training clients with asthma, diabetes, and cardiovascular disease Flashcards
special populations
subgroups of the general population that present with certain acute or chronic conditions that require specialized or adjusted training methods or programs
common examples of special populations
diseased individuals
obese
pregnant
children
older adults
for clients with pre-existing disorders, -__ is often recommended before initiating physical activity
medical referral
asthma
chronic, inflammatory pulmonary disorder that causes bronchospasm and is characterized by hyper-irritability or a reversible obstruction of the airways
exercise induced asthma
narrowing of the airways in the lungs in response to strenuous physical exertion
exercise and asthma: the condition is induced by several mechanisms including
allergens, chemical irritants, smoke and pollutants, cold air
general recommendations for asthmatics
- Evaluate the training environment for common asthma triggers
- Employ longer warm-up and cool down periods to
acclimate the body to changing physiological conditions - Swimming, cycling, and walking are less likely than running to trigger an event
- Participating in sports that use stop-and-go activities (e.g., tennis, volleyball, and basketball) are less likely to trigger ElA when compared to long, continuous activity
- High-intensity exercise triggers ElA more often than moderate-intensity exercise; intensities of 60-80% HRR are recommended when prescribing aerobic training
- Steady-state endurance training is less likely than intervals to trigger a response
- Encourage controlled nasal breathing whenever possible
- Maintain appropriate medications on site and have an emergency plan
diabetes
characterized by high blood glucose levels due to sugar regulation impairment within the body
type 1 diabetes
autoimmune disorder characterized by the production of antibodies that attack the islet cells of the pancreas; reduces or stops insulin production
type 2 diabetes
characterized by insulin insensitivity and beta cell dysfunction in later stages
type 2 diabetes caused by several mechanisms including
genetic predisposition, obesity, sedentary lifestyle, and poor diet
benefits of exercise on diabetes
- improved insulin sensitivity and glucose control
- improved blood lipid profile
- reduced visceral fat storage
- improved cardiovascular and muscular fitness
- reduced risk for cardiovascular/peripheral vascular disease, heart attack, stroke
- improved quality of life
when aerobic and weight training is employed in a circuit fashion, positive adaptations on ____, ____, ____ and ____ are observed
glucose control, insulin action, muscular strength, exercise tolerance
additional screening criteria used to determine risk for injury or complications among diabetics include
age >35
obesity >25 years
presence of type 1 diabetes>15 years
presence of type 2 diabetes >10 years
presence of additional risk factors for HD
presence of microvascular disease, including retinopathy and nephorpathy
peripheral vascular disease
autonomic neruropathy
general recommendations for type 1 diabetics:
avoid exercise if fasting glucose levels are
> 200 mg/dl and ketosis is present
general recommendations for type 1 diabetics:
use caution if fasting glucose levels are
> 300 mg/dl without ketones
general recommendations for type 1 diabetics:
monitor blood glucose before and after exercise and identify
when changes to food or insulin are needed
general recommendations for type 1 diabetics:
use carbohydrates to avoid
hypoglycemia
general recommendations for type 1 diabetics:
pay close attention to signs of
fatigue and metabolic shifts during exercise
general recommendations for type 2 diabetics:
perform regular PA ___
most days
general recommendations for type 2 diabetics:
focus on
caloric expenditure and weight loss
general recommendations for type 2 diabetics:
initiate exercise with
appropriate acclimation periods
general recommendations for type 2 diabetics: work up to aerobic intensities of ____% HRR
60-80
general recommendations for type 2 diabetics:
modify exercise for
microvascular complications
retinopathy
small vessel disease of the eyes
retinopathy: avoid exercises that
produce high BP, particularly high-intensity compressive RT (ex leg press)
retinopathy: do not use activities that
lower the head below the waist (yoga)
retinopathy: do not use activities that may jar
the head, plyometrics
nephropathy
small vessel disease of the kidneys
nephropathy: avoid moderate to heavy
weightlifting
nephropathy: avoid high intensity
aerobic
nephropathy: avoid holding
breath during exercise
nephropathy: maintain adequate
hydration
peripheral neuropathy
small vessel disease of nerve tissue
peripheral neuropathy: avoid exercise that causes
pounding/repetitive stress to feet
peripheral neruopathy: select _____ exercises
non weight bearing
peripheral neuropathy: endure proper ______ is always worn during PA
footwear
participation levels and recommended guidelines depend on specific disease related factors
- progressive stage of disease
- degree of damage or symptoms
- current physical state of the individual
- presence of other heath-limiting factors
hypertension
high BP in circulatory arteries
BP measures at or above ____ are considered hypertensive
130/80
high BP causes ____ blood flow and stress upon _____
turbulent
inner lining of blood vessels
high BP causes ____ lesions
endothelial
high BP causes the formation of _____ and the onset of _____
atherosclerotic plaque, onset of coronary artery disease
high BP causes an increased risk for
kidney damage, stroke, chronic heart failure
prescribing resistance training at ____% 1RM is most appropriate for HTN
50-70
general guidelines for HTN: aerobic exercise time and intensity
40-60 min 50-75% VO2 max, 3-5 days per week
exercise can lower systolic and diastolic measures of BP by ____ over time
9
exercise with HTN can improve endothelial fxn and platelet activation and can lower negative inflammatory response
true
exercise HTN: does not have to be a single, long duration bout; can be
several 10 min sessions
exercise and HTN: RT- ___ reps, preferably in _____, avoid heavy ___%
12-15, circuit, >70%1RM
most common form of heart disease
CAD
CAD characterized by
narrowing, hardening, and blockage of coronary vessels from atherosclerosis plaque build up and/or progressive arteriosclerosis
CAD is commonly attributed to several factors including
obesity, physical activity, high BP, poor lipid profile, diabetes, smoking
aerobic training is a primary focus, but resistance training is also useful for
improving muscle strength
increased metabolic/CV fxn
enhanced psychological well being
reduce CV risk factors
the exercise prescription Among those with CAD should be managed using the following to determine lifting loads and movements
HR, BP, RPP, RPE
general recommendation for CAD:
___ exercise
aerobic
general recommendation for CAD:
accumulate up to ____ min of ___ intensity aerobic activity ___ days; increase to a frequency of ____ sessions per week, at an intensity of ____% HRR for ____ min
40-60, low, most, 3-4, 40-75%, 20-40
general recommendation for CAD:
___ min warm up and cool down
10
general recommendation for CAD:
___ training
resistance
general recommendation for CAD:
introduce resistance training using ____, _____. __ set, ___ reps
closed-chain, body weight
1, 15-20
general recommendation for CAD:
CV measure should be monitored, ___ should be used to gauge intensity
RPE
general recommendation for CAD:
flexibility should be encouraged, utilizing proper
breathing techniques
general recommendation for CAD:
avoid
heavy resistance
isometric training
breath holding
congestive heart failure
chronic progressive condition resulting in an inability to pump adequate blood to the body due to enlargement of heart muscle central portion
stage 1 CHF
breathlessness or tiredness (brisk walk, jog, stairs)
stage 2 CHF
comfortable when resting, heart races or breathless when walking a block or taking the stairs
stage 3 CHF
palpitation or tiredness with simple tasks like getting up from the sofa and walking to the kitchen
stage 4 CHF
heart and breath go faster even at rest
tiredness while sitting
anxiety and palpitations almost all the time
CHF: an appropriate aerobic exercise program can
improve circulation and skeletal muscle O2 delivery and use
increase heart pumping capacity
positively affect heart enlargement
reduce risk for hospitalization and early mortality
improve QDL
significant concern of CHF
peripheral musclar weakness
CHF:
short bouts of aerobic activity at ___% peak O2 capacity, ___min/session
40-50, 3-5
CHF: an appropriate exercise program can improve ___, increase ____ and positively affect ____
circulation, pumping capacity, enlargement
CHF: incorporate RT using ___ muscles at intensities of ___% 1 RM
small, 50-60
CHF: RPE scale should be employed for clients since
most will be on medicine that block HR response
CHF: excessive stress should be avoided due to
limited work capacity
CHF: progressions should mirror
individual tolerance and work capacity
Which of the following statements concerning diabetes is incorrect?
a. Type I diabetes is an autoimmune disorder
b. Pregnant females can suffer an increased risk for diabetes
c. Type II diabetes is characterized by insulin hypersensitivity
d. Type II diabetes can be caused by obesity, a poor diet or sedentary lifestyle
c
Which of the following is recommended for Type II diabetics?
a. Focus on caloric expenditure (minimum goal of 1,000 kcal/week) and weight loss
b. Work up to aerobic intensities of 60-80% HRR
c. Modify exercise activities for microvascular complications
d. All of the above
d
High blood pressure causes all the following, except:
a. Stress to the inner lining of blood vessels
b. An increased risk for kidney damage or stroke
c. Development of atherosclerotic plaque
d. Non-functional capillary enlargement
d
Which of the following is a risk factor for coronary artery disease?
a. Smoking
b. Obesity and/or diabetes
c. High blood pressure
d. All of the above
d
If working with a Type I diabetic client, avoid exercise if fasting glucose levels are ____mg/dl and ketosis is present.
200
for clients with coronary artery disease make sure to avoid heavy weightlifting, isometric training, and _____ during training activities.
breath holding
for a client with congestive heart failure, use resistance training activities as appropriate at ____% of their 1RM and use extended rest intervals.
50-60
true or False? The prevalence of asthma is much higher among obese individuals when compared to those of normal weight.
true
True or False? Diabetic clients should not lift weights.
false
identify at least three potential mechanisms by which asthma is known to be triggered.
allergens
chemicals
smoke
pollutants
cold air
Identify at least three benefits of exercise on diabetes.
a. improved insulin sensitivity and glucose control , b. improved blood lipid profile , c. reduced visceral fat storage , d. improved cardiovascular and muscular fitness , e. reduced risk for cardiovascular/peripheral vascular disease , f. heart attack and stroke , g. improved quality of life (QOL)
Identify the primary recommendation for each of the following if working with a hypertensive client.
a. aerobic exercise
b. resistance training
a. Aerobic exercise accumulate 40-60 min at 50-75% VO2max 3-5 days per week
b. Resistance training use 12-15 repetitions, preferably in circuit format; avoid heavy RT (>70% 1RM) and holding one’s breath
