Week 11 - Exercise for Special Populations p2 Flashcards
How is coronary artery disease caused?
caused by atherosclerosis - thickening of the lining of the artery
What are the risk factors for coronary artery disease (CAD)?
- Age
- Family history
- Cigarette smoking
- Sedentary lifestyle
- Obesity
- Hypertension
- Dyslipidemia
- Prediabetes
How does exercise compare to percutaneous coronary intervention (surgery procedure)?
exercise is more effective and cheaper than PCI - it reduces the risk of subsequent cardiac events
Why should all patients with chronic heart failure be offered exercise-based rehabilitation?
- Improved quality of life
- Improved exercise tolerance
- Reduced occurrence of hospitalization
- Greater peak V02
What are common medications for cardiac patients?
1) B-blockers: decrease HR and/or BP + decrease work of the heart
2) Anti-arrhythmia medications: calcium channel blockers, control dangerous heart rhythms, but incr. risk of bleeding
3) Nitroglycerin: relax smooth muscle in veins to reduce venous return and reduce angina symptoms
What are some implications of common medications for cardiac patients?
- Reduced maximal exercise capacity
- Increased muscle fatigue
- Risk of postural hypotension
What are some contraindications to exercise prescription in CAD?
- New or uncontrolled arrhythmia
- Resting SBP > 180mmHg or DBP of >100mmHg
- Unstable angina
- Unstable diabetes
- Acute or unstable heart failure
What does graded exercise testing (GXTs) include the monitoring of?
- ECG which monitors heart rate and rhythm and signs of ischemia
- Blood pressure
- Ratings of perceived exertion (RPE)
What test should patients with CAD undergo to assess risk and to tailor exercise programs?
Graded exercise testing - push someone to exhaustion with incremental exercise to measure physiological components
What are the 3 phases of cardiac rehabilitation?
Phase 1: impatient exercise program
Phase 2: outpatient exercise, close supervision
Phase 3: less direct supervision, may be home-based
What are the physical activity guidelines for CAD patients?
150mins of moderate-intensity aerobic activity OR 75mins of vigorous-intensity aerobic activity
AND
high-intensity resistance training 2x a week
What are the benefits of exercise for CAD patients?
↓Overall mortality
↓ CVD mortality
↓ Re-infarction
↓ Hospital admissions
↓ BP, lipids, disability
↓ Time off work
↑ Cardiovascular functon
What % of patients that experience myocardial infarction uptake cardiac rehabilitation?
14-43%
What % of adults with disabilities get no aerobic physical activity?
Nearly 50% - this explains why they are more likely to report chronic diseases compared to active disabled adults.
Risk factors of spinal cord injury.
- Increased mortality rate
- Increase prevalence of obesity
- Increase prevalence of diabetes
- Chronic inflammation
- Reduced HDL-cholesterol
- Endothelial dysfunction
What are the exercise recommendations for disabled adults?
1) Strength and balance activities 2x per week
2) 150mins each week of moderate-intensity activity
What are some issues/risks of exercise prescription for disabled adults?
Upper body overuse injuries and
musculoskeletal pain
Fatigue
Pressure sores (skin breakdown)
Thermoregulation issues
Immune suppression and over
training
Outline some considerations when prescribing exercise for disabeld adults.
- Determine the level of functional independence and assistance required: range of movement, sitting and standing balance, strength imbalances.
- Check bone mineral density and possible skin breakdown issues.
- Invisible issues (e.g. autonomic dysfunction in certain neurological conditions): post-exercise hypotension can cause syncope (pass out), minimize autonomic dysreflexia, impaired thermoregulatory control.
