serotonin and norepinephrine, neurotransmitters

Question 29

What chemical change does exercise produce in relation to exercise?

Effectiveness in relation to medication?

What modes/intensities effective for AET?

What modes/intensities effective for RT?

Answer 29

• Increases levels of serotonin and norepinephrine
• May be as effective as medication
• Aerobic = wide range of intensities
• RT = low intensity high volume may be most beneficial

Question 30

What is disordered eating?

What is difference with eating disorders?

Answer 30

• Disordered eating
  
  • Wide array of irregular eating behaviors and patterns that may or may not warrant a diagnosis.
• Eating disorders
  
  • Have narrow diagnostic criteria. Clinical diagnosis, involving severity of disordered eating.

Question 31

Define:

• Osteochondrosis - when does it occur?
• Osteoarthritis - what is it most common in? What does it afect?

Answer 31

• Osteochondrosis
  
  • Degenerative changes in epiphyses of bones, often during significant growth periods in children
• Osteoarthritis
  
  • Degeneration of articular or hyaline cartilage in joint. Most common in weight bearing joints (hip, knee, ankle)

Question 32

What 5 shoulder conidtions require shoulder exercsie modifications?

Answer 32

1. Rotator cuff repair
2. Rotator cuff tendinitis
3. Glenohumeral joint instability (prior dislocation or subluxation)
4. Acromioclavicular joint injury (separation)
5. Glenohumeral joint osteoarthritis

Question 33

Give shoulder modifications for:

• Shoulder press
  
  • When lowering…
• Bench press
  
  • Keep….
  • Do not allow ….
• Pec Deck
  
  • During _ do not ….
• Lat Pull down
  
  • _ bar to _….
  • Use _ grip_

Answer 33

• Shoulder press
  
  • When lowering barbell, allow bar to pass in front of client’s head in order to minimize anterior shoulder stress
• Bench press
  
  • When lowering bar, client should not allow bar to touch chest at lowest point to minimize anterior shoulder stress
  • Keep upper arms near body to limit horizontal abduction and decreased shoulder stress
• Pec deck
  
  • During eccentric, do not allow pads to pass behind body at most posterior portion to minimize shoulder stress
• Lat pulldown
  
  • Allow bar to pass in front of client’s head to minimize anterior shoulder stress
  • Use reverse/supinated grip to reduce shoulder joint stress

Question 34

Define the 2 forms of arthritis, what do they affect?

Answer 34

• Rheumatoid arthritis = inflammatory disease affecting joints and joint connective tissue.
• Osteoarthritis = degenerative joint condition characterized by deterioration of cartilaginous weight being surfaces of articular joints, sclerotic changes in subchondral bone, and proliferation of new bone (bone spurs/osteophytes) at margin of joints

Question 35

What are 7 risk factors associated with osteoporosis?

Answer 35

1. Age 55 and older
2. Sex
3. Family history
4. Cigarette smoking
5. Excessive alcohol and caffeine consumption
6. Lack of exercise
7. Diet lacking calcium

Question 36

What is difference between osteoporosi and osteopenia?

Answer 36

• Osteopenia = bone density lower than normal, but not severe enough to be classified as osteoporosis
  
  • Can be treated slow progression
• Osteoporosis = severe loss of bone mass via deficiency in calcium, vitamin D, magnesium, and other minerals

Question 37

2 reasons why exercise essential for low back pain?

Answer 37

• Strengthen weak muscles that contribute to back pain
  
  • Gluteals (hip lateral rotators)
  • Hip Flexors
  • Hamstrings
• Increase flexibility and range of motion

Question 38

Define Muscle contusion, what causes it? speed of healing? impact on performace?

Answer 38

Commonly referred to as a bruise and occurs from a sudden and forceful blow to the body. The result is formation of a hematoma (blood tumor) in tissues surrounding the injured muscle. Speed of healing depends on extent of damage and internal bleeding. Contusions may severely limit movement of the injured muscle.

Question 39

Define muscle strain. How is it assigned? what are limitations?

Answer 39

Often the result of an abnormal muscle action leading to a stretching or tearing of the muscle fibers. Strains are assigned grades or degrees (first, second, third) to indicate severity of injury. A first- or second-degree strain is a partial tear, whereas third degree reflects a complete tearing of the muscle tissue. Pain, strength limitations, and motion restrictions increase with an increase in the grade.

Question 40

Define:

• Tendinopathy
• Tendinitis
• Tendinosis

Answer 40

• A more recently accepted term to describe the collective effects of tendinitis and tendinosis.
• Inflammation of a tendon. This microtrauma injury is frequently associated with obvious swelling and pain around the injured tendon. If left uncorrected or if the tissue is not allowed to fully heal, may lead to tendinosis.
• Represents a histological definition of tendinitis and involves further breakdown and structural
  degeneration of the injured tendon.

Question 41

Define micro trauma and macro trauma

Answer 41

• Macrotrauma = injury with a sudden and obvious episode of tissue overload and subsequent damage
• Microtrauma = injury from accumulation of tissue damage overtime

Question 42

• What is ligament sprain?
• What causes it?
• How are ligament sprains classified?
• What are assocaited with these classification?

Answer 42

• Trauma to the tissues that connect bone and contribute to joint stability
• Cuased by excessive force (i.e. due to changein direction) causes the joint move beyond its anatomical limits and stretching the ligament.
• Ligament sprains are assigned grades (1, 2, 3) to indicate severity of injury.
• An increase in the grade is associated
  with greater pain and tenderness, swelling, joint instability, and loss of function.

Question 43

• What is joint dislocation?
• What are 2 types of joint dyslocation?

Answer 43

• joint dyslocation = synovial joint moves beyond normal anatomical limits
• Subluxation dislocation = partial displacement/separation between 2 articulating bony surfaces
• Luxation = complete dislocation between 2 articulating bony surfaces

Question 44

• What is brutis and what causes it?
• Where are does it commonly occur?
• What are symptoms?

Answer 44

• Bursae = small fluid-filled synovial membrane sacs designed to reduce friction between tissues
  such as tendon and bone.
  
  • When irritated, the bursa becomes inflamed, resulting in bursitis.
• Common in the hip, knee, elbow, and shoulder
• Swelling, pain, and partial loss of function

Question 45

• What are 2 types of fracture and what are differences?

Answer 45

• Bone fracture = partial/complete disruption of bone due to direct blow
• Stress fracture ( may be influenced by nutrition)
  
  • Microtraumatic injury from
    
    • Abnormal muscle action
    • fatigue-related failure in the stress distribution across the bone
    • Dramatic change in
      
      1. Exercise/training surface
      2. Excessive trianing volume
      3. Both

Question 46

define: deafferentation

Answer 46

microscopic nerve damage in soft tissue

Question 47

What are the 3 phases of healing

1. _ = _-_ days
   
   • Durration
     
     1. Accute = _-_ days
     2. May last _-_ days
   • Goals:
     
     • _ for n_ in _ stages
     • Inury _ and _, d_ _
   • Exercise recommendatons = _ (_ modalities)
2. _ or _ = _-_ days
   
   • Duration
     
     1. _-_ days
     2. May last up to _
   • Goal
     
     1. Improve _ = _ formed
     2. New _ and _tissue form in area
     3. Prevent _ and _ injured area
     4. Promote_
        
        • _ down = framework for _
     5. Avoid _
   • Outcome
     
     1. An_ = (new _)
     2. High _ activity
     3. _ tissue formation
   • Activity recommendations
     
     1. Avoid _exercises to affecting damaged tissue
     2. Activity only after _
     3. S_ exercise okay
        
        1. allows_, but _ prevents damage to _
     4. B_ and p_ training activities
3. _ or _= _ days +
   
   1. Duration = _-_ months or longer
   2. Goal = _ tissue function
      
      1. _ collagen fibers production
         
         1. Allows _ to increase _ and _
      2. _ fibers of _ tissue _with _
   3. Outcome
      
      1. Formation _ fibers
      2. _ lines of stress
   4. Recommendations
      
      1. Exercises _ to facilitate _
      2. Strengthening _ from _ to a_, replicating _
         
         1. _-specific strengthening
         2. _ specific muscle activitiy
         3. _ chain activity
         4. _ training

Answer 47

1. Inflamation = 0-7 days
   
   • Durration
     
     1. Accute = 0-3 days
     2. May last 5-7 days
   • Prepare for new tissue formation in subsqeuent stages
   • Inury stabilized and contained, debris removed
   • Rest, passive modalitites (ice, compression, elevation)
2. Proliferation or Repair = 7-21 days
   
   • Duration
     
     1. 7-21 days
     2. May last up to a couple months
   • Phase Goal
     
     1. Improve tissue intengrity by repairing damaged tissue = scar tissue formed
     2. New capilaries an connective tissue form in area
     3. Prevent excessive muscle atrophy and joint degeneration of injured area
     4. Promote collagen synthesis
        
        • Collagen fibers randomly laid down = framework for repair
     5. Avoid disrupting newly cormed collagen
   • Outcome
     
     1. Angiogenisis (new blood vessels formed)
     2. High fibroblast activity
     3. Granulation tissue formation = CT that grows around wound site
   • Activity recommendations
     
     1. Avoid resitive exercises to affecting damaged tissue
     2. Activity only after consult with physician, athletic trainer, physio
     3. Submax isometric exercise okay
        
        1. allows strength gains, but low intensity prevents damage to new collagen
     4. Balance and proprioceptrive training activities
3. Remodeling or maturation = 21 days +
   
   1. Duration = 2-4 months or longer
   2. Goal = optimize tissue function
      
      1. ↓ collagen fibers production
         
         1. Allows newly formed tissue to ↑ structure strength and function
      2. Collagen fibers of scar tissue hypertrophy with increased loading
   3. Outcome
      
      1. Formation type 1 ccollagen fibers
      2. Collagen alignment along lines of stress
   4. Recommendations
      
      1. Exercises functional to facilitate return to activity
      2. Strengthening transition from general exercises to activity specific, replicating movements in sport/activity
         
         1. Joint angle-specific strengthening
         2. Velocity specific muscle activitiy
         3. Closed and open chain activity
         4. proprioceptive training

Question 48

• How are collagen fibers aligned during phase 2 healing? What is impact of this alignment?
• What is ideal alignment of collagen fibers?

Answer 48

• Phase 2 collagen = random to serve as framework for repair. Many laid down transversely to line of stress, limiting ability to transmit/accept force
• Collagen fibers strongest when parallel and lie longitudinally to primary line of stress

Question 49

Ankle inversion sprain

• Diagnosis
• Movement contraindications
• Exercise contraindications
• Exercise indications

Answer 49

• Diagnosis
  
  • Inversion sprain = ankle rolls inwards when moving upward
• Movement contraindications
  
  • Inversion with weight bearing
• Exercise contraindications
  
  • Activities requiring loaded or full weight bearing
• Exercise indications
  
  • Open chain ROM and strength activities until weight bearing is permitted

Question 50

Define:

• spondylosis
• spondylolisthesis - what is it caused by?
• herniated disc
  
  • What is most common form of herniated disc?

Answer 50

• Spondylosis defect/weakness/facture in facet joint area of part of lumbar vertebra
  
  • This weakness can cause the bones to slip forward out of normal position, called spondylolisthesis, and kink the spinal nerves
• Spondylolisthesis = progression of spondylosis
  
  • lumbar bones bones to slip forward out of normal position and kink the spinal nerves
  • Comonly from lumbar extension injuries
• Herniated disc = a fragment of the disc nucleus is pushed out of the annulus, into the spinal canal through a tear or rupture in the annulus
  
  • Most common = posterolateral disc herniation

Question 51

• What is impingement syndrome?
• What is anterior instability?
• What is rotator cuff repair? When is it used?

Answer 51

• pinching of the supraspinatus and the long head of the biceps tendon or subacromial bursa under the acromial arch
• instability resulting when the head of the humerous to move too far forward resulting in possible injury or dislocation
• Rotator cuff repair = surgery when damage to rotator cuff tendons includes “full thickness tear” (tear through entirety of tendon)

Question 52

Answer 52

Question 53

Answer 53

Question 54

Answer 54

Question 55

Answer 55

Question 56

Answer 56

Question 57

Answer 57

Question 58

Answer 58

Question 59

rf

Answer 59

Question 60

• Define rhabdomyolysis
• Give 5 symptoms

Answer 60

• Degeneration or destruction of muscle tissue because excessive and unaccustomed exercise, traumatic injury, or restriction of blood flow
• Symptoms
  
  1. Pain in muscles
  2. Muscle weakness and swelling
  3. Myoglobin in urine (brown urine)
  4. Muscle proteins and enzymes in blood
  5. ↑ amount of large proteins in blood

Question 61

• What age groups @ higher risk of fractures? And why?
• What injuries tend to happen post puberty?
• What sex @ higher risk of ACL injury and why?
• What sex @ higher risk for overuse injury?

Answer 61

• Age and fractures
  
  • Children = high fracture risk b/c ↑ growth rate → ↓ bone strength and muscular flexibility
  • Older adults b/c loss of BMD
• Females = ↑ ACL injury b/c joint laxity
• Females ↑ overuse injury

Question 62

Define:

1. Hypertension
2. Myocardial ischema
3. Myocardial Infraction
4. Cerebrovascular accident
5. Peripheral vascular disease

Answer 62

1. Hypertension
   
   • Classifications
     
     • Normal = <120 /and/ <80
     • Prehypertension = 120-139 /or/ 80-89
     • Stage 1 = 140-159 /or/ 90-99
     • Stage 2 = ≥ 160 /or/ ≥ 100
   • Causes
     
     • Unknown = idiopathic
     • Secondary causes
       
       • atherosclerotic renal artery stenosis
       • renal failure
       • hypothyroidism
2. Myocardial ischema
   
   1. decreased blood flow to heart b/c coronary artery obstructed with partial/complete blockage by a buildup of plaques (atherosclerosis)
3. Myocardial Infraction
   
   1. Rupture of myocardial ischema (plaques blocking coronary artery)
4. Cerebrovascular accident = stroke
5. Peripheral vascular disease = increase risk of cardiac event, manifests as pain during walking

Question 63

Hypertension exercise

• Aerobic
  
  • Mode (3)
  • ​Frequency
    
    • Begin
      
      • x week
    • Increase to
      
      • x week
  • Intenisty
    
    • Important rule =
      
      • Intensities of _-_% VO2 max allow positive training adaptions of lower BP, but don’t _
      • _ intensity = better at reducing resting BP and BP response to stress than _ intensity
    • Begin at:
      
      • _% VO2 max
      • _/20 RPE
      • kcal/week
    • Can increase to:
      
      • _ VO2 max
      • _/20 RPE
  • Duration
    
    • Begin
      
      • @ _ minutes
      • _ minutes/day
        
        • May use _
      • Minutes/week
        
        • Minimum
        • Range
    • Increase to
      
      • _-_ min
• Reistance training = same for __
  
  • Mode (3)
  • Frequency
    
    • Begin _ x week
    • Progress _ x week
  • Intensity
    
    • Begin
      
      • _ reps
      • _% RM
      • _ Sets
    • Progress to
      
      • % 1RM
      • _ reps
      • _ sets
    • Rest period
    • # Exercises
    • Load progression
      
      • Upper body _ lb
      • Lower body _ lb
• Exercise concerns
  
  1. Breathing/pressure
  2. SBP and DBP during exercise
  3. What blood pressure readings require physician clearance and BP control prior to exercise?

Answer 63

• Aerobic
  
  • Mode
    
    • Walking
    • Jogging
    • Swimming
  • Frequency
    
    • Begin
      
      • 3 x week
    • Increase to
      
      • 3-7 x week
  • Intenisty
    
    • Important rule =
      
      • Intensities of 40-50% VO2 max allow positive training adaptions of lower BP, but don’t put client at risk
      • Low intensity = better at reducing resting BP and BP response to stress than moderate intensity
    • Begin at:
      
      • 40% VO2 max
      • 8/20 RPE
      • 700 kcal/week
    • Can increase to:
      
      • 50-80% VO2 max
      • 10-16 RPE
  • Duration
    
    • Begin @ 15 minutes
      
      • 30 minutes/day
        
        • May use 3-6 x 10 minute bouts
      • Minutes/week
        
        • Minimum = 150
        • Range = 150-250+
    • Increase to
      
      • 30-60 min
• Reistance training = same for PVD clients
  
  • Mode
    
    • Weight machines
    • Elastic bands
    • Circuit training
  • Frequency
    
    • Begin 2x week
    • Progress 2-3 x week
  • Intensity
    
    • Begin
      
      • 16-20 reps
      • 50% RM
      • 1 Set
    • Progress to
      
      • 60-80% 1RM
      • 8-12 (up to 15) reps
      • 1-3 sets
    • Rest 30-60 Seconds
    • # Exercises
      • 8-12, large muscle groups, multi joint
    • Load progression
      
      • Upper body = 2-5lb
      • Lower body = 5-10lb
• Exercise concerns
  
  1. Exercises that increase intrathoracic pressure, reducing blood return to heart → cardiac output
  2. SBP 220 or DBP 105 during exercise
  3. Cancel session if BP ≥140/or/≥90 and seek physician clearance for exercise

Question 64

Myocardial infraction exercise recommendations

• Aerobic
  
  • Mode
  • Intenisty
    
    • Begin @
      
      • _% VO2 Max
      • _/20 RPE
    • Increase to
      
      • _-_% VO2/HRR
      • _-_/20 RPE
  • Frequency
    
    • Begin @ _ x week
    • Increase to _ x week
  • Duration
    
    • Begin @ _ min
    • Increase to _-_ min per day continuous/accumulated
• Reistance training
  
  • Intensity
    
    • Begin @
      
      • _ reps
      • _ sets
    • Increase to ____ program
      
      • _ sets per exercise _____
      • _ reps
      • _% 1RM (_ to _)
  • Frequency
    
    • Begin at _ x week
    • Increase to _ x week
  • # exercises
  • Rest
    
    • _
• Exercise concerns
  
  • Monitor for 6 signs/symptoms during exercise:
  • Avoid __
  • Do not train until _

Answer 64

Myocardial infraction exercise recommendations

• Aerobic
  
  • Mode
    
    • Activities that engage large muscle groups (walking, jogging, cycling)
  • Intenisty
    
    • Begin @
      
      • 40% VO2 Max
      • 9/20 RPE (actually 8/20)
    • Increase to
      
      • 40-80% VO2/HRR
      • 12-16/20 RPE (actually 8-16/20)
  • Frequency
    
    • Begin @ 3 x week
    • Increase to ≥3 x week
  • Duration
    
    • Begin @ 15 min
    • Increase to 20-60 min per day continuous/accumulated
• Reistance training
  
  • Intensity
    
    • Begin @
      
      • 20 reps
      • 1 sets
    • Increase to circuit style program
      
      • 1 set per exercise in circuit format
      • 10-15 reps
      • 40-80% 1RM (light to moderate)
  • Frequency
    
    • Begin at 2 x week
    • Increase to 2-3 x week
  • # exercises = 9-10
  • Rest
    
    • ≤ 30 seconds for circuit format
• Exercise concerns
  
  • Monitor for:
    
    • Angina
    • Palpations
    • Shortness of breath
    • diaphoresis
    • nausea
    • neck/arm/back pain
  • Avoid Valsalva maneuver
  • Do not train until clearance from required doctors

Question 65

5 hypertension exercise goals

Answer 65

1. Increase caloric expenditure
2. Control blood pressure
   
   1. best done with low intensity exercise (40-50%)
3. Increase muscular endurance
4. Increase maximal work and endurance
5. Increase VO2 Max and ventilatory threshold

Question 66

Answer 66

Question 67

What is relationship between MI, Cerebrovascular Accident, and Peripheral vascular disease?

Answer 67

• All three diseases share the same pathophysiology
  
  • Plague forms within lumen of blood vesel
  • Focal inflamation around the plaque area causes instability
  • Collagen develops to stabalize area
  • Collagen cap can rupture causing dangerous effects
• Stroke = insufficient blood supply to brain, prevents adequate nutrients and oxygen to cells
  
  • occurs when arteries leading to brain/in brain become narrowed/blocked
• Heart Attack = when heart muscle doesn’t get enough blood
  
  • occurs when plaque ruptures
• Peripheral Vascular disease = blood circulation disorder, blood vessels outside heart/brain become narrowed/blocked, affecting blood ssupply to legs, arms, kidneys, stomach, or head

Question 68

Stroke exercise recommendations:

• Aerobic
  
  • Mode
  • Intensity
    
    • Begin:
      • _ intensity = _% VO2 Peak
      • _/20 RPE
    • ​Progress to moderate intensity
      
      • _% VO2 Peak
      • _%-_% HRR
    • Frequency
      
      • _ x week
    • Duration
      
      • Begin
        
        • _ minute sessions
        • Some may start with _ minute
      • Progress to _-_ minute sessions
• Resistance
  
  • Mode (3)
  • Intensity:
    
    • Begin _-_%1RM
    • Progress to _-_% 1RM
    • Strive for _ sets _ reps
  • _-_ exercises
  • Frequency
    
    • Begin _ x week
    • Progress to _ x week _
• Other beneficial exercises
  
  • _ exercises
    
    • Frequency , _ minutes
  • ​_ and _ exercises
• Exercise concerns
  
  • _ and _ affected
  • _ cannot be determined, start with _ resistance

Answer 68

• Aerobic
  
  • Mode = Arm crank
  • Intensity
    
    • Begin:
      
      • light intensity = 30% VO2 Peak
      • 9/20 RPE
    • Progress to moderate intensity
      
      • 40-70% VO2 Peak
      • 55%-75% HRR
  • Frequency
    
    • 2-3 x week
  • Duration
    
    • Begin
      
      • 5 minute session
      • Some may start with 15-20 minutes
    • Progress to 30-60 minute sessions
• Resistance
  
  • Mode:
    
    • Bodyweight
    • Machine
    • Elastic tubing
  • Intensity:
    
    • Begin 50-60%1RM
    • Progress to 60-85% 1RM
    • Strive for 2 sets 8-12 reps
  • 8-10 exercises
  • Frequency
    
    • Begin 1-2 x week
    • Progress to 4 x week split
• Other beneficial exercises
  
  • Flexibility exercises
    
    • ​Before and after each session, 5 minutes
  • ​Coordination and balance exercises
• Exercise concerns
  
  • balance and strength affected
  • 1RM cannot be determined, start with very light resistance

Question 69

What are 5 goals of exercise for post MI clients? (2↓, 3↑)

Answer 69

1. ↓ blood pressure
2. ↓ risk of coronary artery disease
3. ↑ aerobic capacity
4. ↑ability to perform leisure, occupational, and daily living activities
5. ↑ muscle strength and endurance
6. ↑ confidence in performing daily living tasks

Question 70

What are 4 goals for clients post stroke? (3↑, 1 prevent)

Answer 70

1. ↑ balance and range of motion
2. ↑ strength in both involved and uninvolved limbs
3. ↑ daily living activities
4. Prevent joint Contractures
   
   • contracture = muscles, tendons, joints, or other tissues tighten or shorten causing a deformity.

Question 71

• Aerobic
  
  • Mode _
  • Intensity
    
    • __
  • Frequency
    
    • _
  • Duration
    
    • Begin _ minute
• Resistance training
  
  • Same as _
• 2 Exercise concerns

Answer 71

• Aerobic
  
  • Mode walking
  • Intensity
    
    • Walk until it hursts, stop, do it again, and a gain, and so on
  • Frequency
    
    • Nearly daily
  • Duration
    
    • Begin 10 minutes
• Resistance training
  
  • Same as hypertension
• Exercise concerns
  
  • Clients may not walk more than 2-5 minutes without having to stop/rest due to calf pain
  • May be at risk for cardiac event
    
    • ​If suspect cardiac event:
      
      • Stop, sit/lay down
      • Use nitroglycerin
      • Call 911

Question 72

What are the 6 categories of peripheral vascular disease on the Ruthford scale?

Answer 72

1. Asymptomatic
2. Mild pain while walking
3. Moderate pain while walking
4. Severe pain while walking
5. Pain while resting
6. Minor tissue loss
7. Moderate to severe tissue loss

Question 73

What are the grades (0-IV) and stages (I-IV) PVD on the Fountane scale?

• Grade 0 = _
• Grade 1 = _
• Grade 2 = _
• Grade 3 = _
• Grade 4 = _

Answer 73

• Grade 0 =
  
  • Stage 1 = asymptomatic
• Grade 1 =
  
  • Stage IIa = mild pain while walking
  • Stage IIb = moderate to severe pain while walking
• Grade 2 =
  
  • Stage III = pain while resting
• Grade 3 =
  
  • Stage IV tissue loss
• Grade 4 =
  
  • Stage IV tissue loss

Question 74

Answer 74

Question 75

How does PVD pain change with exercise and rest?

What are 6 goals of PVD exercise?

• 3 improve
• 2 increase
• 1 reduce

Answer 75

• With exercise, ↑ demand for oxygen may →↑ pain
• With rest, ↓ demand for oxygen →↓ pain
• Goals
  
  1. Improve pain response
  2. improve qaulity of life
  3. improve gait
  4. Reduce CAD risk
  5. increase daily living activities
  6. increase work potential

Question 76

What exercise may be most beneifical for hypertensive clients wanting to decrease BP

• Intensity/mode
• VO2 max
  
  • starting, progress to
• Duration
• Frequency

Answer 76

• Intensity/mode
  
  • Low to moderate aerobic exercise
• VO2 max
  
  • start 40-50%VO2 max
  • Progress to 50-85% VO2 ma
• Duration
  
  • 30-60 minutes
• Frequency
  
  • 3-7 x week

Question 77

• What 3 physiological adaptations to lipid levels will occur from chronic aerobic exercise?

Answer 77

1. ↑HDL-cholesterol
2. ↓Triglycerides
3. Minimal ↓ in LDL-cholesterol, greater impact if paired with weight loss and diet changes

Question 78

What 2 types of exercise is most beneficial for post-cardiac clients?

Answer 78

• Aerobic conditioning to lower BP and strengthen heart
• Muscular endurance to rebuild confidence

Question 79

• Why is exercise essential for clients who have had a stroke?
• What type of exercise is most beneficial for post-stroke clients?

Answer 79

• Clients decondition rapidly, will need to develop new neurologic pathways to affected limbs via recruiting dormant channels
• Resistance training, flexibility training, balance, and aerobic conditioning

Question 80

Answer 80

Question 81

Answer 81

Question 82

What are 2 types of obesity (g & a)

Answer 82

• Gynoid obesity = pear shaped body
• Android obesity = apple shaped body

Question 83

• What is hyperlipidemia?
• What is typical blood profile of someone with hyperlipidemia?

Answer 83

• Hyperlipidemia = elevated concentrations of blood fats (cholesterol, triglycerides and lipoproteins)
• Generally
  
  1. high LDL lipoproteins and VLD lipoproteins
  2. low HDL lipoproteins

Question 84

Answer 84

Question 85

• Aerobic exercise
  
  • Frequency
    
    • _ 5 x week to maximize _
  • Intensity
    
    • _% VO2 \_ or _
  • Durration
    
    • ​_-_ min x day
    • eventual goal = _-_ minutes to promote/maintain _
  • Guidelines/Concerns
    
    • ​_ may limit exercise type
    • Initially emphasise increasing _ > increasing _
• ​​Resistance training
  
  • Type
    
    • _exercises
    • _
  • Frequency
    
    • _x week
  • Intensity
    
    • _-_% 1RM
  • Durration
    
    • _-_ min
• Flexibility training
  
  • Type
    
    • _-_ static stretches
    • target _
  • Frequency
    
    • _-_ x week
  • Intensity
    
    • _ hold _ s
    • repeat holds _ times
  • Durration
    
    • _-_ min

Answer 85

• Aerobic exercise
  
  • Frequency
    
    • ​≥ 5 x week to maximize caloric expenditure
  • Intensity
    
    • ​40-75% VO2 Reserve or HRR
  • Durration
    
    • ​30-60 min x day
    • eventual goal = 50-60 minutes to promote/maintain weightloss
  • Guidelines/Concerns
    
    • ​Obesity may limit exercise type
    • Initially emphasise increasing duration > increasing intensity
• ​​Resistance training
  
  • Type
    
    • 8-12 exercises
    • large muscle groups
  • Frequency
    
    • 2-3 x week
  • Intensity
    
    • 50-85% 1RM
  • Durration
    
    • 20-40 min
• Flexibility training
  
  • Type
    
    • 12-16 static stretches
    • target all major muscle groups
  • Frequency
    
    • 3-7 x week
  • Intensity
    
    • static hold 10-30s
    • repeat holds 2-3 times
  • Durration
    
    • 20-30 min

Question 86

• Metabolic Syndrome =
  
  • _ or more of the following
    
    • __:
      
      • Male __
      • Female ___
    • Hyper__: ≥ _ mg/dl
    • Reduced _:
      
      • <_ mg/dl in men
      • <_ mg/dl in women
    • Elevated __: ≥ _/_ mmHg
    • _ _ _ : ≥ _mg/dl
  • People is Metabolic syndrome typically have _ levels aka __
• Metabolic syndrome total package =

1. _
2. _
3. _
4. _

Answer 86

• Metabolic Syndrome = mix of cardiovascular risk factors and metabolically related abnormalities
  
  • Three or more of the following
    
    • Abdominal obesity:
      
      • Male waist > 40 inches (102 cm)
      • Female waist > 35 inches (88 cm)
    • Hypertriglyceridemia: ≥ 150 mg/dl
    • Reduced HDL-cholesterol:
      
      • <40 mg/dl in men
      • <50 mg/dl in women
    • Elevated blood pressure: ≥130/85 mmHg
    • Elevated fasting glucose: ≥110 mg/dl
  • People is Metabolic syndrome typically have high blood insulin levels aka hyperinsulinemia
• Metabolic syndrome total package =

1. High blood glucose
2. High blood lipids
3. Hypertension
4. Abdominal obesity

Question 87

Diabetes:

• Diagnosis
  
  • # _ glucose levels of _ mg/dl
  • # _ or _ glucose levels of _ mg/dl
• Types
  
  • Type 1 = _ diabetes mellitus associated with _ destruction by _ → _ insulin _
  • Type 2 = _ _diabetes, insulin _ and insulin _ _of _ _ _
    
    • Associated with
      
      1. _
      2. _
      3. _
      4. _
  • _ =

Answer 87

• Diagnosis
  
  • 2 fasting glucose levels of ≥ 126 mg/dl
  • 2 postprandial or casual glucose levels of 200≥ mg/dl
• Types
  
  • Type 1 = insulin dependent diabetes mellitus associated with pancreatic beta cell destruction by auto immune process → absolute insulin deficiency
  • Type 2 = non-insulin dependent diabetes, insulin resistance and insulin secretory deficit of pancreatic beta cells
    
    • Associated with
      
      1. Family history
      2. Older age
      3. Obesity
      4. Sedentary lifestyle
  • Gestational = elevated glucose level/other symptoms during pregnacy in people without previous diabetes diagnosis

Question 88

Obese exercise recommendations:

• Aerobic
  
  • Frequency/duration
    
    • ​minimum = _ minutes _ days (_ min/week)
    • _ _ x week to maximize _
    • eventual goal = _ min/week
    • _ exercise of at least _ min = effective alternative to _ exercise
  • Intensity
    
    • ​Moderate intensity (_-_% VO2 \_ or _)

TO

• Vigorous intensity (_-_% VO2 \_ or _)
• Guidelines and Concerns
  
  • Modify equipment as needed (wider seats on machines)
  • ​Emphasize increasing duration over intensity
  • Take precautions to reduce risk of
    
    • 1
    • 2
    • 3
  • ​Use _ activities
• Resistance training
  
  • Frequency
    
    • ​_ x week, _ days
  • Intensity
    
    • _ sets initially, progress to _-_ sets
    • _ reps/set
    • Train _
    • _ load increase
  • Guidelines and Concerns
    
    • ​Can begin with _ _
    • Can intersperse with _
    • _ as necessary
    • can compliment _ (to _)
• Flexibility
  
  • Frequency
    
    • _ x week
  • Intensity
    
    • _ reps per muscle group
  • Duration
    
    • ​_ _streches for _-_seconds
• General exercise concerns:
  
  • _ concerns
  • _ problems and _ pain
  • _ and _

Answer 88

• Aerobic
  
  • Frequency/duration
    
    • ​minimum = 30 minutes most days of week (150min/week)
    • ≥ 5x week to maximize calaoric expenditure
    • eventual goal = 300 min/week
    • intermittent exercise of at least 10 min = effective alternative to continuous exercise
  • Intensity
    
    • ​Moderate intensity (40-60% VO2 Reserve or HRR)
    • to
    • Vigorous intensity (50-75% VO2 Reserve or HRR)
  • Guidelines and Concerns
    
    • ​Use low impact activityties
    • Take precautions to reduce risk of
      
      • ​orthopedic injury
      • Cardiovascular disease
      • Hypothermia
    • ​Emphasize increasing duration over intensity
    • Modify equipment as needed (wider seats on machines)
• Resistance training
  
  • Frequency
    
    • ​2-3 x week, non consecutive days
  • Intensity
    
    • ​1 or more sets initially, progress to 2-4 sets
    • 10-15 reps/set
    • Train each major muscle group
    • Gradual load increase
  • Guidelines and Concerns
    
    • ​Can begin with bodyweight exercises
    • Can intersperse with aerobic exercise
    • Modify equipment as necissary
    • can compliment aerobic conditioning (to maintain/gain lean mass)
• Flexibility
  
  • Frequency
    
    • 2-3 x week
  • Intensity
    
    • ​≥ 4 reps per muscle group
  • Duration
    
    • ​Hold static streches for 15-60 seconds
• ​​General exercise concerns:
  
  • Balance concerns
    
    • ​may be have less balance and coordination b/c didn’t articipate in sports
  • Posture problems and low back pain
    
    • ​Abdominal fat puts added stress on spine and less strength in abdominal wall muscles
  • _ and _
    
    • ​Hyperpnea = increase in breath rate
    • Dyspenea = labored/diffuclty breathing
    • Combined = uncomfortable and source of anxiety

Question 89

In the contenxt of weight loss for obese clients, what are guidlines for the following:

• Exercise intensity
• Weekly exercise duration to prevent weight gain
• Weekly exercise duration to prevent weight regain
• Weekly caloric expenditure for weight loss
• Weighly calor expenditure to prevent regain

Answer 89

• Exercise intensity
  
  • 40-85% HRR
• Weekly exercise duration to prevent weight gain
  
  • 150-300 min
• Weekly exercise duration to prevent weight regain
  
  • 300+ min
• Weekly caloric expenditure for weight loss
  
  • 1200-2000 kcal
• Weighly calor expenditure to prevent regain
  
  • 2000+ kcal

Question 90

• What is roles of exercise in helping overweight/obese clients reach goals?
  
  1. _ energy _
     
     1. However, many out of shape obese people unable to p_
  2. _ heart disease _
  3. _ body fat and _
  4. _ dietary _
  5. _ _ induced by low calorie diet
  6. ↑ _ and _
  7. ↑_
  8. ↑_ and _
  9. Serves as _

Answer 90

• May not help lose weight, reduces obesity-related risk factors and critical for long-term weight management
  
  1. ↑ energy expenditure
     
     1. However, many out of shape obese people unable to perform exercise @ sufficient duration/intensity to create caloric deficit
  2. ↓ risk of heart disease more than just weight loss alone
  3. May help ↓ body fat and prevent lean body mass loss
  4. May → better dietary adherence
  5. May minimize ↓ in RMR induced by low calorie diet
  6. ↑ mood and well-being
  7. ↑Body image
  8. ↑self-esteem and self-efficacy
  9. Serves as coping strategy

Question 91

• What are diet modification recommendations for obese individuals?
  
  • Refer to dietitian
    
    • Recommended if _ and _
    • Required if _
  • Weight loss goal = _% bodyweight in 6_ months
  • Women consume no less than _ calories a day
  • Men consume no less than _ calories a day
  • Low Calorie Diet
    
    • Calories: _ calorie reduction from typical intake.
    • Total Fat – _ % or _ calories
      
      • Saturated fatty acids: _-_% of total calories
      • Monounsaturated fatty acids _%
      • Polyunsaturated fatty acids _%
      • Cholesterol _ _mg
    • Protein _% total calories
    • Carbohydrates _% or _ total calories
    • Sodium _ mmol
    • Calcium _-_ thousand mg
    • Fiber _-_ g

Answer 91

• What are diet modification recommendations for obese individuals?
  
  • Refer to dietitian
    
    • Recommended if obese and high cholesterol
    • Required if diabetic
  • Weight loss goal = 10% bodyweight in 6 months
  • Women consume no less than 1000-1200 calories a day
  • Men consume no less than 1200-1600 calories a day
  • Low Calorie Diet
    
    • Calories – 500 – 1000 calorie reduction from typical intake.
    • Total Fat – 30% or fewer calories
      
      • Saturated fatty acids – 8 – 10% of total calories
      • Monounsaturated fatty acids – up to 15%
      • Polyunsaturated fatty acids – up to 10%
      • Cholesterol – < 300mg
    • Protein – ~15% total calories
    • Carbohydrates – 55% or more total calories
    • Sodium – Not more than 100 mmol
    • Calcium – 1 – 1.5 thousand mg
    • Fiber – 20 – 30 g

Question 92

How does exercise affect the following metabilolic symptoms?

• Insulin sensitivity
  
  • insulin levels
  • blood glucose
• Triglycerides
• HDL levels
• Body fat

Answer 92

• Exercise ↑ insulin sensitivity → ↓insulin levels to normal levels and ↓ blood glucose
• Exercise ↓ triglycerides
• Exercise ↑ HDL levels
• Exercise ↓ body fat

Question 93

Answer 93

Question 94

How does exercise impact insulin production?

• _ Production of insulin (common with folks with _ diabetes) _ insulin sensitivity
• _ measures improve significantly with resistance training and aerobic training
• _ muscle glucose uptake

What roll does exercise play in improving health-related conditions associated with Type 2 diabetes?

• Long term resistance training _→ _
• Exercise can also help _

Answer 94

• ↓ Production of insulin (common with folks with type 2 diabetes) ↑ insulin sensitivity
• Blood glucose measures improve significantly with resistance training and aerobic training
• Increased insulin-independent muscle glucose uptake
• Long term resistance training increases fat-free mass → ↑ insulin receptors and capacity for glucose uptake
• Exercise can also help utilize glucose in blood

Question 95

Absolute contraindications of exercise for diabetic clients:

• Blood glucose _ mg/dl and _ in urine for type _
• Blood glucose _ mg/dl and _ for type _
• Clients with type _ may participate in exercise provided _ and _
• __ (avoid strenuous and high-intensity activities)
• Severe _ disease
• Loss of _ (_)
• Acute _, _, _
• Evidence of underlying _that has not been medically evaluated

Answer 95

• Blood glucose > 250 mg/dl and ketones in urine for type 1 diabetes
• Blood glucose > 300 mg/dl and no ketones for type 1
• Clients with type 2 may participate in exercise provided feeling well and hydrated
• Proliferative retinopathy (avoid strenuous and high-intensity activities)
• Severe kidney disease
• Loss of proliferative sensation in feet (peripheral neuropathy)
• Acute illness, infection, fever
• Evidence of underlying CVD that has not been medically evaluated

Question 96

Diabetes exercise recommendations

• Aerobic conditioning
  
  • Freequency
    
    • ​_ x week
  • Duration
    
    • _-_min.day (_ min/week)
    • Eventual goal = _ min/week
  • ​Intensity
    
    • _-_% VO2 \_ or _
    • _-_ RPE
  • ​Guidlines
    
    • ​May need _
    • Monitor _
    • Include _
    • Monitor intensity via _ especially if client _
• ​Resistance trianing
  
  • ​Frequency
    
    • _ x week
  • ​Intensity
    
    • ​_ reps (_%1RM)
    • _ sets
  • ​​Mode:
    
    • _ multi joint exercise for all _ in same session or _ into _
  • ​Guidelines
    
    • ​Can begin with _ exercises and progress to _ and _
    • Clients with well controlled diabetes can _
• ​Flexibiltiy Trianing
  
  • ​Frequency_ x week
  • _ reps per _
  • _ for _ seconds

Answer 96

• Aerobic conditioning
  
  • Freequency
    
    • ​3-7x week
  • Duration
    
    • 20-60 min.day (150 min/week)
    • Eventual goal = 300 min/week
  • ​Intensity
    
    • ​50-80% VO2 Reserve or HRR
    • 12-16 RPE
  • ​Guidlines
    
    • ​May need snack before exercise
    • Monitor blood glucose before/after exercise
    • Include 5-10 minute warm up and cool down
    • Monitor intensity via RPE especially if client taking HR altering medication
• ​Resistance trianing
  
  • ​Frequency
    
    • ​2-3 x week
  • ​Intensity
    
    • ​8-12 reps (60-80%1RM)
    • 2-3 sets
  • ​​Mode:
    
    • ​8-10 multi joint exercise for all major muscle groups in same session or session split into muscle groups
  • ​Guidelines
    
    • ​Can begin with bodyweight exercises and progress to freeweights and resitance machines
    • Clients with well controlled diabetes can progress to strength training (higher loads fewer reps)
• ​Flexibiltiy Trianing
  
  • ​Frequency 2-3x week
  • ≥ 4 _reps per muscle group
  • hold static stretches for 15-60 seconds

Question 97

• What is hypoglycemia?
• What are signs/symptoms?
  
  • Head to toe
• How should it be treated?
  
  • Consider _
  • Measure blood glucose. If _ mg/dl, and _, provide _
  • Wait _ minutes, measure blood glucose. If _ mg/dl, administer _, and continue until _

Answer 97

• What is hypoglycemia?
  
  • Blood glucose of 65 mg/dl or lower
• What are signs/symptoms?
  
  • Sweating
  • Headache
  • Dizziness
  • confusion
  • blurred vision
  • Palpitations (rapid HR)
  • Tachyardia (HR over 100)
  • Anxiety
  • Hunger
  • Tremor
  • convulsion
  • syncope (loss of consciousness caused by low BP)
  • Coma
• How should it be treated?
  
  • Consider calling 911
  • Measure blood glucose. If below 70 mg/dl, and signs/symptoms of hypoglycemia, provide 15 g carbohydrate
  • Wait 15 minutes, measure blood glucose. If still below 70 mg/dl, administer 15 g more carbs, and continue until blood glucose above 70 mg/dl

Question 98

Describe the following:

• COPD
• Asthma
• Exercise-Induced Bronchoconstriction
• Emphysema
• Chronic Bronchitis

Answer 98

• COPD = Chronic Obstructive Pulmonary Disease
  
  • Umbrella term for progressive lung disease that is not completely reversible. Includes the below 3 diseases
    
    • Severe cases asthma
    • Emphysema
    • Chronic broncitis
• Asthma
  
  • Reversible airway disease that is associated with hyperactivity and characterized by ease of developing bronchospasm, constriction, or even both of these
  • Inflammation in the lungs that narrows the airways
  • Only severe asthma cases are classified as COPD
• Exercise-Induced Bronchoconstriction
  
  • AKA Exercise-Induced Asthma = narrowing of airways makes it hard to breathe
• Emphysema
  
  • the walls between air sacs (alveoli) in lungs are damaged
• Chronic Bronchitis
  
  • Inflamatation and swelling of the broncial tubes

Question 99

What are exercise recommendations for clients with Asthma and EIB?

• Aerobic
  
  • Objectives
    
    • Increase _
    • Improve _ and _
    • Increase _and _ thresholds
  • Warm-up
    
    • _ may be best
  • Mode
    
    • _ activities
      
      • Facilitates increase in _ and _ thresholds
  • Frequency/ Duraration
    
    • Sessions _x day, _x week, lasting _ minutes
    • Some clients may only perform _-_ minutes
      
      • Goal = _-_ min
  • Intensity
    
    • _-_/20 RPE
    • Monitor with _ and sense of _ (_)
      
      • Many clients unable to achieve _
  • Time of day
    
    • Train _ to _ b/c of _ from gland
  • Enviormental considerations
    
    • _ and _ ↑ _
• ​Resistance training
  
  • _ program recommended
  • Objectives
    
    • Increase _ to desensitize _
    • Increase _
    • Increase _
  • CSCS example client
    
    • _ x week
    • _ intensity (_-_% 1RM)
    • _-_ sets _-_ reps
• General Asthma treatment info
  
  • Asthma has _ and _ phase
  • _ phase is best prevented with
    
    • Inhaler _-_ minutes _ exercise
  • _ phase
    
    • Has _ onset (_-_ hours) due to _
    • Best prevented with inhaler _-_ hours _ exercise

Answer 99

• Aerobic
  
  • Objectives
    
    • Increase VO2 max
    • Improve aerobic capcity and endurance
    • Increase in lactate and ventilatory thresholds
  • Warm-up
    
    • Intervals may be best
  • Mode
    
    • Large muscle group activities
      
      • Facilitates increase in lactate and ventilatory thresholds
  • Frequency/ Duraration
    
    • Sessions 1-2x day, 3-7x week, lasting 30 minutes
    • Some clients may only perform 5-10 minutes
      
      • Goal = 20-60 min
  • Intensity
    
    • 11-13/20 RPE
    • Monitor with RPE and sense of shortness of breath (dyspnea)
      
      • Many clients unable to achieve training HR
  • Time of day
    
    • Train mid to late morning b/c of natural cortisol release from gland
  • Enviormental considerations
    
    • Humitidy and temperature extremes ↑ risk of broncospasm
• ​Resistance training
  
  • General program recommended
  • Objectives
    
    • Increase max number of reps to desensitize shortness of breath
    • Increase training volume
    • Increase lean body mass
  • CSCS example client
    
    • 2-3 x week
    • Moderate intensity (60-80% 1RM)
    • 2-4 sets 6-12 reps
• General Asthma treatment info
  
  • Asthma has both early and late phase
  • Early phase is best prevented with
    
    • Inhaler 15-20 minutes prior to exercise
  • Late phase
    
    • Has deplayed onset (1-6 hours) due to air way edemas
    • Best prevented with inhaler 2-3 hours after exercise

Question 100

What are 3 benefits of exercise for cleints with respiratory disorders/conditions?

Answer 100

• Large muscle aerobic activity → ↑ VO2 max and ↑ lactate and ventilatory thresholds
• ↓ shortness of breath → ↑ activities of daily living

Question 101

• Epilepsy = _ condition
  
  • Collection of _ with common characteristic of _
    
    • Seizure – sudden surge in _ that may affect individual’s _ and _ for short period
  • At least _ unprovoked seizures occurring _ hours apart
• Regular _ exercise may contribute to _ but in _% of people _ exercise is a _ to _

Answer 101

• Epilepsy = Neurological condition
  
  • Collection of disorders with common characteristic of recurring seizure activity
    
    • Seizure – sudden surge in electrical activity of brain that may affect individual’s appearance and actions for short period
  • At least 2 unprovoked seizures occurring more than 24 hours apart
  • Regular aerobic exercise may contribute to seizure prevention but in 10% of people vigorous exercise is a precipitant to seizures

Question 102

Types of seizures

• Partial = affect _ area of brain
  
  • _ seizure
    
    • No _
    • May alter _or change way things _, _, _, or _
    • May result in
      
      • _,
      • Spontaneous _ = _, _, and _
  • _seizure
    
    • _, causing impared _
      
      • Result in _ and _
        
        • _
        • _
        • _
        • _
        • _
• _seirsures = affect _
  
  • _(peit mal)
    
    • _ and _
    • can cause _ (_ seconds) loss of _
  • _
    
    • Sudden, _ or _ of _
  • _ (grand mal)
    
    • _ of all types
    • Loss of _and _
    • _and _
  • _= drop attacks
    
    • _(_s) seizure may cause client to
      
      • _
      • _

Answer 102

• Partial = affect 1 area of brain
  
  • Simple seizure
    
    • No loss of conciousness
    • May alter emotions or change way things look, smell, feel, or taste
    • May result in
      
      • involuntary jerking of part of body,
      • Spontaneous sensory symptoms = tingling, vertigo, and flashing lights
  • Complex seizure
    
    • Alter conciousness, causing impared awareness
      
      • Result in staring and nonpurposful moments
        
        • Hand rubbing
        • Twitching
        • Chewing
        • Swallowing
        • Walking in circles
• Generalized seirsures = affect both sides of brain
  
  • Absense (peit mal)
    
    • stairing and suble body movement
    • can cause breif (2-15 seconds) loss of consciousness
  • Myoclonic
    
    • Sudden, ultra short jerks or twitches of arms and legs
  • Tonic-clonic (grand mal)
    
    • Most intense of all types
    • Loss of conciousness and bladder conrol
    • stuffening and shaking
  • Atonic = drop attacks
    
    • brief (<15s) seizure may cause client to
      
      • lose normal muscle tone
      • suddenly collapse

Question 103

First aid for seizures

1. Keep client _
2. Remove _
3. _ any _ (e.g. _)
4. Do not _ client
5. keep _ client’s _
6. Do not _
7. after seizure _ client _ to _
8. _ client until _
9. _ _and _
10. Client may _ but _ on case by case basis

Weight loss of _ pounds can _ avaiability of antiseizure medications and thus increase _

Answer 103

1. Keep client prone
2. Remove eyeglasses and other items that may break or cause injury
3. Loosen any tight clothing (e.g. around neck)
4. Do not restrain client
5. keep objects out of client’s path
6. Do not place anything inside mouth
7. after seizure turn client to side in recovery position to prevent aspiration
8. Observe client until fully awake
9. Alert phsyician and family
10. Client may return to exercise but evaluate with physician on case by case basis

Weight loss of 10 pounds can increase avaiability of antiseizure medications and thus increase risk of side effects

Question 104

• Multiple Sclerosis = _ _
  
  • _ _disorder characterized by _ of _ that _ the _→ _/_ _signals from _ to _
  • Symptoms
    
    • _ _
      
      • _ and _
      • _ limitations
      • _ sensitivity
      • Reduced _/_
      • _
      • Disturbance of _ _
    • Symptoms can be _ _ or _

Answer 104

• Multiple Sclerosis = Neurological disease
  
  • Progressive autoimmune disorder characterized by deterioration of the myelin sheath that covers around the neuron → slowing/disrupting electrochemical signals from brain to body
  • Symptoms
    
    • Muscular weakness
      
      • Tingling numbness
      • Visual limitations
      • Heat sensitivity
      • Reduced coordination/balance
      • Fatigue
      • Disturbance of cognitive processes
    • Symptoms can be in remission or relapse

Question 105

• Cerebral palsy = _
  
  • Group of _, _ disorders caused by variety of _
  • Affect the _ and characterized by limitations in _ affecting _ _/_
  • Symptoms
    
    • _ = excessive _
    • _= excessive _ or _+ increased _reflexes that may _with movement
    • _ = Lack of _ with _ movements
    • _ muscles
    • Exaggerated _
    • _ abnormalities
      
      • _ gait
      • _ gait
      • Walking _ _
    • Clumsiness to impairments that prevent coordinated movements
• Other complications
  
  • _
  • _ disorders
  • Impaired _

Answer 105

• Hypertonia = excessive muscle tone
• Spasticity = excessive muscle tone or stiffness + increased tendon reflexes that may interfere with movement
• Ataxia = Lack of motor coordination with volitional movements
• Tight muscles
• Exaggerated reflexes
• Gait abnormalities
  
  • Crouched gait
  • Scissoring gait
  • Walking on toes
• Clumsiness to impairments that prevent coordinated movements
• Other complications
  
  • Epilepsy
  • Communication disorders
  • Impaired cognition

Question 106

Related to what condition? Define.

• Apraxia
• ataxia
• atheostis
• chorea
• dyskinesis
• dystonia
• myoclonus
• spacsticity

Answer 106

Question 107

Down’s Syndrome characteristics

• Delay in _
• Muscle _
• _ stature
• _ abnormalities
• _ profile

Answer 107

• Delay in mental maturation
• Muscle weakness
• Short stature
• Cardiac abnormalities
• Flat face profile

Question 108

• Parkinson’s disease = _
  
  • _ disease caused by _/_of _responsible for production of _
  • Symptoms
    
    • _
    • Poor _
    • _ speech
    • _

Answer 108

• Parkinson’s disease = neurological
  
  • Neurodegenerative disease caused by death/impairment of neurons responsible for production of dopamine
  • Symptoms
    
    • Tremor
    • Poor balance
    • Muffled speech
    • Depression

Question 109

• Spinal cord injuries = _
  
  • _ or _ process of spinal cord → altered _, _, or _ functioning
  • Can limit _ ability and _
    
    • _ = spinal cord injury @ _ region that affects _ and _ and _
    • _= spinal cord injury at _/_vertebral levels that affects the _ and _
  • Depending on severity of injury, _ available to contribute to _ impacted
  • With ascending levels of SCI, greater levels of _ dysfunctions → limited _ b/c ↓ _ (_) responses to _ exercise
    
    • Autonomic dysreflexia = disruption of _ → _ (_), _, and constricted _ that causes sudden onset of _)
  • Level of SCI impacts VO2 peak
    
    • People with _ devoid of _ process, limited _ → limited _
  • _, _, and _ overuse injuries common
    
    • Reduce risk by
      
      • stretching _ muscles of _ and strengthening muscle groups of _
  • Unable to increase _ → impaired ability to _ → ↑ risk of _ injuries

Answer 109

• Spinal cord injuries = Neurological
  
  • Injury or disease process of spinal cord → altered motor, sensory, or autonomic functioning
  • Can limit motor ability and sensation
    
    • Tetraplegia = spinal cord injury @ cervical region that affects upper and lower extremities and trunk
    • Paraplegia – spinal cord injury at thoracic/lumbar vertebral levels that affects the lower extremities and portion of trunk
  • Depending on severity of injury, active muscle mass available to contribute to force generation stabilization impacted
  • With ascending levels of SCI, greater levels of autonomic dysfunctions → limited exercise capacity b/c ↓ hemodynamic (blood flow) responses to upper extremity exercise
    
    • Autonomic dysreflexia = disruption of neural regulation of arterial blood pressure → noxious stimuli (distended bladder or bowel), infections, and constricted clothing that causes sudden onset of hypertension)
  • Level of SCI impacts VO2 peak
    
    • People with tetraplegia devoid of sympathetic cardio-acceleration process, limited HR elevation → limited HR peak
  • Shoulder, wrist, and elbow overuse injuries common
    
    • Reduce risk by
      
      • stretching anterior and strengthening posterior muscle groups of shoulder girdle
  • Unable to increase skin blood flow → impaired ability to dissipate metabolic heat → ↑ risk of heat-related injuries

Question 110

What condition is Autonomic Dysreflexia associated with?

Answer 110

Question 111

• Traumatic brain injury = _
  
  • Injury to the brain that takes place when _, _ causes damage to the _
    
    • Mild
      
      • E.g. _
      • _ doesn’t occur or was for _
    • Moderate
      
      • _ > _ minutes < _ hours
      • May result in _, _, or _ impairments for life
    • Severe
      
      • _ > _ Hours
      • _ to brain tissue with range of _/_ outcomes impacting daily life

Answer 111

• Traumatic brain injury = cognitive
  
  • Injury to the brain that takes place when sudden, traumatic force causes damage to the brain tissue
    
    • Mild
      
      • E.g. concussions
      • Loss of consciousness doesn’t occur or was for less than 30 minutes
    • Moderate
      
      • Loss of consciousness > 20 minutes < 6 hours
      • May result in behavioral performance, physical, or cognitive impairments for life
    • Severe
      
      • Unconsciousness > 6 Hours
      • Significant damage to brain tissue with range of physical/behavioral outcomes impacting daily life

Question 112

MS exercise recommendations

• Aerobic exercise
  
  • Mode: mindful of MS affect on balance (5 examples)
    
    1. Stationary/recumbant cycling
    2. Recumbent stepping
    3. water arrobigs
    4. upper body ergometry
    5. walking
  • Intensity
    
    • HRR = _-_%
    • VO2 Reserve = _-_%
    • VO2 peak = _-_%
    • Peak HR = _-_%
  • Duration
    
    • _ min/session
    • may need to be accumulated with _ _ minute sessions
  • Frequency
    
    • _-_ x week on _ days
• Resistance
  
  • Modes: (5 examples)
  • Muscle groups
    
    • _-_ exercises emphasize all muscle groups to balance antagonist/agonist
  • Intensity
    
    • _-_ reps _-_% 1RM
  • Sets
    
    • _ or more per muscle group
  • Rest
    
    • minimum _ rest b/w set/exercise
• Flexibility
  
  • Mode (4)
  • Duration
    
    • hold stretches _-_ seconds
    • with _/_ tension
  • Frequency
    
    • _-_ x day gentle stretching
  • Muscle groups
    
    • _ muscle groups
    • Prioritize 5

Answer 112

• MS exercise recommendations
• Aerobic exercise
  
  • Mode: mindful of MS affect on balance (5 examples)
    
    1. Stationary/recumbant cycling
    2. Recumbent stepping
    3. water arrobigs
    4. upper body ergometry
    5. walking
  • Intensity
    
    • HRR = 40-60%
    • VO2 Reserve = 40-60%
    • VO2 peak = 50-70%
    • Peak HR = 60-80%
  • Duration
    
    • 30 min/session
    • may need to be accumulated with 3 10 minute sessions
  • Frequency
    
    • 2-3 x week on nonresistance training days
• Resistance
  
  • Modes: (5 examples)
    
    1. Machines
    2. Freeweights
    3. Resitance bands/tubing
    4. Pullies
    5. Pilates
  • Muscle groups
    
    • 8-10 exercises emphasize all muscle groups to balance antagonist/agonist
  • Intensity
    
    • 8-15 reps 60-80% 1RM
  • Sets
    
    • 1 or more per muscle group
  • Rest
    
    • minimum 1 minute rest b/w set/exercise
• Flexibility
  
  • Mode
    
    • Active ROM, passive ROM, yoga, tai chi
  • Duration
    
    • hold stretches 30-60 seconds
    • with mild/moderate tension
  • Frequency
    
    • 1-2 x day gentle stretching
  • Muscle groups
    
    • All muscle groups
    • Prioritize:
      
      • hip flexors
      • hamstrings
      • hip abductors
      • plantar flexors
      • anterior shoulder girdle muscles

Question 113

• CP is a collection of _ resulting from injury to _ during _ or early _, which causes impairment of _ and _ of _.
• People with CP have _levels of exercise _ (_ and _) and reduced _
• _ limitations restrict _efficiency →↑_ for _ compared to folks without CP

Answer 113

• CP is a collection of musculoskeletal deficits resulting from injury to the brain during birth or early childhood, which causes impairment of body movement and coordination of muscles.
• People with CP have lower levels of exercise capacity (muscular strength and endurance) and reduced VO2 Peak
• Motor limitations restrict gait efficiency →↑energy demand for movement compared to folks without CP

Question 114

What are common cardiovascular problems for people with chronic spinal cord injuries?

• Orthostatic hypotension “_hypotension = _ in BP when moving from _)
• Autonomic dysreflexia =
• Impaired _ of cardiogenic _
• Loss of _ cardiac a_
• Atrial _ = _
• Sudden _ = total _
• Quadriplegic c_ a_
• c_ heart _= heart doesn’t _ b/c _
• Pseudo _
• _ (_)

Answer 114

1. Orthostatic hypotension “postural hypotension = decrease in BP when moving from sitting to standing)
2. Autonomic dysreflexia = sudden onset of high BP
3. Impaired transmission of cardiogenic pain
4. Loss of reflex cardiac acceleration
5. Atrial fibrillation = irregular and often rapid HR
6. Sudden death from an asystole = total cessation of heart beat
7. Quadriplegic cardiac atrophy
8. Congestive heart failure = heart doesn’t pump as efficently b/c narrowed arteries/high BP
9. Pseudo myocardial infraction
10. Atherosclerosis (plaque buildup)

Question 115

• MS exercise recomendations. Use extreme caution when _
• Be mindful that people with MS are highly sensitive to _/_ increases in _
• Aerobic
  
  • Begin _-_% of VO2 max
  • _-_ minutes
  • _-_ x week
• Resistance training
  
  • _-_ exercises
  • _-_% of 1RM
  • _-_ sets of _-_ reps

Answer 115

• Use extreme caution when testing client
• Be mindful that people with MS highly sensitive to external/internal increases in heat
• Aerobic
  
  • Begin 40-60% of VO2 max
  • 10-20 minutes
  • 3-4 x week
• Resistance training
  
  • 8-12 exercises
  • 40-70% of 1RM
  • 2-3 sets of 8-12 reps

Question 116

SCI exercise recommendations - same as for what other condition?

• AET
  
  • Mode (2)
  • Frequency
    
    • Begin _ x week
    • Progress _-_ x week
  • Itensity
    
    • Begin
      
      • _-_ intensity
        
        • _-_% VO2 or HRR reserve
        • _-_% MHR
        • _-_RPE
  • Duration
    
    • Begin _-_ minute sessions
    • Increase _ minute sessions
• RT
  
  • Frequency
    
    • Begin _-_ sessions week
    • Progress to _ x week _
  • Intensity
    
    • Begin
      
      • _-_ exercises
      • Emphasize _-joint exercises
      • _-_% 1RM
    • Progress
      
      • _-_% 1RM
  • Volume
    
    • Start with 1 set _-_
    • Increase to _-_ sets
    • Rest = _-_ min

Answer 116

• Parkinsons
• AET
  
  • Mode
    
    • Arm crank
    • Riciprocal press-pull exercise
  • Frequency
    
    • Begin 1 x week
    • Progress 2-3 x week
  • Itensity
    
    • Begin
      
      • Light-moderate intensity
        
        • 30-40% VO2 or HRR reserve
        • 55-75% MHR
        • 9-13RPE
  • Duration
    
    • Begin 15-20 minute sessions
    • Increase 30 minute sessions
• RT
  
  • Frequency
    
    • Begin 1-2 sessions week
    • Progress to 4 x week split
  • Intensity
    
    • Begin
      
      • 8-10 exercises
      • Emphasize multi joint exercises
      • 40-60% 1RM
    • Progress
      
      • 60-85% 1RM
  • Volume
    
    • Start with 1 set 10-12
    • Increase to 2-3 sets
    • Rest = 1-2 min

Question 117

Epilepsy benefits

• People with epilepsy have lower _, exercise can help maintain healthy _
• Exercise improves 3 things
• Does not increase _, may for _

Answer 117

• People with epilepsy have lower RMR, exercise can help maintain healthy BMI
• Exercise improves quality of life, strength, peak oxygen consumption, endurance, body composition
• Does not increase seizure rate

Question 118

Exercise benefits for SCI and Paralysis

• Improved _, improved muscle _/_
• _ _training seems most effective

Answer 118

• Improved VO2 peak, improved muscle strength/endurance
• Circuit resistance training seems most effective

Question 119

Downs Syndrome Exercise benefits

• Increased _
  
  • Decreased time to _
  • Increased _ and _
• Increased exercise _

Answer 119

• Increased functional independence
  
  • Decreased time to fatigue
  • Increased cardiovascular fitness and generalized muscle strength
• Increased exercise economy

Question 120

Parkinson’s disease RT benefits:

6 things increase

Answer 120

1. ↑ Muscle strength
2. ↑ Mobility
3. ↑ Balance
4. ↑ walking capacity
5. ↑ muscular endurance
6. ↑ fat free mass

Question 121

How long do the following last (years, weeks, months, etc.):

• Macrocycle
• Mesocycle
  
  • Duration
  • Mesocycles per Macrocycle
• Microcycle
  
  • Duration
  • Varation frequency

Answer 121

• Macrocycle
  
  • Typically 1 year, as long as 4 years
• Mesocycle
  
  • Several weeks to several months
  • Typically 2+ meso cycles 1 year
• Microcycle
  
  • Last 1-4 weeks
  • Include daily and weekly trianing vairations

Question 122

5 Phases of Mesocycle goals:

• Hypertophy phase
  
  • What bases are built in this phase?
  • Includes _ and _ specific execises at _ volume _ intensity
• Strength phase
  
  • Used to increase _
  • Focus on _ exercises at _ volume and _ intensity
• Strength/power phase
  
  • Used to increase _ of _ and _
  • Integrate _ specific _ exercises at _ volume, _ intenisty
• Competition phase
  
  • Used to get to peak of _ and _
  • _ intensity _ volume _ specific exercises
• Active Rest phase
  
  • Allow for _
  • _ volume and _ intensity exercise that is _ related to the athlete’s sport

Answer 122

• Hypertophy phase
  
  • Develop musuclar and metabolic bases for more intense future training
  • Sport and non sport specific exercises done at high volume and low intensity
• Strength phase
  
  • Used to increase max muscle force
  • Focus on exercises at moderate intensity and moderate volume
• Strength/power phase
  
  • Used to increase speed of force development and power
  • Integrate sport specific explosive exercises at low volume, high intenisty
• Competition phase
  
  • Used to get to peak of strength and power
  • High intensity low volume sport specific exercises
• Active Rest phase
  
  • Allow for recovery
  • Low volume and low intensity exercise that is not related to the athlete’s sport

Question 123

• Periodization models manipulate _ (and/or?) _
• Linear Periodization Model
  
  • Gradual continual _ of _ and _
  • Gradual and continual decrease of_ and _
  • _ variation in assigned number of sets and reps within each _
• Nonlinear or _ Model
  
  • Use _ or _changes in _ and _
• Comparing the 2 models
  
  • _ method is used so athlete can train during season and recover
    
    • Typically training _ is reduced and exercise _ is modulated in relation to competition and pratice _
    • Key to this method is it allows _ after competition/training period
  • _ model is more effective at promoting muscular strength gains

Answer 123

• Perioziation methods manipulate volume (sets/reps) or intensity (load)
• Linear
  
  • Intensity (load) = gradual, continual increase.
  • Volume (sets/reps) = no change mesocycles.
  • No variation in assigned number of sets and reps within each mesocycle
• Nonlinear or undulating
  
  • Use within the week or microcycle changes in load and volume that is assigned.
• Comparing the 2 models
  
  • Nonlinear method is used so athlete can train during season and recover
    
    • Typically training frequency is reduced and exercise volume is modulated in relation to competition and pratice volume
    • Key to this method is it allows rest after competition/training period
  • Nonlinear model is more effective at promoting muscular strength gains

Question 124

Answer 124

Question 125

Answer 125

Question 126

Answer 126

Question 127

• What is Fibromyalgia?
  
  • _ widespread _ pain with secondary emphasis on _
  • SImilar to _ syndrome
• What are benefits of exercise for folks with fibromyalgia?
  
  • Increase in _ without increasing _
  • Decrease in _
• Genral exercise recommendations?
  
  • Begin with _ frequency and _ to _intensity
    
    • RT exercise likely _ to _ _-_ x week
    • AET : shoot for _-_ x week
  • _ from other clients
  • Be mindful of _

Answer 127

• What is Fibromyalgia?
  
  • Chronic widespread musculoskeletal pain with secondary emphasis on fatigue
  • SImilar to chronic fatigue syndrome
• What are benefits of exercise for folks with fibromyalgia?
  
  • Increase in functional activity without increasing pain
  • Decrease in depression
• Genreal exercise recommendations?
  
  • Begin with conseravtive frequency and light to moderate intensity
    
    • RT exercise likely unable to exceed 3-4 x week
    • AET : shoot for 3-4 x week
  • Bascially not too different from other clients, just be mindful of postexertion symptomologoy

Question 128

What 5 cancer side effects does exercise improve?

Answer 128

• Fatigue, Neuropathy, Lymphedema, Osteoporosis, and Nausea.

Question 129

• Define HIV = _ (what type of illness) that causes Aids
• AIDS = condition that gradually destroys _, making it difficult to _ and making people more prone to unusual _
• Exercise benefits
  
  • Improve _ function
  • Increase _ particually in early stage of _
  • Immprove _ and _ ability
• Aerobic training concerns
  
  • Exercise mode should be _ to_ impact
  • Mode of exercise can _ based on _ exercise is _

Answer 129

• HIV = retro virus that causes Aids
• AIDS – condition that gradually destroys immune system, making it difficult to fight off infections and making people more prone to unusual cancers
• Exercise benefits
  
  • Improve immune function
  • Increase long term survival in HIV particularly effective in early stages of disease
  • Improve quality of life and functional ability
• Aerobic training concerns
  
  • low moderate impact
  • vary based on how well exercise is tolerated

Question 130

• Chronic fatigue syndrome = _ of _ origin characterized by persistent, _ lasting for at least _, unrelieved by _
• Exercise recommendations
  
  • Strengthening _ muscle groups improves muscle _, and reduces _
  • _ modes of exercise (_) improve symptoms
  • Help maintain )
  • Improve _ and _
• Intensity
  
  • Aerobic
    
    • _ to _ intensity
    • Use _ for intensity monitoring
  • RT
    
    • Start with _-_ reps
    • Intensity short of _
    • Increase intensity based on _
  • Flexibility
    
    • _ intensity
    • Low _
    • Focus on _ to _ mobility and _

Answer 130

• Autoimmune disorder of unknown origin characterized my persistent, medically unexplained fatigue lasting for at least 6 months, unrelieved by bed rest
• Exercise recommendations
  
  • Strengthening major muscle groups improves muscle efficiency, and reduces fatigue
  • Alternative modes of exercise (yoga, qigong) improve symptoms
  • Help maintain body composition
  • Improve flexibility and mobility
• Intensity
  
  • Aerobic
    
    • Light to moderate
    • Use RPE for intensity monitoring
  • RT
    
    • Start with 10-15 reps
    • Intensity short of volitional fatigue
    • Increase intensity based on postexercise symptomatology
  • Flexibility
    
    • Light intensity
    • Low amplitutde
    • Focus on proximal to distal mobility and stability

Question 131

• What is Sickle Cell Animia?
  
  • Genetic mutation of _ → altered _ of _
    
    • Decreased ability to _ to _
  • Pain due to decrease in _ to _
  • Increased risk of (4)
• What intensity is beneficial for Anemia?
• Contraindications
  
  • No _
  • Avoide extreme _, _ frequently and incorporate _ with exercise _ up to _ (duration)
  • No _ in exercise recommendations, based on client’s _ and _
  • Clients with _ avoid _
  • Avoid _ motions, use _ _ modes

Answer 131

• Sickle Cell Anemia = genetic mutation of hemoglobin → altered shape of red blood cells
  
  • Makes it harder to transfer O2 to cells
  • Pain due to decrease in blood flow to tissue
  • Increased risk
    
    1. Infection
    2. Acute chest syndrome
    3. Stroke
    4. Pulmonary hypertension
• Light to moderate exercise
• Contraindications
  
  • No maximal testing
  • Avoid extreme temperature exposure, hydrate frequently and incorporate frequent rest with exercise bouts up to 20 minutes
  • No consistencies in exercise recommendations, based on client’s exertional capacity and symptomatology
  • Clients with enlarged spleen avoid contact sports
  • Avoid ballistic motions, use low impact modes

Question 132

• 8 autoimmune diseases

1. _ Disease (small intensitne)
2. _ _ Disease (gastrointestinal
   
   1. _ Disease (digestive)
   2. _ _ (large intestine)
3. _ _ _ (metabolic)
4. _ (tissues and organs)
5. _ _ (neurological)
6. _ (skin disease)
7. _ _ (joint)
8. _ _ (hormonal)
   
   1. _ _
   2. _ _

• Benefits of exercise for autoimmine disease
  
  • ↑ _ of _
    
    • ↓ _
    • ↓ _ by ↑ _-_compounds (_)
  • ↓ _ risk
  • ↑ _

Answer 132

1. Celiac disease (small intensitne)
2. Inflammatory Bowel Disease (gastrointestinal
   
   1. Crohn’s Disease (digestive)
   2. Ulcerative colitis (large intestine)
3. Type 1 Diabetes (metabolic)
4. Lupus (tissues and organs)
5. Multiple sclerosis (neurological)
6. Psoriasis (skin disease)
7. Rheumatoid Arthritis (joint)
8. Thyroid disease (hormonal)
   
   1. Grave’s Disease
   2. Hashimoto’s thyroiditis

• Benefits of exercise for autoimmine disease
  
  • ↑ quality of life
    
    • ↓ depression
    • ↓ inflamation by ↑ anti-inflamatory compounds (endorphins)
  • ↓ CVD risk
  • ↑ circulation

Question 133

• What is hemophelia?
  
  • _ that occurs due to _ of _ that allow for _
• Hemophilia increases risk for _ _, which leads to _ damage
• People with hemophillia respond positively to _, _, and _ training
• What exercise intensity is most effective for people with hemophillia?
  
  • _> _
• _ intensity aerobic exercise increases _
• Resistance training increases muscle _, muscles around _, helping with _ _
• Resistance training may reduce _ _ and _
• RT: split program into _ _ _ exerised by _ to _frequency, up to _ x week

Answer 133

• What is hemophelia?
  
  • genetic disease that occurs due to lack of specific blood protein factors that allow for clotting
• Hemophilia increases risk for joint bleeding, which leads to joint damage
• People with hemophillia respond positively to aerobic, resistance, and aquatic training
• What exercise intensity is most effective for people with hemophillia?
  
  • Moderate > Mild
• High intensity aerobic exercise increases clotting
• Resistance training increases muscle strength, muscles around joints, helping with joint bleeding
• Resistance training may reduce bleeding frequency and severity
• RT: split program into different body parts exercised by day to increase frequency, up to 5 x week