Week 7 Flashcards
What is balance?
Dynamic process by which
the body’s position is maintained in equilibrium
When is balance greatest?
Greatest when COM, or COG, is maintained over BOS
What is the center of mass?
The unique point where
the weighted relative position of the distributed mass sums to zero, or the point where if a force is applied causes it to move in direction of force without rotation
What is the center of gravity?
Vertical projection of the center of mass to the ground
Where is the CoG in the anatomical position?
2nd sacral vertebra
What is momentum?
Product of mass times velocity
What is the BoS?
Perimeter of the contact area between the body and its support surface
What alter the BOS and changes a personal postural stability?
Foot placement
What happens for a person not to fall?
If a person maintains their COG within the limits of the BOS, (aka limits of stability), they do not fall
What is the limit of stability?
The sway boundaries in
which an individual can maintain equilibrium without change his or her BOS
The limit of boundaries constant constantly change depending on what?
The task, individuals’s biomechanics, and aspects of
the environment
What is ground reaction force (GRF)?
Force exerted by the ground on a body in contact with it
What is center of pressure?
Location of the vertical projection of the GRF
The center of pressure is equal and opposite to…?
The weighted average of all the downward forces acting on the area in contact with the ground
What are the MSK contributions to balance control?
- Postural alignment
- Musculoskeletal flexibility
- Sensation
What are the components of musculoskeletal flexibility that contributes to the MSK contributions to balance control?
ROM, muscle performance, etc
Balance is ____
Balance is postural stability
What are the two main types of momentum?
- Linear
- Angular
What is linear momentum?
The linear velocity of a body along a straight path
What is angular momentum?
The rotational velocity of the body
What are the components that controls balance?
- MSK system
- Nervous system
- Contextual effects
What are the components of sensation that contributes to the MSK contributions to balance control?
Touch, pressure, vibration,
proprioception
The neuromuscular contributions of balance control is responsible for what?
Sensory processing for perception of body orientation
What are the sensory processing components of balance control?
Visual, vestibular, somatosensory
The neuromuscular contributions to balance control is also responsible for what?
- Sensorimotor integration
- Motor strategies for planning,
programming, and executing
balance response
What are the contextual contributions to balance control?
- Environment
- Support surface
- Lighting
- Task characteristics
What are the 2 types of environments that contribute to balance control?
- Closed
- Open
An open environment is __, while a closed environments is ____
An open environment is *unpredictable with
distractions* while a closed environments is predictable with no distractions
What 3 systems comprise our balance?
Visual System
Somatosensory System
Vestibular System
The visual system provides information regarding…?
- Position of the head relative to the environment
- Orientation of the head to maintain level gaze
- Direction and speed of head movements
The somatosensory system provides information about ___
Position and motion of the body and body parts relative to each other and support surface
What do muscle spindles, golgi tendon, and joint receptors tell us?
What the muscle length and position is at any given time
Muscle spindles, golgi tendon, and joint receptors are sensitive to ___
Muscle spindles, golgi tendon, and joint receptors are sensitive to sensitive to muscle length and stretch
Skin mechanoreceptors are sensitive to ___
Skin mechanoreceptors are sensitive to vibration, light touch, deep pressure, etc.
The vestibular system measures the ___
The vestibular system measures the position and movement of the head with respects to gravity and inertial forces
What do the semicircular canals do?
Detect angular acceleration
What do the otoliths (utricle & saccule) canals do?
Detect linear acceleration
and head position
What is the primary processing region for balance?
Cerebellum
___ system has the fastest response time in regards to balance control
Somatosensory system has the fastest response time in regards to balance control
What are the types of balance control?
- Open Loop Motor Control
- Closed Loop Motor Control
- Anticipatory control
What is open loop motor control used for?
Utilized for movements that occur too fast to rely on sensory feedback (reactive responses) or for anticipatory aspects of postural control
What is closed loop motor control used for?
Utilized when precision movements that require sensory feedback (maintaining balance while sitting on a ball, or standing on tandem beam)
What does anticipatory control involve?
Involves activation of postural
muscles in advance of performing skilled movements
___ balance control is automatic and is carried out with no feedback
Open loop motor control balance control is automatic and is carried out with no feedback
What are the primary motor strategies used by healthy adults to recover balance in response to sudden perturbation?
- Ankle strategy
- Hip strategy
- Stepping strategy
What are the movement systems that each primary motor system uses to regain balance?
- Reflex
Automatic - Voluntary
What is the mediating pathway of the reflex movement system for balance control following perturbation?
Spinal cord
What is the mediating pathway of the automatic movement system for balance control following perturbation?
Brain stem/ subcortical
What is the mediating pathway of the voluntary movement system for balance control following perturbation?
Cortical
What is the mode of activation of the reflex movement system for balance control following perturbation?
External stimulus
What is the mode of activation of the automatic movement system for balance control following perturbation?
External stimulus
What is the mode of activation of the voluntary movement system for balance control following perturbation?
External or self stimulus
What is the comparative latency of response of the reflex movement system for balance control following perturbation in regards to the other systems?
Fastest
What is the comparative latency of response of the automatic movement system for balance control following perturbation in regards to the other systems?
Intermediate
What is the comparative latency of response of the voluntary movement system for balance control following perturbation in regards to the other systems?
Slowest
What is the response of the reflex movement system for balance control following perturbation?
Localized to point of stimulus and highly stererotyped
What is the response of the automatic movement system for balance control following perturbation?
Coordinated among leg and trunk muscles; stereotypical but adaptable
What is the response of the voluntary movement system for balance control following perturbation?
Coordinated and highly variable
What is the role in balance of the reflex movement system for balance control following perturbation?
Muscle force regulation
What is the role in balance of the automatic movement system for balance control following perturbation?
Resist disturbances
What is the role in balance of the voluntary movement system for balance control following perturbation?
Generate purposeful movements
What are the factors modifying the response of the reflex movement system for balance control following perturbation?
MSK or neurological abnormalities
What are the factors modifying the response of the automatic movement system for balance control following perturbation?
MSK or neurological abnormalities; configuration of support; prior experience
What are the factors modifying the response of the voluntary movement system for balance control following perturbation?
MSK or neurological abnormalities; conscious effort; prior experience; task complexity
____ movement system for balance control following perturbation is the 1st system to respond to a fall
Automatic movement system for balance control following perturbation is the 1st system to respond to a fall
Movements at the ankle act to restore a person’s ____
Movements at the ankle act to restore a person’s CoM to a stable position
For small external perturbations that cause a loss of balance in a forward reaction, muscle activation usually proceeds in a ___ to ___ sequence
For small external perturbations that cause a loss of balance in a forward reaction, muscle activation usually proceeds in a distal to proximal sequence
In what order do muscles in the ankle strategy responds in a distal to proximal sequence in a forward reaction?
Gastroc 1st, then hamstrings, then paraspinals
In what order do muscles in the ankle strategy responds in a distal to proximal sequence in a backward reaction?
Tibialis anterior 1st, then quads and abdominals
What strategy does the body use with a rapid or large perturbation?
Hip strategy
What does the hip strategy do?
Uses rapid hip flexion or extension to move the CoM within the BoS
In what sequence are muscles activated in response to a forward/backwards body sway in the hip strategy?
Proximal to distal sequence
What muscles are activated in response to a forward body sway in the hip strategy?
Abdominals followed by the quads
What muscles are activated in response to a backwards body sway in the hip strategy?
Paraspinals followed by the hamstring
The step strategy is used to ___
The step strategy is used to prevent a fall
When do we use the step strategy?
When perturbations are fast, are large amplitude, or when other strategies fail
What is the lateral plane movement strategy?
Weight shift strategy
What does the weight shift strategy do?
Shift weight from one leg to the other
What is the key control point of the weight shift strategy?
Hips
When is the suspension strategy utilized?
When a person quickly lowers their CoM, by flexing the knees ankles and hips
The suspension strategy can be combined with___ to enhance the effectiveness of balance and control
The suspension strategy can be combined with weight shift to enhance the effectiveness of balance and control
What causes impaired balance?
Anything that affects the components of information processing
What are the components of information processing?
- Sensory input
- Sensorimotor integration
- Motor output
What are the sensory input impairments?
- Proprioceptive deficits
- Reduced somatosensation
- Visual loss
- Vestibular damage
Individuals with a reduced somatosensation tend to rely more on the ___ strategy to maintain their balance
Individuals with a reduced somatosensation tend to rely more on the hip strategy to maintain their balance
Sensorimotor integration impairments usually stems from ___
Sensorimotor impairments usually stems from *damage to
the basal ganglia, cerebellum, or supplementary motor area*
Sensorimotor integration impairments results in an ___
Sensorimotor integration impairments results in an over-reliance on one particular sense
What can cause deficits in the motor output balance?
MSK or NM issues
___ common and major cause of morbidity, mortality,
reduced function, and premature nursing home admission in the older population
Falls common and major cause of morbidity, mortality,
reduced function, and premature nursing home admission in the older population
What are the intrinsic fall risk factors in the elderly?
- Advanced age
- Previous falls
- Muscle weakness
- Gait and balance problems
- Poor vision
- Postural hypotension
- Chronic conditions including arthritis, diabetes, stroke, parkinson’s, incontinence, dementia
- Fear of falling
What are the extrinsic fall risk factors in the elderly?
- Lack of stair handrails
- Poor stair design
- Lack of bathroom grab bars
- Dim lighting or glare
- Obstacles and tripping hazards
- Slippery or uneven surfaces
- Psychoactive medications
- Improper use of ADs
What are the clinical practice guidelines for prevention of falls in older persons?
- Screening and Assessment
- Customized Exercise Program
- Minimization of Medications
- Treating Visual Impairments
- Managing Postural
- Hypotension
- Managing Heart Rate
- Foot & Footwear Problems
What are the static balance assessments?
- Romberg Test
- Sharpened Romberg
- Single-Leg Balance Test
- Stork-Stand Test
What does the romberg test do?
It tests the patient’s ability to stand while the feet are parallel, with their eyes open and closed for 30 secs
What does the sharpened romberg test do and how is ti done?
Requires the patient to stand with the feet heel to toe and the ams folded across the chest and the eyes closed for a minute
What is the single leg balance test?
Where you ask the patient to stand on one leg without shoes, arms placed across the chest, without letting the legs touch each other. Do 5, 30 sec trials
What is the stork-stand test?
Have the patient stand on both feet with hands on the hips, lift one leg and place the toes of the foot on the knee of the planted leg, the patient will then raise the heel of the foot on the ground and try to hold it for as long as possible
How do we do a dynamic balance assessment?
Observing how well a patient does from sit to stand or from one position to another. The 5 times sit to stand is the standard
What are some anticipatory postural control test?
- Functional Reach Test
- Multi-Directional Reach Test
- SEBT
Anticipatory postural control is evaluated by having the patient perform ___
Anticipatory postural control is evaluated by having the patient perform voluntary movements that require the development of postural set to counteract predicted postural disturbance
What are some reactive postural test?
- Pushes
- Pull Test
- Push and Release Test
- Postural Stress Test
What is the Clinical Test of Sensory Integration on Balance Test (CTSIB)?
A test that requires a patient to maintain their balance under 6 different sensory conditions
What are the sensory conditions that the CTSIB is tested under?
- Standing on a firm surface with the eyes open
- Standing on a firm surface with the eyes closed
- Standing on a firm surface wearing a dome (japanese lantern that covers the face)
- Standing on a foam cushion with the eyes open
- Standing on a foam cushion with the eyes closed
- Standing on a foam cushion wearing a dome (japanese lantern that covers the face)
Individuals that are visual dependent will become unstable when on the CTSIB?
When the eyes are covered/ closed
Individuals that are somatosensory dependent will become unstable when on the CTSIB?
When they’re on the foam
Individuals that have general adaptation problems will become unstable when on the CTSIB?
On all the surfaces
Individuals that have vestibular loss will become unstable when on the CTSIB?
Every time you close the eyes or put the dome on
What are interventions to do when there are deficits in static balance?
- Vary postures
- Vary support surface
- Incorporate external loads
What are interventions to do when there are deficits in dynamic balance?
- Moving support surfaces
- Move head, trunk, arms, legs
- Transitional and locomotor activities
What are interventions to do when there are deficits in anticipatory (feedback) balance?
- Reaching
- Catching
- Kicking
- Lifting
- Obstacle course
What are interventions to do when there are deficits in reactive (feedback) balance?
- Standing sway
- Ankle strategy
- Hip strategy
- Stepping strategy
- Pertubations
What are interventions to do when there are deficits in sensory organization balance?
- Reduce visual inputs
- Reduce somatosensory cues
What are the clinical test and measures for the balance during functional activities test?
- Tinetti
- Timed Up and Go Test
- Berg Balance Scale
- Four Square Step Test
- Dynamic Gait Index
- Functional GaitAssessment
- Dizziness Handicap Inventory
What are interventions to do when there are deficits in balance during functional activities balance test?
- Functional Activities
- Dual or multitask activities
What are the clinical test and measures for the Safety During
Gait, Locomotion, or Balance test?
- Observation on unstable surface
- 5 x STS
What are interventions to do when there are deficits in balance during Safety During
Gait, Locomotion, or Balance test?
- Moving support surfaces
- Move head, trunk, arms, legs
- Transitional and locomotor activities
What are the balance test that we use for a younger population?
- Y balance test
- Balance error scoring system (BESS)
- SWAY balance test (computer/phone aided)
The Y test is a modification of the ___
The Y test is a modification of the STAR Excursion Balance Test
The Y test is measured based the ___
The Y test is measured based the stance leg
What are the directions that the patient reaches for with their non stance foot during the Y test?
- Anterior
- Posterolateral
- Posteromedial
From the Y balance test, a ___ is established
From the Y balance test, a Limb symmetry index is established
The BESS test was developed largely for ___
The BESS test was developed largely for concussions
What are the positions of the BESS test?
All with eyes closed
- Double leg stance on a firm surface
- Single leg stance on a firm surface
- Tandem leg stance on a firm surface
- Double leg stance on a foam surface
- Single leg stance on a foam surface
- Tandem leg stance on a foam surface
What is being tested for in the BESS test?
An error
What are the possible errors that can be made on the BESS test?
- Moving hands off the hips
- Opening the eyes
- Step, stumble or fall
- ABD or flexion of the hip beyond 30 deg
- Lifting the forefoot or heel off the testing surface
- Remaining out of the proper testing position for greater than 5 secs
How does the SWAY balance test work?
The athlete hold the hand up to their chest and goes through a series of movement
What is endurance?
Ability to work for prolonged periods of time and the ability to resist fatigue
What are the two types of endurance?
- Muscular
- Cardiovascular
What is aerobic training/ conditioning?
Augmentation of energy utilization of the muscle by means of exercise
What does aerobic training do?
- Increased oxidative enzymes in the muscles
- Increased mitochondrial density and size
- Increased muscle fiber capillary supply
How long does it take to get significant changes of aerobic training?
10-12 weeks
We see an increased efficiency in ___ and ___ systems during aerobic training/ conditioning
We see an increased efficiency in cardiovascular (CV) and MSK systems during aerobic training/ conditioning
The changes in the CV and MSK efficiency due to aerobic training is more of a response to ___
Neurological, physical, and biochemical changes
What is deconditioning?
The gradual physiological process where the level of physical conditioning and corresponding physical performance is significantly reduced
What is deconditioning on a sports level?
A planned period of inactivity to achieve a specific physiologic end
___ is and energy value of food
A kilocalorie is and energy value of food
What is a kilocalorie defined as?
Amount of heat necessary to raise 1kg of water 1 deg C
What is a MET (Metabolic equivalent) level?
Oxygen consumed (milliliters) per kilogram of body weight per minute (mL/kg)
An average individual engaged in ADL’s expends ___ kcal per day
An average individual engaged in ADL’s expends 1800-3000 kcal per day
What kind of physical activity are a MET level less than 3?
Light intensity activities
What kind of physical activity are a MET level 3- 6?
Moderate intensity activities
What kind of physical activity are a MET level greater than 6?
Vigorous intensity level
What are some fitness test to do for healthy individuals?
- Rockport
- 6 minute walk test
- Step tests
- Correlate with VO2
- 1.5 mile run
- 12 minute run
What is the rockport test?
A test done for those with fairly low fitness level. The purpose is to walk as fast as possible for a mile an take a pulse rate right after
What does the 6 min walk test do?
Test how far a patient can walk in 6 mins. Don’t give encouragement, rest periods are allowed.
What is the procedure of the Harvard step test?
The patient steps up and down a stool at the rate of 30 steps per min for 5 mins or until exhaustion (can’t maintain step rate for a full 15 secs). Take heart beat immediately
What does stress testing do?
Evaluates cardiovascular functional capacity as a means of clearing individuals for strenuous work or exercise program for individuals at risk
What are the two parts of the stress testing?
- A very controlled situation, the heart is stressed using exercise on a treadmill or a chemical injection depending on the individual, throughout the test, HR and rhythm of BP are continuously monitored throughout the exam
- During the 2nd phase of the test, pictures are taken of the heart and the images are compared to those taken prior to the ones before the exercise
What is the FITT principle?
Determinants of an exercise program.
Frequency Intensity Time Type
What is the frequency of activity for individuals age 6-17?
60 minutes of moderate to vigorous activity per day
What is the frequency of activity for individuals age 18-65?
- 30 minutes of moderate intensity 5x a week (MET 3-6), or
* 20 minutes of vigorous intensity (>6 METs) 3x a week
What is the frequency of activity for individuals older than 65?
- 30 minutes moderate intensity 5x a week, or
* 20 minutes of vigorous activity 3x a week
What is the determinant of max HR intensity?
• From multistage test
• Predetermined from
predetermined submax test
• 220 minus age
What is the determinant of exercise HR intensity?
- Percentage of max HR
* Karvonen’s formula (HR reserve)
How long should a work out last if exercising at 60-70% max HR?
20-30 mins
How long should a work out last if exercising at less than 60% max HR?
Approximately 45 mins
How long should a work out last if exercising at more than 70% max HR?
10-15 minute bouts
What mode of exercise are we looking at using for aerobic training?
Large muscle groups and exercises that are rhythmic, aerobic nature
What are the benefits of a warmup in an exercise program?
- Increase in muscle temperature
- Dilation of constricted capillaries
- Neural adaptation
- Increased venous return
- Reduced risk of ischemic ECG changes
What is the neural adaptation benefit of a warmup?
The body starts to move more efficiently
What are the types of trining done during and aerobic exercise period?
- Continuous
- Interval Training
- Circuit Training
What are the benefits of cooling down after exercising?
- Prevents blood pooling in extremities
- Prevents fainting by increasing venous return
- Prevents myocardial ischemia, arrhythmias, & other CV complications
What is the maximal aerobic capacity (VO2 max)?
The maximum rate of oxygen
consumption as measured during incremental exercise
What is the lactate threshold?
Speed of movement or percentage of VO2 max at which a specific blood lactate concentration is observed, or the point at which blood lactate concentration begins to increase above resting levels
What is the exercise economy?
Measure of the energy cost of activity at a given exercise velocity
____ = less energy expended = improved performance = less injuries
High exercise economy = less energy expended = improved performance = less injuries
Training variables revolves around the ___
Training variables revolves around the mode of training
What is the mode of tarining?
Specific activity performed by the athlete
What is the goal of the mode of training?
Goal is to mimic sport/activity
What is the frequency of a training session?
Number of training sessions to conduct per day or week
Frequency depends on and interaction of ____
Frequency depends on and interaction of intensity and volume of training
Higher intensity =___
Higher intensity = shorter duration
High intensity, low duration exercises provide benefits to ___
High intensity, low duration exercises provide benefits to skeletal muscle adaptations
What are the things used to gauge intensity?
- Heart Rate
- Ratings of Perceived Exertion (RPE)
___ is the most frequently used method for prescribing exercise intensities
Heart rate is the most frequently used method for prescribing exercise intensities
___ is a great way for a patient to tell the PT how hard they are actually working
RPE is a great way for a patient to tell the PT how hard they are actually working
You want exercise to be conducted at an intensity that is above ___
You want exercise to be conducted at an intensity that is above maximal lactate steady state
Progressing a training regimen usually involves changing the ___
Progressing a training regimen usually involves changing the frequency, intensity and duration of exercise
Long slow distance (LSD) is training at intensities equivalent to approximately ___
Long slow distance (LSD) is training at intensities equivalent to approximately 70% of VO2 max and about 80% max HR*
What are the characteristics of LSD?
- Slower than typical race pace
- Duration should be longer than race
- “Conversation exercise”
- Used for an endurance athlete
What do LSDs do?
- Enhance cardiovascular as well as thermo-regulatory function
- Increase the utilization of fat a a fuel
What is pace/tempo training?
Steady training conducted at a pace equal to the lactate threshold for a duration of aproximately 20- 30 mins
Pace/ tempo training is also known as ___
Pace/ tempo training is also known as threshold training, or aerobic-anaerobic interval training
What are the 2 methods of pace/temp training?
- Steady
* Intermittent
What does interval training involve?
Involves exercise at intensities close to VO2 max
How long should the intervals in interval training last?
Interval should last between 3-5 minutes
Work to rest interval should be ___
Work to rest interval should be equal
What are high intensity interval training (HIIT)?
High-intensity exercise bouts
interspersed with brief recovery periods
When using the HIIT method of training, the athlete must spend several minutes within
the HIIT session above ___
When using the HIIT method of training, the athlete must spend several minutes within
the HIIT session above 90% of
VO2 max
__ and ___ HIIT intervals can be used to elicit different training responses
Short (<5 seconds) and long (2-4 minute) HIIT intervals can be used to elicit different training responses
What is fartlek training?
A combination of several of the previously mentioned training types
What are the characteristics of the fartlek training method?
- Challenges all systems of the body
* Helps to reduce boredom and monotony of daily training
What is the purpose of pace/tempo training?
To stress the athlete to a specific intensity and improve their energy production from both aerobic and anaerobic metabolism
What should the intensity of a pace/tempo training be?
Intensity at or slightly higher than race pace
For a steady pace/tempo training, the intensity is __
For a steady pace/tempo training, the intensity is *the same, but the training session consist of a series of short intervals with very brief recovery periods between the intervals
What does interval training allow the athlete to do?
It permits the athlete to train at intensities close to VO2 max for a greater amount of time
When should interval training be performed?
When the athlete has established a firm base of endurance training
What does fartlek training do?
- Enhance VO2 max
- Increase lactate threshold
- Increase exercise economy
What is the priority of training during the off-season (base training)?
To develop a basic cardio- respiratory fitness
What should the training program in the off season be?
LSD and eventually move intensity up by no more than 5%
What is the priority of the preseason of training?
Increase the intensity and maintaining or reducing the duration of training
What type of training should be done in the preseason?
All types
What is the priority of the in season (competition) of training?
Having a training design that helps the athlete peak on their competition day
What type of training should be done in the in season (competition)?
LSD should precede competition days so the athlete is full recovered as well as well rested
What is the priority of the postseason (active rest) of training?
Recovering from the previous competitive season
What type of training should be done in the postseason (active rest)?
LSD, but enough exercise should be completed. Necessary for the brain emotional activity
What are the benefits of exercise?
- Improved efficacy of respiration
- Decreased resting heart rate
- Strengthens tendons
- Improves stroke volume
- Improves cardiovascular efficiency
What is the benefit of aerobic intervention in regards to diabetes?
• Improved insulin utilization by improving insulin sensitivity
• Cells better able to use any
available insulin & take up
glucose
What are the precautions to take in regard to aerobic intervention as a treatment method for diabetes?
- Don’t skip or delay meals
- Check blood sugars before exercise
- Progress activity slowly
- Work closely with health care team
What happens within the 1st 15 mins of exercise in diabetic patients?
Blood glucose rises, then falls gradually mirroring the body’s energy requirements
What happens within the 15- 30 mins of exercise in diabetic patients?
Muscles begin to take glucose directly out of the bloodstream without the use of insulin
What happens after 30 mins of exercise in diabetic patients?
The body has burnt any easily available carbohydrates and the blood glucose begins to drop
What is it important to do after 30 mins of exercise in a diabetic patient?
Refuel the body with carbs in order to maintain a healthy blood glucose level
What happens after exercise in a diabetic patient?
Blood glucose can continue to fall so it is necessary to keep checking until stabilized
What is something that can come up when treating a diabetic patient with exercise?
Hypoglycemia
What are the symptoms of hypoglycemia?
- Excessive sweating and hunger
- Fainting, fatigue, lightheadedness
- Nausea or vomiting, shakiness
- Confusion, anxiety, irritability, HA
How do you treat a case of hypoglycemia?
- 15-20 grams of fast acting carbohydrate
* Wait 15 minutes and check again
___ and ___ have the strongest association with seeking care for low back pain
and chronic low back pain.
Overweight and obesity have the strongest association with seeking care for low back pain
and chronic low back pain.
What are the symptoms of depression as illustrated by the DSM-IV guidelines?
- Depressed mood most of the day
- Markedly diminished interest or pleasure in all or most activities
- Significant weight loss when not dieting or weight gain
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness
9.Recurrent thoughts of death, recurrent suicidal ideation, or a
suicide attempt or a specific plan for committing suicide
How many of the symptoms of depression as illustrated by the DSM-IV guidelines must be present to be diagnosed with depression?
At least 5
What kind of evidence supports the use of exercise for depression?
Level 1, Grade A evidence
How does exercise help lower cholesterol?
By helping the patient lose or maintain weight
How does exercise specifically reduce cholesterol?
- By stimulating enzymes that help to move LDLs from the blood to the liver to expel it
- It increases the size of protein particles that carry proteins, which is better
The ___ amount of exercise resulted in greater improvements than did the __ amounts of exercise and was always superior to the control condition
The high amount of exercise resulted in greater improvements than did the lower amounts of exercise and was always superior to the control condition
How does exercise reduce the chance of hypertension?
Exercise significantly decreased systolic and diastolic daytime ambulatory blood pressure by 6±12 and 3±7 mm Hg, respectively
Physical exercise is able to decrease ___ even in subjects with low responsiveness to medical treatment
Physical exercise is able to decrease blood pressure even in subjects with low responsiveness to medical treatment
What does exercise do for stress/ anxiety?
- Decrease overall stress level
- Elevate and stabilize mood
- Improve sleep
- Improve self-esteem
What does exercise do to the brain in regards to stress?
Physical activity reorganizes the brain so that its response to stress is reduced and
anxiety is less likely to interfere with normal brain function
How long does it take to form a habit?
66 days
