Lecture Notes Review PDF

Lecture I Notes Review individuals & who wish to further unhealthy weightgain may Minimum improve their bene fit from recommended amounts of fitness, reduce risk for chronic disease exceeding physical activity the or prevent disability Exercise Prescrip+on Review for Exam 1: aerobic s...

Lecture I Notes Review individuals & who wish to further unhealthy weightgain may Minimum improve their bene fit from recommended amounts of fitness, reduce risk for chronic disease exceeding physical activity the or prevent disability Exercise Prescrip+on Review for Exam 1: aerobic should activity be spread throughout the week 1. Describe recommenda.ons for daily level of ac.vi.es. Moderate Intensity: 150 mins/week (30 minutes 5 x week) 40-60% reserve VO2max or 150 min-300 min -> substantial health benefits reserve HR • if pt. is unable to do 30 mins at a +me, do 10-minute episodes. • strength train 2 x week • dosage rela+onship (addi+onal benefits >300 min/week of moderate) Vigorous Intensity: >60% reserve (20 minutes 3 x week) 79-190 mins • dosage rela+onship (addi+onal benefits > 150 min/week of vigorous) · combination of mod. Vig. Can be performed to meet the recommendation 2. Discuss Assessment Risk Before a Client begins an Exercise Program • Cardiac Deaths are occurring in young individuals, adults, and individuals in cardiac rehabilita+on. - self-guided method • PAR-Q+ is a form to assess the risk of performing exercise (Physical Ac+vity Readiness Ques+onnaire for Everyone) Hypertension is considered CVD risk factors not cardiac disease • ACSM physical Ac+vity Par+cipa+on Screening: Do you par+cipate in regular exercise? Do they have CVD (cardiac, peripheral vascular, cerebrovascular)? Do they have metabolic disease (DM 1 & 2)? Signs/Symptoms @ rest or during ac+vity: pain in neck, chest, jaw, arms or other areas that may result from ischemia; SOB; dizziness / syncope; orthopnea / paroxysmal nocturnal dyspnea; ankle edema; palpita+ons / tachycardia; intermi`ent claudica+on; known heart murmur; unusual fa+gue or SOB level determine currentPA with usual ac+vi+es. emailed about sis of ·identify underlying CV, metab, renal dyslipidemia Risk Factors: ind. WI these diseases identify numbers Men > 45 anitwithin mo. ·use si,hx, current exercise participation, Women >55 & desired exercise intensity to guide Smoking, sedentary <3 days/week, obesity > 30BMI, Hypertension >130/80, recommendations for medical clearance Dyslipidemia, impaired glucose control -fasting 108 family ux:myocardial infarct, coronary revascularization, sudden death before : Obesity Classes: mass (kg) / height^2 (m^2) Normal: 18.5 – 24.9 1- 30-24.9 2- 35-39.9 3- >= 40 (morbidly obese) - · · - 3. Summarize the 4 principles of training. • Overload (intensity > normal) • Specificity • Individual Differences • Reversibility à detraining, VO2Max & muscle mass decrease, about 3 weeks 4. Define and understand factors that affect res.ng metabolic rate (RMR) METà Metabolic Equivalent; mul+ple of res+ng metabolic rate. Oxygen consump+on à measures res+ng metabolic rate. RMR accounts for gender, height, weight, & age 5. Differen.ate METs and oxygen consump.on for measuring exercise capacity. MET:an index ofenergy expenditure (EE) 1 MET = 3.5 ml/kg/min NATO of rate of energy expenditure during an 1 MET = res+ng O2 consump+on to the rate of activity energy expended atrest Increased body mass needs more energy. Energy expenditure increases with intensity & dura+on of ac+vity. Sine amountof at rest energy expenditure Light PA < 3 MET Mod PA 3-6 MET (40-60% VO2max) Vigorous > 6 MET (>60% VO2max) For a given MET, some groups may be working harder at greater rela.ve level of VO2max (a 20 yr old vs 70 yr old) 6. Describe the types of graded exercise tests. of volitional fatigue individuals must exercise to Maximum tests: more accurate i which may be inappropriate point for some & require emergency equipment Bruce Protocol à dura+on 8 – 12 mins, difficult for pts with heart disease, used with more physically ac+ve individuals, large MET increments every 3 minutes. Ramp à work rate increases con+nuously, more accurate es+mates of exercise capacity, beSer for pts. With disease (increase speed un+l 3.0 mph then incline) Balke-Ware Bruce Rampà 1 min stages, more divisions TestTermination - Don’t take the HR from the caro+d artery. 50-70% HRR - Use the radial pulse on the wrist (thumb side) 10-89% age-predicted HRmax Submax tests: Rockport 1 mile: à using HR in final minute. Six-minute walk test is achieved from HR mostaccurate measure of voemax test if all of the following are followed: Steady linear exists between HR and work rate ·difference between actual and mechanical Not Max vs. ex. State HR obtained for each exercise work rate relationship Noton submaximal response to any eficiency HR using high is same for altering quantities Submaxtest:1. reason predicted maximal HR is minimal. everyone medications caffeine, ill, or high-temp environment of for test 2. risk level ofindividual 3. of availability equipment/personnel /may alter HR response) Expected Response: Abnormal Response Increase in HR 10+- bpm per MET Failure of HR to increase STOP wI* exercise intensity Systolic BP increase 10 +- mmHg per MET Peak HR > 20 bpm below age-predicted Stop if exceeds 250 mmHg HR Stop if Systolic BP drops >10 mmHg with an increase in work rate Diastolic BP no change or slight inc/dec Unable to achieve 85% of age-predicted Stop if exceeds 115 mmHg max HR Stop if BP 250/110 Recovery: < 12 beat decrease in 1st 250 115 minute the if for SBP decreases below value Systolic BP fails to increase obtained in the same position, prior to Angina cold/clammy skin testing I Shortness of breath wheezing Dizziness nausea Ataxia leqcramps Feeling faint claudication ECG Changes pallor Measure: Monitor ECG Con+nuously, record last 15 s each stage HR Con+nuously, record last 5s each min BP Record last 45s each stage, last 45s/2min RPE Record last 5s each min Gas Exchange Con+nuously - 7. Describe methods for determining the intensity of aerobic exercise. • % VO2Max à measure oxygen consump+on % VO2Reserve % Max HR à linearly related to %VO2Max • 220-age; underes+mates for younger people (less 40 yr.); overes+mates for older people (Over 40 yr.) • Gellish à 207 – (0.67 x age) • Intensity = HR Actual / HR max à inaccurate for low intensi+es / old age % HR Reserve Is lower than HRmax Rate of Perceived Exer+on (Borg Scale) Use if pt. has a heart condi.on and the HR doesn’t fluctuate as it should. 8. Summarize the factors that determine exercise prescrip.on (FITT principle) Frequency: # of +mes per day / week à take injury risk into account [ for weight loss 3.5d/W you need a greater frequency] at199st 3d/WK V16:00-89% HRR Intensity: level of effort MOD:40-59% HRR Time (dura+on): length of session [20-60 min depending on intensity] [greater risk of 20-20 min/day vig. overuse if longer than 60 min] 30-n0 min/day mod. Type (mode): specificity / specific targeted component of fitness saerobic performed in continuous a intermittent Enjoyment: that involves major muscle groups 9. Specify the ACSM recommended prescrip.on for aerobic exercise. Assess: 1. The current level of fitness 2. Stage of health/disease 3. Goals of client • Take into considera+on the pts. Skill & weight. Warm Up: 5-10 mins à low – mod Condi+oning: Aerobic / Resistance Cool-Down: 5-10 mins à low – mod Stretching: 10 mins auer warm up or cool down • Large muscle groups first Diabe.cs: monitor glucose and .ming of medica.ons As the HR drops due to training effect à increase level of intensity Intensity Ini.al VO2max Prescrip.on Low <40 30% HRR Moderate 40-51 45% HRR High 52-59 75% HRR Very High >60 90% HRR Do NOT ini.ally prescribe greater intensity than the client was assessed at! 10. Classify the stages of progression and be able to apply progression to exercise programs. Ini+alà 4 weeks, allow +me for adap+ve processes. - Start at lower intensity & shorter dura+on. - Increase dura+on 5-10 mins every 1-2 weeks. - Client Edu. - Minimal discomfort & soreness Improvement à 6 months, gradual increase in s+mulus - Progressive overload - Small increments in intensity and dura+on every week - Beware of overtraining à lack of interest, termina+ng session early, increased HR at prior work level, minor aches, and pains - Weekly training volume should not increase more than 10% - Do not progress intensity & dura.on during the same session. Maintenanceà long-term fitness - Different modes of exercise - Intensity is a greater factor than frequency and dura+on. - Can drop off in frequency and dura.on by 2/3 and maintain gains. - Cannot maintain gains by dropping off intensity. 11. Develop ini.al exercise prescrip.on for different case scenarios. Resistance Training Novice /inexperienced) F major = = muscle group 20/WK I 30-70%1RM;8-12 (muscular fitness) variety, multijoint, single joint = reps T: BORO Scale -No 7 BORG Scall CR-10 exertion extremely right - 8 a- very light 3 Somewhat hard - 5 14 13-hard (neavy) 14 17- very very weak hard 18 19-extremely 20-maximal hard exertion just noticeable weak 2-weak right 12 13 0.2-extremely I 10 11- 0-nothing light moderate strong neavy I very strong 10 extremely strong 11 absolute maximum maximal highestpossible case studies from book: risk -> CVD 130 yr old, fACTOr invited to participate in a 10km trail run 40 min. fo currently walks moderate intensity every Monday,Wean,Friday for years is to run the entire race wo stopping, and he is seeking training services. goal He reports having "mild heartattack" at45 yrs. completed cardiac rehabs no problems since. statin angiotensin-converting enzyme (ACE) Inhibitor aspirin daily 2yr) non-smoking recently male visit, wI Cardiologist since last pre-participation, whatwouldyou changes no in his medical condition do? Seek medical clearance, blc not in the last 12 months. A. physically active intensity;may to inc. continue moderate a increase after clearance B. known Cup, mera, renal disease C. Symptoms ofCVD, Meta, Renal grad is campus or 2 22 yr oldrecent college no longer walks across sedentary lifestyle. Although joining plays her BMI is slightly symptoms ofany diseases, even She would like to begin playing golf. 3 exercise:No intensity 45 yr. former collegiate requests assistance with unusually difficult deficiencies in becoming above normal, she when walking medical clearance training. run up 3 feeling His constriction strength. Upon w/ rest I he often feels STOP!! seek medical clearance 2 yr. no further diggy now significantmedical ofstairs to her flights only significantmed in his chest w/ ux. is a nx apartment. vigorous series min/day, Uday/wK overuse of injuries workouts are intensity exertion. Something he attributes questioning, he explains during recovery. that the to chest constriction is professionally led walking program. stent placed in L.ant.desc.coronary a. after a beginning a ago - drug eluting stress testrevealed significant sT-segmentdepression. in the 2 months a reports she CVD risk factor 40 yr. Woman is taking accountantl mo. ago, an necessary In recent weeks, he notes improved -> 4 core Since swimmer turnedavid lifelong triathlete who trains no shoulders andachilles. to his gym. intramural soccer and has concerns abouther and no -mod a following the cholesterol-lowering seek medical procedure buthas been She completed carcriac rehab inactive since. She reports stating antiplateletmedication as directed is vigorous clearance! currently participating in exercise, wI routine exercise sis! desired intensity no sis is by cardiologist. 3 35 yr old business consultantin town for 2 wk, seeking temporary membership atfitness Club. Shedfriends bike ride for the for a long-distance charity have been training atmod-vig intensity past lywks: to lose her She doesn'twant cholesterol-lowering takes current ofhyperlipidemia of CVD/meta, medux & mod-rig intensity; allow for - progression rig. to weekends, drinks 1-2 nights week, height (ubin, 140cm), weight on kg.m2 BM1 22 = symptoms No statin. continue to exercise Female, 21 yr. Smokes fitness. (124#,54.4Kg) RHR:TH PPM BP 118/72 = Total Cholesterol:178 (DL 98 = HDL=G2 - Negative risk factor 140 FBG:94 contraceptives. oral 2 44 min. mod-vig. Class 2-3 parents living good xwk, both Male." ker, BM1= 22.8, RHR:D2, BP:124/78, physically meds, ibuprofen active, No runs 4-7 when TU+M1=187 44 yr. Male. alwk, competes 1-2 marathons, needed nonsmoker BM1=31 nota RAR:42 1281 BP: Eihave time exercise # 2 Mother:living, no CVD no 4 medication Female, 30 ⑪ v & - teaches 47 ofheartattack health 1840 No - no negative-risk fact. dyslipidemia 54 when died 2184 injection, diagnosed& Tyr. high intensity kickboxing [Both parentsgood factor Total Cholesteroy: LDL-C:104 hotunder 10.3 Ulbpon yumoker control by insulin = negative-risk - ↳ bIC LDL 105, FB 6 = HDL-C: 44 to Father DM2-died ⑱ dystipidemia HDL=39, Father died 9 51 of heartattack Mother died & 81 of cancer 3 condition 3x/wK; wI no hx CVD] of walks mod-int Total 45 min. YXoK Cholesteroli 4