340 Final

Front 1

screenings

Back 1

-all facilities should conduct preparticipation screenings!

-why? helps ID those with health conditions that require special attention

ID medical contraindictations that require exclusion from exercise.

Front 2

who needs screenings?
high risk

moderate risk

low risk

Back 2

-needs medical exam, exercise test and MD supervision of an exercise test before engaging in moderate or vigorous exercise

-only need a medical exam before engaging in vigorous exercise

-can engage in moderate or vigorous exercise without any exams/test

Front 3

how do we know risk level?
high risk

moderate

low

Back 3

- individuals who have known cardio. pulmonary or metablic diseases or one or more signs and symptoms.

-asymptomatic men and women who have greater than 2 risk factors

-asymptomatic men and women who have less than 2 CVD risk factors.

Front 4

what are risk factors?
-age
-family history
-cigarette smoking
-sedentary
-obesity

Back 4

-men older than 45 and women older than 55

-myocardial infartction (really any heart disease) or sudden death before age 55 for men (father or first degree male family member) or before age 65 for women (mother or other first degree relative)

- current smoker or who have quit within the last 6 months or exposure to environmental tobacco smoke

- not doing at least 30 mins of moderate PA at least 3 days a week for at least 3 months

-bmi over 30 or waist for men greater than 102cm/ 40inches. and 88cm/35inches for women

Front 5

more risk factors:
-hypertension

-dyslipidemia

-prediabetes

Back 5

systolic BP greater than 140 or diastolic greater than 90. needs to be confirmed on two seperate occasions. or if on antihypertensice meds.

LDL greater than 130 or HDL less than 40. if on lipid lowering meds. or total cholesterol is greater than 200. negative factor if HDL is greater than 60

IFG greater than 100 mg/dl and less than 125 or IGT greater than 140 or less than 199 (ex: 128= Diabetic not pre!)

Front 6

what if we dont know a measurement?

Back 6

always count a point for each risk factor that is unknow except for prediabetes. . Only count this if client is at least 45 years old, especially with a BMI of at least 25 kg/m2 OR if under 45 years old but has additional CVD risk factors for prediabetes such as a family history of diabetes

Front 7

Major signs and symptoms of cardio. pulmonary and metabolic disease

Back 7

-Pain/ discomfort in chest, neck, jaw, arms, or other areas that may result from ischemia

-shortness of breath at rest or with mild exertion (dyspnea)

-dizziness or syncope (loss of consciousness)

-orthopnea: dyspnea occurring at rest in the recumbent position- relieved promptly by sitting upright or standing

-paroxysmal nocturnal dyspnea: dyspnea beginning 2-5 hours after onset of sleep that can be relieved by sitting on side of bed getting up or going potty!

Front 8

more signs and symptoms!

Back 8

ankle edema-bilateral: most evident at night

palpations or tachycardia

intermittent claudication: pain occuring in muscles with inadequate blood supply that are stressed by exercise

known heart murmur:
functional vs. pathological
what is a heart murmur? noises produced by turbulent blood flow.
funx: murmur due to conditions outside of the heart. benign.
pathological= more serious

unusual fatigue or shortness of breath with usual activity

Front 9

known diseases that take you right to the top! (high risk)

Back 9

CVD:
cardiac disease
peripheral vascular disease
cerebrovascular disease

Pulmonary disease:
COPD
asthma
interstitial lung disease
cystic fibrosis

Metabolic disease:
diabetes
renal disease

Front 10

recommendations for exercise testing prior to PA

Back 10

necessary for high risk (need physician present for sub and max testing)

can be beneficial in preping an exercise prescription for those at low risk

health/fitness and clinical exercise pros should choose most appropriate intensity for their setting and population when making decisions about the level of health screening needed.

Front 11

who needs to supervise an exercise test?

Back 11

physician must be immediately available for those at high risk

physician does not necessarily have to be present when testing those at moderate risk. it all depends on..
local policies, circumstances
AED emergency plan
training of the lab staff
health of client

Front 12

cardio vascular conditioning :
Principles of training

Back 12

1.adaptation: When people increase their effort a little more than normal (“overload”) their bodies respond by improving strength, flexibility, aerobic capacity, or any other component of fitness that is challenged. Each bout of exercise-overload-results in temporary fatigue and decrease in performance, then body adapts. As system recovers, capacity increases to a level greater than the original (TIME BETWEEN BOUTS IS RECOVERY)
-Due to physiological adaptations (size of left ventricle, Q, increase in mitochondria, increased motor unit recruitment, etc)


2.overload: : physiologic capacity must be challenged past a minimal intensity called the “training threshold”

3.progression: the exercise stimulus must increase over time in order to elicit continued improvements
4.specificity : specific to clients needs (lose weight, build muscle, etc,)

Front 13

detraining and overtraining

Back 13

Workouts must be spaced carefully to obtain the best results
Body needs time to recover for adaptive process to take place

As training stress increases (intensity or volume) so does recovery time

Front 14

the FITT principle for cardiorespiratory endurance

Back 14

F: at least 5 days a week (moderate( or 3 days a week (vigorous)

I: moderate: 40-60% or vigorous 60-90%

T: 30-60 mines moderate or 20-60 mins vigorous

T: rhythmic movements using large muscle groups

volume= F*I*T (vigorous 5 days a week for 150 mins)

progression: Made gradually; Increase any components of FITT; when first starting program, increase Time by 5-10 min every 1-2 weeks over first 4-6 weeks, then increase any component of FIT over next 4-8 months (longer if older or deconditioned) to meet recommended quantity

Front 15

how to determine the F in FITT

Back 15

if you want to improve cardio fitness:
sedentary individuals = 3 days a week
as they become more fit then increase frequency duration and intensity.

for patients with some chronic conditions:
higher frequency (several times per day), longer duration, lower intensity

Front 16

determine the I of FITT

Back 16

you must challenege the body in order to see changes

the higher the initial aerobic capactiy the higher the minumum intensity must be to further increase that capacity

VO2 max
less than 40 (low to medium initial fitness)= 30% VOR or HRR
40-51 average to good= 45% VOR or HRR
52-59 high (75% VO2R or HRR)
above 60 very high= 90-100%


Regardless of way, we want intensity to fall between 50-85% of VO2reserve
Sedentary: 50-60% (occasionally 40%)
Average, healthy, somewhat active: 60-75%
Highly fit and motivated: 75-85%
As the client progresses, we need to update their prescription (progression and overload)

Front 17

determining the Duration or T of FITT

Back 17

20-30 mins initially
rarely exceed 60mins (injury risk increases)
consider frequency and duration together: only change one variable at a time
can do 10 min bouts
time does not include warm up and cool down

Front 18

determining mode or T type in FITT

Back 18

rhythmic, large muscle groups, at least moderate intensity
safety for client and what they prefer

Front 19

exercise prescription by HR

Back 19

use either : % of max HR OR % of HRR

Front 20

when would exercise prescription by HR not be appropriate?

Back 20

Clinical conditions/medications that impair HR response to exercise (cardiac transplant, beta blockers, pacemaker)
Medications/drugs that elevate HR
Pregnancy (TT or RPE)
Difficulty measuring HR

“Talk Test”: if the client is still able to speak in complete sentences, the intensity is not excessive
-This only gives an upper limit
-Lower limit: Hard enough to make you aware of your breathing

Rating of Perceived Exertion (RPE) scale

Front 21

cardiac disease!

Back 21

part of CVD

Front 22

manifestation of CVD:
-acute coronary syndrome

-CVD

-cerebrovascular disease (stroke)

-CAD

-myocardial ischemia

-Myocardial infarction (heart attack)

-peripheral artery disease (PAD)

Back 22

-manifestation of Coronary Artery Disease (CAD) with increasing symptoms of angina pectoris, myocardial infarction (MI), or sudden death

-diseases that involve the heart and/or blood vessels; includes hypertension, CAD, PAD, & atherosclerotic arterial disease

-Diseases of blood vessels that supply the brain

-disease of the heart's arteries

-lack of adequate coronary blood flow-not enough O2 for the heart, manifests as angina pectoris

-injury or death of heart's muscular tissue

-disease of arteries outside of the heart and brain

Front 23

Following a cardiac event or procedure requiring hospitalization, goals for an inpatient program include:

Back 23

Identify cardiovascular, physical, or cognitive impairments that may influence PA
Offset effects of bed rest
Provide medical surveillance of exercise
Enable patients to return to ADLs
Prepare patient & support system for return home
Refer to an outpatient cardiac rehab program

Front 24

inpatient cardiac rehab FITT
F:

Back 24

mobilization, 2-4 times a day for first 3 days of hospital stay.

Front 25

inpatient I of FITT

Back 25

seated or standing resting HR + 20 bpm for patients with MI, +30 bpm for patients recovering from heart surgery. upper limit is less than 120bpm and RPE of less than 13 on Borg scale

Front 26

inpatient T in FITT (time/ duration)

Back 26

intermittent walking bouts for 3-5 mins as tolerated. progressively increase duration.
rest can be slower walking or complete rest; but should give a 2:1 ratio of walking to rest periods

Front 27

inpatient T for FITT (type)

Back 27

walking

Front 28

inpatient P (progression)

Back 28

when 10-15 minutes continuous walking bouts are reached, increase intensity up to the heart rate and RPE listed above

Front 29

for inpatient cardiac rehab, at time of hospital discharge patient should...

Back 29

Be familiar with exercises that are too extreme
Have a safe, progressive plan for exercise
Have performed a low-level, submax exercise test
Be counseled to identify abnormal signs or symptoms suggesting exercise intolerance & need for medical evaluation
Be educated & encouraged to join an outpatient cardiac rehab program (clinically supervised if patients are still at moderate or high risk according to Box 2.4)
Be educated on use of at home exercise equipment

Front 30

outpatient cardiac rehab goals:

Back 30

Develop & assist patient to implement a safe & effective formal exercise and lifestyle PA program
Provide monitoring to detect change in clinical status
Provide data to patient’s health care providers for medical management
Return patient to normal activities or modify them based on patient status
Provide patient & family education to modify risk factors

Front 31

outpatient cardiac rehab beginning assessment:

Back 31

Medical/surgical history
Physical exam emphasizing cardiopulmonary/musculoskeletal systems
Review of recent cardiovascular tests (ECG, etc.)
Current medications
CVD risk factors

Front 32

what we want to monitor for outpatient cardiac rehab:

Back 32

HR, BP, body weight (weekly)
Evidence of change in clinical status (dizziness, chest discomfort, etc.)
Symptoms of exercise intolerance
Changes in medications/dosage
ECG monitoring or the like

Front 33

out patient F in FITT

Back 33

greater than 3 days a week, preferably all days

Front 34

the I in FITT of outpatient

Back 34

one of the following:

40-80% of exercise capacity from baseline exercise test (either HRR, VO2R, or VO2Peak)
RPE of 11-16 on Borg Scale
HR <10 beats below ischemic threshold
Medications β-blockers, diuretics may influence HR & exercise capacity

Front 35

the T (time) for FITT for outpatient

Back 35

Warm-up/Cool Down for 5-10 min
Aerobic conditioning for 20-60 min; start with 5-10 min bouts, increase 1-5 minutes each exercise session or 10-20% each week

Front 36

T (type) for outpatient

Back 36

-Rhythmic, large muscle group activities
Emphasize increased caloric expenditure to maintain healthy body weight

Front 37

P (progress) for outpatient

Back 37

based on the patient

Front 38

resistance FIT for cardiac patients

Back 38

F-2-3 days/week w/ @ least 48 hours rest in between sessions; performed after aerobic exercise so adequately warmed up
I-RPE of 11-14; Begin with 1 set of 10-15 reps (or 30-40% 1 RM upper body; 50-60% 1 RM lower body; Low risk may progress to 8-12 reps at 60-80% 1 RM
T-Bands, cuffs & hand weights, free weights, wall pulleys, machines (dependent on weight of level arms/ROM)
P-Increase slowly as patient adapts (~2-5 lb/week upper body & 5-10 lb/week lower body); more sets can be added as tolerated


*avoid valsalva maneuvers

Front 39

why resistance train for cardiac patients?

Back 39

Muscular strength and endurance
Self-confidence
Ability to perform ADLs

Maintain independence

Decrease cardiac demands of muscular work during daily activities

Prevent the development of other diseases

Slow age and disease related declines in muscle strength and mass

Front 40

special considerations:

Back 40

1. Patients with heart failure
Aerobic exercise is the main method used
Resistance training has been shown to enhance strength/improved quality of life

2.Patients after cardiac transplantation
First several months post-surgery:
HRrest elevated
HR response to exercise abnormal
Prescribe exercise based on RPE of 11-16
Include warm-up, cool down, ROM exercises

3. Patients with Cerebrovascular Disease (Stroke)
VO2Peak reduced by half
Focus on mobility, recovery of ADLs

Front 41

ohhh hypertension

Back 41

the high blood pressure beast!

Front 42

what is hypertensive systolic of diastolic BP?

Back 42

greater than 140/ 90 (more than 2 occasions)

Front 43

what can hypertension lead to?

Back 43

increased risk of CVD, stroke heart failure PAD and chronic kidney disease

Front 44

normal bp?

prehypertensive?

hypertensive?

Back 44

LESS than 120/ 80

120-139/80-89

greater than 140/90

Front 45

lifestyle modifications for hypertension?

Back 45

QUIT SMOKING!
weight management
reduce sodium intake
moderation of alcohol
DASH diet (dietary approaches to stop hypertension)
make a habit of PA
most patients are on at least 2 BP meds

Front 46

BP meds

Back 46

We’re not pharmacists or physicians, but we should educate ourselves on those medications and how they may affect exercise

Front 47

exercise testing for hypertension

Back 47

If BP is not controlled (>140 and/or >90 @ rest), must consult physician prior to initiating an exercise program
Once medially controlled, can begin @ intensity of 40-<60% VO2R without consulting physician



Those with hypertension & in the High Risk category need a medical evaluation prior to an exercise test


Those with hypertension & in the High Risk category & with target organ disease (e.g. left ventricular hypertrophy) who want to perform moderate to vigorous exercise need a symptom-limited exercise test first

Front 48

more exercise tests for hypertension:

β-blockers?

If resting BP is >200 systolic or >110 diastolic?

If exercising BP gets to >250 systolic or >115 ?

Back 48

-Patients typically take their BP meds as usual for an exercise test

relative contraindication for exercise testing

exercise test should generally be stopped

Front 49

how does exercise help with hypertension?

Back 49

Aerobic exercise can reduce resting BP by 5-7 mm Hg in those with hypertension
Exercise training lowers BP response to submaximal loads
Focus on aerobic training, however, moderate intensity resistance training can be added to this regimen
Flexibility exercises added in as for healthy adults

Front 50

F in FITT for hypertension

Back 50

aerobic exercise on most preferably all days of the week. resistance 2-3 days/week

Front 51

I in FITT for hypertension

Back 51

40-<60% VO2R or HRR; RPE 11-13

supplemented by resistance training at 60-80% 1 RM

Front 52

T (time) in FITT for hypertension

Back 52

30-60 minutes per day of aerobic training

Resistance training: at least 1 set of 8-12 reps for each major muscle group

Front 53

T (type) in FITT for hypertension

Back 53

Emphasis on aerobic activities like walking, jogging, cycling, swimming; Resistance training: use either machines or free weights & consist of 8-10 exercises for major muscle groups

Front 54

the P (progress) for hypertension

Back 54

Generally progress gradually like with healthy population, but pay attention to BP control, changes in medications, adverse effects

Front 55

special considerations for hypertension

Back 55

Patients with uncontrolled hypertension (>180 systolic and/or >110 diastolic) should exercise train only after physician evaluation & medication prescription

When exercising, BP needs to remain <220 systolic and/or <105 diastolic

β-blockers and other medications reduce HR and may decrease exercise capacity; Rely on RPE of 11-13 or talk test

Focus on caloric expenditure/reduction if overweight

Avoid Valsalva maneuver during resistance training

Front 56

PAD and

Back 56

pulmonary disease

Front 57

PAD is characterized by systemic atherosclerosis

symptoms?

Back 57

Mismatch between oxygen supply & demand causing ischemia in calf, thigh, or glutes

aching or cramping sensation in one or both legs that typically is triggered by weight bearing exercise (induce by exercise and relieved by rest)

patients have a 6.6 times greater chance of dying of CVD

Front 58

treatment for PAD

Back 58

drug therapy
exercise
peripheral interventions
amputations

Front 59

exercise testing for PAD

Back 59

Measure pre & post bilateral ankle & brachial blood pressures

Divide highest ankle BP by highest brachial BP
Exercise test must be done with physician present (high risk)

Use graded exercise test

Use a pain scale to record time & distance to onset of pain & maximal pain

After laying in supine position for 15 minutes, measure ankle & brachial BPs again

Front 60

exercise prescription for PAD: F of FITT

Back 60

3-5 days per week aerobic. more than 2 days of resistance training

Front 61

I of FITT for PAD

Back 61

: 40-<60% VO2R; To the limit of pain tolerance (to “moderate claudication”)
No more than a 3 (intense pain) on the 4 point pain scale
Intervals help! Between bouts, allow time for pain to subside before resuming exercise

Front 62

T (time) of FITT for PAD

Back 62

30-60 mins

Front 63

T (type) of FITT for PAD

Back 63

Weight-bearing exercise, walking, & supplement with others

Cycling may be used as a warm-up, but should not be the primary type of activity

Resistance training recommended to maintain muscular strength/endurance

Front 64

special considerations for PAD

Back 64

A cold environment may aggravate the symptoms of intermittent claudication longer warm up

Encourage patients to stop smoking if they are current smokers

Exercise program should also be designed to target CVD because of its association with PAD

Optimal benefit is seen in a supervised exercise program lasting @ least 6 months

Front 65

pulmonary disease results in what?

Back 65

Results in shortness of breath with mild exertion
May lead to limited PA and thus, deconditioning

Exercise is an effective intervention that lessens the development of functional impairment

examples: COPD
-emphysema
-chronic bronchitis
-experience of dyspnea
Asthma

Front 66

exercise prescription for asthma: F of FITT

Back 66

2-3 days a week

Front 67

I of FITT for asthma

Back 67

@ ventilatory threshold or 60% of VO2Peak or 80% of maximal walking speed during 6-minute walk test (D=rt)

Front 68

T (time) of FITT for asthma

Back 68

at least 20-30 minutes per day

Front 69

T (type) of FITT for asthma

Back 69

aerobic activities using large muscle groups, swimming in non-chlorinated pool.

Front 70

resistance training for asthma

Back 70

follow the same principles for healthy adults

Front 71

exercise prescription for COPD

Back 71

F: 3-5
I: vigorous or light if necessary or 4-6 on borg scale
T: discontinuous short bouts, interval training
T: walking/cycling

resistance/ flex same as healthy adult

focus on muscles of shoulder girdle

Front 72

and the password is..

Back 72

diabetus

Front 73

what kind of disease is diabetes and what does it result from?

Back 73

metabolic disease reasulting from defects in insulin secretion and/ or ability to use insulin

characterized by high fasting blood glucose (greater than 126)

impaired fasting glucose greater than 100

most is type 2

Front 74

normal functioning vs type one and type two diabetes

Back 74

Eat a meal
Gets digested and absorbed, blood glucose goes up
High blood glucose causes the B-cells of the pancreas to secrete insulin
Insulin causes muscle and fat cells to take up glucose
Results in lower (normal) blood glucose level

Type I diabetes: autoimmune disease, B cells of the pancreas don’t produce insulin
Treatment: insulin

Type II diabetes: dysfunction in insulin receptors in adipose and muscle cells (still plenty of insulin, elevated), cells are “insulin resistant”
Treatment: oral hypoglycemic agents and sometimes insulin

Front 75

what does exercise do for diabetes?

Back 75

exercise has an insulin-like effect:
increase of sensitivity of insulin receptors
allows cells to absorb more glucose

goals of exercise:
reduce risk f CVD for both types
for type 2 or prediabetes: increase cellular insulin sensitivity
for type 1: may reduce need for insulin

Front 76

FITT for diabetes

Back 76

F: 3-7
I: 40-<60% VO2R, 11-13 RPE; higher intensity for long-term exercisers better glucose control
T: at least 10 min bouts. total 150min/wk. no more than 2 consecutive days of rest
T: large muscles, repetitive, aerobic

Progression: to increase caloric expenditure increase duration


Retinopathy: persistent or acute damage to the retina of the eye
Some evidence that combination of aerobic & resistance training improves blood glucose control more than just one modality

Front 77

potential exercise complications for diabetics

Back 77

hypoglycemia: low blood glucose is the most common problem for exercising diabetics (insulin and exercise both reduce blood glucose)

symptoms: weak, light headed, shaky, tingling fingers and mouth

Front 78

interrpretting glucose levels post exercise

Back 78

>250-300 mg/dl. Plus ketones; postpone exercise; consult physician/inject insulin

>250-300 No ketones; exercise okay, but use caution

100-250 exercise is recommended

less than 100 consume CHO before exercising


Ketones are substances that are made when the liver breaks down fatty acids for energy.

Normally, your body gets the energy it needs from CHO, but stored fat is broken down and ketones are made if your diet does not contain enough carbohydrate to supply the body with sugar (glucose) for energy or if your body cannot use blood sugar (glucose) properly.

Ketosis (large amounts of ketones) occurs when in starvation state or the above. Body tries to get rid of it in urine, which may cause dehydration, hypotension, and/or tachycardia
Newer home blood sugar meters can also measure ketone levels in the blood. Home urine tests to measure ketones are available.

Front 79

special considerations for diabetes

Back 79

Glucose levels pre & post activity
Fast acting glucose source readily available
Timing of insulin administration & CHO intake may need to be altered

Foot care
Sock and shoe type
Keep feet dry to prevent ulcers/blistering by using silica gel, air insoles, & polyester or blend socks

BP monitoring/Use of RPE

Lower impact movements may be advised
Vigorous exercise & resistance training greatly increases BP and can lead to hemorrhage of the eye in those who are at risk of retinopathy

Front 80

hyperglycemia

Back 80

...increases risk of heat illness and affects thermoregulation
Proper hydration is key
Avoid extreme temperatures

Always workout with a partner & wear diabetes tag!

Front 81

weight control and

Back 81

metabolic syndrome

Front 82

what is metabolic syndrome?

Back 82

a condition leading to higher risk of type 2 diabetes, CVD

combination of obesity hypertension dyslipidemia insulin resistance

Front 83

metabolic syndrome

Back 83

must have three of the following:
waist circumference obesity
triglycerides greater than 150
HDL for women greater than 50 and for men greater than 40
BP greater than 130/85
fasting glucose greater than 100-110

Front 84

treatment for metabolic syndrome

Back 84

weight control
PA
treatment of the associated CVD RF which may include pharmacotherapy

Front 85

FITT for metabolic syndrome

Back 85

F: most days
I: Initial training should be mod. intensity (40-<60% VO2R or HRR)
Progress to more vigorous (>60% VO2max or HRR)
T: 150 mins/wk increase to 300
many bouts of 10 mins
to promote or maintain weight loss workout 60-90 a day
T: large muscle
cardio

Front 86

health benefits of weight loss

Back 86

losing 5-10% of weight gives significant health benefits
lower CVD risk
Better glucose control

Front 87

how to find BMI

Back 87

weight in kg (lbs/2.2) divided by height in m squared

(inches to meters is inches times 2.54 divided by 100)

Front 88

Jim’s current weight is 240 lb and height is 5 ft 10 in. His goal BMI is 29. How much weight should he lose?

Back 88

240/2.2 = 109 kg
70(2.54) = 178 cm/100 = 1.78 m
current BMI = 109/(1.78)2 = 34 kg/m2

Weight he wants to be at: 29 = X/1.782
Weight he wants to lose = current weight - X

Front 89

exercise effects on obesity

Back 89

Promotes fat loss in abdominal sites
particularly effective for those with visceral adiposity

Metabolic rate declines with weight reduction through caloric restriction alone
Exercise may help prevent this decline in metabolic rate

Caloric restriction (or changing eating behaviors) is necessary to achieve weight loss

Front 90

most successful losers continue to exercise for how long?

Back 90

250 mi/wk

Continuing appropriate dietary & exercise patterns as PERMANENT behavior change
(want a negative energy balance of 500-1,000 kcal/day)

Front 91

weigth loss FITT

Back 91

F: greater than 5 days
I: moderate (40-60%) progress to vigorous ( greater than 60% of HRR/ VO2R)
T: 150mins/wk progress to 300

*Incorporating vigorous intensity exercise into the total volume may provide additional health benefits & should be encouraged in those willing to do it-utilize 10 min bouts if needed.
T: aerobic activity

Front 92

how do we get people to exercise?

Back 92

Utilize the flexibility available in the FITT principles
Create individualized programs
Aid in increasing perceived exercise benefits & self efficacy
Provide social support during weight loss & on into weight maintenance

Front 93

arthritis

Back 93

49% diagnosed with arthritis and will go up b/c of baby boomers

Front 94

what is osteoarthritis and rheumatoid arthritis?

Back 94

Degenerative joint disease affecting one or multiple locations in the body; loss of articular cartilage

*Generally impacts knees, hips, spine, hands

*Symptoms:
Pain, tenderness, locking
Stiffness after getting out of bed
Effusion-extra intra-articular fluid

Front 95

what is rheumatoid?

Back 95

Inflammatory disease resulting from pathologic activity of the immune system against joint tissue
Impacts wrists, fingers, neck, shoulders, elbows, hips, ankles, and feet
Symptoms:
*Warm or swollen joints
*Stiffness early in the morning that may increase over an hour after waking(osteoarthritis pain typically starts to subside then)

Front 96

effects of exercise

Back 96

Exercise is essential for managing these conditions!

Decreased joint pain

Maintains muscle strength around affected joints

Prevents functional decline

Improved mental health

Improved quality of life

Front 97

FITT for arthitis

Back 97

cardio:
Frequency: 3-5 days/week
Intensity: 40-<60% HRR/VO2R; may be limited by pain or deconditioning-then use light intensity
Time: intermittent (discontinuous) 10 min bouts (or less if needed), progress based on tolerance (goal >150 min/week)
Type: low joint stress (walking, cycling, swimming)


respiratory:
Frequency: 2-3 days/week
Intensity: low weight, high reps (40-60% 1 RM; 10-15 reps)
Type: All major muscle groups as seen for healthy adults
Flexibility/ROM exercises: stretch all major muscle groups daily

Front 98

VO2max-true physiological limit shows what?

Back 98

: shows a plateau in VO2
Those with certain diseases (CVD, etc.) may not actually reach this level before they have to stop, thus VO2 peak is how high they get (probably won’t see VO2 plateau, but peak is useful for ExRx)

Front 99

1 MET=

Back 99

resting VO2 = 3.5 ml O2/kg/min

Front 100

VO2/3.5=

Back 100

METs

Front 101

min/mile to MPH


MPH to min/mile

Back 101

60 min/1 hour * 1 mile/___min (ex. 8)= 60miles/8mins= 7.5 mph

1hour/ 6.8 miles* 60mins/ 1hour= 60mins/ 6.8miles= 8.82min/mile (.82*60)= 8 mins 45 seconds per mile

Front 102

1 MET=

Back 102

3.5 ml/kg/min (rest)=1 kcal/kg/hour

Front 103

For every 1 L of O2 we consume= calories?

Back 103

we use ~5 kcals