Week 11 - Exercise for Special Populations p2

Question 1

How is coronary artery disease caused?

Answer 1

caused by atherosclerosis - thickening of the lining of the artery

Question 2

What are the risk factors for coronary artery disease (CAD)?

Answer 2

• Age
• Family history
• Cigarette smoking
• Sedentary lifestyle
• Obesity
• Hypertension
• Dyslipidemia
• Prediabetes

Question 3

How does exercise compare to percutaneous coronary intervention (surgery procedure)?

Answer 3

exercise is more effective and cheaper than PCI - it reduces the risk of subsequent cardiac events

Question 4

Why should all patients with chronic heart failure be offered exercise-based rehabilitation?

Answer 4

• Improved quality of life
• Improved exercise tolerance
• Reduced occurrence of hospitalization
• Greater peak V02

Question 5

What are common medications for cardiac patients?

Answer 5

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

Question 6

What are some implications of common medications for cardiac patients?

Answer 6

• Reduced maximal exercise capacity
• Increased muscle fatigue
• Risk of postural hypotension

Question 7

What are some contraindications to exercise prescription in CAD?

Answer 7

• New or uncontrolled arrhythmia
• Resting SBP > 180mmHg or DBP of >100mmHg
• Unstable angina
• Unstable diabetes
• Acute or unstable heart failure

Question 8

What does graded exercise testing (GXTs) include the monitoring of?

Answer 8

• ECG which monitors heart rate and rhythm and signs of ischemia
• Blood pressure
• Ratings of perceived exertion (RPE)

Question 9

What test should patients with CAD undergo to assess risk and to tailor exercise programs?

Answer 9

Graded exercise testing - push someone to exhaustion with incremental exercise to measure physiological components

Question 10

What are the 3 phases of cardiac rehabilitation?

Answer 10

Phase 1: impatient exercise program
Phase 2: outpatient exercise, close supervision
Phase 3: less direct supervision, may be home-based

Question 11

What are the physical activity guidelines for CAD patients?

Answer 11

150mins of moderate-intensity aerobic activity OR 75mins of vigorous-intensity aerobic activity
AND
high-intensity resistance training 2x a week

Question 12

What are the benefits of exercise for CAD patients?

Answer 12

↓Overall mortality
↓ CVD mortality
↓ Re-infarction
↓ Hospital admissions
↓ BP, lipids, disability
↓ Time off work
↑ Cardiovascular functon

Question 13

What % of patients that experience myocardial infarction uptake cardiac rehabilitation?

Answer 13

14-43%

Question 14

What % of adults with disabilities get no aerobic physical activity?

Answer 14

Nearly 50% - this explains why they are more likely to report chronic diseases compared to active disabled adults.

Question 15

Risk factors of spinal cord injury.

Answer 15

• Increased mortality rate
• Increase prevalence of obesity
• Increase prevalence of diabetes
• Chronic inflammation
• Reduced HDL-cholesterol
• Endothelial dysfunction

Question 16

What are the exercise recommendations for disabled adults?

Answer 16

1) Strength and balance activities 2x per week
2) 150mins each week of moderate-intensity activity

Question 17

What are some issues/risks of exercise prescription for disabled adults?

Answer 17

 Upper body overuse injuries and
musculoskeletal pain
 Fatigue
 Pressure sores (skin breakdown)
 Thermoregulation issues
 Immune suppression and over
training

Question 18

Outline some considerations when prescribing exercise for disabeld adults.

Answer 18

1. Determine the level of functional independence and assistance required: range of movement, sitting and standing balance, strength imbalances.
2. Check bone mineral density and possible skin breakdown issues.
3. Invisible issues (e.g. autonomic dysfunction in certain neurological conditions): post-exercise hypotension can cause syncope (pass out), minimize autonomic dysreflexia, impaired thermoregulatory control.