KINE 3660 Final Exam Review PDF

ALZHEIMER’S DISEASE 1. Be familiar with the areas of neurodegeneration and the neurocognitive deficits associated with Alzheimer’s disease. Neuronal loss, synaptic loss, olfactory deficits, memory impairment, cognitive and functional deterioration, interferes with daily life, apathy, d...

ALZHEIMER’S DISEASE 1. Be familiar with the areas of neurodegeneration and the neurocognitive deficits associated with Alzheimer’s disease. Neuronal loss, synaptic loss, olfactory deficits, memory impairment, cognitive and functional deterioration, interferes with daily life, apathy, depression 2. Be familiar with the “hallmark” signs of Alzheimer’s Disease Neurofibrillary tangles, hyperphosphorylated tau protein, buildup of amyloid plaque 3. Be familiar with the pathophysiological consequences of Alzheimer’s disease? (Refer to flowchart) Starts with amyloid precursor protein Secretase doesn't break down APP like it's supposed to Amyloid becomes phosphorylated Amyloid beta plaques form Amyloid plaques can form and break down naturally  4. What are the risk factors for developing Alzheimer’s disease? Unhealthy diet, alcohol misuse, smoking, obesity, hypertension, dyslipidemia, vascular insults, neuronal damage, age, sex, genetics, cardiovascular disease, moderate-severe tbi 5. Be familiar with the prevalence of Alzheimer’s disease as presented in Dr. Rosetti’s lecture 60%-80% of dementia cases, affects 1 in 3 adults by age 85 6. What are the potential benefits of exercise for those at risk for developing Alzheimer’s disease and those who have been diagnosed with the condition? Health promotion, delay onset of dementia, risk reduction of dementia, preserve function, induce growth factors (hippocampus), neurogenesis, enhance cognitive function, reduce neurodegenerative disease related depression 7. For the two neurodegenerative conditions discussed (AD and PD) what are the appropriate F.I.T.T. prescriptions? What other factors would be important to incorporate? AD: moderate walking 3 times a week, work up to aerobic and anaerobic, over 15 mins, at least 6 months PD: structured, motor fitness hypothesis, social engagement, music bypasses the basal ganglia, light to moderate (40% to 60%) 8. In terms of cognitive performance, what benefits have been reported for those with Alzheimer’s disease? Information processing, executive function, memory 9. Be familiar with the statistics associated with Alzheimer’s disease. In other words, which population(s) are most likely to develop the condition? Women above the age of 65 10. Be familiar with the projection of how many Americans are projected to develop Alzheimer’s disease throughout the next ~30 years 115.4 million people by 2050 11. Be familiar with the specific areas of the brain and neurotransmitter(s) associated with both AD and PD AD: basal forebrain, cortex, limbic system PD: dopaminergic neurons in the substantia nigra, cortex PARKINSON’S DISEASE 12. For the two neurodegenerative conditions discussed (AD and PD) what are the appropriate F.I.T.T. prescriptions? What other factors would be important to incorporate? AD: moderate walking 3 times a week, work up to aerobic and anaerobic, over 15 mins, at least 6 months PD: structured, motor fitness hypothesis, social engagement, music bypasses the basal ganglia, light to moderate (40% to 60%) 13. Be familiar with the specific areas of the brain and neurotransmitter(s) associated with both AD and PD AD: basal forebrain, cortex, limbic system PD: dopaminergic neurons in the substantia nigra, cortex  14. Be able to describe the motor, non-motor and cognitive abnormalities associated with Parkinson’s Disease Motor: bradykinesia, tremor, rigidity, gait, postural instability, loss of control, vocal changes, trouble swallowing, chronic constipation Non-motor: decreased independence, mood disorders, hallucinations, blood pressure changes, sleep disorders, pain, fatigue, loss of smell, weight fluctuation Cognitive: attention, executive dysfunction, working memory, processing speed, set shifting, language, visuospatial processing, personality changes, dementia 15. Be prepared to address the statistics associated with Parkinson’s Disease 2nd most common neurodegenerative disease, 1/1000, 1% over the age of 60 5%-20% of patients have cognitive symptoms at time of diagnosis, 80% will develop cognitive symptoms 16. What is the onset of motor symptoms in relation to the time of diagnosis of Parkinson’s disease? Early diagnosis: bradykinesia, rigidity, tremor Late diagnosis: dysphagia, postural instability, freezing of gait, falls 17. Be able to describe the pathophysiology of Parkinson’s disease. Degeneration of dopaminergic neurons in the substantia nigra and cortical thinning 18. Be familiar with the known benefits of exercise for those with or at risk for- developing Parkinson’s disease Improved mobility, flexibility, emotional well being, balance, gait, qol, decreased fall risk, neurogenesis, angiogenesis, synaptogenesis, increased hippocampal volume, increased grey and white matter in the frontal region and corpus callosum  19. What are the different methodologies that we discussed to treat Parkinson’s disease? Motor: levodopa, dopamine agonists, anticholinergics, deep brain stimulation, stereotactic lesioning Non-motor: cholinesterase inhibitors, ssris/snris, melatonin, klonopin, treatment of urinary symptoms and constipation 20. Be familiar with the proposed mechanisms of how exercise may benefit those with Parkinson’s disease as presented by Dr. Barrett Motor: balance, flexibility, strength, mobility, step length Non-motor: qol, cognition, executive function, improved depression and anxiety, cerebrovascular and cardiovascular health, sleep quality, neuroplasticity, neurotrophic factors, blood flow, immune system CONCUSSION 21. What is the definition of concussion? Traumatic brain injury caused by a direct blow to the head, neck, or body. Symptoms can take up to 24 hours to appear, may or may not include loss of consciousness. No visual abnormality on standard imagery 22. Which population(s) and what demographic variables have been demonstrated to lead to an increased risk of sustaining a sport concussion? Countries where walking and mopeds are common forms of transportation, females  23. Be familiar with the neurometabolic cascade associated with sport concussion. - Force to brain - Neuronal axon stretches - Glutamate released (excitatory amino acid) - Glutamate binds to NMDA receptor - Influx of Na+ and Ca+, efflux of K+ - Sodium-potassium pump activates to correct ion imbalance - Pump activation causes increased glucose demand Cerebral blood flow reduced by 50% for 7-10 days 24. How do we assess sport concussion? What is the best (as of 2017) approach to assess sport concussion? Why? Pre injury assessment, neurocognitive assessment, balance assessment, cranial nerve assessment, symptom tracking, sleep behavior 25. What is the typical recovery from sport concussion (in days) for adolescent vs adult athletes? Is there a difference? Same recovery WITH the same system, resources, etc. Recovery doesn’t depend on age, but rather access 26. Be familiar with the stages of the return-to-play protocol following a sport concussion 1. Symptom limited activity 2. Aerobic exercise 3. Sport specific exercise 4. Non-contact training drills 5. Full contact practice 6. Return to sport 27. In terms of concussion legislation, be familiar with the common components of each state’s bill. Washington: first state, education, immediate removal of athlete, return to sport Arkansas: dedicated money to research Return to learn 28. What are the most common symptoms of a concussion? The least common? Most common symptom is headache, difficulty concentrating, dizziness, photophobia Less common symptoms: amnesia, loss of consciousness Vestibular deficits, cognitive deficits, ocular deficits 29. What is the Buffalo Concussion Treadmill Test? What is it used for and what are the benefits? Protocol to prescribe exercise post concussion 30. When developing a new test, why should a test have evidence of objectivity, reliability and validity? Objectivity: inter-rater reliability Reliability: test-retest reliability Validity: sensitivity and specificity 31. What is Chronic Traumatic Encephalopathy (CTE)? Neurodegeneration characterised by abnormal buildup of tau protein in the brain. CTE can only be diagnosed post-mortem HEART DISEASE 32. Be able to describe the epidemiology of congenital heart defects and heart failure. CHD: 1 in 110 children, 500,000 adults CV disease: accounts for 1 in 3 deaths, leading global cause of death, cases increase by 25% annually, costs $32 billion 33. Be able to discuss risk factors associated with congenital heart defects/disease as discussed by Dr. Dean. Genetic variations, non-cardiac abnormalities, abnormal fetal blood flow, alcohol, medication, viral infection, anesthesia in early life, bypass machine early in life, post-op complications 34. What are the common cognitive deficits associated with congenital heart defects and heart failure? CHD: delayed/atypical development, behavioral difficulty, academic underachievement, depression and anxiety, decreased qol, autism HF: attention, planning, memory, 25% to 80% have cognitive deficits 35. Be familiar with the rationale behind NOT restricting exercise with patients with a congenital heart defect Lack of evidence to support, safer place to arrest, kids don’t listen, doesn’t increase mortality, isolation, decreased qol, false sense of security, higher bmi 36. Be familiar with how to create a prescription for those with heart failure and congenital heart defects CHD: normal prescription for children, consider severity of condition - 20 mins, 3 times a week, moderate intensity, 150 bpm minimum HF:  37. What are the benefits of exercise for those with congenital heart defects and heart failure? Exercise capacity, bmi, heart function, bnp levels, qol, lower depression, self-efficacy, survival, cardiac output, systemic blood pressure, pulmonary artery pressure, heart rate, sympathetic drive CANCER 38. Be able to discuss the epidemiology of breast cancer. Who is most likely to be diagnosed? Most common cancer for women, 1 in 8 women, risk increases with age 39. What is cancer-related cognitive impairment? Chemo brain: 1-2 standard deviations from baseline, depression, anxiety, fatigue, learning, memory, verbal fluency, visuospatial functioning, processing speed 40. Be able to list the consequences of chemotherapy and other therapies for those being treated for cancer Chemo is non-selective, harms healthy cells, disrupts the formation of DNA RNA and proteins, weakens immune system, chemo brain 41. What are the proposed mechanisms behind a reduction in white matter integrity in cancer patients? Neuroinflammation, neurotoxic injury, endothelial dysfunction, hormonal changes 42. Be able to compare and contrast the effects of cancer treatment(s) and the benefits of exercise? Community, enjoyment, qol, socialization, distraction from diagnosis  43. Be able to discuss the considerations of prescribing exercise for a cancer patient? Increased risk of fractures, cardiovascular event, balance issues 44. Be familiar with the goals and objectives of an exercise prescription for those diagnosed and recovering from cancer Pre-chemo: build strength and endurance, improve tolerance to chemo During chemo: maintain functioning and health, reduce side effects, enhance treatment efficacy, support immune system, improve mental health Post-chemo: rebuild strength, manage prolonged side effects, reduce risk of recurrence, improve qol KEY TAKEAWAYS 45. Throughout the semester we have addressed several key points that have reemerged in just about every section of the course. Consider these key points, take home points. Be familiar with these take home points for the exam. The finger study: one group received education, another group received nutrition counseling, physical activity, cognitive training, management of risk factors. Individuals in the intense intervention cohort had a lower risk of developing chronic illnesses. 46. Reflect upon the material from KINE 3660. Think about topics that were routinely discussed as well as key components for children, adults, and aging adults with or without neuropathology. Inverted U hypothesis Meeting patients where they are Cardiovascular fitness hypothesis, motor fitness hypothesis, CV reserve hypothesis, bioenergetic hypothesis, catecholamine hypothesis