Health, Illness, and Wellbeing Exam 2

Prominent hormones in pregnancy

estrogen, relaxin, human chronic gonadotropin, and progesterone increase

oxygen delivery to the fetus in pregnancy

maternal cells require more oxygen with exercise → fetal cells might be deprived → growth and development might suffer → risk is minimized due to increased blood volume and number of red blood cells that accompany pregnancy and training

body temp changes with pregnancy

increased core body temp (can denature proteins → unable to function normally → exercise produces significant amounts of heat → extreme temp can result in neural tube defects)

musculoskeletal changes in pregnancy

body weight increases, center of balance changes, joints become less stable - risks from these changes can be minimized by avoiding contacting sports and activities that require quick movements or high impact

anatomic and physiological changes in first trimester

hormone levels fluctuate dramatically and promote nausea, breasts swell and become tender, perspiration increases, fetus enlarges and put pressure on urinary bladder, fetal organs begin to develop

anatomic and physiological changes in second trimester

body adjusts to hormone levels, enlarging fetus promotes back pain, center of balance changes, joints become less stable, reflux develops, edema develops

anatomic and physiological changes in third trimester

fetus enlarges and crowds maternal organs, urge to urinate increases, constipation develops, fatigue ensues, Braxton Hicks contractions might develop

Precautions during exercise for pregnant women: risks and recommendations, when is it not safe to exercise during pregnancy

not safe if: persistent excessive shortness of breath, severe chest pain, regular and painful uterine contractions, vaginal bleeding, persistent loss of fluid from the vagina, persistent dizziness or faintness that doesn’t resolve with rest

safety precautions: avoid PA in the heat, avoid activities with increased fall risk, avoid scuba diving and sky diving, and contact sports. maintain adequate nutrition and hydration

why does exercise have risk of low birth weight

increased risk for low birth weight babies (developing fetus requires energy → energy might be used to support activity rather than to support developing fetus → LBW is typically due to lower fat stores in baby, which doesn’t appear to cause any health problems)

General guidelines and recommendations for exercise for pregnancy, both cardiovascular and resistance training

follows the general non-pregnant population guidelines with minor modifications

women should accumulate 150 minutes of moderate PA each week

PA is encouraged everyday, but should occur over a minimum of 3 days per week

variety of PA should be incorporated, both aerobic and resistance in nature, along with yoga and gentle stretching

pelvic floor related exercises should be performed daily

warm up and cool down periods should be included

PA programs should be individualized for each women based on situation, experience and current health status

Benefits of exercise for pregnant women

improve or maintains physical fitness, reduces risk of gestational diabetes, enhances psychological well-being, minimizes potential perinatal complications for mother and fetus

Health promotion considerations as they relate to pregnancy: barriers, motivators, challenges. Mechanisms for encouraging healthy behaviors in this age group

socioeconomic- low income, lack of health insurance, limited access to nutritious food

educational- lack of knowledge about pregnancy 

psychological- stress and depression or low motivation/body image concerns

*motivation comes from desire to protect and ensure healthy development of baby, wanting to feel energetic, and positive influence from others

nutritional concerns for pregnant women

imp nutrients: folic acid, iron, calcium and vit D, protein

Common health concerns during pregnancy: gestational diabetes and preeclampsia- what are they, what are they caused by, and how are they prevented?

gestational diabetes: develops during pregnancy in women who don’t already have diabetes.

Preeclampsia: rapid rise in blood pressure that can lead to seizure, stroke, multiple organ failure, and even death

can be prevented by exercise

What are the anatomical/physiological changes that occur with aging that impact physical activity? Include details of musculoskeletal changes, nervous and sensory system changes, cardiovascular changes, and temperature regulation

muscle fiber size starts to decrease at around 20 years old, but regular exercise can maintain high proportion until 60 years in muscle groups being trained.

• fast twitch are lost more rapidly slow twitch

muscle loss happens as a result of a decrease in muscle protein synthesis with little change in degradation

nervous system changes with aging

loss of alpha motor neurons and start loss of communication route from CNS as early as age 25 with accelerated loss after age 70.

rate of loss can be slowed down

cardiovascular changes with aging

muscle is highly vascular and metabolically active tissue and decreases in muscle contribute to decreasing endurance capacities

decrease is capillaries supplying muscles, capillary density, capillary to fiber ratio, number of capillaries in contact with each muscle fiber

leads to less blood supply, less oxygen, less ability to contract 

*all can be maintained with regular exercise

What are the safety considerations for exercise for older adults?

medical clearance, proper warm up and cool down, low impact activities, stability and balance, gradual progression

Benefits of physical activity for healthy aging

improved strength and mobility, better heart health, stronger bones, longer lifespan

What is sarcopenia? Why is it a concern?

sarcopenia is a decline of muscle mass. it brings health risks for older adults because of impairment on maximal aerobic capacity, glucose intolerance, lowering resting metabolic rate, immune dysfunction, slower gait speed, functional dependency, weakness, disability, morbidity

*sarcopenia is a complex process that involves much more than simply age related decreases in activity

Identify the different types of reaction time.

simple reaction time: when only one stimulus and only one response

choice reaction time: more than one possibility of action, must make a choice

discrimination reaction time: when told there will be a stimulus, but don’t know when. requires a decision to be made about the stimulus prior to reacting

What are some situations/tasks that aging adults perform where reaction time declines become problematic? How do older adults compensate for those changes?

older adults incorporate other parts of their brains to help with some activities to counter age related neural decline

movement time- time interval between the start of a movement and its completion

becomes problematic with safety in driving and walking; sensory systems overlap each other and provide a redundancy in information (as a loss is experienced in one system, the other sensory systems can help provide the needed info to a certain point)

for example, vision → decline in depth perception and narrowing of visual field

Describe the psychosocial changes/concerns that are common among older adults. How can exercise help minimize negative outcomes in this area?

arthritis (rheumatoid, osteoarthritis)

exercise does not exacerbate pain or disease progression, it can decrease pain and improve function and reduce the risks of falls. also increases the sense of well being and self image

Be able to perform a task analysis and complete the FITT process for an older adult

task analysis breaks down what older adults need to be able to do in daily life or exercise, identifying physical abilities required and limitations.

• F- frequency

  • exercise most days of the week (aerobic + strength)

• I- intensity

  • light to moderate intensity, emphasize comfort and safety

• T- time

  • start with 20-30 min of aerobic activity per session, and 1-3 sets

• T- type

  • aerobic (walking, cycling, swimming), strength (resistance band, body weight, light weight), flexibility (stretching, yoga, tai chi)

Health promotion considerations as they relate to older adults: barriers, motivators, challenges. Mechanisms for encouraging healthy behaviors in this age group

barriers: physical limitations, cognitive decline, social isolation, financial restraints, fear of injury

motivation: maintain independence, social engagement, improved energy

challenges: changing long term habits, limited transportation

mechanisms: provide education, encourage social support networks, use goal setting, offer accessible and low cost programs

What are the recommendations for exercise for older adults? In what ways are they different/similar in comparison to those for the general population?

150 minutes at moderate intensity per week or 75 minutes of vigorous intensity

at least two days of activities that strengthen muscles, and include activites to improve balance

What is functional-based exercise and why is it important for older adults?

focuses on movements that mimic everyday activities, like sitting, standing, lifting, reaching, or walking

this is important to help maintain independence, reduce risk of fall, improve mobility and confidence

Know the steps/be able to perform a task analysis

• Identify the Task or Goal

  • Choose the specific activity or skill to be analyzed (e.g., getting up from a chair, walking up stairs, lifting groceries).

• Break the Task into Components

  • Divide the task into smaller, manageable steps or movements needed to complete it successfully.

  • Example: For standing from a chair: scoot forward → place feet flat → lean forward → push up with legs and arms → stand upright.

• Identify Physical and Cognitive Requirements

  • Note what the person needs to do the task: balance, coordination, strength, flexibility, endurance, attention, or memory.

• Assess Barriers or Limitations

  • Determine what might make the task difficult (e.g., pain, weakness, poor balance, limited range of motion).

• Determine Training or Support Needs

  • Identify exercises or adaptations that could help improve performance (e.g., strength training, balance exercises, use of assistive devices).

• Evaluate and Modify

  • Observe the person performing the task, provide feedback, and adjust the plan as abilities change or improve.

What is the definition of a chronic disease?

a disease that lasts 1 year or more and requires ongoing medical attention or limits activities (or both)

Describe some of the important ways in which the neuroendocrine system impacts weight loss efforts.

neuroendocrine system regulates appetite, metabolism, and energy balance, all of which affect weight loss efforts

action of leptin in neuroendocrine

produced by fat cells, leptin signals the brain that the body has enough energy stored (when leptin levels drop, hunger increases, and metabolism slows making weight loss harder)

action of ghrelin in neuroendocrine

‘hunger hormone’ is released by stomach and singles the brain to increase appetite

action of insulin in neuroendocrine

promotes uptake of glucose into cells (high levels make weight loss more difficult)

action of estrogen in neuroendocrine

regulates body fat distribution and metabolism (in women)

What are the physical activity recommendations for individuals wanting to lose weight?

minimum of 150 minutes per week of moderate to intense exercise

minimum of 75min of vigorous

strength training (2 or more days per week)

How might you explain the fact that the traditional calorie deficit-focused weight loss programs do not tend to be effective long term?

sustainable weight management requires gradual, lifestyle based changes rather than severe calorie restriction

What are some issues with BMI and the way it is used in clinical practice?

BMI doesn’t distinguish fat from muscle, and doesn’t show fat distribution. it also doesn’t show for individual differences (age, sex, ethinicity…)

What are the main focuses of health promotion for obesity now?

long term lifestyle changes, overall wellbeing and community support rather than just weight loss

Outlines the pros and cons of the various modern treatments for obesity.

lifestyle modification- noninvasive and low risk, improving overall health; results can be slow and require high motivation

pharmacotherpay- can lead to significant weight loss when combined with lifestyle changes, but has side effects like nausea and GI issues, and weight regain occurs if medication is stopped

bariatric surgery is effective but very invasive and requires lifelong diet changes and nutrient supplementation

review Q’s from week 9 check in