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[Front]

the hypothesis that there is no significant difference between specified populations, any observed difference being due to sampling or experimental error

[Back]

null hypothesis

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Registered KIN Exam - Detalles

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The hypothesis that there is no significant difference between specified populations, any observed difference being due to sampling or experimental error

Null hypothesis

Reject the null hypothesis in favor of the alternative hypothesis, when in fact the null hypothesis is true

Type 1 statistical error

Accepting the null hypothesis when in fact the null hypothesis is false

Type 2 statistical error

Mode = Endurance-type physical activities Intensity = moderate intensity PA (3 - 6 METs) Frequency and duration = at least 150 - 300 min per week (30 mins, 5 days/week or 60 mins 3 days/week)

Cardio guidelines for exercise prescription for improved health - Frequency, Mode, Intensity

Progression = Increase duration 5 – 10 mins every 1-2 weeks for the ﬁrst 4-6 weeks of their exercise program Time = 30-60 mins of moderate-intensity, 20-60 mins of vigorous-intensity, Mode = aerobic activities that can be maintained continuously and that involve large muscle groups and require little skill to perform Volume = target 1000 kcal/week moderate-intensity exercise • Daily pedometer steps: >5,400 – 7,900 steps daily

ACSM guidelines for exercise prescription for improved health and cardio respiratory ﬁtness - General Healthy Population- Progression - Time - Mode and Volume

2 days/week at moderate intensity to improve strength should exercise the major muscle groups at least 2 days/week on nonconsecutive days At least one set of 10-15 reps for 8-10 different exercises each workout Exercise session should last 20-30 mins and not exceed 60 mins 48 hours of rest between exercise workouts

ACSM guidelines for resistance training for older adults

Mode: endurance activities (everyday) and resistance exercise (2 - 3 days a week) Intensity: moderate-intensity endurance (40-60% VO2R) and resistance training (60-80% 1RM) Duration: 30-60 mins or more of continuous aerobic PA per day and a min of one set (8-12 reps) of resistance training exercises for each major muscle group

ACSM exercise prescription for individuals with hypertension Mode, intensity, duration and Frequency

Exercise performed at least 3 days/week • avoid supine exercises and motionless standing after ﬁrst trimester because this compromises venous return, which compromises cardiac output • Stop exercising when fatigued and should not exercise to exhaustion • non-weight-bearing activities are encouraged (ex. Cycling, swimming) • extra 300 kcal per day • Ensure ﬂuid intake is sufﬁcient

Guidelines: Pregnancy and exercise

3 - 6 METS is how intense and what is the ventilatory symptomatology?

Moderate Can pass talk test

High Heavy breathing

>9 METS is how intense and what is the ventilatory symptomatology?

150 mins of moderate PA weekly or 75 mins of vigorous PA • Adults should engage in 2 or more days of muscle strengthening activities that involve all major muscle groups

Physical Activity Guidelines for Chronic Care - Weekly time spent and Resistance Training

Less than 2.59 mmol/L (100 mg/dL)

LDL cholesterol optimal level

4.15 and up (160 mg/dL)

LDL cholesterol high level

(increased risk) less than 1.0 mmol/L (40 mg/dL)

HDL cholesterol Low

(decreased risk) 1.55 mmol/L (60 mg/dL)

HDL cholesterol High

Less than 5.18 mmol/L (200 mg/dL)

Total Cholesterol Optimal

6.22 mmol/L and up (240 mg/dL)

Total Cholesterol High

Less than 1.70 mmol/L (150 mg/L)

Fasting TGS Optimal

2.3 – 5.6 mmol/L and up (200 -499 mg/dL

Fasting TGS High

Decreased oxygen in air at high altitude • Heart rate increase • Lower atmospheric partial pressure of oxygen necessitates increased cardiac output and myocardial oxygen demands

Altitude and body changes

Heart Size Stroke Volume Heart Rate Blood Flow Blood Pressure Blood Volume

CV adaptations to training

Primary factor determining SV is increased preload • When the ventricle stretches more during ﬁlling, it contracts more forcefully • At level of muscle ﬁbre – the greater the stretch of the myocardial cells, the more actin-myosin cross-bridges formed, and greater force is developed

What is the Frank-Starling Mechanism?

Cardiac muscle mass and ventricular volume increase with training • Left ventricular wall thickness increases (increases contractility)

How is the size of the heart effected with CV training

• Increased capillarization • Greater recruitment of existing capillaries • More effective blood ﬂow redistribution from inactive regions • Increase total blood volume

How is Blood flow effected with CV training?

Lactate Threshold and Respiratory Exchange Ratio

What are the Two Metabolic Adaptations to Training

Lactate threshold • The higher the threshold, the better the performance capacity • In trained states, one can exercise at a higher percentage of one’s VO2 max before lactate begins to accumulate in the blood

Metabolic Adaptations to Training - Lactate threshold explain

Progressive degeneration of nerve cells that control muscle movements • Most common motor neuron disease among adults

What is amyotrophic lateral sclerosis?

Chronic disease affecting the central nervous system (brain, spinal cord and optic nerves) • Autoimmune disease caused by the immune system attacking and damaging the nervous system

What is Multiple sclerosis?

Neurological disorder that targets brain cells that control movement • Common symptoms: tremors, poor balance, depression, dementia • Disease targets neurons that produce dopamine

What is Parkinson’s Disease?

Low blood insulin levels attributable to the inability or reduced ability of the pancreas to produce insulin • Prone to hypoglycemia during and immediately after exercise because the liver fails to release glucose at a rate that can keep up with glucose utilization

Type 1 Diabetes

1) Lack of target cell response to insulin (insulin resistance) • Because the cells become resistant to insulin, the hormone cannot perform its function of facilitating glucose transport across the cell membrane 2) Act of muscle contraction has an insulin-like effect • Membrane permeability to glucose increases with muscular contraction • Therefore, acute bouts of exercise decrease insulin resistance, and increase insulin sensitivity • Reduces cells’ requirements for insulin

Type 2 Diabetes (definition) and Benefits of X

Major blood vessels that supply the heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased •Plaque formation in the arteries and inﬂammation causes coronary artery disease •Plaque formation causes coronary arteries to narrow which decreases blood ﬂow to the heart. This leads to angina (chest pain), shortness of breath and other symptoms. Complete blockage can lead to a heart attack •Angina – the heart does not get enough arterial blood supply

Coronary artery disease/ischemic heart disease

Occurs when blood supply to part of your brain is interrupted or severely reduced - Deprives brain tissue of oxygen and nutrients

Stroke

Occurs when heart muscle does not pump blood as well as it should • Conditions such as coronary artery disease or high blood pressure leave heart too weak or stiff to ﬁll and pump efﬁciently

Congestive heart failure

A group of acute and chronic heart disorders that can occur as a result of rheumatic fever • Common result is heart valve damage (mainly mitral valve) • Rheumatic fever is an inﬂammatory disease that affects many connective tissues of the body, especially those of the heart, joints, brain or skin • It starts out as strep throat

Rheumatic heart disease

Common circulatory problem in which narrowed arteries reduce blood ﬂow to limbs • Extremities (usually legs) don’t receive enough blood ﬂow to keep up with demand • Causes leg pain while walking • PAD is also likely a sign of more widespread accumulation of fatty deposits in your arteries (atherosclerosis). This can reduce blood ﬂow to your heart and brain, as well as legs

Peripheral arterial disease

Work of breathing increases • Hyperinﬂation places inspiratory muscles at a mechanical disadvantage • Increased dead space contributes to an inappropriately high ratio between physiological dead space and tidal volume

Chronic obstructive pulmonary disease (COPD)

• Facilitation of ADLs • Cardiovascular reconditioning • Improved ventilator efﬁciency • Improved lactate thresholds • Increased strength and endurance

Benefits of PA on COPD

Max or submax tests • Cycle ergometer with low-level ramp protocol • Treadmill walking with low-level ramp or steady-state protocol

Best Exercise test for COPD

Cycle ergometer testing is safe and feasible • Due to signiﬁcant loss of muscle function, survivors have a severely reduced maximal or peak oxygen uptake • The cycle is best to reduce the risk of unbalance and falls

Acsm guidelines X types and problems - stroke

Improved tolerance of ADLs • Allows more PA to be completed at a lower submax threshold reduces myocardial oxygen demand

Goal of aerobics training for stroke

30-60 minutes a day most days of the week is ideal • intensities of 40-70% of peak VO2 or HHR, while monitoring RPE

Frequency and duration of aerobics exercise with stroke

Umbrella term that encompasses a group of non-progressive, but changing motor impairments that affect muscle tone and occur secondary to early development lesions or anomalies in the motor control areas of the brain Main consideration for muscular strength and endurance testing are stability, coordination, ROM and timing

Cerebral palsy

Parkinson's disease Exercise testing recommendations

Independent mobility via weight-bearing or wheelchair ambulation, transfers, and self-care with or without assistive devices

Spinal Cord Dysfunction Rehab goals

• Increased activity and exercise may aggravate and increase pain in these patients • Patients may not respond positively to increased exercise • Increased walking and recreational activities may be a useful goal for these patients

Peripheral Neuropathy and Neuropathic Pain - Exercise/functional testing

Degenerative joint disease - Most common type of arthritis • Signs and symptoms  • Pain during joint use • Short-term stiffness • Gait problems • Muscle weakness

Osteoarthritis

Chronic, systemic inﬂammatory disease affecting the synovium of diarthrodial joints • Signs and symptoms  • Joint pain and swelling • Joint stiffness • Contractures • Fatigue • Muscle weakness • Low grade fever

Rheumatoid arthritis

Chronic diffuse non-articular musculoskeletal pain • Not an inﬂammatory process • Signs and symptoms • Diffuse non-articular pain • Multiple tender points • Fatigue and sleep disturbance (most limiting feature) • Morning stiffness • IBS • Cognitive dysfunction

Fibromyalgia

Intracerebral – bleeding directly into the brain • Subarachnoid – bleeding into the spaces and spinal ﬂuid around the brain

What are the two subtypes of Hemorrhagic stoke

Thrombotic – thrombus/clot forms on an atherosclerotic plaque Embolic – material/embolus formed elsewhere in the vascular system and occludes an artery or arteriole

What are the two subtypes of Ischemic stroke

0° to 130° - 140

Knee - ROM Flexion

120° to 0

Knee extension

30 to 50 - Lower Body

Ankle - Plantar flexion

Ankle - dorsiflexion

Foot inversion

Foot eversion

Elbow Flexion

Elbow - Extension

Elbow Pronation

Elbow - supination

Wrist - Flexion

Wrist - Extension

Wrist - abduction

Ulnar deviation

Shoulder - Flexion

Shoulder - extension

Shoulder - abduction

Shoulder adduction

Shoulder - lateral rotation

70 to 90°

Medial rotation - Shoulder

The law of movement control for rapid aiming tasks, stating that movement time is linearly related to the index of movement difﬁculty

Fitts Law

The fulcrum is located between the weight (resistance) and the force • Example: joint between the head and the ﬁrst vertebra • Head = resistance • Posterior muscles attaching to the skull (ex. Trapezius) = force

First Class Lever

The resistance is located between the fulcrum and the force

Second Class Lever

Most common lever in the human body • Force is applied between the resistance and the fulcrum

Third Class Level

Aerobic weight-bearing program and a resistive exercise program • Balance training program and falls intervention program to reduce risk of falls • 1 RM muscular strength assessment is discouraged because of safety concerns

Osteoporosis - Recommended Exercise, fitness and functional testing

Often used fro individuals without stress test data Target HR = [(HRPEAK - HRREST) x %Intensity] + HRREST

Calculate HR Reserve (Karvonen method)

1.Force 2.Repetition 3.Postures

Primary ergonomic risk factors for MSK disorder

• Technique to objectively measure the physical demands associated with a job • Evaluates the job not the individual performing the job • Integral for a return-to-work program (RTW)

Physical Demands Analysis (PDA)

Work area - Ergonomics

• Identify primary hand movement area: between 15-40cm from the front of the body and within 40cm from the side of the body at elbow height • The secondary hand movement area is beyond the primary, but within 60cm from the side of the body at elbow height

1) 0° to 125° • 2)15° to 0

Hip ROM 1) Flexion and 2) Extension

0° to 15°

Hip hyper-extension ROM

1) 0° to 45° • 2) 45° to 0°

HIP ROM 1) abduction and 2) adduction

0° to 45° both

HIP ROM - Lateral and medial rot

Between 15-40cm from the front of the body and within 40cm from the side of the body at elbow height

Work Area - Identify primary hand movement area:

Around elbow level

40cm at knee level, 60cm for the feet