Exercise In Chronic Disease and Disability Flashcards

Question

AIDS Complications

Answer 1

Cardiovascular and metabolic abnormalities Fatigue Depression Chronic diarrhea Anemia Muscle wasting Pneumocystis pneumonia Peripheral neuropathy (VERY COMMON)

Answer 2

AEROBIC TRAINING Frequency: 3-5 days per week Intensity: 40-60% VO2 or HRR Time: 10 minutes initially, progressing to 30-60 minutes per day Type: Individually dependent Include weight-bearing activities if osteopenia is a concern Avoid high-risk and high-contact activities Overall Goal: Improved aerobic capacity over 3-6 months

Answer 3

``` RESISTANCE TRAINING Frequency: 2-3 days per week Intensity: 2-3 sets of 10-12 repetitions @ approximately 60% 1RM Type: Individually dependent Free Weights Weight Machines ``` Overall Goal: Improved muscular strength, power, and/or endurance over 3-6 months

Answer 4

Must adhere to strict universal precautions No evidence of exercise induced immunosuppression No established guidelines regarding contraindications for exercise Dizziness, joint swelling, or vomiting preclude exercise Increasing fatigue, lower GI distress, or DOE should be reported Symptomatic individuals and those with comorbidities should be supervised Anti-retroviral treatment may be associated with dyslipidemia, abnormal body composition, and insulin resistance

Answer 5

Paresis and atrophy Spasticity Impaired skin integrity Osteopenia / Osteoporosis Autonomic dysreflexia Respiratory dysfunction Bowel and bladder dysfunction Impaired thermoregulation

Answer 6

person doesn't feel something crushing their toe = body goes into overdrive, BP increases, potentially lifethreatening. Complains of headache, blurred vision. SIT THEM UP, then find cause, get help, check clothing..

Answer 7

VO2 peak may decrease as much as 26% Exercise may improve VO2 peak by 10-20% UE ergometry reduces VO2 values by approximately one-half compared to LE ergometry Quadriplegia reduces VO2 values by one-half to one-third compared to paraplegia T6 and above are at risk for autonomic dysreflexia Disruption of sympathetic innervation may limit HR to 115-130 bpm Many individuals will experience muscular fatigue before achieving sufficient cardiovascular capacity

Answer 8

HR max very low, 100 bpm

Answer 9

AEROBIC TRAINING Frequency: 3-5 days per week Intensity: Initially 40-60% VO2 reserve Progress to 60-80% of VO2 reserve Time: 30-60 minutes total Initially 5-10 minutes of moderate intensity activity alternated with 5 minute active recovery periods Progress to 10-20 minutes of vigorous intensity activity alternated with 5 minute active recovery periods Type: Arm or w/c ergometer, swimming, adapted aerobics, FES Aerobic Training Goals Increase active muscle mass and strength Maximize overall strength for functional independence Improve efficiency of manual W/C propulsion Flexibility Goals Improve / maintain ROM Prevent contracture Prevent injury (rotator cuff!!!)

Answer 10

``` RESISTANCE TRAINING Frequency: 2-4 days per week Intensity: 2-3 sets of 8-12 repetitions Type: Weight machines or free weights Wrist weights if hand function impaired ``` Overall Goals: Increase strength and muscle mass Maximize functional independence Facilitate w/c propulsion

Answer 11

Depression TBI Improvements may be small (

Answer 12

Chronic metabolic disease resulting in absolute (type I) or relative (type II) insulin deficiency Hyperglycemia (blood glucose > 120 mg/dL) Macrovascular complications: Cardiovascular disease Cerebrovascular disease Peripheral vascular disease Microvascular complications Retinopathy Nephropathy Neuropathy (peripheral and autonomic)

Answer 13

Improves insulin sensitivity Improves lipid profiles Reduces blood pressure Promotes weight loss Increases strength Improves well-being

Answer 14

Testing may not be necessary for asymptomatic and low risk individuals beginning light to moderate intensity exercise GXT with EKG should be conducted in those > 35 years old or with type I DM > 15 years or type II DM > 10 years who want to begin moderate to vigorous intensity exercise CVD risk factors should be reassessed annually

Answer 15

Frequency: 3-7 days per week Intensity: 40-60% VO2 reserve or RPE 11-13/20 Improved glycemic control may be achieved at intensities > 60% Time: 150 minutes per week in bouts of > 10 minutes Additional benefits may be achieved by increasing to > 300 minutes of moderate to vigorous intensity activity per week Type: Emphasize large muscle groups

Answer 16

RESISTANCE TRAINING General population guidelines apply in the absence of retinopathy or other complications Adjust parameters as needed to accommodate comorbid conditions

Answer 17

Retinopathy: Avoid vigorous intensity activity and resistance training Peripheral neuropathy: Enforce regular foot checks, limit weight bearing activities if evidence of Charcot joint Autonomic neuropathy: Monitor BP and HR closely Nephropathy: No restrictions for tolerable moderate intensity activity

Answer 18

Closely monitor BS | No exercise if BS > 250 or

Answer 19

Permanent loss of kidney function due to Physical injury Disease Affects 20 million US adults, with another 20 million at risk Diagnosis based on: Microalbuminuria Glomerular filtration rate (GFR)

Answer 20

``` Metabolic Acidosis Hypertension Left ventricular hypertrophy Anemia Secondary hyperparathyroidism Peripheral neuropathy Muscle weakness Autonomic dysfunction Elevated triglycerides and decreased HDLs ```

Answer 21

``` Congestive Heart Failure (CHF) Due to fluid overload, especially prior to dialysis Cardiomegaly Due to fluid overload Accelerated atherosclerosis Pericardial effusion Due to inadequate dialysis and uremia Dysrhythmias Due to electrolyte imbalances and structural changes Renal osteodystrophy Due to hyperparathyroidism Persistent anemia Peritonitis ```

Answer 22

Low exercise tolerance (VO2 peak

Answer 23

AEROBIC TRAINING Frequency: 3-5 days per week Intensity: 40-60% VO2 reserve or RPE 11-13/20 Time: 20-60 minutes of continuous activity Can be accumulated in as little as 3-5 minute bouts Type: Walking, cycling, swimming Progression: Increase duration in 3-5 minute weekly increments

Answer 24

``` RESISTANCE TRAINING Frequency: 2-3 days per week Intensity: ≥ 1 set of 10-15 repetitions @ 70% RM Type: Weight machines or free weights ```

Answer 25

Avoid exercise immediately post-dialysis Exercise during dialysis should occur during the 1st half of the treatment Be aware of arteriovenous fistula and IV access lines Avoid resting weight on fistula area Avoid taking BP measurements on fistula arm Spontaneous avulsion fractures may occur in patients with long-standing renal bone disease Use 3RM or higher (10-12RM) for strength assessment Medically cleared patients may begin exercise training as early as 8 days post-transplant

Answer 26

Highly diverse and variable treatment and response Exercise testing is not required for light intensity aerobic, resistance, or flexibility training Prescription is individualized, but generally follows the guidelines for healthy populations Treatment toxicity may increase risk for fracture, CV events, and neuropathies

Exercise In Chronic Disease and Disability Flashcards

(51 cards)