W2: Introduction to Exercise Prescription for Rehabilitation Part B Flashcards
What are some of the CVD risk factors?
Age
Family history
Smoking
Physical inacvitivy
Obesity
Hypertension
Dyslipidemia
Diabetes
HDL-C content
What are the 8 steps in designing a rehabilitation program?
- Assess current health status
- determine their physical activity levels
- Identify exertional symptoms that limit PA
- Evaluate physical function and performance
- Selecting physical performance assessment
- Considerations for formal exercise tolerance testing
- Considerations for programme referal
- Develop a strategy for monitoring progress
What domains should some follow up questions be focused on when assessing current activity levels?
frequency, duration, intensity, symptoms, type
What are helpful information when observing and identifying exertional symptoms that limit PA. (retrieving information from patients from just observing and talking)
Paying attention to objective and qualitative description of the symptoms.
Getting the idea of the recovery time needed to for symptoms to ease.
What might you start of with for patients that have symptoms related to general deconditioning and weakness, join discomfort and stiffness?
general deconditioning and weakness –> start with strength training and gradually progressing to aerobic
Joint discomfort and stiffness –> specific physical theraphy interventions to enhance range of motion
What should exercise specialists do when patients have a exertional symptoms?
provide training programs that mitigate symptoms
Guide the patient to the most appropriate mode of exercise
Depending on the level of impairment in physical functioning (4 levels) what kind of exercise program should be prescribed?
For no to mild symptoms, program should be designed in accordance to the ASCM recommendations.
For those with chronic or moderate, should be referred to an exercise specialist with more in-depth evaluation of functionin.
What are some of the basic movements that should arouse clinical suspicion?
Reaching with arms, tremors, coordination
Inability to bed
Abnormal gait
Any other signs of neurological impairment.
When evaluating physical function and performance what might you look out for for patients with type 1 and 2 diabetes and individuals with risk of fall.
For diabetes: Being alert to any signs of neurological impairment
For fall risk: Balance issue is quite multifactoral therefore, signs of balance instability should be a precursor for sending the patient to a therapist trained in balance problems.
What are the holistic advantages of the physical functioning measures (not just for assessing physical activity but also the broader advantages)
Cost effective, Ease of use in a clinic, Reproducibility of protocol, Efficient use of clinic time, Low preperation aftereffects and time or cost burden for the patients, Well-established norms for comparison, Highly predictive of disability, admission to nursing home, and health care utilisation in older people.
What are examples of physical activity assessments for deconditioned or Frail Adults (both self-assessment methods and physical methods)?
The Senior Fitness Test
Fullerton Advanced Balance Scale
Others such as:
1. gait speed test
2. Walking test
3. Core and Lower extremity test
4. Upper extremity test
5. Test batteries
Self-Assessment Methods:
KATZ ADL Questionnaire (ADL), Lawton Questionnaire (IADL)
How should we assess activities of daily living (ADL) and instrumental activities of daily living (IADL)
For both standardised questionnaires can be used.
For ADL: Katz ADL questionnaires (eg. Grooming, bathing, dressing, eating etc.)
For IADL: Lawtons IADL questionnaires (eg. Preparing meals, shopping, handling money/bills, housework etc.)
What is the primary purpose of clinical testing exercise toleranece?
- To diagnostic assessment of symptoms of ischemic heart disease
- To assess exertional symptoms such as light-headedness, short breathedness, dizziness
- To assess blood pressure management
This can be also used for exercise prescription and to track improvements
What are factors that determine referral to a formal exercise program?
- Specific limitations to functioning
- clinical condition and safety of exercise
- Patient preference
- Location that encourages attendance
- Staffing levels and qualifications
- Patients understandings of symptoms
What are some considerations when referring a patient to a formal exercise program?
We dont want the patient to fully depend on the clinical supervision as the goal of it is to educate, motivate, and facilitate incorporation of regular PA/exercise training into lifestyle.
So supervision should be gradually decreased over time.
