Exercising for successful Aging Flashcards

Question

Explain what leads to muscle mass decrease and the results of this. What is result of remodeling? What is the main cause of reduced strength between ages 25 and 80?

Answer 1

Muscle mass Decrease: - Motor unit remodeling represents Normal CONTINUOUS process that involves motor endplate repair and reconstruction - Remodeling leads to DENERVATION muscle atrophy which magnified by reduced physical activity, progressively Reduces muscle cross section, mass and function - Primary cause of reduced strength between ages 25 and 80 relates to a 40-50% REDUCTION in muscle mass from muscle fiber Atrophy and Loss of motor units, even among healthy, physically active adults

Answer 2

Total number of muscle fibers and cros-sectional area are DIRECTLY Related. as you have more muscle fibers, cross-sectional area Increases.

Answer 3

Resistance training for older adults - Moderate resistance training provides a SAFE way to Stimulate protein synthesis and Retention while slowing the normal and inevitable loss of muscle mass and strength with aging. - Older men who resistance train have GREATER absolute gains in muscle size and strength (due to men having greater cross-sectional area) than women, but percentage improvement is similar - A regular program of aerobic, strength, flexibility, and balance training for those 70 to 89 prevents both loss of muscle strength and increase in muscle fat infiltration - muscle responds to vigorous training with Rapid improvement into the night decade of life

Answer 4

Muscle strength increases(both extension and flexion ) progressively throughout training in Older Adults after training, older men have an increase In muscle fibers.

Answer 5

Neural function: neural function declines as we age -Aging leads to a 40% DECLINE in a spinal cord axon number and a 10% Decline in nerve conduction velocity -Changes likely contribute to age-related DECREMENT In Nueromuscular Performance -a physically active lifestyle and specific exercise training POSITIVELY affects neuromuscular functions at any age to slow age-related decline in cognitive performance.

Answer 6

- Young active have QUiCKEST simple movement | - Old active is better than young nonactive an old non-active is the worst

Answer 7

Endocrine changes - 40% of those 65 to 75 years and 50% of those > 80 have IMPAIRED Glucose Tolerance leading to type 2 diabetes - Pituitary gland DECREASES Thyrotropin release- leads to REDUCED metabolic function- decreased metabolic rate, glucose metabolism and protein synthesis.

Answer 8

Hormonal system changes due to aging: - Hypothalamic-pituriatary-gonadal axis leading to MENOPAUSE and ANDROPAUSE( men tesotrone levels drop) - Adrenal cortex leading to REDUCED Output of DHEA - Growth hormone/ Insulin-like growth factor axis leading to SOMATOPAUSE.

Answer 9

- Physical activity can lead to reduced vascular risk which leads to reduced cognitive decline/dementia - Physical activity along with reduced obesity also lead to reduced vascular risk - Reduced obesity or reduced vascular risk can lead to reduced inflammatory markers which leads to reduced cognitive decline and dementia. - reduced inflammatory marks can lead to reduced cognitive decline/dementia which lead to enhanced neuronal function - physical activity can cause enhanced neuronal function and hence reduced cognitive decline/dementia

Answer 10

in the ANTERIOR pituitary: Growth Hormone DECREASES and causes IGF-1 in Liver and tissues to Decrease (somatopause) - In the posterior pituitary- Corticotropic hormone and ACTH, have NO change, cortisol has NO change but DHEA DECREASES (Androgenopause) 3. The gonadotropic hormones (LSH/FSH) DECREASE causing estradiol in the ovaries to decrease (Menopause) and in testes, decreases Testosterone (Andropause)

Answer 11

Pulmonary function -Mechanical constraints cause Deterioration in Static and Dynamic lung function -SLOWING of pulmonary ventilation and gas exchange kinetics during translation from rest to submaximal exercise In elderly men, aerobic training INCREASES gas exchange kinetics to levels approaching values for fit young adults. -Older endurance-trained athletes demonstrate GREATER pulmonary function capacity than sedentary counterparts.

Answer 12

Cardiovascular function: - VO2 max DECLINES 1% yearly and occurs TWICE as fast in sedentary Compared to Physically active - Regular aerobic exercise CANNOT Fully Prevent age-related decline in aerobic power with aging - Exercise maximal heart rate DECLINES with age - Maximum Cardiac Output DECREASES IN trained and Untrained due to LOWER maximal heart rate and Stroke volume - Compliance of Large arteries DECLINES from changes in arterial wall properties. - DECREASED Capillary: muscle fiber ratio and Arterial Cross-section causes LOWER Blood flow to muscle

Answer 13

VO2 max DECREASES with age - Young men have the highest VO2 max levels - Older women tend have lowest VO2 max levels - those with highest VO2 max levels will have HIGHEST appendicular muscle mass.

Answer 14

Central and Peripheral Cardiovascular functions Central: 1. Heart Rate -Maximum heart rate DECLINES with age -reflects REDUCED medullary outflow of sympathetic activity (men and women) -Maximum heart rate DECLINE In athletes between age 50 and 70 is SMALLER than predicted (indicates Training effect) 2. Cardiac output -maximum cardiac output DECREASES with age in trained and untrained due to LOWER maximum heart rate and stroke volume -stroke volume DECLINE reflects combined effects of REDUCED Left Ventricular Systolic and Diastolic Myocardial performance Peripheral factors: -REDUCED Peripheral BLOOD FLOW capacity accompanies age-related decrease in muscle mass.

Answer 15

Physiologic Loss with Aging: - Sedentary and unhealthy behaviors produce LOSSES in Functional capacity as great as aging affects - Training of older person may SLOW or even Reverse decline in functional capacity - Low- and high-intensity exercise allow elderly to RETAIN cardiovascular function at higher level than sedentary counterparts. - After age 18, men and women progressively GAIN body mass and Fat until 5th or 6th decade - Bone mass DECREASES 30 to 50% in those above age 60. ; weight-bearing and resistance exercise can INCREASE BONE MASS

Answer 16

The older the age, the longer it will take to run 100-M sprint -Men run the 100 M sprint faster than women due to greater muscle mass and muscle strength. The time it takes to run 100-M sprint will increase as we age.

Answer 17

As we age most measurements of the body increases. - Waist Girth Increases as we age - Waist:Hip ratio Increases as we age - Sum of skin folds increases as we age - Percentage of body fat increases as we age - Fat-free Body Mass DECREASES as we age (when one is younger, Fat-free body mass is higher)

Answer 18

Trainability and Age - Exercise improves Physiologic responses at any age - Several factors affect magnitude of response, including initial fitness, genetics and type of training - Exercise in healthy elderly men ENHANCES heart's systolic and diastolic properties and INCREASES VO2 max to same relative extent as younger adults. - INCREASES in VO2 max for older women depend largely on Peripheral adaptations in trained muscle - Sex hormones probably INFLUENCE gender-related adaptations to endurance training.

Answer 19

Classic View of training- belief that we just Decline in training as we age Modified view- We can maintain health and fitness until we reach a certain age (curve line)

Answer 20

maintaining physical activity and fitness throughout life provides SIGNIFICANT HEALTH and LONGEVITY Benefits - Low physical fitness is a more POWERFUL Risk Factor than High blood pressure, high cholesterol , obesity and family history. - Long-term studies (ex: Harvard Alumni Study) on effects of physical activity include: - COUNTERS Life-shortening effects of Cigarette smoking and Excess weight - REDUCES death from hypertension by one Half - REDUCES genetic tendencies towards early death - DECREASES mortality rate by 50% for active men who's parents lived > or equal to 65 years.

Answer 21

Epidemiologic Evidence: - Forty-three studies of relationship between inactivity and coronary heart disease showed LACK of regular physical activity contributes to Heart Disease in a CAUSE-and-EFFECT manner - Sedentary person DOUBLES Risk of developing heart disease as most active individual - Strength of association between lack of exercise and heart disease risk equals that for high blood pressure, cigarette smoking, and high cholesterol - Light-to-moderate physical activities produce health benefits for previously sedentary middle-aged and older persons

Answer 22

Regular Moderate physical activity - Moderate activity such as walking REDUCES levels of Diabetic, hypertensive and cholesterol medications required by patients - for postemenopausal women, walking briskly for 2.5 hr per week REDUCES heart disease risk by 30% regardless of age, race or body weight - Most active women REDUCED risk by 63%.

Answer 23

Physiologic measures like Low-level of Cardiorespiratory fitness provide a strong INDEPENDENT PREDICTOR of Increased risk for Cardiovascular Disease and all-cause mortality - A Strong INVERSE ASSOCIATION exists between regular physical activity and level of aerobic fitness and All-cause mortality. - Moderate-intensity regular activity substantially REDUCES risk of dying form heart disease, cancer and other causes.

Answer 24

Trends for effects of physical activity or increased fitness on risk of chronic disease - EXCELLENT Evidence of reduced disease rates for All-cause mortality, Coronary Heart disease, Obesity, and Type 2 Diabetes with regular physical activity and increased fitness - GOOD Evidence of reduced Hypertension rates, Colon cancer and OSTEOPOROSIS with regular physical activity and increased fitness - SOME Evidence of Stroke, Breast cancer, Prostate cancer, Lung cancer with regular physical activity, and increased fitness. - There is NO apparent difference in rate of peripheral vascular disease , rectum and stomach cancer and pancreatic caner, and Osteoarthritis across activity or fitness categories (NO change in these rates based on l regular physical activity or increased fitness)

Answer 25

NO, Health- Derived Benefits from regular physical activity DO NOT require highly structured or Vigorous activity

Answer 26

Coronary Heart Disease - Involves DEGENERATIVE CHANGES in intimate or Inner lining of larger arteries that supply myocardium - Damage to arterial walls begins as a multifactorial immunologically mediated, inflammatory response to injury. - From hypertension , cigarette smoking, infection, homocysteine, elevated cholesterol, or free radicals . - Damage INITIATES complex Series of Changes that produce lesions that bulge into vessel lumen - initally take form of fatty streaks: FIRST Sign of ATHEROSCLEROSIS - vessels congests and bursts with fibrous scar tissue

Answer 27

C-reactive protein- INDICATOR of Arterial Inflammation - Half of people with Heart disease have normal or slightly elevated cholesterol; must consider other factors like C-reactive protein (CRP) in process - CRP produced in LIVER and ADIPOCYTES to help Fight Inflammation - CRP levels rise during acute and chronic reactions - Levels rise when arteries Accumulate PLAQUE - HIGH CRP also relates to hypertension (CRP increases with people who have hypertension) - Normal CRP=1.5 mg/dL; High CRP= 3.0-4.0 mg/dL

Answer 28

Vulnerable Plaque: Difficult to Detect, yet Lethal - Soft type of metabolically active Unstable plaque - Does NOT produce arterial Narrowing but tends to FISSURE and BURST resulting in CLOT Formation (THROMBUS) and subsequent Myocardial Infarction

Answer 29

Vascular Degeneration Begins Early in Life - Fatty streaks and Plaque DEVELOP rapidly during Adolescence through third decade of life - Can identify those with DEGENERATION by examining related risk variables: - Increased BMI, Elevated blood pressure, and high cholesterol, triacylglycerols, and LDL-C

Answer 30

Atherosclerosis- is a progressive occlusion (blockage) of the artery that results form build up Calcified fatty substances. These substances form plaque (containing fat, cholesterol, other substances) that obstruct blood flow.

Answer 31

Cardiovascular Disease (CVD) -Epidemic - CVD ranks as LEADING HEALTH PROBLEM and primary cause of death among Americans less than or equal to 85 years old. - In 2012, 82,600,000 individuals suffered from CVD in U.S - GREATEST PREVALENCE occurs for Hypertension and Coronary heart disease - Over 1,255,000 heart attacks yearly - About 500,000 recurrent yearly heart events

Answer 32

Modifiable and Unmodifiable Coronary Heart disease risk factors - Modifiable Factors - Diet, elevated blood lipids, Hypertension, personality and behavior patterns, cigarette smoking, high serum uric acid, sedentary lifestyle, pulmonary function abnormalities, excessive body fat, Diabetes mellitus, ECG abnormalities, tension and stress, Poor education, Elevated Homocysteine, Sleep apnea Unmodifiable Factors: -Age -Gender, -Ethnic background -Male-pattern baldness, particularly lack of hair on the crown of head; possibly from raised androgen levels Family history

Answer 33

Coronary heart disease (CHD) : Not only Male Disease: - LEADING CAUSE OF DEATH for Women in U.S.; accounted for 1 in 4 female deaths in 2009 - SAME number of females as males die form CHD - Leading cause of Death for African American and white women in the U.S. - For Hispanic women, CHD and CANCER cause EQUAL deaths each year - SECOND LEADING CAUSE OF DEATH among Native Americans, Alaska, and Pacific Islander women - CHD prevalence about: 5.8% white, 7.6% of black, 5.6% Latino women

Answer 34

Blood lipid abnormalities: Hyperlipidemia- Abnormal Blood Lipid level and a crucial component in genesis of Atherosclerosis -Approximately 30% of adults require intervention for High cholesterol -Cholesterol distribution among various lipoproteins provides a more POWERFUL PREDICTOR of heart disease risk the Total blood cholesterol -Elevated HDL-C levels relate CAUSALLY with a Lower Heart disease risk -Total Cholesterol: HDL-C ratio greater than or equal to 4.5 HIGH heart disease risk; ratio of less than or equal to 3.5 desirable risk

Answer 35

``` Total cholesterol -200-239: Borderline High - > or equal to 240- HIGH HDL: cholesterol -less than 4O: Major risk for CHD LDL: cholesterol -130-159- Borderline High -160-189- HIGH - > 190 - VERY HIGH Triacylglycerol: -150-199 : Borderline High -200-499 - HIGH - > 500- Very High ```

Answer 36

Behaviors that FAVORABLY affect cholesterol and lipoprotein levels : - Weight loss - Regular aerobic exercise - Increased dietary intake of water-soluble fibers - Increased intake of polyunsaturated-to-saturated fatty acid ratio and monounsaturated fatty acids - Increased Dietary intake of Omega-3 fatty acids and elimination of trans fatty acids - Moderate alcohol consumption

Answer 37

Variables that Adversely (unfavorably) affect cholesterol and Lipoprotein levels; - Cigarette smoking - Diet high in saturated fatty acids and preformed cholesterol and Trans fatty acids - Emotionally stressful situations - Oral Contraceptives

Answer 38

Specific Exercise Effects on Cholesterol: - Short-term effects - A single exercise session produces only Transient changes in lipid and apolipoprotein concentrations - Long-Term effects - Exercising regularly produces SMALL reductions in LDL - Exercise DURATION exerts the GREATEST positive effect on HDL while exercise Intensity favorably modifies Blood pressure and waist girth. - Standard resistance training exerts Little or NO EFFECT on triacylglycerol, cholesterol or lipoproteins

Answer 39

An immune response likely TRIGGERS PLAQUE DEVELOPMENT within arterial walls -Regular physical activity may STIMULATE the immune system to INHIBIT agents that facilitate arterial disease

Answer 40

Homocysteine: - Highly reactive, Sulfur-containing amino acid, forms as byproduct of Methionine metabolism - High levels related to arterial or venous thrombosis by age 30 - LOCKSTEP ASSOCIATION (linear relationship) between homocysteine and heart attack and mortality in men and women.

Answer 41

Homocysteine mechanism: 1. Protein-rich foods contain an amino acid, methionine, that converts to homocysteine 2. Excess homocysteine levels damage the lining of arteries 3. cholesterol builds up inside the scarred arteries, which leads to fatal blockages (cut of blood flow) Proposed DEFENSE: -Vitamins in fresh foods and dietary supplements CATABOLIZE homocysteine -vitamin B12- meat, fish and dairy products Vitamin B6, - green leaf, vegetables, poultry, nuts, whole grain cereal, fish -Folic acid- green leafy vegetables, fruits, organs juice, wheat germ, dried beans and peas

Answer 42

One risk Factor: 45 year old man's chance of heart risk DOUBLES risk vs man without risk factors With Three risk factors, chance for angina, heart attack or sudden death INCREASES 10-fold. Regular physical activity exerts POSITIVE Influence on obesity, hypertension, type 2 diabetes, stress, and elevated blood lipid profile

Answer 43

SMOKING is the single most important, modifiable and preventable cardiovascular disease risk factor: one of the STRONGEST predictors of premature CHD

Answer 44

Regular physical activity exerts POSITIVE Influence on obesity, hypertension, type 2 diabetes, stress, and elevated blood lipid profile

Answer 45

The greater the number of CHD risk factors, the LARGER the CHD incidence per 100,000 persons

Answer 46

Risk factors in children: - Risk factors assessed in childhood associated with THICKNESS of Carotid Artery later in life - Fatter children usually have HIGHER levels of cholesterol and Triacylglycerol - Childhood adiposity INCREASES heart disease morbidity and mortality in adulthood. - A supervised program of moderate food restriction and physical activity with behavior modification REDUCES Heart disease risk in Obese adolescents.

Answer 47

For pre-treatment- there were MORE risk factors | with post-treatment, there is a reduction in risk factors.

Answer 48

Calculating CHD Risk -Risk inventories assess susceptibility to CHD -Framing Risk Score- considers age, gender, smoking status, total cholesterol, HDL cholesterol, systolic blood pressure and diabetes -European SCORE- estimates a 10-year risk of FATAL cardiovascular disease in European nation in primary prvention; includes age, gender, total cholesterol, systolic blood pressure, and smoking status -The AHA assesses the risk profile by determining numerical value that best describes a person's status -

Answer 49

Summary 1. Physical activity evaluates nature, extent, and demographics of exercise participation 2. Only 10 to 15% adults in U.S. obtain enough regular physical activity for health benefits 3. Healthy people 2020 attempts to achieve new health goals for U. S. citizens 4. Prehabilitation, particular among older adults, that emphasizes core strengthening and training can REDUCE injury from exercise. 5. Physical inactivity promotes Unhealthy gene expression 6. Increasing regular physical activity should become TOP public health prioritiy 7. Physiologic and performance capability usually declines after age 30 8. Biologic: Aging relates to changes in 3 hormonal system; Hypothalmaic-pituitary-goandal axis. 9. Four important factors to evaluate physiologic and performance differences, between children and adults: Exercise economy, FFM (fat-free mass) and anaerobic power, and anabolic hormones insulin 10. Primary cause of age-associated reduction in muscle strength is 40 to 50% reduction in muscle mass from a loss of motor units and muscle fiber atrophy 11. considerable plasticity exists in physiologic, structural and performance characteristics among older individuals 12. Physically active lifestyle affects neurotransmitter - 13. VO2 max declines 1% a fat, for men and women 14. Physically active Older men and women have higher VO2 max than sedentary peers 15. Sedentary living cause functional capacity losses at least as a great 16. Regular physical activity improves physiologic function at any age 17. Active older athletes average at least 20% less fat and 20% more Fat free mass than nonathletic lifestyle. - 18. Vigorous physical activity and early in life contributes little to increased longevity or health in later life. 19. Physically active lifestyle throughout life confers significant health benefits.

Answer 50

Continuation of summary 20. Regular, moderate physical activity counters the life shortening effects of heart disease risks that include cigarette smoking and excess body weight 21. Sedentary person runs almost twice the risk of developing heart disease as the most active individuals. 22. The risk of CHD form sedentary living equals that for hypertension,Cigarette smoking, and high serum cholesterol 23. The life-protecting benefits of physical activity relate more to preventing early mortality than extending overall life span 24. Regular, moderate physical activity substantially reduces risk of dying from heart disease, cancer and other medically related maladies 25. Greatest health benefits emerge when a person alters a sedentary lifestyle and becomes just moderately physically active 26. Regular, moderate physical activity counters the life-shortening effects of heart disease risks such as cigarette smoking, and excess body weight 27. CHD is most Prevalent cause of death in western world 28. Major CHD risk factors include: age, gender, blood, lipid abnormalities, hypertension, smoking, obesity, inactivity, diet, family history, ECG abnormalities during rest and exercise 29. Chronic low-grade arterial inflammation is major trigger for heart attack 30. Desirable: cholesterol value is less than or equal to 200 mg/DL

Answer 51

31. Distribution of HDL-C and LDL-C provides a more powerful predictor of heart disease than Total cholesterol 32. LDL-C participates in atherosclerosis by stimulating monocyte-macrophage infiltration 33. HDL-C facilitates reverse cholesterol transport 34. Increased physical activity favorably alters HDL-C 35. Homocysteine exerts a powerful independent CHD risk 36. Dietary fiber prevents hyperinsulinemia 37. Cigarette smoking doubles risk of heart disease compared to nonsmokers 38. Sedentary lifestyle doubles the risk of Fatal heart attack 39. Interaction of heart disease risk factors magnifies there individual effects 40. Nutrition, physical Activity, and weight control favorably alter heart disease risk and usually improve one's health profile

Answer 52

Clinical Exercise Physiologist (CEP)- has become an integral component in TEAM APPROACH to patient care In the clinical setting, the CEP focuses on RESTORING patient mobility and functional capacity. -SPORTS MEDICINE closely links to clinical exercise physiology

Answer 53

1. Cardiovascular Diseases/Disorders- ischemia. chronic heart failure, cardiomyopathies, 2. Pulmonary Diseases/Disorders- COPD, cystic fibrosis, Asthma and exercise-induced asthma 3. Neuromuscular Disease/Disorder- Stroke, multiple sclerosis, Parkinson's disease an Alzheimer's disease 4. Metabolic diseases/Disorder- Obesity, diabetes, renal disease 5. Immunologic and hematologic disease/disorder- immune deficiency; Allergies, sickle cell disease, HIV/AIDS 6. Orthopedic Diseases and Disorders- Osteoporosis; osteoarthritis and rheumatoid arthritis; Back pain 7. Aging: sarcopenia 8. Cognitive and Emotional Disorder: Anxiety and stress disorders; mental retardation, depression

Answer 54

Regular Physical Activity; protective Effects on Cancer Occurrence - LOWERS circulating levels of blood glucose and insulin - INCREASES anti-inflammatory cytokines - INCREASES Corticosteroid hormones - AUGMENTS insulin-receptor expression in cancer fighting T cells - PROMOTES Interferon production - STIMULATES glycogen synthesis - ENHANCES leukocyte function - IMPROVES ascorbic acid metabolism - EXERTS beneficial effects on provirus or oncogene activation

Answer 55

cancer patients receive a SYMPTOM-LIMITED GXT to form their exercise prescription. GXT (graded exercise testing) - Procedure is the same as for healthy individuals except GREATER Attention to sensations of fatigue - Prescription recommendations include symptom-limited progressive and individualized physical activity - AMBULATION (movement of body) of any kind as soon as possible - Intervals of LOW-to MODERATE aerobic physical activity performed several times daily - ROM (range of motion) and other exercise to improve muscular strength, augment FFM (fat free mass) and improve mobility

Answer 56

Most studies of physical activity for cancer patients demonstrate physiologic and psychologic benefits -effects of 10 weeks of moderate aerobic exercise on depression, trait and state anxiety in women recovering from breast cancer surgery. Before exercise- depression, and anxiety (trait and state anxiety) were high after exercise- depression levels, state and trait anxiety levels DECREASED State anxiety- induced by a situation (ex: time of diagnosis of cancer can cause depression or high anxiety to occur ) Trait anxiety- occurs on a daily bias; happens to someone who already had anxiety initially and has added more anxiety after cancer diagnosis

Answer 57

Designing aerobic exercise programs for cardiac patients should consider : - Specific Pathophysiology of the disease - Mechanisms that may LIMIT exercise performance - INDIVIDUAL DIFFERENCES in functional capacity.

Answer 58

Terms to indicate myocardial disease: Degenerative Heart disease (DHD); ATHEROSCLEROTIC Cardiovascular disease, arteriosclerotic cardiovascular disease, coronary artery disease (CAD) or coronary heart disease (CHD)

Answer 59

Diseases affecting the Heart Muscle: -CHD, Angina, Myocardial Infarction, Pericarditis, Congestive heart failure, Aneurysms Diseases affecting the Heart Valves- -Rheumatic fever, Endocarditis, Mitral valve prolapse, congenital deformations Diseases Affecting the Cardiac Nervous System -Arrhythmias -Tachycardia -Bradycardia

Answer 60

HIGHER percentage of hypertension for African Americans compared to whites -also hypertension is increased in males compared to females. High percentage of hypertension in black males and females -as you age, higher rate of hypertension for black females

Answer 61

Regular physical Activity and Hypertension - Systolic and Diastolic blood pressure DECREASES from 6 to 10 mm Hg with aerobic physical activity in previously sedentary individuals. - Regular physical activity controls tendency for blood pressure increase over time in those at risk - Precise way physical activity LOWERS blood pressure is unclear, but contributing factors include: - REDUCED sympathetic nervous system activity and possible normalization of arteriole morphology decreases peripheral resistance to blood flow - ALTERED renal function facilitates kidneys' elimination of sodium, which reduces fluid volume

Answer 62

Changes in resting blood pressure; -During 1 month of detraining blood pressure of individuals were HIGH after 3 to 6 weeks of training , there was a DECREASE in ALL levels of Blood pressure. -Decrease in systolic blood pressure, Mean blood pressure and diastolic blood pressure

Answer 63

Noninvasive Physiologic Tests -ECHOCARDIOGRAPHY: pulses of reflected ultrasound assess functional and structural characteristics of myocardium -used to diagnose heart murmurs, evaluate valvular lesions, quantify congenital defects and myopathies Ultrafast CT scan: 10 mins, noninvasive test that uses rapid electron beam computed tomographic scan to assess calcium deposition within plaque in coronary artery linings -Determines how aggressively to treat blood lipid abnormalities and other CHD risk factors.

Answer 64

Graded Exercise Stress Testing (GXT) : - EVALUATES cardiac function under conditions that exceed resting requirements in defined, progressive exercise increments to increase myocardial workload. - OBJECTIFIES functional capacity of patients with known disease and evaluates progress following surgery or other therapeutic interventions - Cardiologist and exercise physiologist supervise GXT, interpret data, and prescribe exercise intervention

Answer 65

Congestive Heart Failure (CHF)- Heart failures to pump adequately to meet needs primary causes include: -NARROWED arteries form CHD -past MI with necrosis -Chronic HYPERTENSION -Heart valve disease form past RHEUMATIC FEVER -Intrinsic myocardial DISEASE -CARDIONMYOPATHY -CONGENITAL defects -Infected heart valves (endocarditis, myocarditis)

Answer 66

For CHF (congestive heart failure) patients who contract before age 60, about 20% die within 1 year of diagnosis; nearly half die within 5 years - after the year 2000s, the number of deaths have increased - At age 55-64 those with congestive heart failure increased for men - after age 65, CHF rates are Equal for men and women

Answer 67

Graded exercise stress testing: - Graded multistage bicycle and treadmill tests - include several levels of 3 to 5 min submaximal effort to a volitional end point - Graded test permits intensity increase in small increments to pinpoint ischemia and rhythm disorders - In heart disease GXT provides reliable, quantitative index of person's functional impairment (cardiac) - GXT cannot show extent of CHD or specific location.

Answer 68

Four purposes for the use of exercise testing: 1. ECG observations (look for arrhythmias) 2. EVALUATE patients with Exertional discomfort (indicator of angina) 3. DETERMINE pharmacological and therapeutic treatment strategies 4. EVALUATE physiologic adjustments to increasing metabolic demands to objectify physical activity recommendations

Answer 69

Six functions in CHD evaluation: 1. DIAGNOSE overt heart disease and screens for "silent" CHD in seemingly healthy adults 2. ASSESS exercise- related chest symptoms 3. SCREEN candidates for entry into preventive and cardiac rehabilitative programs 4. UNCOVER abnormal blood pressure responses 5. MONITOR value of therapeutic interventions to improve hear disease status and cardiovascular function 6. QUANTIFY functional aerobic capacity

Answer 70

Those who require Stress testing (ACSM Recommendations) : High risk : individuals with one sign/symptoms of cardiovascular or pulmonary disease or know cardiovascular or pulmonary, or metabolic disease (COPD< asthma, cystic fibrosis, thyroid disorder, renal or liver) -medical examination and GXT, along with MD supervision recommend moderate exercise or vigorous exercise -Moderate risk Men with HDL-C <45 mg dL: moderate exercise not necessary Women with HDL-C < 55 mg dL : recommended vigorous exercise Low risk: Men < 45 years: moderate exercise not necessary Women < 55 years; asymptomatic ;with less than 1 risk factor; moderate exercise not necessary

Answer 71

Stress Test protocols: Treadmill Tests - CHOICE of specific exercise test should consider overall health, age, and the person's fitness status - Total DURATION should average about 8 minutes - Longer than 15 mins adds LITTLE additional information

Answer 72

BOTH Bruce and Blake Treadmill tests begin at moderately-high levels of exercise for cardiac patients and older individuals so may need Modification - Bruce test provides more ABRUPT INCREASES in exercise intensity between stages, which may improve sensitivity to detect ischemic ECG responses - Bruce protocol incorporates LOWER initial exercise levels - Balke has 2 to 3 min initial stage at 2 mph, O% grade

Answer 73

Stress Test protocols: Bicycle Ergometer Tests -Portable, safe, inexpensive and power output is easy to compute and INDEPENDENT of BODY WEIGHT -two types of ergometers -ELECTRICALLY BRAKED -preselected power input that remains fixed within range of RPMs -WEIGHT-LOADED, friction-type -Weight-loaded power output relates directly to FRICTIONAL RESISTANCE and PEDALING RATE. Guidelines for treadmill testing APPLY to bicycle tests: 2 to 4 min stages with initial resistance between 0 and 15 to 30 watts -increases in 15 to 30 watt increments per stage, at 50 to 60 RPM

Answer 74

Arm-Crank Ergometer Tests -Application for GXT in special situations and DISABLED individuals -Arm exercise LOWERS VO2 max by 30%, and maximum heart rate average 10 to 15 bpm lower than treadmill or bicycle exercise; BLOOD PRESSURE DIFFICULT to measure -Submaximal arm cranking produces HIGHER blood pressure, heart rate and oxygen consumption values at same power output with legs The arm-crank ergometer have protocols SIMILAR to leg cycling tests -Initial resistance remains lower in arm exercise with SMALLER increments in adjusted power inputs

Answer 75

Stress Testing Safety - Depends on knowing who NOT to test, knowing when to TERMINATE test and preparing for emergency - RISK-Benefit ratio favors GXT testing as part of medical evaluation process - Risk of death: < or equal to 0.01% - Risk of an acute MI: less than or equal to 0.04% - Risk of complications that require hospitalization, including acute MI or serious arrhythmias: less than or equal to 0.2%

Answer 76

Improvements in CHD patients: -Properly PRESCRIBED and monitored exercise safely IMPROVES patient's functional capacity Clinical symptoms IMPROVE or DISAPPEAR from structural and functional changes in myocardium -Cardiac patients respond to exercise training with physiologic adjustments that Reduce cardiac work at any given external exercise load -REDUCED exercise heart rate and blood pressure -REDUCED rate pressure product delays onset of angina or Greater intensity and duration of activity.

Answer 77

Resistance exercise benefits: - Resistance exercises with normal cardiac rehabilitation, RESTORES strength, PRESERVES FFM (fat-free mass) , IMPROVES psychologic status and quality of life, INCREASES glucose tolerance and insulin sensitivity - Combining resistance and aerobic training YIELDS more pronounced Physiologic ADAPTATIONS in CHD patients than AEROBIC training alone

Answer 78

-CONTRAINDICATIONS: Unstable angina; uncontrolled arrhythmias, left ventricular outflow obstruction, recent history of CHF (congestive Heart failure ); severe valvular disease, hypertension, poor left ventricular function and exercise capacity (less than or equal to 5 METs with anginal symptoms or ischemic S-T- Segment depression)

Answer 79

Resistance training prescription - Cardiac patients: Light resistance with elastic bands, light cuff and hand weights, light free weights, and wall pulleys - NO resistance training until 2 to 3 week post-MI - Introduce barbells and or weight machines after 4 to 6 weeks convalescence - Peform 1 set 10 to 15 reps with RPE of 11 to 14 using 8 to 10 different exercises, 2 to 3 days a week.

Answer 80

Cardiac Rehabilitation - Focuses on IMPROVING longevity and quality of life, plus risk factor modification - A SUCCESSFUL cardiac rehabilitation program includes: 1. APPROPRIATE patient selection 2. CONCURRENT medical, surgical and pharmalogic therapies 3. COMPREHENSIVE patient education 4. APPROPRIATE exercise prescription 5. CAREFUL patient monitoring during rehabilitation

Answer 81

Inpatient Cardiac Programs - Focuses on Four objectives: 1. Medical SURVEILLANCE 2. IDENTIFICATION of patients with significant impairments before discharge 3. RAPID patient return to daily activities 4. PREPARATION of patient and family to optimize recovery upon discharge - physical activity during the first 48 hr post MI/ and or Cardiac surgery restricted to self-care movements; then sit and stand without assistance, perform self-care activities, and walk independently up to 6 times a day.

Answer 82

Outpatient Rehabilitation programs - Four goals: 1. MONITOR to detect changes in clinical status 2. RETURN to premorbid/vocational/recreational activities 3. ASSIST in at-home, unsupervised exercise program 4. PROVIDE family support and education - Most sites encourage MULTIPLE physical activity (resistance exercise, Walking, cycling, and swimming) - SUPERVISION includes those trained in CPR, Advanced life support, and home defibrillators.

Answer 83

Pulmonary Diseases: classify as either OBSTRUCTIVE (normal airflow impeded) or RESTRICTIVE (Lung volume dimensions reduced) 1. Chronic Obstructive pulmonary disorder (COPD) -comprises respiratory tract diseases that obstruct airflow (ex: emphysema, asthma, and chronic bronchitis) 2. Restrictive Lung Dysfunction -Abnormal Reduction in pulmonary ventilation which diminished lung expansion, decreased TV (tidal volume) , and Loss of functioning alveolar-capillary units (not optimizing gas exchange)

Answer 84

Chronic bronchitis- long-term inflammation (swelling) of the bronchi (occurs when airways in lungs are inflamed) - when airways are irritated and inflamed, mucus forms which makes it harder to breathe and the body does not take in enough oxygen. This causes cynaosis, which leads to one's skin and lips to turn blue (hence blue boater) - Characteristic Emphysemic "BARREL CHEST" (where there is increased anterior-posterior chest diameter). This arises due to lung being filled with too much air and air being trapped in lungs, causing lungs to inflate like a ballon and expands the ribs.

Answer 85

Pneumonia- fluid and blood cells in alveoli, and alveolar walls are thickened by edema Emphysema- Alveolar membrane's breakdown and NO gas exchange occurs.

Answer 86

Clinical signs and symptoms of cystic fibrosis: Early stage- clinical signs and symptoms of cystic fibrosis: -persistent cough and wheezing -Recurrent pneumonia -Excessive appetite but poor weight gain -Salty skin or sweat -Bulky, foul-smelling stools (undigested lipids) Late-Stage clinical signs and symptoms of cystic fibrosis with pulmonary involvement -tachypnea (rapid breathing) -sustained chronic cough with mucus production on vomiting -Barrel chest -cyanosis and digital clubbing -exertional dyspnea with decreased exercise capacity -pneumothorax -Right Heart failure secondary to pulmonary hypertension

Answer 87

Typical response to Asthma Attack: Early response in asthma: -Air passage becomes smaller from bronchial spams and edema (cannot get air in, and passage for air flow is reduced_ Late response in asthma -Greater inflammation, increases bronchial constriction, mucus secretion and edema (no passage for air to go in, causing difficulty breathing)

Answer 88

Major goals for pulmonary rehabilitation: 1. IMPROVE health status 2. IMPROVE respiratory symptoms 3. RECOGNIZE signs that require medical intervention 4. DECREASE frequency, severity of respiratory problems 5. MAXIMIZE arterial O2, saturation and CO2 elimination 6. ENHANCE daily functional capacity 7. MODIFY body composition to help functional capacity 8. OPTIMIZE nutritional status

Answer 89

Pulmonary Rehabilitation Exercise prescription - Pretraining GXT and spirometric analyses FORM BASIS for exercise prescription - INTERPRETATION of GXT includes 1. Whether test TERMINATED because of cardiovascular or ventilatory end points 2. DIFFERENCE between pre-and post exercise pulmonary function (look at improvements ) 3. NEED for supplemental oxygen during exercise

Answer 90

Dyspnea- difficult or labored breathing that aren't due to underlying disease -Dyspnea scale - a way to describe the shortness of breath one feels while exercising to monitor dyspnea , it requires assessment by perceived Dyspnea scale

Answer 91

Benefits of warm-up and modification -Fifteen to 30 min light-to moderate, continuous warm-up intervals initiate refractory period where subsequent intense exercise DOES NOT trigger severe bronchoconstrictive response -EFFECTIVE pre-exercise medications: bronchodilators and inhaled heparin therapy, anti-inflammatory corticosteroids or cromolyn sodium Training INCREASES pulmonary airflow reserve and REDUCES ventilatory work by potentiating exercise bronchodilation to let asthmatics maintain HIGHER airflow and SUSTAIN intense exercise despite impaired pulmonary function

Answer 92

Stroke, Multiple sclerosis, and Parkinson Disease

Answer 93

Stroke: -POTENTIALLY fatal reduction in brain's blood flow resulting from ischemia or hemorrhage Effects include motor and sensory impairment and language, perception, and affective and cognitive dysfunction Exercise prescription: - EMPHASIZES rehabilitation of movement (passive and active- assisted flexibility and muscle strength) during first 6 months of recovery.

Answer 94

Multiple Sclerosis: - CHRONIC disease characterized by destruction of myelin sheath surrounding nerve fibers - Exercise prescription - INVOLVES aerobic, strength, balance coordination, and flexibility exercises - Ideal exercise CONSISTS of walking in climate-controlled area providing stable temperature, level surface, opportunity to rest frequently - Training 3 times weekly; minimum 30 min per session in 10 min periods

Answer 95

Parkinson's disease -Motor system DISORDER from loss of Dopamine-producing brain cells -CLINICAL symptoms include tremor, bradykinesia (slowness of movement) rigidity, impaired postural reflexes -produces extreme gait/postural instability Exercise prescription -INDIVIDUALIZED, directed toward interventions that affect associated motor control problems; emphasizes slow, controlled movements for specific tasks while lying, sitting, standing, walking.

Answer 96

Chronic renal disease- Kidneys no longer carry out filtering functions -symptoms referred to as UREMIA (retention in body of waste products normally excreted in urine) -Chronic UREMIA progresses to end-stage renal disease (kidney failure) , requiring life-long dialysis or transplant Exercise prescription: -LOW-LEVEL Endurance training lowers muscle protein degradation in renal insufficiency (lower amino acid breakdown) ; lowers resting blood pressure in hemodialysis and improves aerobic capacity

Answer 97

Cognitive/Emotional Diseases and Disorders: - Twenty-six percent of U.S. adults suffer from a diagnosable mental disorder in a given year - Four of the 10 leading causes of disability in U.S - MENTAL DISORDERS - Depression, bipolar disorder, schizophrenia, obsessive-compulsive disorder

Answer 98

5 main classifications: 1. MAJOR DEPRESSIVE DISORDER: referred to as depression 2. DYSTHYMIA- mildly depressed on most days 3. SEASONAL AFFECTIVE DISORDER- recurrence of depression during certain seasons (winter) 4. POSTPARTUM DEPRESSION- occurs in the first few months after delivery 5. BIPOLAR DISORDER: previously termed manic-depressive illness; characterized by extremes in mood and behavior

Answer 99

Depression has NO SINGLE CAUSE, but often results from a combination of factors: FAMILY situation PESSIMISTIC personality HEALTH status -OTHER Psychologic disorders (the more chronically ill someone is, the more likely they will have depression)

Answer 100

Common signs/symptoms of Depression: 1. Loss of enjoyment from things that were once pleasurable 2. Loss of energy 3. Feelings of hopelessness or worthlessness 4. Difficulty concentrating 5. Difficulty making decisions 6. Insomnia or excessive sleep 7. Stomachache and digestive problems 8. Decreased sex drive 9. Aches and pains (ex: recurrent headaches) 10. Change in appetite causing weight loss or gain 11. Thoughts of death or suicide 12. Attempting suicide

Answer 101

Exercise prescription in Clinically Depressed individuals; - ANTICIPATE barriers - KEEP expectations realistic - DESIGN a feasible plan - ACCENTUATE pleasurable aspects - INCLUDE group activities - ENCOURAGE compliance - INTEGRATE exercise with other treatments

Exercising for successful Aging Flashcards

(125 cards)