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CSEP-CPT Theory > Training for Clients Living with Chronic Conditions > Flashcards

Training for Clients Living with Chronic Conditions Flashcards

1
Q

Arthritis

A

describes over 100 conditions involving joints. Often have difficulty with physical activity due to pain, stiffness, decreased ROM. education and exercise are important parts of treatment.

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2
Q

Benefits of PA for those with arthritis

A

decrease sedentary behaviour and promote weight loss, decreasing stress on joints.
aerobis- helps cardivascular fitness.
ROM exercises help reduce stiffness
blaance an agitily- improve balance and decrease fall
resisitance- help maintian or build strength to suppirt joints.

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3
Q

Pre participation health screening- arthritis

A

identify arthritis in question 4 of get active questionnaire. Probe clients for additional info about medical history.

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4
Q

Understanding risk of PA- arthritis

A

may be at increased risk of adverse effects especially if: experince joint pain, severe swelling or stiffness for >14 days, has limited mobility, comorbid conditons- (refer).

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5
Q

Disease and treatment considerations- arthritis

A

NSAID have no significant impact on exercise response, tollerance, HR or BP. Initiate and progress PA cautiously. Back pain- antidepressants and muscle relaxants- montior for drousiness.

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6
Q

Prescription parameters- arthritis

A

adapt 24h movment guidline depending on fitness level. Include aerobic, resisistance, and flexibility. Montior joint pain- pain should not exceed 2hrs after sessation or increase by >=2 points on pain scale.

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7
Q

Prescription parameters: frequency- arthritis

A

aerobic 3-5x/week accumulation 150mins. Resistance training daily at low intensity. Flexibility training= beneficial.

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8
Q

Prescription parameters: intensity - arthritis

A

MVPA (40-90% HRR/ 2-12 RPE) for aerobic. Resisitance training start at lower end and progress slowly (30-60% 1RM). Isometric exercises may be prescriped to minimize inflamation response. carfully monitor technique.
flexibility- slow static stretching to point of tension.

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9
Q

Prescription parameters: time - arthritis

A

aerobic: 10-30mins/session
resitance: 1-3 sets 1-10 reps

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10
Q

Prescription parameters: type - arthritis

A

aerobic: rhythmic low impact incorporating major muscle groups.
Resistance: isometric (to minimize inflammatory response) with body weight or light free or machine weight
low back pain- focus on core strengthening.

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11
Q

Safety considerations- arthritis

A

monitor pain.
fear of pain is major limiting factor
refer to care provider if pain >2hrs after exercise (sharp, stabbing, constant, gets worse at night, lots swelling, hot joints)

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12
Q

carcinoma

A

cancer involving skin or tissue covering internal organs

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13
Q

sarcoma

A

cancer involving msucle, bones, connective tissue

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14
Q

leukemia and myelomas

A

cancer involving blood forming tissues

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15
Q

lymphomas

A

cancer involving lymphatic tissue and immune system

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16
Q

melanomas

A

cancer involving pigment producing cells

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17
Q

Benefits of regular PA- Cancer

A

PA can help manage adverse effect of cancer and treatment. Aerobic and/or resiitant traninge can decrease anxiety, depression, fatige, imporve phyical functioning and QOL. Exercise may decreases progression, recurrance and cancer specific mortality

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18
Q

Canadian cancer statistics

A

most common in 50+, leading cause of death (30%)- lung, prostate, breast, colorectal are most common

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19
Q

disease treatment considerations- cancer

A

primary treatment= preferred treatment
adjuvant therapy- given after primary treatment to decrease risk of recurrence (ie hormone, chemo, radiation), can also be given before primary treatment (neo-adjuvant)
local therapy: directed to specific region vs systemic therapy- travels via bloodstream. Trageted therapies are systemic therapies that target cancer cells.

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20
Q

Pre-participation health screening- cancer

A

indentify history of cancer on get active questionaire- probe for more info of medical history and cancer-type, treatment, ect. refer cleints with comorbid considons.

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21
Q

Understanding risk- cancer

A

can be at increased risk of adverse effects

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22
Q

Prescription parameters- cancer

A

aim >=150mins moderate intensity PA and 2x/week resitance trianing- focus on major muscle groups adapting for fatigue , encouraging decreased sedentary time.

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23
Q

Prescription parameters: frequency - cancer

A

aerobic 3-5days/week- accumuate 150 mins
resistance 2-3x/week w/ 48hrs rest b/w
flexibility taining may be appropriate

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24
Q

Prescription parameters: intensity- cancer

A

light-moderate intensity for areobic and resitance especailly those previosuly inactive or weak.
aerobic 20-60% HHR; RPE 9-13
resitance 40-60% 1RM
flexibility- slow static stretch to point of tension

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25
Q

Prescription parameters: time- cancer

A

aerobic up to 60 mins/session, shorter as needed (10mins).
resitance 1-3 sets of 8-10 as tollerated for each muscle group
stretch 10 min cool down

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26
Q

Prescription parameters: type- cancer

A

rythmic low impact appropritate. resitance- body weight, free wieght, bans- to help increase functional capacity. Yoga, taichi and dance can help can help add exercise and fatigue.

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27
Q

Exercise before cancer treatment- prehab

A

treatment outcomes can be improved by optimixing wellbeing prior to treamtent- interventions help imporve health, decrease incidence and severity of furutre impairments.

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28
Q

Safety considerations- cancer

A

start with mild intensity for deconditoned or weak cleints- build slowly. Can have highly variable episotic symptoms, capacity can fluctuate. Advanced cancers , matatesis to bone- at high risk of injury- refer to specilaized QEP. Stop exercise immediately if chest pain, SOB, high risk of bleeding, uncontrolled vomitong or diherrea, ect. Avoid public fitness centres due to comprimized immune systems.

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29
Q

Coronary heart disease (CHD)

A

circulation to heart comprimized- partil blockage to 1 or more coronoary artery- can resilt in shortage of O2 to heart - causes chest pain, SOB. total blockage casues nerosis or heart attack.

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30
Q

cerebrovascular disease

A

circulation b/in brain comprimized- blocked for mins to hours: TIA
most common invlove ischemic stroke- often due to athlesclerosis of carotid artery.
less common: hemeragic stroke: occurs when weakness of BV causes rupture- risk facotr= high BP.

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31
Q

Peripheral artery disease

A

impacts circulation in limbs causes pain in muscles especailly at high exercise demands common woth cornoary arety disease

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32
Q

heart failure

A

heart cant provide enouhg blood to the body typically due to heart dmage. have increased sympathetic activity, volume retention and peripheral muscle dysfunction. typically suffer from SOB, swelling of lower limbs. exercise important for managment.

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33
Q

arrythmias

A

irregular heart beat often due to electrical circuitry. can casue deecreased exercise capacity and or increased HR

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34
Q

congenital heart disease

A

variety of birth defects in heart, some result in death, others disability.

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35
Q

hypertension

A

high BP related to CDV, mortality doubles w. every 20/10mmhg. medication helps decrease BP, lifestyle changes important

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36
Q

hyperlipidemia

A

high cholesterol and/or cholesterol- major risk factor for CVD. can lead to buildup and narrow arteries. high LDL is of concern- deit and exercise.

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37
Q

Benifits of regular PA- CVD

A

can help decrease mortality and need for surgical intervention.
regular aerobic can increase fitness, endurance and cardiovascular function. increase in fitness decreases resting HR, BP and increases SV at rest and at submax exercise. cardiac demads at given intensity decrease. increases skeletal muscle function and increase VO2 max.

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38
Q

disease treatment considerations- beta blockers

A

decrase HR and BP at rest and attenuate increase during exercise- use RPE

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39
Q

disease treatment considerations- diuretics

A

increase fluid loss- ensure proper hydration
no impact on HR

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40
Q

disease treatment considerations- ACE

A

decrease resting BP and attenuae bp response to exercise but dont impact tollerance.

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41
Q

disease treatment considerations- calcium channel blockers

A

depress AV and SA node conduction and produce peripheral vasodialtion- decrease BP and HR at rest and exercise.

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42
Q

disease treatment considerations- anticoagulants

A

for those with clotting risk. dont impact HR or BP but increase risk of bleeding- cautin for impact sorts.

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43
Q

disease treatment considerations- statins

A

lower toal or specific subparticles of cholesterol- dont impact HR or BP or tollerance.

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44
Q

disease treatment considerations- Nitrates

A

control acute angina symtoms- increase HR and decrease BP- can increase tollerance for exertional angina

45
Q

disease treatment considerations- Acetylsalicylic acis (ASA)

A

asprin. prescribed after event or if at hogh risk. anticoagulent- at minster at sign of heart attack. long term use associated with proloned clotting and brusing.

46
Q

Pre-prescription health screening CVD

A

identify on get active questionaire- probe for additonal info- detemine if in scope.

47
Q

Prescription parameters- CVD

A

canadian 24 hr guilnine appropriate- alter intensity to prevent triggering symptoms

48
Q

Prescription parameters: frequency- CVD

A

aerobic 3-5x/week–> 150mins
resistnace 2-3x/week w/ 48+ hrs b/w sessions. flexibility appropriate for some.

49
Q

Prescription parameters: intensity- CVD

A

light-moderate effor for resitacne and aerobic.
aerobic- for deconditoned start on lower end (20-40% HHR or 9-11 RPE) and increase progressively to moderate intensity (40-60% HRR or 12-13 RPE).
resistance- work 30-60% 1 Rm, low risk clients work 60-80% 1RM- closely monitor technique
Flexibility- slow static stretch to tension

50
Q

HR considerations for CVD

A

if max HR unavailable then use resting +20bpm
if have pacemaker target 10bpm below device threashold.
dont use age max hr prediciton for those on certain meds like beta blockers.

51
Q

Prescription parameters: time- CVD

A

aerobic 20-40 mins/day as tollerated (as short as 10mins). Resistance 1-3 sets of 8-12 reps

52
Q

Prescription parameters: type - CVD

A

all aerobic modalities. Low impact may be suitable for older/overweight. resistance can be body, or mahcine weight

53
Q

Prescription parameters: HIIT- CVD

A

confers similar or greater changes in VO2max over shorter periods- has been sucessful for patients w/ coronary hear disease and failure. should be introduced progressively for those in suitable/ well managed disease state.

54
Q

Safety considerations CVD

A

stop immediately if have chest pain, symptoms of myocardial ischemia, excessive sweating, ect. Exercise may not be suitble if condition very unstable. start slowly and progress slowly.

55
Q

Clinical exercise testing

A

may be necessary prior to initiating training. American heart association produces absolute and relative contraindications to testing. If have absolute- refer to QEP with advanced training.

56
Q

Type I diabetes

A

autoimmune… immune system attacks/destroys insulin producing cells of pancreas. Must use insulin to manage blood glucose. Typically occurs before 40

57
Q

type II diabetes

A

metabolic disease- body doesnt properly use insulin produced or body doesnt produce enough. higher risk if overweight, often diagnosed after 40.

58
Q

pre-diabetes

A

high blood glucose indicates increased risk of type II diabetes- lifestyle interventions can help.

59
Q

Gestational diabetes

A

hyperglycemia during pregnancy- decreases after delivery, at risk of type II diabetes w/in 5-10 years.

60
Q

benefits of regular physical activity- diabetes

A

can prevent and manage diabetes. IMproves how body responds to insulin. Can help protect against heart disease. Aerobic and resistance training both independently influence blood glucose uptake.

61
Q

Disease treatment considerations

A

may be prescribed >=1 blood glucose reducing medication.
May need to supplement w/ carbohydrates to prevent drop in blood glucose to <5-6mmol/L
HR and BP response may be blunted in diabetes clients- particulary if on CVD meds or have neurapathy

62
Q

hypoglycemia

A

blood glucose <4mmol/L
causes: too much insulin, skip meals, alcohol, lots exercise, ect
symptoms: weakness, shaking, increased BP, hunger, ect
Treatment: 15g carbs; 5-6 hard candies, 1 tbsp sugar honey or sugar, 3-4 glucose tabs, 1/2c fruit juice
retest sugar 15min- retreat 15g if <4mmol/L

63
Q

Pre-participation health screening- diabetes

A

identify on get active questionaire- probe about history- what ype, when diagnosed, medications, comorbid conditions- refer if needed. If within scope get more info from physicians PA clearance form

64
Q

Understanding the risk of PA- diabetes

A

may be at increased risk of adverse effects- ie hypoglycemia, lightheadedne srs, ect. refer if have certain comorbid conditions

65
Q

Prescription parameters- diabetes: Aerobic training

A

frequency: 4-7days/week- 150 mins/week- daily exercie recommended w/ no more htan 2 consecutive days w/out exercise.
intensity: MVPA recommended- vigorous may be accpetable for experienced exercises and those with weel contolled doabetes
Time: 20-60 min sessions (as short as 10 mins)
Type: rythmic, continous incorporating major muscle groups. Aquatic based exercise have similar benifits

66
Q

Prescription parameters-diabetes: Resistance training

A

Frequency: 2 days/week, preferably 3. flexibility also appropriate for some
intensity: MVPA. Work low-mod range (30-40% 1RM) at out set progressing towards 60-80% 1RM. Greatest benifit for glucose control for those progress 3 sets ~8rps 3x/week. increase intensity resitance training may only be exepriened for those with well controlled diabetes
Time: 1-3 sets of 8-12 reps for all major muscle groups
Type: body, free, machine cn be used

67
Q

Safety considerations diabetes

A

be aware of comorbid conditions that may impact exercise tollerance.
start slowly and progress gradually frequency and duration and intensity
may have decreased ability to detect heat- and can impair ability to maintain body temp.
may need to delay exercise if blood sugar too low or high

68
Q

when to delay exercise- diabetes

A

<5.5mmol/L- ingest 15-30g carbs prior to exercise
>16.7 mmol/L and client doesn’t feel well

69
Q

Dementia and mild cognitive impairment

A

dementia- set of symptoms; experience decline in cognitive function severe enough to decrease ability to perform everyday tasks.
if decline doesn’t impact daily living- mild cognitive impairment.
depression and anxiety common with dementia

70
Q

Person 1st language- dementia

A

person living with dementia

71
Q

Benefits of regular physical activity- dementia

A

helps improve aerobi fitness, strength, blance, mobility- helps daily living. Aerobic and resitance may help cognitive function by changing chemicals in brain. PA may also help mental and social wellbeing- can feel more confident and cpable, give sense of control.

72
Q

Disease treatment considerations- dementia

A

may or may not be on medication. Acetylcholine inhibitors can decrease HR especially when combined with other drugs that decrease HR- may need to use RPE. May also be on medication for vascular disease.

73
Q

Pre-participation health screening- dementia

A

may or may not identify self in Q 4 of get ative questionaire. Clarification needed on medical history, if need extra guidance- Pa clearance form.

74
Q

Prescription parameters- dementia

A

24h movment guideline for 65+ appropriate for most. decreased volume- (60mins 2X/week) may improve functional and cognitive function. Adapt to current fitness

75
Q

Prescription parameters: frequency- dementia

A

aerobic 2-5 days/week aiming for >=150mins/week
resistance >=2x/week w/ 48+hrs b/w- except core which can be performed daily.
flexibility for some
if poor balance- do balance trianing but expect less gains

76
Q

Prescription parameters: intensity- dementia

A

moderate effort-aerobic and ressitance
aerobic: 40-60% HHR (RPE 12-13)- vigorous possible for more fit
resistance- ensure proper form-go lighter if needed- progress to 8-15 reps at max intensity (while maintaining good form) Progress to higher intensity with supervision if appropriate.
core- encourage endurance- more reps at lower intensity

77
Q

Prescription parameters: time- dementia

A

aerobic can be accumualted in bouts from 10-60mins
resitance- time depends on number of exercises, sets and reps

78
Q

Prescription parameters: type- dementia

A

carefully monitor if inexeprience- may be more sucessful w/ familliar activities/
focus on functinl mocments for resitance training
walking safe for most.

79
Q

Safety considerations- dementia

A

at higher risk of injury, abilities can fluctuate
may have decreased insight to abilities- need to monitor closely.
speak slowly and use common language

80
Q

mood disorders

A

people feel prolonged emotions negatively impacting weelbeing, physical health, relationships and behaviour. 10% people experience at some point.

81
Q

Anxiety disorder

A

people living in state fo constant worry and fear that can be overwelming

82
Q

eating disorders

A

serious emotional and physical problems that have life threatening consequences if QEP senses client has ED refer to health care provider. May encounter client that engage in disordered eating and/or over exercising.

83
Q

Benefits of regular exercise- mental health and illness

A

good for mental health- prevents symptoms of mental illness, increases QOL, wellbeing ect among those with anxety and mood disorders. Has demonstrated greater impact than other atlernative therapies. Impacts brain chemicals and stress system, providing distraction for coping.

84
Q

Disease treatment consideration- mental health and illness

A

program must be flexible and planned during time with hogh enerfy levels for those wood mood disorders
antidepressants can cause drousiness- dont impact HR, BP or decreased tollerance.
axiety disorder- start with low intensity- so dont mimic symtoms, home based programs may be more approriate

85
Q

Pre-participation health screening- mental health and illness

A

may not identify self on get active questionaire- if do dislose probe for more info to better understand conditon- refer if needed.

86
Q

Prescription parameters: frequency- mental health and illness

A

aerobic 3-7x/week
resitance 2-3x/week w/ 48+ hrs b/w
flexiblity may be appropriate

87
Q

Prescription parameters: intensity- mental health and illness

A

MVPA for aerobic and resistance
erobic: 40-60% HRR (12-13 RPE), vigorous (60-90% HRR) may be appropriate for experienced.
Resistance 40-50% 1RM at outset, progress ti 60-80% 1RM according to abilities- closely monitor inexperienced for technique
lighter intneisty ok to set foundation

88
Q

Prescription parameters: time- mental health and illness

A

aerobic 20-60mins/session
resistance 1-3sets of 8-12 reps for all major muscle groups

89
Q

Prescription parameters: Type- mental health and illness

A

all modalities appropriate- limited by client abilites and comorbidiites- enjoyment is importamt
group may help engagment- w/in comfort of cleint

90
Q

Safety considerations- mental health and illness

A

if suspect eating or substance use disorder refer. Don’t push too hard when just starting out

91
Q

disease treatment considerations risk classification- osteoporosis

A

based on screening placed in 1 of 3 categories based on risk of fracture in next 10yrs; low: 10%, moderate 10-20%, high >20%- those with spine or hip fractures or with very low bone mineral density (even with absence of other risk factors) automatically considered high risk- should refer high risk. risk helps tailor exercise programs
those at low risk often don’t need medication

92
Q

Risk factors for osteoporosis or bone loss

A

age, histort of fractrues, low BMI, parental hip fracture, rhematoid arthritis, ect

93
Q

Pre-participation health screening- osteoporosis

A

may identify on question 4 of get active questionaire- probe for additional info

94
Q

understanding risk- osteoporosis

A

risk of fracture may be elevated for certian tyes and intensities especially if had fragility fracutre over 40, taken systemic corticosteroids for 3m+, recent fall or >=2 falls in last 12m, prexisit conditon, hisotry of spine or hip fracture.

95
Q

Prescription parameters- spine sparing strategies; osteoporosis

A

loads to avoid: apllying rapid, repetitive, weighted, loaded, sustained, or end range flecion or twisting torque to the spine.

96
Q

Prescription parameters- challenging balance exercises; osteoporosis

A

most effective program to prevent falls–> functional strength and blance training- should be challenging balnce DAILY
tai chi can be effective

97
Q

Prescription parameters- progressive resistance training; osteoporosis

A

should be inlcuded in all programing and performed 2+ days/week. if new start at low intensity and build up- high intensity may not be appripriate for those at a high risk of fractures.

98
Q

Prescription parameters- impact activities; osteoporosis

A

participation in MVPA can prevent early death and disability- walking (weight bearing) has shown modest impact on bone density higher impact may incrase hip bone mineral density. best to start lower then progress

99
Q

Beniftis of regular PA- respiratory conditons

A

can improve strength and endurance, respiratory symptoms and exercise capacity

100
Q

Pre participation health screening- respiratory conditions

A

asthma- identify on screening- probe for more info
if have comorbid conditions- at higher risk of adverse events- refer

101
Q

Disease treatment considerations- respiratory conditions

A

copd and athsma mediacation help decrease inflammation and decrease risk and severity of subsequecnt exasp[eration and increase exercise performance.
2 types of drugs: releiver and maintence
nearly all drugs help experice tollerance

102
Q

Prescription parameters: respiratory conditions

A

24h movment guidelines appropriate with some modifications- pay attention to early signs and symtoms to prevent an attack

103
Q

Prescription parameters-frequency: respiratory conditions

A

aerobic 3-5x/week aim for >=150mins/week
resitance 2-3x/week w/ 48h b/w sessions working same muscle group. flexibility training may help some

104
Q

Prescription parameters-intensity : respiratory conditions

A

low-mod aerobic for those w/ COPD and athsma who are deconditoned
Asthma- aerobic-work w/in 40-59% HHR if well tolerated progress to 60-70%
COPD- aerobic- 50-80% or 4-6 on Borg scale of dyspnea
resiitance- copd and athsma work at 60-70% 1RM for beginer and >=80% for exeriecned, tain at <50% for endurance training- monitor closely for technique and breathing

105
Q

Prescription parameters-time : respiratory conditions

A

asthma and COPD
aerobic 20-60mins (as short as 10)
resitance 2-4 sets of 8-12 reps for strength trianing and sets of <=2 of 15-20 for endurance

106
Q

Prescription parameters-type: respiratory conditions

A

rhythmic activities incorporating major muscle groups
resitance should be body weight, or loght weights or machine

107
Q

PA recomendatins for COPD

A

stretching and breathing and daily walks are good
try to exercise >=3x/week.
3 types of exercise to incorporate: stretch for relaxation and flexibility, aerobic for fitness, resitance for strength and endurance.

108
Q

PA recomendations for Athsma

A

shouldnt avoid exercise if well controled- ensure to always have enhaler. emphasize proper warmip and cool down. avoid triggers- be mindful of temp and air quality. stop and take enhaler- then wait a few mins, if have symptoms - take another does if symptoms still presnt

CSEP-CPT Theory (11 decks)

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