Exercise Prescription Lectures

Introduction

• Importance of risk factors in health screening.

• Differentiation between signs, symptoms, and risk factors.

Risk Factors for Cardiovascular Disease

• Categorization:

  • Risk Factors vs. Signs/Symptoms:

    • Risk factors indicate a higher likelihood of disease, while signs and symptoms demonstrate the presence of disease.

  • Examples of Risk Factors:

    • Obesity: Excess body weight, which may increase the risk of various diseases.

    • Hypertension: High blood pressure; evaluated through systolic and diastolic readings.

    • Dyslipidemia: Abnormal fat levels in the blood, determined by LDL, HDL, and total cholesterol levels, or medication use.

    • Diabetes: Assessed through glucose levels and overall health management.

• Multiplicity of Criteria:

  • Only one risk factor needs to be identified to categorize someone as at risk, even if they meet multiple criteria within one category.

Determining Physician Referral

• Sending Clients to a Physician:

  • When working with new clients, if there’s uncertainty regarding their health status, it is safer to refer them to a physician.

  • Concerns over losing clients may discourage referrals, but health and safety should be prioritized.

• Old Practices of Referral:

  • Earlier methods required referrals based solely on risk factors present and existing cardiovascular, metabolic, or respiratory diseases.

  • Controlled conditions led some individuals with chronic conditions to be cleared for exercise without referral, which was overlooked.

Activity as a Risk Factor

• 2015 ACSM Findings:

  • Key Finding: The greatest determinant of risk for acute myocardial infarction (heart attack) is the individual's level of physical activity.

  • Sedentary individuals face significantly higher risks compared to those engaging in regular exercise.

• Decision Tree for Screening:

  • Screening involves assessing if the client is physically active (defined as 3 days/week at 40-60% heart rate reserve for at least 30 minutes over 3 months).

  • If not, no further evaluation is necessary regarding disease.

Signs and Symptoms of Concern

• Signs/Symptoms Requiring Medical Clearance:

  • If a patient presents with any symptoms indicative of cardiovascular disease, immediate referral to a physician is warranted regardless of activity levels.

• **Specific Signs/Symptoms:

  • Angina: Chest pain indicative of ischemia.

  • Dyspnea: Shortness of breath at low levels of exertion.

  • Syncope: Episodes of loss of consciousness.

  • Orthopnea: Difficulty breathing when lying down.

  • Ankle Edema: Swelling indicates potential circulatory problems.

  • Palpitations: Elevated heart rates (tachycardia) above 100 bpm, or bradycardia below 60 bpm.

  • Intermittent Claudication: Cramping pain in calves due to inadequate blood flow.

Cardiovascular and Metabolic Diseases

• Categories of Relevant Diseases:

  • Conditions including heart attacks, coronary artery disease, heart surgery, pacemakers, heart failure, certain congenital diseases, and diabetes.

• Importance of Monitoring:

  • Individuals with controlled metabolic diseases (like diabetes) still retain an increased risk for cardiovascular events.

Resting Measurements and Health Screening

• Key Measurements:

  • Blood Pressure and Heart Rate as usual cardiovascular measures; EKGs may also be employed.

  • Importance of performing these measurements prior to further assessments or exercise programs.

• Blood Pressure Considerations:

  • Blood pressure often undetected until measured; can be often deceptively high and termed the "silent killer."

Physiological Concepts in Measurement

• Systematic vs. Pulmonary Circulatory Differences:

  • High pressure and high resistance in systemic circulation, designed to support blood flow throughout the body.

  • Lower pressure and resistance in pulmonary circulation due to shorter pathways.

• Blood Pressure Equation:

  • Influences include length of vessels, blood viscosity, and radius.

  • Radius can actively change in response to various physiological conditions.

• Effect of Red Blood Cells:

  • Increased red blood cells enhance blood viscosity, affecting blood pressure and capacity to carry oxygen.

Conclusion

• Blood Doping Considerations:

  • Definition and Risks:

    • Blood doping involves extracting and reintroducing red blood cells to enhance performance, leading to increased viscosity and cardiovascular risks.

• Blood Pressure Importance:

  • Accurate blood pressure measurement is essential for evaluating cardiovascular health. Regular monitoring is advised for potential at-risk patients. \