Thera Ex1 Report by Shahnelg

8/12/2019 Thera Ex1 Report by Shahnelg

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Individuals undergoing stress testing

should have a physical examination,

be monitored by the ECG, and the

closely observed at rest, during

exercise, and during recovery.


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Changing the workload by increasing thespeed and/or grade of the treadmill or theresistance on the bicycle ergometer

An initial workload that is low in terms of

the individuals anticipated aerobicthreshold

Maintaining each workload for 1 minute orlonger

Terminating the test at the onset ofsymptoms or a definable abnormality of theECG

When available, measuring the individualsmaximum oxygen consumption


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Helps establish a diagnosis of overt or latent

heart disease. Evaluates cardiovascular functional capacity

as a means of clearing individuals forstrenuous work or exercise programs.

Determines the physical work capacity inkilogram-meters per minute (kg-m/min) orthe functional capacity in METs.

Evaluates responses to exercise trainingand/or preventive programs.

Assists in the selection and evaluation ofappropriate modes of treatment for heart

disease.


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Increases individual motivation for entering

and adhering to exercise programs.

It used clinically to evaluate pt. with chest

sensations or a history of chest pain to

establish the probability that such pt. have acoronary disease.

It can also evaluate the functional capacity

of pt. with chronic disease.


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Have had a physical examination. Be monitored by ECG and closely observed

at rest, during exercise, and during recovery.

Sign a consent form.


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Progressive angina

A significant drop in systolic pressure in

response to an increasing workload.

Lightheadedness, confusion, pallor, nausea,

or peripheral circulatory insufficiency.

Abnormal ECG response including ST

segment depression greater than 4 mm.

Excessive rise in blood pressure. Subject wishes to stop.


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Monitor the pulse to assess abnormal

increases in heart rate Blood pressure increases with exercise

approximately 7 to 10 mm of mercury per

MET of physical activity Systolic pressure should not exceed 220 to

240 mm Hg.

Diastolic pressure should not exceed 120mm Hg

Rate and Depth of respiration increase with

exercise


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Respiration should not be labored The individual should have no perception

of SOB

The increase in blood flow while exercising,which regulates core temp. and meets the

demands of working muscles, results in

changes in the skin of the cheeks, nose,

and earlobes. They become pink, moist andwarm to touch.


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Can provide a direct measurement of VO2 max by

analyzing samples of expired air. Differences in protocols involve the number of

stages, magnitude of the exercise, equipmentto be used, duration of stages, endpoints,

position of the body, muscle groups exercised,and types of effort.

Protocols have been developed for multistagetesting.

The most popular treadmill protocol is theBRUCE PROTOCOL.

Treadmill speed and grade are changed every 3minutes. Speed increases from 1.7 mph up to5.0 mph, and the initial grade of 10% increases

up to 18% during five stages.


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There is no clear-cut information provided

on the most effective frequency of exercisefor adaptation to occur.

Frequency may be less important factor

than intensity of duration training. Frequency varies, dependent on the health

and age of the individual.

Optimal frequency of training is generally 3to 4 times a week.


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Low intensity, greater frequency may bebeneficial.

A frequency of 2 times a week does not

generally evoke cardiovascular changes,

although older individuals and convalescing

pt. may benefit from a program of that

frequency.


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Overload principle

Specificity principle

Reversibility principle


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is stress on an organism that is greater than that

regularly encountered during daily life.

Exercise load Must be above the training stimulus threshold for

adaptation to occur. Once adaptation to a given load has taken place,

the training intensity must be increase for the

individual to achieve further improvement.

Level of health, level of activity, age, gender.

The higher the initial level of fitness, the greater the

intensity of exercise needed to elicit a change.


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A conditioning response occurs at 60% to 90%

maximum heart rate (50% to 85% VO 2 max )

Depending on the individual and the initial level offitness.

Methods to determine Maximum heart rate and

Exercise rate. Determine Maximum heart rate (HR)

From multistage test

HR achieved in predetermined submaximum test

220 minus age

Determine Exercise heart rate Percentage of maximum heart rate

Karvonensformula

Exercise heart rate= HR rest + 60-70% (HR max- HR rest )


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Adaptation in metabolic and physiological

systems depending on the demand imposed. Workload and work- rest periods are selected

so training result in:

Muscle strength without a significant increase intotal oxygen consumption.

Aerobic or Endurance training without training the

anaerobic systems.

Anaerobic training without training the anaerobicsystems.

Aerobic training specific to the type of activity.

When training for swimming events, the individual

may not demonstrate an improvement in VO2max


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Dependent on

Total work performed

Intensity

Frequency

Fitness level

Greater Intensity Shorter

Duration

Lower Intensity Longer

Duration


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o 2030 minute of session is generally

optimal to 60% to 70% maximum of heartrate.

o 45 minute continuous exercise period may

provide the appropriate overload.o 1015 minute exercise period

o 35 minute daily period


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Large muscles Rhythmic

Aerobic such as Cycling and running the

overload msut use the muscles required bythe activity and stress the cardiorespi.

System (Specific principle)


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The beneficial effects of exercise training are

transient and reversible.

Detraining exercise occurs rapidly when a

person stop exercising. After 2 weeks of

detraining, significant reductions in workcapacity can be measured, and improvements

can be lost within several months.

A similar phenomenon occurs with individualswho are confined to bed with illness or

disability; the individual becomes severely

deconditioned. With loss of the ability to carry

out normal daily activities as a result of


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The frequency or duration of physical activity

required to maintain a certain level of aerobicfitness is less than that required to improve it.


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Warm up period

Aerobic exercise period

Cool down period


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Muscle temperature Need for oxygen to meet the

energy demands for the muscle

Vasodilation Adaptation of respiratory centers

Venous return


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Purpose

Prevent or Decreases Musculoskeletal system to injury.

Risk for ECG changes (arrythmias)

Guidelines

Should nbe Gradual and Sufficient to Increase muscle

and core temperature without causing fatigue or

reducing energy stores.

Characteristic of period include:

10 minute period of total body movement exercise such as

calisthenics and walking slowly.

Attaining heart rate that is within 20 beats/min of the target

heart rate.


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Is the conditioning part of the exerciseprogram.

Emphasized

Continuous Interval

Circuit

Circuit interval


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Submaximal and sustained

Achievement of the steady state

Duration; 2060 minutes

Most effective in increasing endurance for

healthy individuals

Work rate us Increased progressively as

training improvements are achieved.

Increase exercise duration


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Is perceived to be less demanding than

continuous training. Improve strength and power more than

endurance.

Exercise period is followed by rest interval Rest relief (Passive recovery)

Work relief (Active recovery)

Work recovery ratio

1:1 to 1:5 1 : 1.5 work interval allows the succeeding

exercise interval to begin before recoveryis complete


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Circuit Training

Series of exercise activities Several exercise modes

Improves both strength and endurance


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Combining Circuit and Interval Trainingeffective

Stresses both aerobic and anerobic

systems

Delays the need for glycolysis and lactic

acid production


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Is similar to the warm up period in that it

should last 510 minutes and consist of the

total body movements and static stretching.

Prevents

Pooling of blood

Fainting

Enhance recovery period With the oxidation of

metabolic waste and replacement of the energystores.

Myocardial ischemia, arrhythmias or other

cardiovascular complications.


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Cardiovascular Changes

Respirator Changes

Metabolic Changes


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Changes at Rest Reduction in the resting pulse rate occurs in some

individual

Decrease in blood pressure

Increase in blood volume and hemoglobin

Changes During Exercise

Reduction in the resting pulse rate occurs in some

individual

Increased stroke volume Increased cardiac output

Increased extraction of oxygen by the working muscle

Decreased blood flow per kilogram of the working

muscle.


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Changes at Rest Large lung volumes

Larger diffusion capacities

Changes during Exercise Larger diffusion capacities

Maximum diffusion capacity is unchanged

Maximal Ventilation is Increased

Ventilatory efficiency increased


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Changes at Rest

Muscle Atrophy and Increased Capillary densityoccurs.

Number and size of mitochondria are increased

Increase capacity to generate ATP aerobically.

Increase Muscle myoglobin Concentration

Increase the rate of oxygen transport and diffusion

to the mitochondria.

Changes during Exercise Decreased rate of depletion in muscle glycogen at

submaximum work level.

Increased fat mobilizing and Fat metabolizing

enz mes.


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Changes during Exercise Lower blood lactate level at submaximal work

Mechanism is unclear

Less reliance on phosphocreatine (PC) and ATP in

skeletal muscle

Increased Capability to oxidize carbohydrate

Increased Oxidative potential of the mitochondria

Increased Glycogen storage in the muscle.


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Decrease in body fat Decrease on blood cholesterol and

triglyceride levels.

Increased Heat acclimatization.

Increase in the breaking strength of the

bones and ligaments and the tensile strength

in tendons.


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END

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Thera Ex1 Report by Shahnelg

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