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Exercise Testing and Prescription > Week 10 > Flashcards

Week 10 Flashcards

1
Q

Arrange

A
  • Thank the client for taking the time to do the assessment and planning work
  • Discuss the clients requirements for subsequent sessions
  • Send the client away with words of encouragement and instructions on how to contact the exercise professional if they have any questions
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2
Q

How to keep clients accountable to themselves

A
  • encourage to keep PA log
  • Use weekly planner
  • Helps them monitor their own progress
  • may provide insight for next trainer-client meeting
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3
Q

Relapse planner

A
  • Preemptive measure
  • Facilitate discussion of what things might derail the client’s efforts and what strategies might help to keep them of track
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4
Q

Establishing a follow-up schedule

A
  • Facilitates adherence and helpful adjustment to the action plan and physical activity prescription
  • may be especially important for clients who have been inactive and strive to make significant change in their behavioral patterns
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5
Q

Creating a network of online and community based resources

A
  • Provide advice to clients based on sound, current and evidence-based information, using ethical and professional conduct
  • Identify community resources, websites etc. that can help the client
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6
Q

Who is an older adult?

A
  • 65+, 70+ by CSEP definition
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7
Q

How is age demographics changing in our population

A
  • Fastest growing population age group is 85+ and 100+
  • By 2031, 1 in 4 Canadians will be 65+
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8
Q

Expected physiological changes with age to cardiovascular system

A
  • Increase left ventricle wall thickness
  • decrease myocardial contractility
  • decrease max HR
    -Increased intimal thickness and vascular stiffness
  • 25% decrease in CO during exercise
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9
Q

Changes in VO2 with age

A
  • Decrease CO and decreased muscle oxidative capacity
  • decreased VO2max
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10
Q

Physiological changes with age respiratory system

A
  • Increase chest wall stiffness
  • Decreased respiratory muscle strength
  • Decreased sensitivity of respiratory receptors
  • Decreased alveolar surface area
  • increased bronchi diameter
  • decreased bronchiole diameter
  • decreased elastic recoil
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11
Q

Results of physiological changes to respiratory system with age

A
  • Decreased maximal voluntary ventilation
  • Increased residual lung volume
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12
Q

Physiological changes with age to MSK system

A

Sarcopenia
- Reduction in # of muscle fibers and fiber size
- greatest decline in type II fibers
- increase in intramuscular fat
By age 70
- 40 % decrease in muscle mass
- 30% decrease in strength
- 3.5% decrease in power per year

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13
Q

Result of MSK system changes with age

A

decreased strength and power

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14
Q

Physiological changes with age to neuromuscular system

A
  • decrease coordination of the muscles with the nervous system
  • decreased nerve muscle conduction velocity
  • decreased muscle coordination
  • ability to respond to an unexpected stimulus
  • reaction time and time to execute movements
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15
Q

Physiological changes with age to skeletal system

A
  • connective tissue loses elasticity, muscle fibers shorten, decrease production of synovial fluid
  • Thinning + calcification of vertebrae, reduction in height, poor posture, increased rigidity
  • Arthritis
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16
Q

Physiological changes with age to sensory system

A
  • Layout, position of limbs, navigation, anticipation/ avoidance
  • hearing, maintaining balance, vestibular system
  • spatial position and movement of body relative to support surface
  • decreased proprioceptor sensitivity, particularly at the foot and ankle
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17
Q

Physiological changes with age to cognitive system

A
  • reductions in brain volume - executive function
  • neurons and synapses
  • mild decline in short-term memory
  • increased forgetfulness
  • increase in time to learn new information
  • slowing in speed of response and problem-solving
    Some changes can start as early as 40s
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18
Q

Changes with age to mental health

A
  • Most common: depression, delirium
    Physiological changes require readjustment and psychological coping:
  • Social isolation
  • Functional decline
  • Substance abuse
  • Elder abuse
  • changing life situation
  • Financial insecurity
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19
Q

Benefits of physical activity to our health as we age

A
  • Improved cardiorespiratory function
  • Maintain bone health
  • Improved cognition
  • Improves emotional well-being
  • increased life expectancy
  • Slow premature aging
  • maintain functionality and independance
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20
Q

Old Canadian PA guidelines for 65 and older

A
  • 150 minutes of moderate to vigorous in bouts of 10 minutes or more
  • strengthening activities 2 days per week
  • those with poor mobility should perform PA to enhance balance and prevent falls
  • 30-70% reduced risk
  • only 25% of Canadian older adults reach the recommended guidelines
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21
Q

New PA guidelines

A
  • 150 minutes moderate to vigorous
  • physical activities that challenge balance
  • strengthening twice per week
  • several hours of light physical activity
  • 7-8 hours of good quality sleep
  • limited sedentary time to 8 hours or less
  • no more than 3 hours recreational screen time
  • 30-70% reduced risk
  • about 50% of Canadian older adults reach the recommended guidelines
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22
Q

Medical history in older adults

A

65-79
- 12% no disease
- 23% one disease
80+
- 8% no disease
- 14% one disease
Most common is high blood pressure followed by arteritis and then heart disease

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23
Q

What is risk of adverse effects correlated with

A
  1. physical condition/functional capacity
  2. Presence of disease/disability
  3. Inherent danger of the physical activity
24
Q

Training principles

A
  • Overload: ability to get uncomfortable
  • Progression: ability to build on and improve ( 20% improvement in VO2max, 30% in strength/power)
  • Specificity: making sure exercise is practical
  • Reversibility: more pronounced with age (10 days VO2 decrease by 10%)
  • Individuality: everyone is unique
25
Q

Aerobic FIIT for older adults

A

F: 4-5 days moderate, 3 days vigorous
I: moderate to vigorous, 60% HRmax, 12-14/20 RPE (HRmax=208 - (0.7x age)
T: 30 min per day for mod, 20 for vigorous, 60-90 min to max health and fitness benefits, 10 min bouts
T: Rhythmical movement of large muscles

26
Q

Muscle strength FITT

A

F: 1-3 days per week
I: Moderate 50% 1rm, heavy 80% 1rm
T: varies 8-10 repetitions for strength, 10-15 for endurance
T: progressive weight training program

27
Q

Muscle power FITT

A

F: 1-3 times per week
I: low <50, moderate, high >70%
T: 1-3 sets for 6-10 reps
T: high velocity or intent to move at a high velocity - increase function/mobility (task specific movement)

28
Q

Flexibility FITT

A

F: 2-4 sets, 2-3 times per week
I: Static or dynamic
T: Static 10-30, 60 seconds per muscle
T: Static or Dynamic

29
Q

Warm up for older adults

A
  • Longer warm-up needed 10 min minimum
  • dynamic movement of large muscle groups
  • Progress to target intensity by end of warm up
30
Q

Cool down in older adults

A
  • Longer cool-down needed (5-10 min)
  • Goal is to reduce body temperature, HR and respiration to baseline
  • Want to avoid hypotensive response risk
  • visual checks of HR and BP may be warranted
31
Q

Internal factors to keep older adults active

A

Motivation
- Greater concern for health and mobility outcomes
- Annual fitness assessments as a motivator
Long-term adherence
- Self-efficacy
- Task-specific self efficacy
- Plans for lapses (coping planning)

32
Q

External factors keeping older adults active

A

Environment
- Accessibility
- Fall risk
Planning/timing session
- Morning vs night (vision)
- Winter vs summer

33
Q

Differences in child cardiovascular fitness

A
  • Higher resting HR at rest and during exercise
  • Faster heart rate recovery (greater parasympathetic input)
  • Lower stroke volume - lower Q
  • Lower absolute VO2, higher VO2 (small body mass)
  • Higher respiratory rate
  • ventilation threshold decreases with age
34
Q

Metabolic differences with children

A
  • Lower blood lactate production during exercise
35
Q

Neruomuscular differences with children

A
  • Lower economy of locomotion (stride length, motor skills)
  • Resistance training - muscle strength increase but not size
  • Fiber type proportion is differentiated in early childhood
  • Faster anaerobic exercise recovery
36
Q

Perceptual differences in children

A
  • Lower RPE during short-duration exercise and higher REP in longer exercise
37
Q

24 hour movement guidelines for children (5-17)

A
  • Sweat: 60 min Moderate to vigorous
  • Step: several hours of structured and unstructured activities
  • Sleep: 5-13: 9-11 hours, 14-17: 8-10 hours
  • Sit: No more than 2 hours recreational screen time
38
Q

24 hour movement guidelines for 0-4

A

MOVE
- Infants: several times a day through interactive floor play and tummy time
- Toddlers (1-2) and preschoolers (3-4): >180 minutes of PA at any intensity spread throughout the day (60 min vigorous to moderate)
SLEEP
- Infants: 0-3 14-17 hours, 4-11 12-16
- Toddlers: 11-14
- Preschoolers: 10-13
SIT
- not restrained for >1 hours at a time
- no screen time <2 years old
- < 1 hour for 2-4

39
Q

PA levels in children CAN and screen time

A
  • 1/3 of children and youth meet guidelines
  • 60% of preschoolers meet guideline
  • boys engage in more MVPA than girls
  • 50% of children and youth exceed the screen time recommendation
  • 24% of preschoolers exceed the screen time recommendation
40
Q

Health benefits of PA for children

A
  • Better motor development
  • Improved cognitive development
  • Better psychosocial health
  • Better cardiometabolic health
  • Aerobic fitness
  • Better bone health
  • Favorable body composition and weight status
    In older children
  • muscular stregth
  • heart health
  • higher academic achievement
  • better mental health
41
Q

Facilitators of PA participation for children

A
  • Fun and friendship
  • being outdoors
  • access to facilities
  • school PA policies
  • high perceived motor competence
  • sport participation
  • opportunities for unstructured free play
  • parental physical activity and parental support for physical activity
42
Q

BMI index on growth charts

A
  • 85th percentile cut-off for over weight
  • 95th percentile for obesity
43
Q

Aerobic fitness assessments in children

A
  • children often fail to demonstrate plateau 0 use VO2 peak
  • Use treadmill vs bike
  • need size adjusted equipment
  • workloads adjusted to child’s age and size
44
Q

PACER 20m shuttle run

A

Beep test
- Field-based test
- Starts at 8.5 km/h increases 0.5 every min
- 21 levels
- correlated with measured VO2 peak
- 8+

45
Q

Guidelines for treadmill testing protocol

A
  • 2 hours after solid food consumption
  • no vigorous activity that day
  • habituated to lab environment and equipment
  • contraindications to exercise ruled out
  • low intensity warm up
  • age maturity and attention span considered (8 to 12 minutes)
  • ancillary measure taken by discontinuous tests
  • speed change should not be excessive
  • end-points decided prior to test
  • cool down after
46
Q

FITT for PA in children

A

F: Daily, with a mix of structured and unstructured activities in a variety of environments
I: Moderate (5-6/10 RPE) heavy breath and vigorous (7-8/10) out of breath
T: anything fun and enjoying
T: At least 60 minutes of MVPA throughout the day + several hours of light physical activity

47
Q

Guiding principle for long-term development in spor

A
  1. Quality is key
  2. Optimal programming is critical
  3. Inclusion is non-negotiable
  4. Collaboration makes the system better
48
Q

Goals of log-term development in sport and PA

A
  1. Support development of physical literacy
  2. Strive for excellence
  3. Empower people to be active for life
49
Q

Domains of physical literacy

A
  • Affective: Motivation and confidence
  • Physical: physical competence
  • Cognitive: knowledge and understanding
  • Behavioral: engagement in physical activities for life
50
Q

Physical literacy 5 core prinicples

A
  • Is an inclusive concept accessible to all
  • Represents a unique journey for each individual
  • Can be cultivated and enjoyed through a range of experiences in different environments and contexts
  • Needs to be values and nurtured throughout life
  • Contributes to the development of the whole person
51
Q

Physical-literacy based programming

A
  • Activities scaled to participants ability
  • structured and unstructured movement opportunities
  • opportunities for participants to personalize activities
  • instructors provide mastery experiences
  • Aerobic physical activity = high participation
  • Age and size-appropriate equipment
52
Q

Physical literacy 5+5

A
  1. Always moving
  2. Fun and social
  3. Challenging
  4. with purpose
  5. everyone included
    +
  6. Appropriate (space and equipment)
  7. Symmetry
  8. Mimicry
  9. Cueing and feedback
  10. Teaching games for understanding
53
Q

Resistance training in children and youth considerations

A
  • Training plan should consider age, sex, training status, health status and fitness
  • Ensure the exercise environment is safe and free of hazards; use appropriately sized equipment
  • begin with 5-10 minutes of dynamic warm-up
  • Low to moderate intensity 2-3 times/ week, with 1 to 2 sets (progress to 3-5) 8-12 exercises
  • Proper form and technique is prioritized over progression in intensity
  • Include exercises that challenge balance and coordination
  • vary the program to optimize gains, have fun and avoid boredom
54
Q

benefits of RT in children

A
  • increase strength, bone density, coordination, balance, sport performance and self-esteem
  • Decrease cardiovascular risk
55
Q
A

Exercise Testing and Prescription (10 decks)

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