exercise prescription and chronic disease

List six physiological benefits of regular exercise.

Improved body composition; lipid profile; glucose tolerance/insulin sensitivity; BP; inflammation/coagulation; coronary blood flow.

What psychological benefits are linked to physical activity?

Reduced stress, anxiety and depression; improved coping, confidence, competence and self-efficacy.

Why is psychological wellbeing relevant to chronic disease management?

It supports prevention and management of CVD and other chronic conditions.

What functional benefit can exercise provide?

Greater functional independence.

What is the overarching approach to exercise prescription for chronic disease?

Use baseline measures and the patient’s goals; apply specificity, individualisation and progression.

What effects did progressive resistance training have in older adults?

Moderate-to-large improvements in strength.

Did progressive resistance training clearly improve VO2max in the older-adult evidence cited?

No clear VO2max effect; moderate improvement in the 6-minute walk test.

How did prior functional limitations affect older adults’ resistance training gains?

Smaller strength gains, despite benefit from training.

What did both 50% and 80% 1RM groups improve in the cited study?

1RM strength, mood/cognition and quality of life.

Which resistance training group gained more lean mass in the cited study?

The 80% 1RM group compared with control.

Which resistance training group had better mood/QoL scores in the cited study?

The 50% 1RM group compared with the 80% group.

What does COPD stand for?

Chronic obstructive pulmonary disease.

What are common COPD symptoms?

Dyspnoea, cough, sputum, fatigue, reduced exercise capacity and poorer quality of life.

What inactivity cycle can develop in COPD?

Breathlessness leads to activity avoidance, deconditioning and further activity limitation.

Name two psychological or functional issues common in COPD.

Anxiety/depression and reduced functional independence.

Which co-morbidities should be considered in COPD?

Hypertension and coronary artery disease, among others.

What are key benefits of exercise for people with COPD?

Better capacity/tolerance, less breathlessness anxiety, more ADL independence, less fatigue and improved sleep/QoL.

Does training necessarily restore impaired lung function in COPD?

No. Functional and psychological benefits can occur despite persistent lung impairment.

Why is a medically monitored exercise evaluation recommended in COPD?

To assess cardiac risk and physiological/subjective responses to exercise.

What can symptom-limited exercise testing help establish in COPD?

An appropriate range of exercise exertion.

What is monitored during a COPD 6-minute walk test?

Heart rate, oxygen saturation, RPE and dyspnoea.

What does the Modified Borg Dyspnoea Scale measure?

Perceived breathing difficulty from 0 (none) to 10 (maximal).

What Borg dyspnoea scores correspond to moderate and somewhat severe?

3 = moderate; 4 = somewhat severe.

What is the COPD training target on the 10-point Borg scale in the cited endurance table?

About 4–6.

How long should a COPD warm-up last according to these notes?

5–10 minutes of low-to-moderate whole-body aerobic/local endurance activity.

What is the COPD warm-up breathlessness goal in these notes?

Avoid shortness of breath during the warm-up.

How long is the COPD cool-down in these notes?

Usually 3–5 minutes, including stretching.

Why is cooling down important in COPD?

To reduce risks of hypotension, arrhythmias and post-exercise bronchospasm.

What is the exercise program duration suggested for COPD?

6–8 weeks.

How often is continuous COPD endurance training prescribed in the cited table?

3–4 days per week.

What initial continuous-training intensity is cited for COPD?

60–70% of peak work rate (PWR).

What initial duration is cited for continuous COPD endurance training?

10–15 minutes for the first 3–4 sessions.

What longer-term duration is targeted for continuous COPD endurance training?

30–40 minutes.

What eventual work rate is targeted for continuous COPD endurance training?

Approximately 80–90% of baseline PWR, if tolerated.

How often is interval COPD endurance training prescribed in the cited table?

3–4 days per week.

Give two COPD interval work:rest examples.

30 seconds work:30 seconds rest, or 20 seconds work:40 seconds rest.

What initial interval intensity is cited for COPD?

80–100% of peak work rate for the first 3–4 sessions.

What initial duration is cited for COPD interval training?

15–20 minutes, including rest, for the first 3–4 sessions.

What longer-term session duration is targeted for COPD interval training?

45–60 minutes including rest.

What eventual work rate is targeted for COPD interval training?

Approximately 150% of baseline PWR, as tolerated.

How should COPD training workload progress in the cited table?

Increase workload by 5–10% as tolerated.

Which breathing technique may help limit dynamic hyperinflation in COPD?

Pursed-lip breathing (or a PEP device).

What did the 2009 COPD review find comparing interval and continuous training?

No significant differences in exercise capacity or health-related QoL outcomes.

Why might interval training suit someone with severe COPD?

It may produce less dyspnoea and lower metabolic and ventilatory stress during exercise.

What two components must COPD pulmonary rehabilitation include in the notes?

Lower-limb endurance training and a home exercise program.

What components should COPD pulmonary rehabilitation ideally add?

Upper-limb endurance, strength, flexibility/stretching and balance.

What walking speed is suggested for COPD endurance training based on 6MWT?

Approximately 80% of the average 6MWT walking speed.

What training speed is suggested using the incremental shuttle walk test?

Approximately 75% of peak ISWT speed.

What COPD lower-limb endurance frequency appears in the example program?

4–5 days/week, including 2–3 supervised sessions and home exercise.

What dyspnoea rating is used in the sample COPD walking prescription?

3/10 (moderate).

What treadmill adjustment is suggested when starting COPD training?

Reduce walking speed by 0.5–1 km/h until familiar with the treadmill.

What is the example COPD strength prescription?

1 set of 10 repetitions at about 10RM, 2–3 times weekly with a rest day between.

What BP threshold defines hypertension in these lecture notes?

SBP ≥140 mmHg or DBP ≥90 mmHg (lecture classification).

Name four health risks associated with hypertension.

Stroke, coronary heart disease, heart failure and chronic kidney disease.

Name common modifiable contributors to hypertension.

High salt intake, poor diet, obesity, alcohol excess and physical inactivity.

How much can aerobic exercise reduce resting BP in hypertension, per the notes?

About 5–7 mmHg in both SBP and DBP.

What other cardiovascular adaptations can aerobic exercise produce in hypertension?

Greater exercise capacity, lower submaximal exercise SBP and regression of cardiac wall thickening.

What is the aerobic FITT frequency for hypertension?

5–7 days/week.

What is the suggested aerobic intensity for hypertension?

Moderate; RPE 12–13.

What is the aerobic time target for hypertension?

At least 30 minutes/day, continuous or in bouts of at least 10 minutes.

What is the aerobic exercise type for hypertension?

Prolonged rhythmic, large-muscle activity.

What is the resistance training frequency for hypertension?

2–3 days/week.

What starting resistance intensity is suggested for novice/older hypertensive clients?

40–50% of 1RM.

What resistance intensity progression is listed for hypertension?

60–70% 1RM, progressing towards 80% if appropriate.

What resistance volume is recommended for hypertension?

2–4 sets of 8–12 repetitions for major muscle groups.

What is the flexibility frequency and hold time for hypertension?

2–3 days/week; 10–30 second holds, repeated 2–4 times.

What BP-related issue can occur after exercise in hypertension?

Post-exercise hypotension.

What should a clinician do if a patient with hypertension takes medication?

Liaise with their doctor/GP and consider medication effects.

What exercise SBP thresholds are flagged as abnormal in the notes?

Above 210 mmHg for males or above 190 mmHg for females.

What exercise SBP decrease is flagged as abnormal in the notes?

A drop greater than 10 mmHg below resting SBP.

What delayed BP response is noted after exercise?

SBP not returning towards resting level after about 6 minutes.

What DBP exercise responses are flagged as abnormal in the notes?

Peak DBP >90 mmHg or DBP increase >10 mmHg.

What BMI indicates obesity in the supplied notes?

BMI ≥30 kg/m².

What BMI range is classified as overweight (not obese)?

25 to <30 kg/m².

How do the notes define severe obesity?

BMI ≥35 with co-morbidities or BMI ≥40 kg/m².

What waist thresholds are cited for increased risk?

Males ≥101 cm; females ≥89 cm.

Why is obesity described as multifactorial?

Genetic, developmental, behavioural, medication, social and environmental factors contribute.

How is metabolic syndrome described in these notes?

Central obesity plus at least two: raised BP, raised triglycerides, low HDL or raised fasting glucose.

What diseases are associated with metabolic syndrome?

Heart disease, stroke and diabetes.

What inflammatory pathway is linked to physical inactivity in the notes?

Visceral fat accumulation → systemic inflammation → insulin resistance and other disease pathways.

What are five obesity exercise-prescription goals?

Increase daily activity, reduce chronic disease risk, improve functional capacity, ADLs and QoL.

What aerobic exercise frequency is suggested for obesity?

5–7 days/week, possibly starting with fewer days.

What exercise intensity is suggested for obesity?

About 60–70% HRmax (upper-light to mid-moderate).

What daily exercise duration is suggested for obesity in the notes?

At least 60 minutes/day, optionally split into two sessions.

What types of activity may be useful initially for obesity?

Enjoyable, accessible aerobic options; non- or partial-weight-bearing if needed.

What issues need special consideration during exercise with obesity?

Co-morbidities, orthopaedic/CVD risk, heat tolerance, hydration and gradual progression.

What methods are noted for obesity aerobic exercise testing?

Cycle/treadmill staged (3-minute stages) or ramp testing.

What variables are monitored in the cited obesity exercise test?

12-lead ECG, heart rate, blood pressure and RPE.

What weekly activity volume is noted for greater weight loss?

More than 250 minutes of moderate-intensity activity/week.

What is the main insulin problem in type 1 diabetes?

Little or no insulin production/secretion.

What are the main insulin problems in type 2 diabetes?

Insulin resistance and/or impaired insulin secretion.

What metabolic consequence defines diabetes in these notes?

Persistent hyperglycaemia.

Name five type 2 diabetes risk factors in the notes.

Overweight/obesity, abdominal adiposity, inactivity, age and genetic predisposition.

Name major therapeutic targets in diabetes management.

Glucose profile, cardiovascular/lipid risk, glycaemic control and self-management.

What does HbA1c help assess?

Longer-term glycaemic control.

What are four broad components of diabetes management?

Monitoring/education, medication, diet and exercise.

What are key benefits of physical activity for diabetes?

Better glucose tolerance/sensitivity, lower cardiovascular risk, better wellbeing and reduced morbidity.

What effect does muscle contraction have on glucose uptake?

Facilitates GLUT4 translocation and glucose uptake into muscle.

What weekly moderate aerobic exercise total is recommended for type 2 diabetes in the notes?

210 minutes/week.

What weekly vigorous aerobic exercise total is recommended for type 2 diabetes in the notes?

125 minutes/week.