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PT663 > Physical Activity, Reconditioning, and Aerobic Training > Flashcards

Physical Activity, Reconditioning, and Aerobic Training Flashcards

1
Q

What is moderate to vigorous physical activity (MVPA)?

A

MVPA includes exercise, physical activities, and activities of varying intensity levels like moderate and vigorous physical activities.

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2
Q

What is the goal of the physical activity guidelines set by the federal government?

A

To create a healthier nation through increased participation in physical activity.

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3
Q

How is daily time typically divided between different activities according to the schematic?

A

About 8 hours each are spent on sedentary behavior, sleep, and light physical activity, with very little time spent on moderate to vigorous physical activity (MVPA).

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4
Q

What is the difference between exercise and physical activity?

A

Exercise is goal-directed, planned, and structured, while physical activity includes any movement caused by muscles.

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5
Q

Why do physical activity guidelines use the term “physical activity” rather than “exercise”?

A

Many people are not fond of the term “exercise,” and using “physical activity” may encourage broader participation.

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6
Q

What are the characteristics of exercise studies compared to physical activity studies?

A

Exercise studies are typically short, controlled trials focusing on specific exercises and outcomes, while physical activity studies are long-term observational cohort studies.

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7
Q

What is the main limitation of observational cohort studies on physical activity?

A

They can show a relationship between physical activity and outcomes but cannot establish cause and effect.

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8
Q

How do exercise and MVPA fit into the ICF model used in physical therapy?

A

Exercise is often seen in the realm of activity, while physical activity can be considered part of participation.

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9
Q

What benefits can meeting the physical activity guidelines provide?

A

It could prevent 1 in 10 premature deaths, 1 in 8 cases of breast or colorectal cancer, 1 in 12 cases of diabetes, and 1 in 15 cases of heart disease.

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10
Q

What is a common reason people exercise, according to the content?

A

People often exercise to look good and feel better, not primarily to meet public health goals.

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11
Q

What percentage of adults meet the physical activity guidelines needed to prevent chronic diseases?

A

About 50% of adults meet the guidelines for physical activity.

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12
Q

How does physical activity participation differ among education levels?

A

People with a college degree or more have higher participation rates, while those with less than a high school education have lower rates.

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13
Q

What trend is observed in physical activity participation over time?

A

Although there has been some increase, only about 20-25% of adults meet both the aerobic and muscle-strengthening guidelines.

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14
Q

What is the difference between physical activity and exercise in terms of study types?

A

Exercise studies are typically randomized controlled trials, while physical activity studies are more observational and cohort-based.

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15
Q

What are two types of activities emphasized in the physical activity guidelines?

A

Aerobic endurance activities and muscle-strengthening exercises, which contribute to bone health and balance.

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16
Q

What is a significant barrier to improving physical activity participation?

A

Changing behavior and encouraging more participation, especially among those with chronic diseases.

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17
Q

How can the medical model serve as a barrier to physical activity?

A

The medical model often focuses on medications rather than promoting physical activity as part of treatment, which can reduce motivation for exercise.

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18
Q

What was the key conclusion from the study on physical activity in patients with type II diabetes and hypertension?

A

Physicians should prescribe physical activity as seriously as medications, providing evidence-based guidelines for exercise.

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19
Q

How does the environment in Denmark support physical activity?

A

Denmark encourages cycling with facilities like bike racks at train stations, rail systems accommodating bikes, and parks designed for cycling.

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20
Q

What is one contrast between Denmark’s environment and that of the United States?

A

Denmark promotes active transportation like cycling, while the U.S. has a culture of drive-through conveniences, contributing to inactivity.

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21
Q

What are the dangers of sedentary behavior as shown in meta-analyses?

A

High amounts of sitting time are associated with an increased risk of all-cause mortality, even when combined with moderate to vigorous physical activity.

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22
Q

How does moderate to vigorous physical activity (MVPA) affect the risks associated with sitting?

A

MVPA can reduce the risks of sitting, but sitting for long periods still increases the risk of all-cause mortality.

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23
Q

What did the study on sitting time and physical activity find about the relationship between activity levels and sitting?

A

Even highly active individuals have increased risks of mortality if they sit for prolonged periods each day.

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24
Q

What is the public health challenge regarding physical activity in the U.S.?

A

Promoting physical activity is challenging because many people remain inactive, and increased inactivity is associated with higher healthcare costs.

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25
What is the estimated economic burden of inadequate physical activity in the U.S.?
Inadequate physical activity costs the government around $117 billion.
26
What role do physical therapists play in promoting physical activity?
Physical therapists are movement specialists and play a crucial role in addressing the consequences of inactivity and encouraging more active lifestyles.
27
What is still unknown about light physical activity according to current evidence?
While light physical activity is considered better than sitting, its specific health benefits are not yet fully understood.
28
Why might observational studies be important for understanding physical activity?
They provide insights into long-term trends and associations between activity levels and health outcomes, despite not establishing cause and effect.
29
How does environment influence physical activity behavior?
Environments that facilitate active lifestyles, like those with accessible cycling infrastructure, encourage more physical activity among residents.
30
What are the physical activity recommendations for adults (18-64 years)?
At least 150 minutes per week of moderate-intensity activity (e.g., brisk walking) and muscle-strengthening activities on 2 or more days per week.
31
What additional recommendation is given for older adults in the physical activity guidelines?
In addition to aerobic and muscle-strengthening activities, older adults should include exercises that improve balance, like standing on one foot.
32
What is the daily physical activity recommendation for children and adolescents?
60 minutes or more of moderate to vigorous physical activity every day, including activities that strengthen muscles and bones.
33
What are the three key aspects of physical activity guidelines?
Intensity (how hard), frequency (how often), and duration (how long)
34
What is absolute intensity in physical activity?
The energy expended during an activity compared to rest, measured in multiples of the energy used while sitting (METs).
35
How is relative intensity different from absolute intensity?
Relative intensity considers an individual's fitness level and effort, meaning less fit individuals exert more effort for the same activity.
36
What is the MET value range for moderate-intensity activities?
3 to 5.9 METs, meaning the activity is 3 to almost 6 times more intense than resting.
37
How often should moderate and vigorous intensity physical activities be performed?
Moderate activities: at least 5 days per week; Vigorous activities: at least 3 days per week.
38
What is the recommended weekly duration for moderate and vigorous physical activity?
150-300 minutes per week for moderate-intensity or 75-150 minutes per week for vigorous-intensity activities.
39
What is the focus of physical activity for insufficiently active people?
Reduce sedentary behavior first, then gradually increase moderate-intensity activity for the most health benefits.
40
What are some of the health benefits of physical activity according to recent evidence?
Improved bone health and weight status in children, reduced cancer risk, improved cognitive function, and reduced anxiety, depression, and mortality risk.
41
How do physical activity guidelines relate to physical therapy?
They are based on strong evidence, align with the physical stress theory, and are used to set goals, monitor progress, and encourage lifelong activity for patients.
42
What role do physical therapists play in promoting physical activity?
They provide physical activity plans during treatment and discharge, helping patients achieve better long-term health through activity.
43
How does vigorous activity differ from moderate activity in terms of intensity?
Vigorous activity is greater than 6 METs and corresponds to a 7 or 8 on a scale of 0 to 10, making conversation during the activity difficult.
44
What approach should inactive individuals take to begin increasing their physical activity?
Start by reducing sedentary behavior and gradually incorporate moderate-intensity activities, progressing slowly over time.
45
What is deconditioning?
Deconditioning describes physiological changes resulting from prolonged bed rest or a drastic reduction in activity, leading to declines in function.
46
How soon can muscle loss be detected in different immobilization conditions?
Muscle loss can be detected after 7 days in microgravity, 10 days of bed rest, and 10-14 days with limb casting or suspension.
47
What are the consequences of muscle loss during immobilization?
Muscle loss leads to functional declines and cardiovascular changes, such as reduced strength and decreased aerobic capacity.
48
What happens to a person's function when they fall below the "threshold of independence"?
They may lose the ability to perform activities like getting out of a chair or using the toilet without assistance, often requiring physical therapy.
49
What are some cardiovascular changes associated with bed rest in older adults?
Increased resting heart rate, faster heart rate with activity, reduced stroke volume, and a higher risk of blood clots like deep vein thrombosis.
50
What is orthostatic hypotension, and why is it a concern during bed rest?
Orthostatic hypotension is a drop in blood pressure upon standing, leading to dizziness or fainting, and is a common issue after prolonged bed rest.
51
How does bed rest affect the pulmonary system?
It leads to decreased lung volume, increased respiratory rate, shallow breathing, and higher risk of pneumonia due to reduced air exchange.
52
What are other adverse effects of prolonged bed rest on the body?
Loss of muscle strength, constipation, urinary incontinence, depression, confusion, pressure ulcers, and bone loss.
53
How much time do hospitalized older adults typically spend in bed each day?
Hospitalized older adults spend an average of 17 hours a day lying in bed, leading to significant inactivity.
54
Why is the message "sit up, get dressed, and keep moving" important for hospitalized patients?
It emphasizes the need to reduce bed rest and promote movement to prevent the negative effects of prolonged inactivity.
55
What did a study on stroke patients' activity levels in hospitals reveal?
Most stroke patients spend their time alone in their bedrooms with limited physical activity, even during formal therapy sessions.
56
How did a study in the Veteran Association hospital measure patient activity levels?
Using accelerometers, the study found that 83% of the hospital stay for older veterans was spent lying in bed.
57
What did a study in Denmark reveal about physical activity levels of hospitalized ambulatory patients?
Even ambulatory patients spent about 17 hours per day lying in bed, with very limited time standing or engaging in higher-level activities.
58
Why is bed rest considered "inactivity on steroids"?
Because it results in profound inactivity, which rapidly accelerates physical decline, particularly in older adults and those with low functional reserves.
59
How does prolonged inactivity during hospitalization impact patients with low functional reserves?
It can push them below the threshold of independence, making recovery more difficult and often requiring intensive rehabilitation.
60
What are the four key components of exercise prescription in physical therapy?
Intensity, duration, frequency, and mode.
61
What is the age-predicted max heart rate formula?
220-age
62
What is the heart rate reserve (HRR) method used for?
It is used to prescribe exercise intensity, accounting for a person's resting heart rate and fitness level.
63
How is the heart rate reserve calculated?
HRR = Max heart rate (220 - age) - Resting heart rate, then multiply by a percentage (e.g., 50-85%) and add back the resting heart rate.
64
Why is the heart rate reserve method preferred over age-predicted max heart rate for exercise prescription?
It better accounts for an individual's fitness level and correlates closely with physiological work and oxygen consumption.
65
What is VO2 max?
The maximum amount of oxygen a person can utilize during intense exercise, often used as a measure of aerobic capacity.
66
How does age affect VO2 max and heart rate?
VO2 max and maximum heart rate decline with age due to changes in heart function and muscle mass.
67
What factors can influence VO2 max?
Testing mode (e.g., treadmill vs. cycle), age, sex, body size, composition, and heredity.
68
What is the relationship between heart rate and oxygen consumption during submaximal exercise?
There is a linear relationship, allowing for predictions of VO2 max based on heart rate measurements during submaximal exercise.
69
Why are submaximal exercise tests commonly used in clinical settings?
They are less expensive, safer, and can predict VO2 max using the linear relationship between heart rate and oxygen consumption.
70
What is a nomogram used for in exercise testing?
It helps predict maximal oxygen consumption (VO2 max) based on submaximal exercise test results.
71
What conditions or factors can affect the accuracy of exercise intensity predictions?
Caffeine, sleep, menstrual cycle, medications, and day-to-day variations in heart rate.
72
Why should patients on heart rate-affecting medications avoid predictive heart rate tests?
Medications can alter heart rate, making predictions inaccurate and potentially misleading for exercise intensity.
73
What is the difference between age-predicted max heart rate and heart rate reserve when prescribing exercise?
Age-predicted max is a simpler method, while heart rate reserve provides a more accurate reflection of fitness level by including resting heart rate.
74
How is exercise intensity defined in physical therapy?
Exercise intensity is the level of effort required, typically measured using heart rate, oxygen consumption (VO2), or perceived exertion.
75
What is a metabolic equivalent (MET)?
MET is a measure of energy expenditure, where 1 MET equals 3.5 milliliters of oxygen per kilogram per minute, the amount of energy used while at rest.
76
How does the Compendium of Physical Activities relate to exercise prescription?
It assigns MET values to various activities, helping to estimate their energy expenditure and categorize their intensity.
77
Why is MET considered an absolute measure of intensity?
Because it does not account for an individual’s fitness level when measuring energy expenditure.
78
What is perceived exertion, and how is it measured?
Perceived exertion is how hard a person feels their body is working during exercise, often measured using the Borg scale (6 to 20) or a modified scale (0 to 10).
79
What is the Borg scale, and how is it related to heart rate?
The Borg scale rates perceived effort from 6 (very light) to 20 (very hard), correlating with heart rate (e.g., a rating of 19 may correspond to a heart rate of 190 bpm).
80
Why is perceived exertion useful for patients on beta blockers?
Beta blockers can blunt heart rate responses, making perceived exertion a better indicator of exercise intensity for these individuals.
81
What intensity levels do the physical activity guidelines associate with a 0 to 10 scale?
Moderate intensity corresponds to a 4-6 (40-60% HRR), while vigorous intensity corresponds to a 7-8 (70-80% HRR).
82
What is the recommended minimum duration for a continuous exercise session?
A minimum of 20 minutes per session.
83
How often should exercise be performed according to exercise prescription guidelines?
At least 2 times per week, with many studies suggesting 3 times per week for better outcomes.
84
What types of activities can be used as modes of exercise?
Walking, running, cycling, swimming, rowing, dancing, and any activity that raises the heart rate, including functional exercises like chair rises.
85
How do upper extremity exercises compare to lower extremity exercises in terms of cardiovascular demand?
Upper extremity exercises result in a higher heart rate and oxygen consumption at the same workload compared to lower extremity exercises.
86
What is continuous training in exercise?
A type of exercise where an individual maintains a steady intensity level for a set period, allowing for gradual overload and improved efficiency.
87
What is interval training, and how does it differ from continuous training?
Interval training involves alternating between high-intensity work intervals and lower-intensity recovery periods, resulting in a higher average heart rate.
88
Why is it important that recovery heart rate during interval training does not return to resting levels?
Keeping the heart rate elevated during recovery maintains stress on the cardiovascular system, enhancing the training effect.
89
What are some examples of functional exercises that can be used for interval training?
Walking up and down stairs, repeated chair rises, and whole-body motions like active range of motion exercises.
90
What is a common clinical measure of aerobic capacity and endurance in physical therapy?
The six-minute walk test, where a patient walks back and forth in a corridor for six minutes to measure distance covered.
91
How does the two-minute walk test differ from the six-minute walk test?
It measures distance covered in two minutes instead of six, offering a shorter assessment option.
92
What is the 400-meter walk test used for?
It assesses aerobic capacity in higher-functioning individuals by measuring the time taken to walk a quarter mile.
93
What factors should be considered when developing an exercise program for a patient?
Conditioning status, functional ability, comorbid conditions, activity preferences, accessibility, ability to self-monitor, and personality.
94
What is reserve capacity in terms of aerobic capacity?
It is the remaining capacity for physical activity after accounting for the energy needed for activities of daily living (ADLs) and community independence.
95
How does aging affect reserve capacity?
Aging decreases VO2 max, which reduces reserve capacity and limits the ability to perform additional activities beyond basic daily functions.
96
Why is reserve capacity important for understanding the needs of deconditioned patients?
Reduced reserve capacity means that even basic activities like getting dressed or walking can be very fatiguing for these patients.
97
How does deconditioning affect heart rate response to physical activity?
Deconditioned patients often have an exaggerated heart rate response, meaning their heart rate increases more at a given work level compared to before deconditioning.
98
What is the role of interval training in acute care for deconditioned patients?
Interval training, involving short bouts of activity followed by rest, helps to slowly rebuild aerobic capacity and manage the limited reserve of deconditioned patients.
99
How do comorbid conditions impact exercise prescription?
Conditions like hypertension, diabetes, and joint pain can require adjustments in exercise types, intensity, and monitoring methods to ensure safety.
100
Why is it important to consider a patient's activity preferences when prescribing exercise?
Tailoring exercises to activities a patient enjoys increases their willingness to participate and adhere to the exercise plan.
101
What type of exercise might be appropriate for a patient who has very low capacity due to deconditioning?
Activities like sitting up, standing, and short walks, performed in intervals with rest, can help rebuild strength and endurance gradually.
102
How do you assess a deconditioned patient's baseline capacity?
By observing their vital signs' response to basic movements, such as sitting up or walking a few feet, to gauge their initial exercise tolerance.
103
What can exaggerated heart rate responses in a deconditioned patient indicate?
They suggest that even low levels of physical activity are a significant challenge for the patient's current physical condition.
104
Why might interval training be more suitable than continuous exercise for certain patients in acute care?
It allows patients with limited endurance to perform brief periods of activity with rest breaks, accommodating their reduced physical capacity.

PT663 (22 decks)

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