Unit 1 : exercise is medicine in chronic care Flashcards
Benefits of training with chronic conditions ? (4)
- Increases longevity and mitigates disability in some conditions
2.Increases the length of disability-free life
3.Improves metabolic function, shifting away from diabetes and CVD
4.Improves physical functioning and QoL
three barriers to prescribing exercise over medicine
It’s easy to prescribe a pill.
* It’s difficult to counsel patients on lifestyle.
* Many societies don’t pay health care professionals
for exercise management.
4 examples of programs that can help patients keep up with regular PA
- Physical and occupational therapy
- Cardiac and pulmonary rehabilitation
- A medically supervised exercise program
(e.g., aquacise for patients who have arthritis
or are obese) - A carefully prescribed and monitored
independent home program for those with
stable disease
4 examples of programs that can help patients keep up with regular PA
- Physical and occupational therapy
- Cardiac and pulmonary rehabilitation
- A medically supervised exercise program
(e.g., aquacise for patients who have arthritis
or are obese) - A carefully prescribed and monitored
independent home program for those with
stable disease
Exercise vital sign questions
On average, how many days per week do
you engage in at least moderate to vigorous
physical activity like a brisk walk?
* (Response range: 0-7 days)
* On those days, for how many minutes
do you engage in physical activity at this
level?
* (Response range: 10, 20, 30, 40, 60, >60
min)
why are these vital signs important ?
Multiplying the two responses together gives
the number of minutes per week of self-reported
moderate to vigorous physical activity (MVPA)
done each week by that patient. ,150 min/week to be flagged
what is a health risk assessment
(HRA) questionnaire
Health risk assessment tools go
beyond physical activity and also ask the patient
questions about diet, tobacco, stress, and other
lifestyle-related risk domains.
Useful suggestions in apparently healthy individuals:
Buy a pedometer (daily goal = 8000-10000 steps)–
Join an exercise class or group–
Invest in an exercise game or video
–Get advice from an expert
FITTVP style ?
Frequency–How often
*Intensity–How hard
*Time–How long
*Type–What type/kind?
*Volume of exercise–product of frequency x intensity x time *Progression–transitioning from easier to harder exercise over time
What are the two types of training styles ?
FITT & Pharmacy
Pharmacy style
Indication
*Specific exercises
*Dose–Measured by duration and intensity
*Progression and renewals (time course for prescription) *Adverse effects
Pharmacy style
Indication—the chronic condition for which exercise
training is prescribed
Specific exercises—the specific nature of the activity
or activities to be performed
Dose as measured by
* duration (time) or number of repetitions and
* intensity of subjectively perceived or objectively
quanti”ed level of exertion.
Progression and renewals—the time course over
which the program should continue
Adverse effects—chronic conditions or exercisespecific
risks worthy of caution
Explain the disuse syndrome/ downward
spiral of chronic disease
they are vulnerable to becoming
increasingly sedentary, which has a cascade
of adverse effects:
Low functional capacity, which predicts
poor outcomes and mortality
* Reduced gait speed and lower-extremity function
associated with loss of independence
* Loss of independence, which has a negative
impact on quality of life
* Increased risk of excessive weight gain
* Skeletal muscle insulin resistance or frank
type 2 diabetes, with subsequent cardiovascular
disease
* A gradual deterioration toward being disabled
Most common cause of death for diabled px ?
heart disease
Name three barriers to exercise and how to overcome :
–Lack of time:
Strategies–Wake up earlier for exercise (gradually progress waking up a few minutes earlier)–Break up exercise into shorter bouts–Create a schedule for workouts–Combine leisure time with exercise–Alter desk set up to include activity
Lack of confidence
Exercise with a close friend–Start slow–Gym instructor–Educate oneself on technique and correct execution–Exercising infront of a mirror–Find a smaller gym/gender-type gym–Take progress pictures to document improvement–Speak positivity into your day and allow constructive criticism–Be realistic; do what is in your capacity or capabilities
