Exercise is Medicine Exam 2

How much PA is needed for good musculoskeletal health?

*Children/Adolescents:* 60+ min 3x/wk *Adults:* 150-300 min/wk moderate; 75-150 min/wk vigorous *Older Adults:* <150 min/wk moderate aerobic

What's the difference between muscular strength and muscular endurance?

*Muscular Strength:* ability of a muscle/set of muscles to generate adequate force to move a predetermined load -A.D.L: moving a heavy piece of furniture, getting out of bed, standing up to get off toilet -PA/Exercise: 1 RM bench press, back squat, deadlift *Muscular Endurance:* ability of a muscle/set of muscles to repeatedly generate submaximal force to sustain a contraction for a given amount of time -A.D.L: walking -PA/Exercise: push ups, pull ups, sit ups

What's the difference between osteoporosis and osteopenia?

*Osteoporosis:* low bone mineral density (decreased mass & strength) associated w/increased risk of fracture *Osteopenia:* when your bones are weaker than normal but not so far gone that they break easily, which is the hallmark of osteoporosis

What does the research say about reducing risk of falls? Improving functional health and bone health? Recommendations for populations?

*Reducing risk of falls:* strong evidence that participation in community-based or home-based PA programs can significantly reduced the risk of injury from falls *Improving functional health:* moderate evidence that PA/exercise at midlife+ reduces the risk of moderate to severe functional limitations; regularly is safe & improves functional ability; weaker evidence for risk of vertebral fractures (hips=stronger ev) *Improving bone health:* moderate evidence of an inverse relationship btwn PA/exercise & the risk of hip fractures in adults *Recommendations for populations:* older adults should include balance activities in their PA/Exercise ~3x/wk (i.e. backward/sideways/heel/toe walking, & STS)

What tests measure cardiorespiratory fitness and where can they be performed?

-Graded exercise testing (GXT) -classify physical activity and exercise workloads

What are the risk factors for metabolic syndrome?

-abdominal obesity -triglycerides >150 mg/dl -HDL Cholesterol(men <40 mg, women<50mg) -Blood pressure >130/>85 mmHg ->100 mg/dl

Who is at risk for diabetes? (gender? Age? Ethnicity?)

-men >40,women >50 -men are higher risk for CVD at earlier age -women risk for CVD increase postmenopause -African Americans, Hispanics, Asians, Native Americans

Why is HIIT considered as time efficient?

-no one has time to work out for hours on end -see results sooner

Based on the research discussed, what benefits were seen as a result of high intensity interval training?

-rapid improvements in cardiorespiratory fitness -time efficient -improvements in body comp (fat free mass: fat mass)

How can cardiac rehabilitation programs impact mortality rates?

-shown to stabilize, slow or even reverse the natural progression -within the first six months has been shown to reduce total mortality for patients by 20% and cardiac mortality by 26% -has three phases: 1. inpatient programming with education (2-3 days) 2. outpatient programing that is supervised in clinical settings (4 weeks) 3. voluntary patient participation in outpatient programs like local hospital (>12 weeks discharge)

What's the most common method of measuring VO2max?

-using any protocol that requires self-selected physical activity or exercise at moderate - to vigorous- intensity levels for 20 to 30 minutes or for three bouts of ~10mins per day. Ex: distance run tests(1-mile run, 1.5-mile run, 12-min run) Nonexercise prediction equations

What are the risk factors for adequate musculoskeletal and functional health?

1) physical inactivity (low aerobic capacity, lack of muscular strength, poor balance) 2) existing/developing mobility challenges 3) medical management issues 4) rehabilitation issues 5) osteoporosis 6) osteoarthritis 7) low muscle mass 8) cultural & societal factors

How many minutes a week will significantly decrease rates of all-cause mortality?

150 min

What work:rest ratios are discussed in the research presented?

2 minute on 1minute off 1 minute on 1 minute off 4 minute of 2 minutes off

How do we calculate an individual's target HR?

220-Age x %HRmax = Target HR

What HR%max should individuals aim to hit during their "work" cycle?

80-95% HRmax

What happens to resting and working heart rates, blood pressure, stroke volume, and VO2 max with consistent exercise?

lowering resting heart rate and increasing stroke volume

What exercises can improve strength and quality of bone tissue?

moderate-intensity physical activity, most people see improvements in strength (muscle mass quantity) and muscular endurance (muscle mass quality related to function) other activities such as working with resistance bands, doing calisthenics (push-ups, pull-ups, sit-ups), carrying heavy loads, climbing stairs, and heavy gardening (digging and hoeing) are also associated with positive changes in strength and muscular endurance

What are the musculoskeletal disorders and related health challenges discussed in this chapter (Chapter 7)?

osteoporosis, osteoarthritis, osteopenia, sarcopenia

What scientific evidence from the Diabetes Prevention Program was discussed in this chapter?

stroke and ischemic heart failure -Risk appears to continue to decrease with increased exposure up to at least three to five times the amounts of the lower bound of moderate to vigorous physical activity -the relationship of moderate to vigorous physical activity and risk reduction has no lower limit.

Explain how men and women respond to HIIT protocols. What similarities/differences do they demonstrate?

women had greater fat oxidation/ men saw greater muscle protein synthesis

How many minutes should a typical HIIT session last?

Between 5-10 minutes of work not factoring in rest

Why is muscle mass (quantity) and function (quality) important?

Can lead to musculoskeletal disorders such as: - Osteoporosis: bone health - Osteoarthritis: joint health - Low muscle mass

How are the PAGA recommendations regarding aerobic exercise intensity different for children, adults and older adults? How are they the similar?

Children it is recommended to do moderate to vigorous activity daily, in adults and older adults it is better if it is spread throughout the week

What are the recommendations for children, adults and older adults regarding minutes spent in aerobic exercise? What are the recommendations about the time spent in moderate or vigorous aerobic exercise intensities?

Children: 60+ min/day Adults: ~150-300 min/wk moderate; ~75-150 min/wk vigorous Older Adults: 150 min/wk

What different HIIT protocols are appropriate for different populations?

Depending on the population; individuals may need to adjust intensity or duration of exercise (Work:Rest ratio). Frequency how often are they doing HIIT

What is good functional health and how can it be improved?

Good Functional Health= Functional Ability + Role Ability 1) People w/ Limitations (most of us have at least 1 limitation present) • Exercise is recommended • Follow PAGA guidelines 2) People w/ Disability • Exercise is recommended • Avoid inactivity - perform as much PA as they are capable of • Talk with health care provider for appropriate exercise 3)People w/ Chronic Condition • Exercise is recommended • Talk with health care provider

What solutions related to preventing the development of diabetes do you hear about?

HIIT can improve body composition (Decrease in triglycerides and Fasting Glucose), VO2 peak and insulin sensitivity

How is HIIT different from sprint interval training? From moderate intensity continuous training?

HIIT: Short duration as little as 1 minute to 4 minutes with high intensity exercise followed by periods of rest SIT: Short durations with maximal effort (Repeated Wingate Sprint Style Training) MICT: Continuous training at a moderate intensity without rest periods in-between

The physiological basis of HIIT relies on what primary mechanisms?

Increased mitochondrial density and associated enzymatic adaptations and a high level of type II muscle fiber recruitment and enhanced muscle buffering capacity

What is MES? How does it work?

Minimal Essential Strain -when you combine it with axial loading, we overload the bone greater relative to normal daily activities. -it is key in signaling the clean up of old bone (weak) and the formation of new bone (strong)

According to the ACSM, what %HRmax is representative of moderate intensity exercise? vigorous intensity exercise? low intensity exercise?

Moderate: 65-75% Target HR Vigorous: 76-96% Target HR Low: <64% Target HR

What are the modifiable and non-modifiable risk factors that impact cardiorespiratory and metabolic health?

Modifiable: atherogenic dyslipidemia, diabetes mellitus, obesity, tobacco use, physical inactivity, metabolic syndrome, elevated inflammation, hypertension Non-modifiable: age, sex, heredity (genetics), ethnicity or race

What glucose levels indicate normal, prediabetic and diabetic classifications?

Normal: 80-100 mg/dl Prediabetic: 101-120 mg/dl *Diabetic: >120 mg/dl*

What are the musculoskeletal disorders and related health challenges discussed in this chapter?

Osteoporosis, Osteoarthritis, Sarcopenia (Low muscle mass), low muscle density

At what age does peak BMD occur?

Peak bone mass (or BMD) occurs on average for men and women by age 30 and begins to drop after menopause in women, and by age 70 in most men

What physiological, biomechanical and behavioral adaptations occur due to consistent cardiorespiratory exercise?

Physiological: increased VO2max, low RHR, reduced inflammation, increased lactate threshold, greater stroke volume, reduced girth width, increased muscular strength, increased TEE, reduced body fat Biomechanical: improved economy, improved balance, increased motor skill, improved proprioception Behavioral: experience w/behavioral change, improved stress management, improved self-efficacy, improved sleep patterns, decreased depression, increased self-confidence

What's the difference between Type 1 and Type 2 Diabetes Mellitus?

Type 1: a syndrome in which a person's immune system attacks and destroys the insulin-producing beta cells of the islets of Langerhans in the pancreas Type 2: a syndrome related to overweight, obesity, and insulin resistance(IR, impaired glucose homeostasis)

According to the video, if someone wanted to incorporate HIIT into their exercise routine, the recommended total HIIT component of aerobic exercise should be composed of a) a total of 10 sessions over three weeks to avoid overreaching/overtraining b) a total of 12 sessions over four weeks c) a total of 6 sessions over two weeks- anything more than that may cause overreaching/overtraining d) a total of 15 sessions over five weeks

c) a total of 6 sessions over two weeks- anything more than that may cause overreaching/overtraining

Which of the below option/s was a benefit seen as a result of HIIT? Select all that apply. a) rapid improvements in cardiorespiratory fitness b) time efficient c) improvements in body composition (fat free mass: fat mass) d) relatively quick results e) upregulation of protein synthesis f) all of the above

f) all of the above

What are the different ways doctors can diagnose clients with diabetes?

blood tests

In a HIIT session, what % of HRmax should individuals aim to hit during their "work" interval? a) 90-99% HRmax b) 65-85% HRmax c) 80-95% HRmax d) 75-95% HRmax

c) 80-95% HRmax