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99 Cards in this Set

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Risk factor - age

Men : greater than Or equal to 45 Y°Women: greater than or = to 55 yo

Risk Factor - FHX

MI, cardio Revascularisation, or sudden death before 55 yo In a father or male of the 1st °Be for 65yo In a mother or female of the 1st °

Risk Factor- smoking

Current Smoker or those who have quit in the last 6 months or are exposed to 2nd hand smoke

Risk Factor- Sedentary lifestyle

< 30 min of moderate Intensity exercise (40-60% VO2R) on at least 3 days of the WK for at least 3 mo

Risk factor- obesity

BMI of 30 or higher OR waist girth> 102 cM for men and > 88cm for women

Risk Factor- HTN

Systolic > or = 140mm and / or diastolic > or= 90 mm (2 occations) or on anti HTN medication

Risk Factor -Dyslipidemia

LDL > or = 130mg OR HDL <40mg OR on medication OR total is > or = 200mg

Risk Factor- pre diabetes

Impaired Fasting glucose > or = 100mg and or = 140mg an < or = 199mg ( 2 occurrences)

Negative Risk Factors

HDL> or = 60mg

AACVPR- lowest Risk

Aacvpr- Moderate Risk

AACVPR - Highest Risk

Classification and management of BP of adults

A Recent Significant change to the resting ECG suggesting ischemia, recent Ml (within 2 d) or other acute cardiac event

Absolute Contraindication to Exercise testing

Unstable angina

Absolute contraindication to Exercise testing

Uncontrolled cardiac dysrhythmias causing Symptoms or Hemodynamic Compromise

Absolute Contraindication to exercise testing

Symptomatic Severe aortic stenosis

Absolute Contraindication to exercise testing

Uncontrolled symptomatic Heart Failure

Absolute contraindication for exercise testing

Acute pulmonary embolus or pulmonary Infarction

Absolute Contraindication to exercise testing

Acute myocarditis or pericarditis

Absolute Contraindication to Exercise testing

Suspected Or known dissecting aneurysm

Absolute Contraindication for Exercise testing

Acute systemic infection, accompanied by fever, body aches, or swollen Lymph glands

Absolute Contraindication for exercise

Left main coronary Stenosis

Relative Contraindication to Exercise testing

Moderate Stenotic Valvular heart disease

Relative Contraindication to Exercise testing

Electrolyte abnormalities ( Ex: Hypokalemia)

Relative Contraindication for exercise testing

Severe arterial HTN ( Systolic > 200 and/ or diastolic > 110)

Relative contraindication for exercise testing

hypertrophic Cardiomyopathy and other forms of outflow tract obstruction

Relative contraindication for Exercise testing

Neuromuscular, Musculoskeletal, or rheumatoid disorders that are exacerbated by exercise

Relative contraindication for exercise testing

High-degree atrioentricular

Relative Contraindication for exercise testing

Ventricular aneurysm

Relative Contraindication for Exercise testing

Uncontrolled Metabolic disease ( Ex: diabetes, thyrotoxicosis, or myxedema)

Relative contraindication for exercise testing

Mental or physical impairment leading to the inability to exercise adequately

Relative contraindication for Exercise testing

Participant Instructions for exercise testing

-No food, alcohol, caffeine or using tobacco within 3 hrs


-Should be rested, avoid sig exercise/exertion


-Wear comfortable clothing


-the test may be fatiguing, the pt may want transportation


-for DX the pt may be requested to discontinue some cadiovascular meds by their physician prior to testing ( B-blockers, this is due to hemo Changes during testing, pt also to taper due to withdrawl)


- for functional or Rx testing pt should continue meds


- list of meds with time taken


- Drink ample fluids for 24 hrs prior to testing

Purpose for health-related physical fitness testing

-Education on current heath status


- provide data that aids in the development of an ExRx that promotes health/fitness


- motivation for participants

organization for the test

1. documents are together and in the clients file/ during test


2. Calibrate equipment


3. organize equipment for test(s) order to prevent fatigue or decreased performance


4. Informed consent


5. Room temp between 68°F-72°F ( 20-22°C) and humidity <60%

Disease Risk based on BMI

Disease Risk based on BMI

Circumference sites for fat %

- abdomen ( iliac crest @the umbilicus


- Arm (midway between acromion and olecranon processes)


-Bultocks/hips ( Maximal Cirwmference of the buttocks)


- Calf ( max b/T knee and ankle)


- Forearm (max circum )


- Hips/thigh ( Max just under gluteal fold )


- mid-thigh ( midway B/T patella and inguinal creasewaist


Waist - narrow point b/T bellybutton and Xyphoid Process

define FITT - VP

Frequency


Intensity


Time / duration


Type / Mode


Volume


Progression

Components of the Medical Hx

Diagnosis


Prior physical Exams


Hxof S/s


Recent illnesses?


orthopedic problems?


Meds


Recreational habits (cigs, alcohol, weed?


Exercise Hx


Work HX


FHX

Symptom- Limited Exercise test Physical Examination components

-Body wt


-pulse rate and rhythm


-Resting BP


-Auscultation of lungs


-Palpation of cardiac apical impulse and point of Max impulse


-Auscultation of heart


-palp and Auscultation of cartoid abd and femoral arteries


-Eval of Abd


-palp and Examine Lower extremities


-Note tendon Xanthoma and Skin xanthelasma


-follow up exam for orthopedic or other medical conditions limiting exercise


-tests for neurological function


-inspection of skin (expecially those with DM



With circumference measures for fat %, within how many mm should a second measure be?

5mm

Risk criterion for waist circumference

Very low


Low


High


Very high



*no moderate

Skin fold sites

-Abd - vertical fold, 2 cm from umbilicus


-Triceps - vertical, mid b/T acromion and olecranon processes


-Biceps - vertical, over the belly of the Biceps


-chest/pectoral - diaganal, half way b/T anterior axillary line and nipple, for women one third


-medial Calf - vertical, max circum


-Midaxilliary - vertical, Midaxilliary level with the Xyphoid


subscapular - diagonal, 1-2 cm below inferior angle of the scapula


- subscapular - diagonal, 1-2 cm below inferior angle of the scapula-suprailiac - diagonal, taken at the natural line-thigh- vertical, mid b/T patella and inguinal crease


-suprailiac - diagonal, taken at the natural line


-thigh- vertical, mid b/T patella and inguinal crease

all skin folds are on what side of the body

Right

The caliper measurements should be b/T how many mm

1 to 2 mm

Ways to measure body Comp

Circumference


Skin fold


Densitometry


Hydrodensitometry


Plethysmography


Conversion of body density to body composition


Most accurate estimate for VO2max from HR response in submax testing

-steady state heart rate for each work rate


-linear relationship between HR and work rate


-difference b/T actual and predicted is minimal


-mechanical efficiency is the same for everyone at a particular work rate


-subject is not on meds

Sally


Likes


Dark


M&Ms

Modes of testing

Field test


Treadmills


Cycle ergometers


Step test

Per stage of a sub max test what range should the two HRs be within?

5 bpm

Onset of angina or angina-like symptoms

Indication for stopping an exercise test

Drop in SBP of g

Indication for stopping an exercise test

Excessive rise in BP : Systolic > 250 MM and/or diastolic > 115 mm

Indication for stopping an exercise test

SOBwheezing leg cramp or claudication

Indication for stopping an exercise test

Signs of poor perfusion: light headedness, confusion, ataxia, pallor, cyanosis, nausea, or cold and Clammy skin

Indication for stopping an exercise test

Tachydysrhythmia or bradydysrythmia

Relative contraindication for exercise testing

Chronic infectious disease

Relative contraindication for exercise testing

1kg= ? lbs

2.2 lbs

1 mph = ? meters per min

26.8 m / min

Convert 7 mph to min / mile

8.6 min/mile

1 L of O2 = ? Kcal

5 kcal

1 MET = ? ml / kg / min

3.5 mL/kg/min

1 MET = ? Kcal / kg / hr

1 kcal /kg/hr


*remember hour NOT min

1 watt = ? kgm / Min

6 kgm/min

3.5 mL/kg/min = ? METS

1 MET

kg×m / min = ? (Equation)

Kg × 6 × rpm (monark cycle)

Absolute VO2

rate of O2 uptake in L/ min

Relative VO2

Rate of 02 Uptake in ML / Kg / min. used to compare VO2 between people of different body size

Gross V02

total Consumption of 02 Under any circumstances

Net V02

02 consumption Above resting 02 Consumption. Used to describe Caloric cost of exercise

Calculate energy expenditure of a 62 kg woman cycling at a work rate of 450 kgm/min



VO2 = ( 1.8 × kgm / min ) / M (wt. in kg) + (7)


VO2 = (10.8 × watts) / M (wt in kg) + (7)


What are these components?

Calculate VO2 for a70 kg subject who is walking on the treadmill at 3.5 mph and 10% grade

Calculate VO2 for someone running 7.5 mph and 5% grade?

1 mile per hr = ? km/hr?

1.609 km/hr

how many calories are in one pound of fat?

3500 kcal

what is the purpose for metabolic calculations?

estimate energy expenditure during steady state exercise

monark cycle work rate calculation

resistance * (revolutions/min) * 6m/revolution




*note: 6m/rev is only for leg monark (arm is 2.4)

kcal/ minute = (equation)

(METS*3.5*kg)/ 200




"the 200 equation"

What range of speed is the walking calculation most accurate?

1.3-3.7 mph

What range of speed is the running calculation most accurate?

>5 mph (so anything in the 4 mph range you are just weird, stop that)

If your patient is not at steady state your estimation of VO2 will (blank) estimated.

over

at steady state (submax exercise), O2 cost ? O2 uptake

Equals

at maximal exercise, O2 cost ? O2 uptake

greater than (>)

all metabolic equations give (blank) VO2 values

gross

NET VO2 = (equation)

Gross VO2 - resting value (3.5 ml/kg/min or 1 MET)

VO2 for walking @ 3.0 mph at 5% grade (answer in VO2 and METS)

18.7 VO2 and 5.4 METS

VO2 for running at 6.0 mph at a 5% grade

42.9 VO2 and 12.26 METS

What is the VO2 for a 90 kg subjectpedaling at 2.0 kg at 60 rpms

6.1 METS

What is the VO2 of a 100kg person who uses a Monark arm ergometer at 3 kg at 50 rpms.



Hint: arm is 2.4 m/rev

14.3 ml/kg/min

what unit is used to represent step height?

meters (1 inch = .0254 m)


What is the VO2 fora 55 kg woman who is stepping on a 12”bench at 30 steps per minute


What is the kcalexpenditure (kcal.min-1) for this 55 kg person exercising at the above VO2or METS?



This person exercises at this rate 3 times per week for 30 minuteseach session.


How long will it take this person to lose 10 pounds exercising at thisrate?

9.1 METS



(remember weight loss...so this is gross VO2 you need net for the 200 equation)



49.9 Weeks

1 KPM = ? Newtons (if asked to calculate joules)

9.79 newtons

1 KPM = ? Ml/kg/min

1 ml/kg/min (same thing written different)

Power conversions

Power conversions

Work is measured in ?

Joules and kpm