Study manual week 1

Week 1 - Lung infections + healthy aging

Case study

PT anamnesis - ICF

Request for help: be less short of breath during ADLs

Impairments

  • feeling unwell for years

  • short of breath

  • Diagnosis: Pneumonia, GP prescribes antibiotics

Activity

  • during extortion

  • walking: 300 m in 7 minutes - catch the bus (walking to the bus station)

  • feeling extortion after and during coughing

Participation:

- — -

Personal factors:

  • 41 years old, male

  • PT didn’t exercise for years

  • smokes cigarette (10 x day, for 20 years) tried to stop but failed

  • gained 5 kg

  • problem sleeping → smokes

  • coughed phlegm after taking his antibiotics

  • in his free time, he writes children’s stories

  • Body weight: 90 kg, height 165 cm

Environmental factors

  • support system → wife

  • works in an accountant firm

Clinical measurements

  • BORG dyspnoea: 6

  • BORG fatigue: 7

  • NPRS: 2 when coughing

In class - friday, 2nd class

Hypotheses

1) smoking induced lung damage

2) physical deconditionong

3) obesity related difficulties

4) Potential early stage COPD

5) Residual pneumonia effect

assessment → look into chapter 6 for ASSESSMENT

1) ascultation, saturation

2) 6 minute walk test (endurance test)

3) BMI, body fat percentage, waist circumference

4) Spirometry, CAT, CCQ

Treatment

Goals

1) improve respiratory function

2) Increase physical fitness

3) Support stop smoking

4) Enhance overall qualitty of life

Means (aka how?)

  • anamesis it’s important too

  • how? breathing techniques exercuses

  • Supervised cardiovascular exercises

  • how? gradual exercsie rehab

MB preparation

did it in block 1.1

Wasserman model: interaction between the 3 Systems: muscles, heart, and lungs during physical exertion to maintain body homeostasis and adapt to the body's changes in energy demands

How do these systems work together?

Roles of Each System and Their Interconnections: 

System 1: Muscles

  • it’s the peripheral component

  • They demand energy to create movement, this energy comes from the nutrients that are sent to them via aerobic and anaerobic processes

  • Muscles use oxygen when at rest, the oxygen is obtained by “aerobic metabolism“, when in exertion, the anaerobic metabolism is used and there is a production of lactate

  • Lactated it’s a bioproduct of the anaerobic metabolism (when oxygen is limited), the lactate goes again into the bloodstream and other organs (liver/heart) convert it into energy

System 2: Heart

  • it’s the central component

  • The heart pumps blood and delivers oxygen and nutrients to the muscles, it gets rid of carbon dioxide and lactate

  • HR and stroke volume increase with greater exercise intensity → = Higher cardiac output

  • The heart takes care of the oxygenation process, the heart sends the blood to the lungs, in the lungs the blood gets oxygen and it’s pumped to the muscles, the muscles give as a bioproduct CD and lactate, the blood rich in carbon dioxide and lactate returns to heart and heart sends it back to lungs

  • The function of the heart is regulated with a combo of neuro and hormonal signals, they respond to the muscle’s energy demands

System 3: Lung

  • it’s the ventilatory component

  • The main role is the gas exchange, to remove CD from blood

  • During exercise, Breath frequency and volume increase to meet the demand for oxygen and expel excess CD,

  • Ventilatory Threshold (VT) → point that marks the transition where ventilation rises to remove the larger quantities of CD (due to exercise)

  • lactate buffering: when L accumulates in the blood, there is more CD → It further stimulates breathing to expel the excess

How do they work together?

Summary:

1) System integration: the systems work together to meet body energy demands during exercise. It’s a cycle, the muscles require more oxygen and expel bioproducts, and the heart and lungs work faster and harder to supply oxygen and expel bioproducts

2) Feedback: there is constant communication between the systems and they respond to each other needs

3) Efficiency and performance: if one of the systems is not working, it affects the overall efficiency and performance

Notes in another file:

done

PT preparations

Core concepts PT

Study task 1 → done

Study task 2 → done

Study task 3

ascultation

Study task 4:

Pneumonia is an infection of the lungs that causes inflammation in the air sacs (alveoli). The alveoli may fill with fluid or pus, leading to symptoms such as coughing, fever, chills, and difficulty breathing. Pneumonia can be caused by bacteria, viruses, fungi, or, in some cases, inhalation of harmful substances. It ranges from mild to severe, with severity depending on the cause, the person's age, and overall health.

Study task 5: BRUCE TEST

The BRUCE test, or Bruce Protocol, is a commonly used graded exercise test to assess cardiovascular fitness and determine maximum oxygen consumption (VO₂ max). It is often performed on a treadmill and consists of progressively increasing stages of intensity.

Key Features of the Bruce Test:

  1. Protocol Stages:

    • The treadmill speed and incline increase every 3 minutes.

    • The starting point is usually a speed of 2.7 km/h (1.7 mph) and a 10% incline.

    • Each stage gets progressively harder, challenging the heart, lungs, and muscles.

  2. Purpose:

    • Assess aerobic capacity (VO₂ max).

    • Monitor cardiovascular response (e.g., heart rate, blood pressure, ECG) during exercise.

    • Diagnose or monitor conditions like coronary artery disease or exercise-induced symptoms.

  3. End of Test:

    • It continues until the subject reaches exhaustion, experiences symptoms (e.g., chest pain, dizziness), or the tester terminates it for safety reasons.

    • The total time or stage reached is used to estimate VO₂ max.

Study task 6:

BC preparations

I feel like I know this things enough

Key words to know

Moos & Scaefer Illness processes

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