Final Flashcards
(93 cards)
1
Q
Is exercise Safe?
A
Yes, in an appropriately controlled scenario.
Proper coaching and a program that is specific to the patient
2
Q
What is the most dangerous consequence is exercise?
A
Sudden cardiac death and acute myocardial infarction (risk is very small)
3
Q
What is the rate of exercise-related cardiac events for those who exercise compared to those who are sedentary
A
50x lower for those who engage in PA more than 5 times a week compared to those who are sedentary
4
Q
Why are people who are sedentary at risk?
A
Higher oxygen demands, more dilation of the heart
Bending of coronary arteries leads to a rupture of plaque - travelling of the plaque can lead to thrombosis/heart attack
5
Q
What is the absolute risk of cardiovascular problems during a bike race?
A
Very low
.2 out of 100,000 running hours we will see a cardiac issue (AMI, death) during marathons
6
Q
What is the purpose of the Pre-participation Screening Algorithm
A
Removal of a barrier to exercising participation
Ppl previously had to seek dr approval to engage in new exercise
7
Q
What is considered “regularly active”
A
30 minutes a day of at least moderate 3x a week for 3 months is considered regularly active in the algorithm
8
Q
How can you determine moderate exercise
A
HR, Max HR, RPE
9
Q
What is the Borg Rating of Perceived Exertion Scale
A
How hard do you feel your body is working
Can be based on increases HR ,breathing rate, sweating, muscle fatigue
10
Q
What are the key descriptors in the borg scale?
A
6 - no exertion at all
7 - extremely light
9 - very light
11- light
13 - somewhat hard
15 - Hard (heavy)
17 - very hard
19 - Extremely Hard
20 - Maximal Extertion
11
Q
What are the major signs/symptoms of CVD?
A
- Pain, discomfort (or other anginal equivalents) in the chest, jaw, arms, or other areas that may result from myocardial ischemia
- Shortness of breath at rest or with mild exertion
- Dizziness or syncope
- Orthopnea or paroxysmal nocturnal dyspnea
- Ankle edema
- Palpitations or tachycardia
-Intermittent claudication (pain in low extremities due to lack of blood supply)
- Known heart murmur
- Unusual fatigue or shortness of breath with activities
12
Q
What are some common signs/symptoms of T2D?
A
More tired than normal, always thirsty, frequent urination (esp at night),
Hyperglycemia - high blood sugar
13
Q
What should I include in medical history?
A
Demographics, Disease/family history, treatment history, sign and symptom history (lab findings) , orthopedic problems, contraindications, risk factors, PA history, others
14
Q
What is metabolic syndrome
A
The co-occurrence of 3 CVD risk factors
abnormal cholesterol levels, insulin resistance, obese/overweight
15
Q
What is the risk of a cardiovascular event for those who have metabolic syndrome compared to those who do not?
A
The risk of a cardiovascular event is 2x greater than for people who do not have metabolic syndrome
Women at 30% greater risk of a cardiovascular event when they have metabolic syndrome than men (important to eliminate this in women when diagnosing)
16
Q
What are some key trends in metabolic syndrome?
A
- co-occurrence of variables together exponentially increases risk, eliminating at least one will help lose exponential impact
17
Q
Is aerobic or resistance training better in reducing metabolic syndrome contributors?
A
Aerobic - WC, FBG, HDL
18
Q
What are the two ways to check HR?
A
Use Polar or other HR monitors, or valid smartphone apps
Make sure tools are valid and reliable
Pulse palpation (old-fashioned way)
Find space between radius and artery/tendon “corridor”, press gently with two fingers (not thumb), count # beats in 10s and multiply by 6
Or can also use a stethoscope with a heartbeat
19
Q
What are the components of a health-related physical fitness assessment
A
Screening, Pre-exercise evaluation (medical history), resting measurements, body composition, CRF, muscular fitness
20
Q
What is blood pressure?
A
The force being exerted by the blood vessels in our body
21
Q
What is blood pressure?
A
The force being exerted by the blood vessels in our body
22
Q
What is Systolic pressure?
A
Heart Beats: the surge of blood through vessels, increasing pressure
23
Q
What is diastolic pressure?
A
When the heart relaxes between beats and decreases
Relaxing
10mmHg increase results in 2x in CVD risk
24
Q
What is the relationship between systolic and diastolic pressure vs mortality?
A
direct linear relationship in systolic pressure with mortality in older and younger people
Diastolic pressure:
Under 65; hockey shape curve till 80, then mortality risk increase
Over 65:J shaped curve, the risk is high, lowers at 80, then continues to rise
25
What are the values of a Good BP, prehypertensive and hypertensive?
Good = under 120/80
Prehypertensive = 120-139/80-89
Hypertensive = Over 140/ Over 90
26
What should you recommend for a client who is hypertensive?
Lifestyle changes such as PA, weight loss, DASH diet (fruits, veggies, low fat dairy, less sodium). These are the cornerstones of hypertension therapy
27
How do you take resting BP?
Allow client time to relax upon arrival (3-5 min), do not speak to them, put cuff on bare arm, align arm at brachial artery, ensure feet are uncrossed and planted on the floor
28
How do you take resting BP manually?
Put a stethoscope on the arm
Pump up the cuff, occlude the vessel to prevent blood from travelling.
Slowly release air
Listen for Korortkoff sounds
- Phase 1: released air + tapping sound = systolic BP
- Last phase: no sound = diastolic BP
29
What is white coat syndrome and how does it have an effect on BP?
Patients feel stress and anxiety in a medical clinic which causes an increase in BP
BP will be lower at home than in the clinic
30
How do you measure BMI?
mass (kg)/height (m2)
Don't forget to convert cm to m!!!!!
31
What are the normal values for BMI? What is considered overweight? Obese?
Normal: 18.2kg/m2 - 25kg/m2
Overweight: 25kg/m2-30kg/m2
Obese: over 30kg/m2 (CVD RISK FACTOR)
32
What are the limitations of BMI? Strengths?
Limitations: Does not discriminate between fat and fat-free mass, Does not provide any information on fat distribution
Strengths: easy to administer, not invasive
33
Does it matter where you store your fat? Why?
Yes, people who have an apple (android - fat around the stomach) distribution have a higher risk of metabolic syndrome, CV issues, diabetes and dyslipidemia, CVD and death.
34
Why is it important to measure WC?
People in the same BMI category have a different amount of visceral adipose tissue. Measuring WC better predicts someone's visceral adipose tissue and cardio/metabolic disease risk
35
How do you measure WC?
Start at the top of the iliac crest. Use cloth tape measure, do not pull too tight, and make the tap measure level to ground (not tilted on an angle)
36
What does the acronym HAES stand for?
Healthy at every size. We can see major increases in CRF but not weight loss,
37
Why is it important to measure your patient/client's CRF?
Fitness is a key variable that is not measured by family Drs.
strong relationship between mortality and CRF
low CRF = risk of early death
Low fitness = #1 predictor of death
38
What is VO2 max?
The maximal volume of oxygen consumed per ml/kg/min
Resting rate: ~3.5ml/kg/min
Typical measure for a man ~30: 40-47ml/kg/min
Reflection of how much oxygen-rich blood you can deliver to working muscle
39
What is Vo2peak?
Highest attainable Vo2 value for the given exercise. Used when the levelling off (plateau) of Vo2 does not occur. Individual still reaches the end of the test
40
What is the relative vs absolute measure for VO2 max?
relative measure: ml/kg/min
absolute measure: L/min
41
What is the gold standard way of measuring VO2 max/peak testing? Explain
open circuit spirometry (indirect calorimetry)
- measured directly in the lab using a valve to measure oxygen and carbon dioxide. The mode selected can impact the results (treadmill vs cycle ergometer)
42
What is the general procedure of conducting a submax CRF test
1. Obtain resting HR and BP prior to exercise in the exercise posture
2. Familiarize the individual with the treadmill or ergometer
3. Begin with a 2-3 min warm up to acquaint the individual with the treadmill/ergometer
4. Specific protocol should be done in 2-3 min stages and the appropriate increments in work rate
5. HR should be monitored at least two times near the end of the second and third min of each stage
6. BP should be monitored in the last min of each stage and repeated if hypotensive or hypertensive
7. RPE and other scales should be monitored near the end of each stage
8. individual's symptoms and appearance should be monitored and recorded regularly
9. Test ends when an individual reaches 70% of HRR, fails to adhere to test protocol, shows adverse signs and symptoms, and requests. to stop or has a medical emergency
10. Need to have a cool-down period
11. Physiologic observations should continue 5 min after the test unless abnormal responses occur
43
What are three modes of CRF testing and examples of each?
1. Treadmill tests (i.e modified bruce)
2. Cycle ergometer (e.g., Astrand, YMCA)
3. Field tests (e.g., cooper 12 min test, Rockport one-mile fitness test, walking test, 6 min walk test)
44
What is the Cooper 12-minute test?
A CRF field test requires the individual to cover the greatest distance in the allotted time period. Vo2 max can be estimated using the equation : (distance in meters - 504.9)/44.73
45
What is the Rockport one-mile fitness test?
A CRF test requires the individual to walk 1 mile as fast as they can. HR is obtained in the final minute.
46
What is the 6 min walk test?
A CRF field test is used for individuals with a predicted low CRF. Aim to walk over 300m in 6 min. A sub max test but since given to older individuals/those w chronic disease they may come close to reaching their max
47
What is a good Vo2 max number?
Treadmill-based values*** Cycle ergometer will be 5-10%.
Men in 20s = in the 50sml/kg/min
Women in 20s = ~40sml/kg/min
48
What is an excellent VO2max/peak for men and women in their 50s? Treadmill vs Cycle Ergometer
Treadmill:
- Men; 43.2mls/kg/min
- Women; 30.2mls/kg/min
Cycle Ergometer:
- Men: 32.1mls/kg/min
-Women: 21.5mls/kg/min
49
What is overload?
A training regime of greater intensity than the individual is accustomed to
Most of the time trying to get patients to lift one weight or two, rather than 100lbs or 200lbs
50
Explain the Law of Overload
1.Start with a stimulus = workout
- Stimulus needs to be above a certain threshold (different thresholds based off aerobic fitness)
- generally, 40-80% of HRR (deconditioned people may need 30%)
2.Fatigue occurs soon after the stimulus
3.Compensate: the body takes time (1-3 days) to respond and rebuild
4. Overcompensate: body and systems come back stronger - a result of compenstion
51
What are some Adaptations from overload?
Capillarization
Increases In aVo2 diff
Improved endothelial functions
Oxidize fatty acids
Increase mitochondria size
Increase muscle size + ability to recruit muscle size
52
Explain progression
If you do not progress in training you will plateau
Progressing too quickly is dangerous***
10% rule:
- ACSM says to increase any of the FITT-VP parameters by 5-19% every two weeks
-Avoid progressing more than one parameter at once
53
How do you progress training
10% rule - one parameter at a time
Increase intensity (e.g. weight, speed)
More repetitions, sets, time
Less rest, the recovery period in HITT aerobic program, in resistance training sets
Increase # of sessions in a week
New harder multi-joint exercises
Ex: plank
Two elbows on the floor, then lift elbow or leg, go onto side etc
54
What does Specificity mean when creating a fitness program?
We specify exercises to elicit specific adaptations to create particular training effects
to optimize performance and maximize the translation of training, you want to mimic movements as closely as possible
55
What are the types of specificity?
Movement specificity: try to mimic the pattern of movements (or angle of joints)
Metabolic specificity:
Strength training yields specific strength adaptations
Ex: muscle fibre size
Temporal specificity:
Performance optimized at the same time you train
Ex: if games @ 8 pm you should train at 8 pm
Mode specificity:
Aerobic training benefits usually stick with the mode of training you are doing
56
Explain the concept of Individuality
Adaptations to training are unique to individuals and vary with:
One’s baseline fitness
Individual “responsiveness”
57
Explain the findings from the twin research in individuality
Twin A (x- axis) vs twin B (y axis)
College rec athletes introduced to aerobic training program
Important: strong correlation between improvement in twin sets
Ex: If twin a improve vo2 max 40%, twin B improved 30%
Illustrates impact that genetic makeup can have on individuality responsiveness on training program
58
What is periodization
- The organization of an individual's training into cycles to promote peak condition
Team sports:
high volume, lower intensity further from the competitive season
- focuses on improving aerobic capacity and muscle strength
closer to the season: low volume, higher intensity, maximizes benefits, speed, power and agility
59
Explain the importance of rest in making a fitness program
exercises using multiple joints may require more rest
Aerobic training should be 5x a week, 6 and 7th days should be rest
Without adequate rest you are overtraining and will result in no overcompensation
60
Explain reversibility
The loss of physiological and performance training adaptations
Can occur quickly
College athletes asked to detrain
VoO2 max drops @ day 12 ~6-7% (two weeks of de-training)stroke volume and cardiac output also decrease
aVo2 diff maintains then drops at 56 days
HR max increases (could be a result of lower SV and CO)
Best way to mitigate or reduce reversibility: maintain a FITT-VP principle
INTENSITY = best
Even if you drop frequency or volume you can still be fit (maintain VO2 and other physiological variables)
61
What makes up a comprehensive exercise program?
Aerobic, resistance, sedentary behaviour (tackle as a separate movements behaviour) flexibility, neuromuscular/balance
An exercise program including all of the above is essential in maintaining physical fitness and health
Pick 1-2 exercises for the program, choosing all four makes it difficult to keep routine
62
What are the Canadian 24-hr Movement Guidelines for Adults
7-9 hours of good quality sleep have a consistent bedtime and wake-up time
Walk or stand after 45 min of sedentary behaviour (at least 2 min)
MVPA no longer needs to be in bouts at least 10 min long, just needs to meet 150min
limit sedentary behaviour to 8 hours or less
no more than 3 hours of recreational screen time
Constant movement
- Several hours of light physical activities, including standing
Progressing towards any of these targets will result in some health benefits
Important to have people try to reach the guidelines since some movement is better than none
63
What are the ACSM's guidelines for Aerobic exercise (FITT-VP)
Frequency: 3-5 days/week
Intensity: 40-89% HRR
Time: 20-60 minutes
Type: large, rhythmic eg, swimming
Volume: mins of MVPA/week
Progress: 10% rule
Pattern: MICE, interme, HITT
64
Why is it important to exercise 3-5 days a week?
In general, cannot reasonably accept improvements in less than 3 days a week
Why not more than 5 days a week = can cause MSI, no time for recovery, benefits, / fitness can plateau, and increase cardiovascular events
If the athlete and already fit - can go up to 6-7 days but can if cross training (running some days and yoga others)
Do not do MVPA 7 days a week
65
What are the three ways to prescribe exercise intensity?
1. Borg RPE scale
2. The talk test
3. %HRR
66
What are the three ways to prescribe exercise intensity?
1. Borg RPE scale
2. The talk test
3. %HRR
67
What is the talk test?
A way to prescribe exercise intensity
Ask individuals to participate in exercise task
If they are gasping for air - the vigorous zone Over 9 METS)
If they can get 3-5 words without gasping = moderate (3-6 METs)
Conversation = light (1.5-3 METs)
68
What are the components of an aerobic exercise training session?
Start: 5-10 mins light to moderate intensity activity
Cardiovascular Drift: heart rate climbs over course of the workout
This is why intensity is in a range (fluctuates)
5-10 minutes of cool down
Light to moderate activity
Warm-up: injury prevention
Cool down: gradual recovery - heart rate back to baseline
- Clear metabolites
- Venous cooling
69
Warm-up, How? and Why?
How: Light to moderate intensity exercise activities to target specific muscle groups that will be used during exercise
Why: Dynamic stretches, never static stretches
70
Cool-down, How? and Why?
How? : Low-moderate intensity flexibility exercises or static stretching
Why?: Return to near resting levels, oxygen level, heart rate, etc after exercising
71
Stretch: flexibility training (How?, Why?)
How?: hold the static stretch untill before discomfort 30/90s for every major muscle group
Why? Maximizes performance
72
Cross-train, How? Why?
How? Using different training modes (running, swimming, walking)
Why? Prevents injury, promotes rest, targets different muscle groups, is motivated longer, a better position to do more vigorous exercise since not tired in legs, etc
73
Rest, How? Why?
How? Having breaks in between exercises, and sleeping
Why? Reduce chances of overcompensation without rest, adequate sleep, rest days week days of rest between vigorous bouts of exercise/modes of each exercise
74
Gradual Progression of volume/intensity, How? Why?
How? Start low and go slow
Why? Prevent injury, keep motivation
75
How can you progress with Aerobic exercise
Use the triangle method:
1. Establish a routine (base of the triangle)
On a regular basis, etc once a week, before increasing the volume
Focus on a routine early on
2. Increase the volume
Ideally, guideline levels
Once they have a regular routine and reached guidelines for a week, then we can start to increase the volume
Must increase so that it increases vo2 - since cardiac fitness is the most important
3. Optimize intensity
76
What weer the outcomes of the Study: Developing the P (for progression) in a FITT-VP Exercise Prescription
Generally want to progress as slowly as possible to not increase risk of injury
Ex: how to progress someone in a walk-jog program
Beginners will increase mins/week and intensity from light level to moderate
At 10 min to weekly total each week until reaching 100 min
Then increase intently from light to moderate level
Once comfortable, continue to add 10-15 min/week until reaching 150 min
Intermediate level - progress two variables at a time rather than on (pace and time)
77
Why and how do you prescribe a HITT program?
Not just for the super fit
A most common pattern in exercise prescription
80% more HRR
Program sample
3-minute warm-up and 2.5 min cooldown
30-second sprints, 90-second active recovery intervals
How to incorporate
Use an app
Can attach intervals of high training to a certain part of a song
Ex; go faster at the chorus
Study results: HITT has greater benefits than MICE training
Better VO2 improvements
78
What is muscular fitness?
A term that encompassed:
muscular strength (muscle's ability to exert maximal force on occasion),
muscular endurance (muscle's ability to continue to perform successively exerts or repetitions against a submaximal load)
and muscular power (muscles' ability to exert force per unit of time)
79
What are the ACSM FITTVPP guidelines for resistance training exercise prescription
F: 2-3d (per muscles group)
I: 60-80%, 1RM
% varies depending on goal: hypertrophy, strength, power, endurance
Deconditioned adults: get them to do 5-10 times and then you can predict 1RM
60-80% helps achieve 8-12 reps in a set, you will max hypertrophy and strength gains this way, most important for health benefits
T: 8-12 reps, 2-4 sets, 2 min rest
T: 10 major muscle group, multijoint (usually preferred) vs single joint, core exercises (abdominal, hip and lower back)
V: sets/week
P: increase load or volume or reduce rest or increase complexity (front plank on knees, to
toes, to side plank) - fiddle with the platform
P: full body (all 10 muscle groups), split (half muscle group) , circuit (exercises in sequence)
80
What are the major muscle groups?
Chest, biceps, triceps, quads, glutes, hamstrings, calf, back, abs, shoulders,
81
What are the five benefits of increasing muscle mass
Increases resting metabolic rate
Decreases risk of injury (by increasing integrity of bone/muscle/tendon capsule
Bone strength
Functional independence
Better glycemic control (more muscle = more glucose muscles can take up to use for energy)
82
What are the two ways to prescribe exercise intensity in resistance training
RPE and %1-RM
83
How do you practically progress resistance training?
Increasing load by 5%, adding more repetitions, increasing the number of sets/week
84
What are 3 patterns of resistance training programming
Full body (all 10 muscle groups), split (half muscle groups), circuit (exercises in sequence)
85
What are 3 patterns of resistance training programming
Full body (all 10 muscle groups), split (half muscle groups), circuit (exercises in sequence)
86
What’s a compound exercise?
Exercises that work multiple muscle groups at the same time
87
What is progressive overload and why is it important
A gradual increase in stress is placed on the body.
Important because it subjects the muscles to greater stimuli for continues increase in muscular fitness
88
What is the defining criteria for waist circumference risk factors in Canada/USA
Men > 102cm, Women >88cm
89
What are the defining criteria for waist circumference risk factors in Europids (Middle-Eastern; Sub-Saharan Africa;
Mediterranean)
Men > 94 cm
Women >80cm
90
What are the defining criteria for waist circumference risk factors in Asians?
Men > 90 cm
Women > 80 cm
91
What is the defining risk factor criteria for HDL-C?
> 1.55mmol/L (negative risk factor) You want high HDL
92
What is the defining risk factor criteria for LDL and HDL
LDL: 3.37mmol/L
HDL: 1.04 (men), 1.30 (women)
93
What is the defining risk factor criteria for fasting blood glcuose
5.5mmol/L
