Flashcards in Exercise Deck (45):
Identify the exercise benefits with strongest evidence.
-Lower risk of early death
-Lower risk of coronary heart disease, stroke, high blood pressure, adverse blood lipid profile
-Lower risk of type 2 diabetes and metabolic syndrome
-Lower risk of cancer: colon and breast
-Prevention of weight gain
-Weight loss, particularly when combined with reduced calorie intake
-Improved cardiorespiratory and muscular fitness
-Prevention of falls
-Better cognitive function (for older adults)
Identify the exercise benefits with moderate-strong evidence.
-Better functional health (for older adults)
-Reduced abdominal obesity
Identify the exercise benefits with moderate evidence.
-Lower risk of hip fracture
-Lower risk of lung cancer
-Lower risk of endometrial cancer
-Weight maintenance after weight loss
-Increased bone density
-Improved sleep quality
What impact does exercise have on mortality?
-Regular exercise reduces risk of all-cause mortality for most individuals (all sexes & age populations)
-Beneficial effects are dose-dependent
What is the significance of 100 minutes of exercise and mortality?
-Duration above 100 minutes/day for moderate-intensity physical activity in healthy individuals do not appear to be associated with additional reductions in mortality rates.
Impact of exercise on cardiovascular disease.
Strong inverse relationship between habitual exercise and the risk of coronary disease, cardiac events, and cardiovascular death for both primary and secondary prevention
Exercise impact on lipoproteins.
induces beneficial effects on lipoproteins (e.g., decrease in very low-density lipoprotein, increase in high density lipoprotein), body composition, and aerobic capacity, as well as improves hemostatic factors associated with thrombosis.
Impact on markers of inflammation.
Regular physical activity is associated with decreased levels of markers of inflammation (CRP and IL6).
Long-term aerobic exercise impacts
-beneficial on systemic BP
-reduce risk of stroke
Impact on diabetes/prediabetes.
-may improve glycemic control, insulin sensitivity, and may prevent the development of type 2 diabetes in high-risk groups.
-exercise is one of the lifestyle changes that has been shown to reduce the risk of diabetes in people with high risk (multiple risk factors)
Impact on cancer prevention and treatment.
-modest protection against breast, intestinal, prostate, endometrial, colorectal, and pancreatic cancer
-observational studies have reported a link between survival and exercise, with most of the data coming from survivors with breast, colorectal, or prostate cancers
Impact on obesity.
Compared to a weight loss diet alone, diet coupled with either exercise or exercise and resistance training is associated with a greater reduction in body fat compared to diet alone
Impact on osteoporosis
-weight-bearing exercise is associated with an increase in bone mineral density in men and women
-among patients with osteoporosis, exercise is associated with a decreased risk of hip fractures
Impact on smoking cessation
-vigorous exercise modestly facilitates short- and long-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program
-vigorous exercise also delays weight gain following smoking cessation
Impact on gallstones
Associated with a decreased risk of symptomatic cholelithiasis
Impact on function and cognition
-may reduce the risk of dementia and cognitive decline in older patients
-also associated with improved cognitive function in young adults
Impact on psychological
-regular exercise reduces stress, anxiety, and depression
-recommended in the treatment of depression.
What are the risks associated with exercise?
-sudden cardiac death (SCD)
-myocardial infarction (MI)
What are the musculoskeletal injuries associated with exercise?
-Acute strains and tears, inflammation of various types, chronic strain, stress fractures, traumatic fractures, nerve palsies, tendonitis, and bursitis all may occur during or as result of physical activity.
-Many are secondary to overuse.
Which patients are at risk for arrhythmia with exercise?
In patients with underlying heart disease or a prior history of arrhythmia.
*Exercise training may reduce atrial and ventricular arrhythmia risk by increasing myocardial oxygen supply and by reducing sympathetic nervous system activity.
Identify sudden cardiac death (SCD) risk with exercise.
-risk is less or may not be increased at all if there is habitual, heavy leisure-time physical activity
Mechanism of SCD in exercise.
-include coronary artery disease, arrhythmias (especially ventricular tachycardia and ventricular fibrillation), structural heart disease, and myocarditis.
-causes of SCD in people who exercise can be divided according to age.
What is SCD generally a result of?
-SCD is generally a result of atherosclerotic coronary artery disease in those over age 35 years.
-it is more likely to be due to congenital abnormalities such as hypertrophic cardiomyopathy, coronary anomalies, or to myocarditis in younger individuals.
What are the myocardial infarction risks associated with exercise?
-exercise associated with a temporary increase in the risk of having a myocardial infarction (MI), particularly among those who exercise infrequently and have multiple cardiac risk factors.
Pts with coronary disease are more likely...
to have a myocardial infarction at the time they are participating in strenuous exercise than when they are not.
Pts with coronary disease are less likely...
to have an MI than those with coronary disease who do not exercise.
Rhabdomyolysis may occur following...
extreme exertion in individuals with normal muscles when the energy supply to muscle is insufficient to meet demands
What is common following physical exertion?
-subclinical myoglobinemia, myoglobinuria, and elevation of creatine kinase (CK) are common following physical exertion
-CK level can rise several fold, particularly after intense exercise for extended periods of time (e.g., marathon running)
What are the severe complications of rhabdo?
include renal failure, electrolyte abnormalities (e.g., hyperkalemia, metabolic acidosis), and compartment syndrome.
What are the risks of bronchoconstriction associated with exercise?
-occurs in the majority of patients with current symptomatic asthma.
-magnitude is correlated with the degree of airway hyperresponsiveness.
Improving a patient's cardiovascular fitness reduces...
the minute ventilation required for a given level of exercise, thereby decreasing the stimulus for bronchoconstriction.
How can one prevent the onset of exercise-induced bronchoconstriction?
Regular, long-term exercise
What are the heat-related risks associated with exercise?
Hyperthermia, hypothermia, and dehydration are potential preventable risks of physical activity.
What are the risks of amenorrhea associated with exercise?
-intense exercise can lead to amenorrhea and infertility, particularly in women with low body weight.
What is the "female triad"?
-The "female athlete triad" consists of disordered eating, amenorrhea, and osteoporosis.
-This is commonly seen in younger individuals, especially those who exercise regularly and intensely.
What are the risks of exercise-induce hyponatremia?
primarily occurs in athletes participating in aerobic (endurance) events, such as marathons (42.2 km), triathlons (3.8 km swim, 180 km cycling, and 42.2 km running), and ultra-distance (100 km) races.
Who should undergo pre-participation in exercise?
-Asymptomatic individuals with multiple cardiovascular risk factors including hypercholesterolemia, hypertension, smoking, diabetes
-H/o premature myocardial infarction or sudden cardiac death in a first-degree relative under age 60
What should you include in a prescription for exercise?
-type of exercise
What are the recommended exercises for adults regarding overall cardio health according to the current guidelines?
-at least 30 minutes of moderate-intensity aerobic activity at least 5 days per week for a total of 150
-at least 25 minutes of vigorous aerobic activity at least 3 days per week for a total of 75 minutes (or a combination of moderate- and vigorous-intensity aerobic activity)
-moderate- to high-intensity muscle-strengthening activity at least 2 days per week for additional health benefits.
What are the recommended exercises for adults regarding lowering blood pressure according to the current guidelines?
An average 40 minutes of moderate- to vigorous-intensity aerobic activity 3 or 4 times per week
Regular physical activity in children and adolescents...
-has big benefits.
-it not only makes them healthier and fit now, but it lowers their risk of chronic diseases and improves their chances of becoming healthy adults.
What do the guidelines recommend for children and adolescents for daily physical activity?
children and adolescents ages 6 to 17 do 60 minutes (1 hour) or more of physical activity each day
Children and adolescents
Most of the 60 or more minutes a day should be either moderate- or vigorous-intensity aerobic physical activity (such as running, dancing, or biking), and include vigorous-intensity physical activity at least 3 days a week
Children and adolescents
As part of the 60 or more minutes of daily physical activity, include muscle-strengthening physical activity (such as climbing trees, using playground equipment, or lifting weights) on at least 3 days of the week