Describe the medicinal effects of an exercise program, and other lifestyle recommendations; and compare the effects to the conventional health care’s “ABCs of CVD Prevention.” In your essay, describe the dose-response when using exercise as medicine, and summarize the findings of a landmark study that demonstrates the effects of exercise on disease prevention.
ABCs of Cardiovascular prevention
- Aspirin; anti-inflammatory; study showed lowering inflammation may even be more important than lowering cholesterol, LDLs, as shown in the Jupiter trial
- Blood pressure medication; beta blockers can cause lower cardiac output- sprint trial showed its better to lower BP to 120
- Cholesterol lowering therapy; usually statin drugs but they weaken cell membranes making more DOMS making patients more sore and lower vitamin D and Coq levels which act as antioxidants;
- Don’t smoke and diet- recommend low saturated fat but should recommend high fiber, low sodium and sugar diet Professional Custom Writing Services from the Experts!
- Exercise or estrogen replacement therapy- 150 minutes per week of exercise where you “sweat”
- Fish oil (omega 3)- or flaxseed
- Glucose lowering medication
Leading killer in the US is CARDIOVASCULAR DISEASE; stroke and heart attacks. Leading cause of disability and have trouble with high quality of life and doing daily living activities.
Lifestyle change has the ability to work on every one of the ABC aspects; exercise and diet you lower inflammation systemically. Exercise lowers BP and diet does too and you get chronic acute effects; after a workout it will continue to lower it. With a plant based diet you can continue to lower it. Reducing sugar and solid fats in your diet you can also lower cholesterol. Exercise improves glucose sensitive and can help with obesity; study showing this is the Diabetes Prevention Program which compared lifestyle to metformin. In over 3000 pre-diabetic patients the primary outcome was diabetes. Lifestyle could prevent diabetes in 1 out of 6.9 patients. Metformin could prevent diabetes in 1 out of 13.9 patients.
List the order of events in an effective health screening and wellness assessment protocol, and provide some information to describe each.
- Informed consent
- You need to ask if the patient has any questions and watch them sign the consent in order to not be liable, need a witness to sign it as well
- Waiver of liability
- Explain the benefits/risks of exercise and exercise testing
- Protection when you aren’t negligent
- Free to stop at any time. Aren’t forced to continue
- Health screening: Health status questionnaire (HSQ) and/or PARQ
- Allows to get a good detail of information about a person; PARQ for self assessment/ checklist of walk ins; physical activity readiness
- Health appraisal looking for risk factors
- HSQ- face-to-face format to help make sure the client understands the questions; helps get idea of diet, behaviors, exercise, etc.
- Resting measures (RHR, RBP, lipids, etc.)- **Decide if medical clearance is necessary**
- HEALTH RELATED FITNESS COMPONENTS OF FITNESS
- Body composition: BF%, BMI, waist circumference, regional fat distribution looking at central obesity
- Cardiovascular: VO2 max, HR, BP
- HEALTH RELATED FITNESS COMPONENTS OF FITNESS
- Strength- posture, movement screen, grip strength
- Muscular endurance
- Modified version: CV, Body Comp (metabolic), musculoskeletal (flexibility, strength), nutrition
What factors determine that a patient will need to be medically cleared prior to an exercise program? In your answer, make sure to cite the risk factors for CVD as discussed in class.
Any chronic disease like cancer, diabetes, Alzheimer’s, osteoporosis, pregnant, etc. automatically require medical clearance. IF they have a resting heart rate greater than 100 or irregular that is a symptom. Resting blood pressure over 160 systolic or diastolic is over 100 that automatically need medical clearance. If a male has a body fat percentage of over 30% or female greater than 40% they would need a medical referral.
- Sedentary less than 150 minutes of moderate activity (walking) per week or less than 75 minutes of vigorous activity (jogging/weight lifting); less than 10,000 steps per day
- Family history; first degree male relative having coronary event <55 years old or female 1st degree relative <65 years old
- Elevated hypertension- blood pressure of over 140 systolic or over 90 diastolic; however the disease of hypertension such as those treated with medication for high blood pressure or someone diagnosed with hypertension
- Lipidemia- non-hdl cholesterol of 160 or more; cholesterol over 200 or HDL less than 40 or LDL over 130; or cholesterol medication
- Elevated blood sugar; fasting over 100
- Obesity- BMI > 30; waist circumference for male over 40 inches and female over 35 inches; or waist to height measurement over 50%
People at risk:
- Male with 2 or more risk factors over 45 years old and a female with 2 or more risk factors over 55 years old.
- 6 METS or more requires medical clearance- such as weight training or jogging
Negative risk factors (subtract one of above): HDL-C > 60 mg. If someone has two or more risk factors but over 60 HDL, then that eliminates a risk factor.
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