Ex Phys FINAL
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- Safe exercises for pregnant women:
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o Do not increase HR >140 bpm
o Ab work is ok - What happens to cardiovascular system when pregnant?
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RHR elevated by 16 bpm
o RCO elevated 40% during 1st trimester, decreases by 3rd
o SV decreases in 3rd trimester probably due to venous pooling decreasing venous return - Side effects of pregnancy
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Constipation
o LBP, greater lordosis
o Weight gain
o Protruding abdomen, wide gait, center of gravity moves forward - Training effect:
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Reversibility: two weeks, significant decrease in ex. capacity; 20 days bed rest decreases VO2 max by 25%
o Visibility: varies - Psychological effects of exercise:
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↓ feeling of anxiety, mod depression, severe depression w/ drug therapy, stress
o ↑ self esteem, sleep behavior - What happens when exercise aerobically?
- ↑ # of capillaries
- Calorie
- amount of heat necessary to raise one Kgm of water one °C
- Joule
- unit used to represent energy
- Bomb calorimeter
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method used to determine heat production by food
o Food oxidized (burned) inside the calorimeter
o Amt of heat produced is measured directly and called direct calorimetery - Heat production for food/body:
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o Fat: 9.4 Kcal/gm // same for body
o Carb: 4.2 Kcal/gm // same for body
o Protein: 5.65 Kcal/gm // 4.6 for body b/c bomb oxidizes nitrogen and body does not - Creatine supplement and weight lifting:
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o Thought to replenish ATP for energy like creatine phosphate
o Subjects taking CP shortly before lifting were able to lift 8% more than those who did not - Effects of SCI:
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o C4: have scapular elevators and diaphragm; no use of extremities
o C5: some function of biceps, deltoid, scapular adductors; no hand fn
o C6: have brachioradialis, wrist extensors, pectoralis major, latissimus dorsi; very functional
o T1-5: all UE function; not complete innervation of intercostals and abdominals (respiration)
o L1-3: have hip flexion and adduction; full fn for muscles of respiration; usually good temp control - Exercises for SCI
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o Arm ergometer for aerobic training
o Weight training with hand or wrist weights
o Water exercise if pt is safe
o Pulmonary fn exercises
o Slow deep breathing exercises
o w/c push-ups - Why do SCI pts have trouble cooling themselves?
- o Decreased activity of sympathetic nervous system
- Most common way to get a SCI
- MVA/traumatic
- Traumatic SCI
- MVA, fall, GSW, diving accident
- Autonomic hyperreflexia:
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o SCI above T6
o Higher centers not controlling sympathetic NS and may lose control
o Painful stimulus (pt not aware), SNS activated, body cannot stop SNS rxn
o Result: nausea, sweating, inc. BP, shivering, headache, etc. - Contracture:
- o Without PROM, SCIs develop shortened muscles that will lead to permanent bony contractures
- Obesity in children:
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o Higher morbidity and mortality in adulthood
o Higher risk of respiratory impairments, diabetes, orthopedic impairments - Difference in obesity and over weight:
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o Over weight: based on height/weight tables; 20% mod and 30% severe
o Obesity: based on % of fat in body; males > 25% bf and females > 30% bf - Info included in food intake diary for obese:
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o Everything eaten
o How much
o Time of day
o Where person was
o Who with
o How person felt before eating - Cause of obesity
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o Eat too much
o Set point too high or low
o genetics - What should exercise prescription for obese include?
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o Sit to stand
o Sitting for UE
o Theraband/free weights: curls, overhead press, shoulder abduction and flexion, hip abduction and flexion
o Calorie burning: stairs, park far away, walk - Ways to burn calories in obese:
- stairs, park far away, walk
- Reasons for obesity
- hypertension, hypercholesterolemia, diabetes
- Guidelines for nutrition for obese
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o 10 kcal/lb
o reduce sat fat, use of oils, frying, sugars, fast food
o increase dietary fiber, fruits, veggies, lean meat
o broil or bake - Complications of diabetes mellitus
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o Increased risk of amputation
o Heart disease
o Stroke - Exercise for people with DM:
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o Aerobic submax
o Morning b/c it tends to be better for glucose control
o Type I: monitor glucose levels at any time during ex - Insulin resistant tissue
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Type II
o Ex will halp make the tissues less insulin resistant - Asthma symptoms
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o Shortness of breath
o Excessive mucus production
o Wheezing
o Coughing - Who gets asthma?
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o 1-2% of adults
o 7% of children
o 10 million ppl - Where is asthma most prevalent?
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o Males
o NYC, Cook County IL, Fresno County CA - Exercise prescription for asthma patients:
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o 4-6 min workout w/ 5 min break with 20-30 min goal
o intensity starts at 50% of max HR and progress as tolerated
o frequency 5-7 days/week - When do you stop an emphysema patient from exercising?
- o When respiration exceeds 30 bpm
- Benefits of exercise in elderly:
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o Maintain and improve the efficiency of the cardiovascular system
o Slow the decreases in oxygen uptake
o Decrease LE edema
o Increase collateral circulation and overall systemic circulation
o Increases joint mobility, neuromuscular coordination and flexibility
o Muscle strength improves by 200%
o Muscle mass increases by 15% - Considerations for exercise in elderly:
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o Must fit person for safety and appropriateness
o Should be based on client goals
o Need flexibility, strength and endurance training
o Check meds from contraindications of ex rx - What to expect in elderly >85:
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o 80% will need help w/ ADLs
o wheelchair only mobility - What happens to the heart at age 65?
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o Decreased myocardial muscle size
o SA node changes in excitability and loss of nodal cells
o Fibrosis and calcification of heart valves
o Narrowing of coronary arteries
o Loss of arterial elasticity
o Decreased SV and max HR
o Orthostatic hypotension - What happens to the lungs at age 65?
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o Decreased number of cilia
o Decreased thoracic wall mobility
o Decreased total lung capacity by 50%
o Weakness of muscles of inspiration and expiration - What causes falls in elderly?
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o Vestibular changes
o Loss of bone mass
o Gait changes - What happens to muscles in elderly?
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o Not inevitable to lose muscle mass w/ age
o Exercise increases strength in ppl >85 - Osteoporosis: progressive bone loss
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o May be slowed by mod ex as shown by decreased number of fractures following falls
o Loss of bone related to fractures in elderly - Who gets osteoporosis?
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o Women over 35 lose 1% bone mass each year
o Men around 60 years old