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Ex Phys > Chapter 17/21: Exercise for Special Populations COPY > Flashcards

Chapter 17/21: Exercise for Special Populations COPY Flashcards

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1
Q

signs and symptoms of diabetes

A

polydipsia, polyuria, unexplained weight loss, infections and cuts slow to heal, blurry vision, fatigue

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2
Q

for type 1 diabetics, what happens if they do not inject adequate insulin before exercise?

A

show in increase in plasma glucose

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3
Q

effects of normal insulin levels on liver glucose release, glucose uptake by muscle, and BG levels

A

increased liver glucose release, increase glucose uptake by muscle, BG levels remain constant

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4
Q

effects of hypoinsulinemia on liver glucose release, glucose uptake by muscle, and BG levels

A

increased glucose release from liver, less of an increase of glucose uptake my muscles, so BG levels increase

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5
Q

effects of hyperinsulinemia on liver glucose release, glucose uptake by muscle, and BG levels

A

increased glucose uptake by muscles, less of an increase in liver glucose release, leading to decreased BG levels

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6
Q

major concern for type 1 diabetics during exercise

A

hypoglycemia, may result in insulin shock

GLUT 4 receptors increase; if normal insulin injections too this could cause a major drop in BG

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7
Q

what lowers the odds of exercise-induced hypoglycemia?

A

regular exercise schedule

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8
Q

Explain why exercise might complicate the life of a person with type 1 diabetes, while being
a recommended and primary part of a program with someone with type 2 diabetes

A

Exercise for type 1 will drop blood glucose via glut 4 translocation and if this is in conjunction with insulin injections, they run the risk of hypoglycemia

For type 2 the main issue is insulin resistance, so glut 4 translocation helps reduce resistance and control blood glucose

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9
Q

How a person with diabetes responds to exercise when blood glucose is “in control”
compared to when it is not.

A

ketone bodies would stay at a level just above normal vs. dramatically increases

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10
Q

at what fasting glucose level should a type 1 diabetic avoid exercising?

A

fasting glucose > 300 mg/dl

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11
Q

when should a type 1 diabetic ingest carbs?

A

glucose < 100 mg/dl

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12
Q

where should the insulin injection site be for type 1 diabetics?

A

away from working muscle to prevent increased rate of uptake and hypoglycemia

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13
Q

relationship between exercise and type 2 diabetes

A

exercise is a primary treatment (treats obesity, helps control BG and reduce insulin resistance, helps treat CVD risk factors)

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14
Q

can a combo of diet and exercise eliminate need for diabetic drugs for type 2 diabetics?

A

yes

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15
Q

how does exercise improve glucose uptake?

A

muscle contraction causes translocation of GLUT-4 transporters to the cell surface

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16
Q

describe how blood glucose and insulin levels change in type 2 diabetics when they exercise vs not exercising

A

type 2 diabetics who exercise show a decrease in blood glucose levels with less of a spike in insulin compared to diabetics who don’t exercise (during an OGTT)
* became more insulin sensitive

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17
Q

different ways airway is restricted in asthma

A

1) contraction of smooth muscle of airways
2) swelling of mucosal cells
3) hypersecretion of mucus

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18
Q

how is asthma diagnosed?

A

using pulmonary-function testing which assesses vital capacity and forced expiratory volume

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19
Q

define vital capacity

A

maximal volume of air expelled after maximum inhalation

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20
Q

define forced expiratory volume

A

volume of air expired in 1 second during maximal expiration

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21
Q

asthma triggers

A

allergens, exercise, stress, cool/dry climates

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22
Q

describe the asthma response to triggers

A

plasma cells produce IgE antibodies which attach to mast calls lining bronchial tube —> mast cells release inflammatory mediators

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23
Q

what is exercise-induced asthma caused by?

A

cooling and drying of respiratory tract which triggers release of chemical mediators and airway narrowing

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24
Q

if properly controlled, does EIA impair performance?

A

no

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25
how is EIA diagnosed?
strenuous running at 85-90% of max HR, if forced expiratory volume (FEV) decreases by 10% or more, EIA is indicated
26
why is there less of a decrease in FEV for asthmatic-swimming compared to asthmatic-running or cycling?
Breathing in humid air = no drying
27
strategies for preventing an asthma attack during exercise
1) warmup (15 mins at 60% of VO2max) 2) performance short-duration exercise 3) use a mask or face mask in cold weather
28
treatment of EIA
B2-agonist in case of attack during exercise, or other medications * B2-agonist causes smooth muscle relaxaton and vasoodilation = increasing airways
29
how do B2-agonists affect performance?
inhaled B2-agonists do not improve performance (too low of a dose) but ingested salbutamol (B2-agonists) does improve strength, anaerobic power, and endurance (10-20x inhaled dose)
30
normal BP
systolic < 120 **and** diastolic < 80
31
elevated BP
systolic between 120-129 **and** diastolic < 80
32
stage 1 hypertension
systolic 130-139 **or** diastolic 80-89
33
stage 2 hypertension
systolic > 140 **or** diastolic > 90
34
prevalence of hypertension
1/3 of U.S adults, and prevalence increases with age
35
how does hypertension affect vascular endothelium?
hypertension damages the endothelium, which predisposes the individual to atherosclerosis and other vascular pathologies
36
how does hypertension affect afterload?
increases afterload which leads to left ventricular hypertrophy, which is an important cause of heart failure
37
nonpharmacological treatments for hypertension
lose weight, limit alcohol intake, reduce sodium intake, eat diet rich in fruits and veggies, stop smoking, exercise
38
recommended exercise prescriptions for those with hypertension
frequency: aerobic exercise on most, if not all, days of the week (dont want resistance = spike in bp) intensity: moderate duration: 30-60 mins of continuous or intermittent (min of 10 min bouts) aerobic activity mode: primarily aerobic exercise supplemented by resistance exercise
39
how does strength change with exercise in children? what does the extent of muscular development depend on?
increases as muscle mass increases with age, the extent of muscular development depends on relative maturation of the nervous system (need signals to continue muscle growth)
40
how is thermoregulation different for children?
children have increased surface area:mass ratio so they have **greater conductive** heat loss and gain, they also have **less evaporative** heat loss leading to a **slower heat acclimation**
41
how is blood pressure different in children?
lower resting and submax blood pressure than adults (relative to body size), they have smaller hearts and lower peripheral resistance during exercise
42
how are heart rate & stoke volume different in children? what affect does this have on cardiac output?
higher HR, which **almost** compensates for the lower SV (smaller heart and lower BV), which results in a slightly lower cardiac output than an adult
43
how do children compensate for the slightly lower cardiac output?
a-vO2 difference increases to compensate and maintain oxygen consumption
44
how does absolute VO2 max change with age in boys and girls?
increases with age
45
how does relative VO2 max change with age for boys and girls?
relative VO2max remains steady with boys, but decreases with age for girls * boys produce more testosterone —> encourages lean muscle mass (which consumes more O2) * females produces estrogen which encourages more fat mass (doesn't consume oxygen)
46
how does lung function change with age in children?
lung volume and peak flow rate increase with age
47
how does children’s economy differ from adults?
child’s O2 consumption per kilogram is greater than adults (bad economy), but with age, skills improved and stride lengthens
48
how does endurance running pace change in children with age? why? occurs regardless of what?
endurance running pace increases with age because of better economy of effort, regardless of VO2 max changes or training status
49
how does anaerobic performance in children compare to in adults?
children limited in anaerobic performance because of low muscle mass
50
how does the glycolytic capacity in children compare to that in adults?
children have a lower glycolytic capacity (less muscle glycogen, less glycolytic enzyme activity, and lower blood lactate)
51
how do the resting stores of ATP-PCr compare in children and adults?
similar in children and adults
52
pros and cons of strength training in children
historically controversial with concerns about damage to articular cartilage, epiphyseal growth plate, and muscle-tendon insertion but, weight lifting is safe when proper technique and can promote muscular strength and bone density
53
2 physiological adaptations children experience with aerobic training
1) improvement in VO2 max - similar to adults 2) performance increases due to improved running economy
54
3 physiological adaptations in children due to anaerobic training
1) higher resting PCr, ATP, glycogen 2) higher PFK activity 3) higher maximal blood lactate | same adaptations as adults
55
how does early specialization in one sport affect lifelong fitness?
reduces the “fun” physical activities, which leads to reduced lifelong physical activity
56
cause of sudden cardiac death during exercise in young adults
congenital heart defects, **not exercise** **Abnormal, lethal heart rhythms**
57
females’ responses to training are similar to males, with one exception, what is the exception?
thermoregulation is impaired during the luteal phase of menstrual cycle (due to increased basal temp)
58
athletic amenorrhea ## Footnote incidence of amenorrhea in female athletes versus the general population
cessation of menstruation * 12-69% of female athletes * 3% in general populations
59
3 potential causes of athletic amenorrhea
1) amount of training: linear relationship - greater miles of running = greater incidence of amenorrhea 2) psychological stress 3) low energy availability
60
describe anorexia nervosa
extreme steps to reduce body weight (starvation, exercise, laxative use) which causes excessive weight loss, amenorrhea, and even death
61
why would the body want to cease menstruation in female athletes?
allows the body to divert more resource to survival and key cellular mechanisms rather than reproduction
62
describe anorexia nervosa
extreme steps to reduce body weight (starvation, exercise, laxative use) which causes excessive weight loss, amenorrhea, and even death
63
Warning signs of anorexia nervosa
* rapid weight loss * mood swings * excessive exercise * avoiding food-related activities * wearing baggy clothes * preoccupation with food, calories, or weight
64
describe anorexia bulimia
pattern of overeating followed by vomiting which leads to damaged teeth and esophagus
65
Warning signs of bulimia
* noticable weight loss * depressive mood * excessive concern about weight * strict dieteing followed by binges * bathroom visits after meals * increased critisism of body
66
# female athlete triad 2 major causes of osteoporosis
1) estrogen deficiency due to amenorrhea 2) inadequate calcium intake due to eating disorders
67
how does the bone mineral content of female runners compare to untrained females?
female runners have a higher bone mineral content
68
female athlete traid
the inner play of low energy availability, mentral dysfunction, and low bone minderal density
69
describe RED-S
relative energy deficiency in sports: newer version of the female triad - applies to both men and women * has more components
70
treatment of RED-S
Primary objective = increase energy availability 1) increase energy intake and reduce energy expenditure 2) nutritional counseling and psychotherapy if practicing restrictive eating behaviors
71
how does recovery from RED-S progress? (when does each component recovery)
recovery of energy status happens first (days to weeks), then recovery of menstrual status (months), then recovery of bone mineral density (years)
72
3 reasons why female athletes are at a higher risk of certain knee injuries compared to men
1) fluctuation in hormones during menstrual cycle may compromise ACL strength and/or proprioreceptor feedback 2) knee anatomy (may be due to greater joint laxity) 3) dynamic neuromuscular imbalance (imbalanced strength, proprioception, and landing biomechanics) | females at a 3.5x higher risk of non-contact ACL injury
73
major adaptations to pregnancy
Cardiovascular: increase in plasma volume, cardiac output, stroke volume, and heart rate Lungs: increase in tidal volume and minute ventilation
74
exercise recommendations during pregnancy
regular endurance exercise poses little risk to the fetus and is beneficial to the mother, but pregnant women should consult their physician before beginning an exercise program
75
exercise during pregnancy reduces the risk of
gestational diabetes and preeclampsia
76
how do training adaptations differ during pregnancy?
1) absolute VO2 max is increased or maintained due to increased cardiac output & O2 capacity 2) combo of training and pregnancy results in greater adaptations that training alone due to plasma volume increase
77
ASCM/CDC specific exercise recommendation for pregnant women
30 min/day of moderate-intensity activity on most, preferably all days
78
how should intensity be determined for exercising pregnant women?
Rate of perceived exertion (12-14), heart rate (may not be best) and “talk test”
79
how should body temp be maintained for pregnant women while exercising?
limit body temp increases to less than 1.5 degrees celsius (aquatic exercise recommended) * prevents hypothermia
80
how should exercising pregnant women maintain hydration?
consume fluids at regular intervals (every 15 mins) * monitor by measuring body weight
81
how should training change as pregnancy advances?
reduce intensity and volume as pregnancy advances
82
what sort of exercises should pregnant women avoid?
supine exercises * avoid pressure on abdomen
83
why is exercising into old age an unusual pattern?
natural tendency to be sedentary, unmotivated
84
potential motivating factors for older people to engage in physical activity
be fit enough to play with grandkids, maintain independence, social incentive
85
how does endurance performance change as you age?
endurance performance declines after age 60 ## Footnote mainly caused by decline in VO2max
86
how does VO2 max change with age?
declines about 1% per year
87
what two factors don’t really change with age?
exercise economy and lactate threshold
88
how does training affect the decline in VO2 max as you age?
training can slow but not prevent the decline in VO2 max
89
how does weight change with age?
* from age 25-45, decreased physical activity and increased caloric intake causes weight gain * older than 65, loss of body mass and appetite causes weight loss
90
Height changes with age
decrease begins at 35-40 due to * compression of intervertebral discs * Poor posture * Later on, due to osteopenia and osteoporosis
91
Major body composition changes with age
* increase in body fat content * Decrease in fat-free mass (muscle and bone mass)
92
4 factors contributing to decreased fat-free mass starting around age 40
1) decreased muscle and bone mass 2) sarcopenia (decreased protein synthesis) 3) lack of activity 4) decreased growth hormone & IGF-1
93
2 factors contributing to loss of strength with age
1) lower level of activity 2) sarcopenia (loss of muscle mass)
94
3 defining characteristics of sarcopenia | that explain why it leads to loss of strenght with age
1) decrease in muscle size (both type I and II) 2) decrease in number of fibers (both type I and II) 3) greater reduction in type II fibers with aging - type I are used daily
95
how does exercise affect reflexes in older people?
exercise preserves reflex response time so that active older adults are approx equal to young active people
96
how does motor unit activation change with age? how does exercise prevent this?
motor unit activation decreases; exercise retains maximal recruitment of muscle
97
how does bone mineral content change with age?
decrease; bone resorption > bone synthesis due to a lack of weight bearing exercise
98
why is osteoporosis more common in women?
due to lack of estrogen
99
recommendations for exercise to maintain bone health
frequency: weight bearing 3-5 times/week, resistance 2-3 intensity: moderate to high bone loading duration: 30-60 mins/ day mode: weight-bearing, jumping, resistance
100
What type of training is most effective to increase muscle strength
Resistance training is most effective for maintaining muscular strength - combination of resistance and balance trianing can reduce risk of falls

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