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Kinesiology 247 Exam 2 Study Guide

by: AnthonyA

Kinesiology 247 Exam 2 Study Guide Kin 247

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- Notes for Exam 2 - Full study guide completed - Refer back to slides in class for graphs and charts for further information for the test
Physical Activity/Health and Disease
Sarah Witkowski
Study Guide
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This 13 page Study Guide was uploaded by AnthonyA on Saturday February 27, 2016. The Study Guide belongs to Kin 247 at University of Massachusetts taught by Sarah Witkowski in Spring 2016. Since its upload, it has received 198 views. For similar materials see Physical Activity/Health and Disease in Kinesiology at University of Massachusetts.

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Date Created: 02/27/16
KIN-247: Exam 2 Study Guide Note that this guide is not meant to be all-inclusive. You should use this as a supplement to your notes, quizzes, and any material covered during lecture   In general: know important statistics, trends, how to interpret definitions/concepts, how to read and interpret graphs/data, and the strengths/weaknesses of any methods discussed   Concepts: ▯ What is the difference between prevention and treatment? Prevention – precautions taken to stop something before it occurs Ex: working out and eating healthy so you don’t get a chronic disease or have a heart attack Treatment – caring given after it has already happened Ex: rehab for an injury, or working out and eating healthier to fix an obesity issue **(INFORMATION ON THIS CAME FROM THE LECTURE SLIDES IN CLASS)** ▯ What are the ACSM and PA Guidelines for Americans? Be able to compare and contrast. General Guidelines on slides in class 1. Avoid sedentary lifestyle, some activity is better than none 2. Benefits will occur with at least 150 minutes (2.5 hours) of PA a week of moderate intensity a. Ex: Brisk walking 3. More benefits with more PA a. Higher intensity, greater frequency, longer duration 4. Aerobic (endurance) and resistance (muscle-strengthening) PA are effective 5. Health benefits occur for everyone of any age, race, and ethnicity 6. Also occur for disabled people 7. Benefits outweigh the adverse outcomes with PA For Adults • At least 150 min/week (2.5 hrs) moderate intensity aerobic • 75 min/week (1 hr 15 min) vigorous intensity aerobic • Aerobic performed in at least 10 min intervals spread throughout the week • Additional o 300 min/week (5hrs) moderate intensity o 150 min/week vigorous intensity o Additional benefits gained beyond this amount • Muscle strengthening activities moderate or high intensity for all muscle groups 2 or more days a week Inactive • No activity beyond baseline • No benefits • Unhealthy Low • Activity beyond baseline <150 min/week • Some benefits • Better than being inactive Medium • 150-300 min/week • Substantial benefits • More extreme additional benefits High • >300 min/week • additional • infinite benefits, science is currently unable to identify an upper limit of activity where benefits cease and health hit a peak (see powerpoint lecture 1 unit 2 for charts and more info) ▯ What is the FITT principle? How should it be used for exercise prescription? o What are different methods for assessing intensity? FITT Frequency • Minimum 3 non-consecutive days/week • <2 days between sessions • 4-5 days/week for improvements in CRF • Optimal if PA done daily • Short duration, increased frequency may be useful for diseased people o 2 10-15 min sessions • MORE IS BETTER Intensity • Heart Rate, RPE indications • ACSM recommendations o RPE: 11-16 (fairly light-hard) o HRR: 40-85% o HRmax: 64-94% o Vigorous range: 60-85% Calculations: MHR = 220 - age HRR = HRmax – RestHR(HRR*%) + RHR (Lecture 1 Unit 2 slides) • Too much intensity? o Faster rate of physiological change o Non-compliance o Increased fatigue o Overuse and over-reaching syndrome o Can eventually lead to musculoskeletal injury Time • 20-60 min/day (min 3 days/week) o Continuous preferred • Control rest periods if you choose to take breaks in between sets within the 20-60 mins/day • Progress by increasing exercise period and decreasing rest • Shorter duration should result in increased intensity improvements in CRF Type • Large muscle groups, continuous, rhythmic • Some things affect capacity to increase intensity o Water aerobics o Arm or combines arm-leg exercise o Seated stepper, elliptical with arms ▯ What are: • Overload o Physical stress placed on the body which is greater than usual o Body adapts o Increases capacity • Progression o Increasing capacity requires overload leading to more adaptations o Small changes improve ability o Progress duration before intensity o Depends on § Initial fitness level, tolerance § Frequency § Compliance o Goals § <10-15% per week § depends on population • Specificity o Benefit from exercise occurs in the parts doing the work § Ex: bench press = benefits in chest/triceps/front deltoids • Reversibility o Adaptations lost if the stimulus is not maintained at the same intensity or duration *Unit 2 Lecture 2 Slides* Cardiorespiratory Fitness • Cardiorespiratory (aerobic) fitness – attribute or characteristic, endurance, ability to sustain work for a long period of time • Indicator of overall health o Inversely related to all-cause death, heart disease & CHF death, diabetes, etc.. o 1 MET increase in fitness = 100% decrease in mortality o Prevention of chronic disease • Can be used to monitor training progress Oxygen to skeletal muscles, respiratory system, heart, and blood vessels allow us to sustain work Cardiovascular system • The heart pumps de-oxygenated blood to the lungs • The oxygenated blood returns from the lungs • The heart pumps oxygenated blood to the muscles • The heart receives de-oxygenated blood from the muscles Measurement of Cardiorespiratory fitness • VO –2The volume of oxygen consumed during physical activity. o Measured in ml O /kg2min o Indirect Calorimetry o Direct Fick Method o VO2 = § (cardiac output) X (a-VO2 difference) • VO 2max: Maximal oxygen consumption test o Indirect calorimetry o Cycle ergometer (increase load) o Treadmill: Increase speed and/or incline gradually o Measure ventilation, carbon dioxide, oxygen Max fitness? 1. HR within 15 beats of age predicted max HR 2. No further increase in VO with increase in workload 2 3. RPE > 17 4. Respiratory exchange ratio (RER) of 1.1 or greater • VO “2eak” o highest VO ac2ieved during a test § test was not performed to max effort § VO s2ill increasing when test stopped Other ways to measure aerobic fitness 1. Sub-maximal test a. Similar to max test but only take people to sub-max and then predict based on heart rate 2. Time of treadmill 3. Timed 1-mile a. Prediction equation based on how long it takes to walk a mile (Rockport Walk test) 4. Step test a. 16” step, take ~ 22 steps/minute. Predict based on HR 5. non-exercise prediction equations a. age, sex, activity level What limits VO2max? 1. Cardiac Output a. L/min b. Heart rate (beats/min) X stroke volume (ml/beat) i. HR ~60 beats/min ii. SV ~70 ml/beat iii. CO ~4200 mL/min c. 5 L/min @ rest d. 35 L/min @ exercise i. Elite athletes 2. a-vO 2ifference a. difference in O between arterial & venous O 2 2 b. ml O2/100ml blood c. @ rest: a-vO2 ~5 ml/100ml blood i. arterial = 20 ml/100ml, venous = 15 ml/100ml d. @ exercise: a-vO2 = ~16 ml/100ml! i. arterial = 20 ml/100ml ii. venous = 4 ml/100ml iii. More extraction! 3. Oxygen uptake in the lung a. Hemoglobin b. Mechanical limitations 4. Oxygen Delivery a. Distribution of cardiac output 5. Oxygen Usage a. Mitochondrial dysfunction ▯ Cardiovascular Disease o How does it occur? • Has to do with plaque build up in a blood vessel • Heart and/or blood vessel disease • Atherosclerosis o Response to injury § Endothelial dysfunction • Fatty steak o Sticky o Adhesion molecules o LDL-Cholesterol becomes trapped and oxidized o Foam cells are created o Monocytes/Lymphocytes enter o Smooth muscle begins to migrate • Fibrous plaque (fibrous cap in vessel) *diagram on slide 22 Lecture 3* o Smooth muscle o Connective tissue o Dead cells, Ca2+, foam cells o Some LDL o Endothelial damage continues o Cap thickness – area with smooth muscle cells and collagen are most stable part of the cap • Complicated lesion o Calcified (decreased elasticity) o Clot: thrombus ----- Embolus o Reduced radius Types 1. Coronary a. Blood vessels delivering oxygen to heart i. Blockage of the vessels ii. Narrowing of vessel compromises O2 delivery to muscles 1. O2 is less than the demand for it 2. Symptoms a. Chest pain (angina) b. Shortness of breath c. Pain down arm or in back or jaw d. Sweating and nausea b. Causes Angina and Myocardial Infarction 2. Cerebrovascular Disease a. Blood vessels delivering oxygen to brain i. Stroke 1. Blockage (ischemic – restriction in blood supply to tissues) a. Stops blood supply 2. Aneurysm (hemorrhagic – caused from ruptured vessel) a. Blood leaks into tissues Thrombus – solid mass of platelets and/or fibrin that forms locally in a vessel Embolus – a piece of thrombus carried in the bloodstream 3. Hypertension a. Elevation in pressure in arteries i. Heart has to work harder to pump blood ii. Increases stress on arterial walls (can lead to aneurysm) iii. Kidney failure 4. Heart Failure a. Heart fails to pump blood functionally 5. Peripheral Vascular Disease a. Narrowing of peripheral arteries i. Pain, walking, decreased flow b. Peripheral Artery Disease (PAD) i. Numbness and weakness ii. Sore that don’t heal iii. Slow hair/nail growth iv. Weak peripheral pulse v. Erectile dysfunction vi. Intermittent claudication 6. Rheumatic Heart Disease a. Involves heart valves 7. Cardiomyopathies a. Abnormalities of heart muscle Disabilities • 8 million Americans due to CV disease • 19% of all disabilities due to CV disease • Stroke is leading cause of long-term disability • 2/3 of heart attack patients don’t make a full recovery o What are risk factors for CVD?’ • What are the criteria for being considered a risk factor? 1. Statistical relationship 2. Potential mechanism to explain the relationship • What are modifiable vs. non-modifiable risk factors? Non-modifiable • Age • Sex • Heredity o Fam history o 2%: familial hypercholesterolemia § LDL receptor mutation (chromosome 19) § High LDL and Heart Attack at young age Modifiable • Smoking • High blood cholesterol o <200 mg/dl = optimal o >240 = high • high triglycerides o <350 = optimal o <mg/dl = height • high blood pressure o <120/80 = normal o 120-139/80-89 = pre-hypertension o 140-159/90-99 = stage 1 o >169/>100 = stage 2 • Diabetes o FPG < 100 mg/dl o 126 mg/dl • Obesity o BMI 18.5-24.9 = normal o 25-29.9 = overweight o > 30 = obese • Physical inactivity/sedentary lifestyle • Diet o Fat intake o Fruit and veggie consumption • How were risk factors identified? o Objective: to identify the common factors or characteristics that contribute to CVD § CVD endpoints • Coronary Heart Disease • Stroke • Peripheral Artery Disease • Congestive Heart Failure o 5209 participants, aged 30-62 o No symptoms of CVD, no MI or stroke o Prospective o What are symptoms of CVD? • What are the symptoms a result of? o Hypertension o Triglycerides and cholesterol o Diabetes o Obesity 1) Vessel walls become “sticky” a. adhesion molecules increase b. platelets and other factors stick 2) Factors (i.e. LDL) move under endothelial cells c. Followed by monocytes and macrophages d. Inflammatory cytokines increase 3) Endothelial cell communication with smooth muscle cells changes e. vasoconstrictor factors > vasodilatory factors i. Dilation = Nitric Oxide ii. Constriction = Endothelin-1 (ET-1) o How does exercise affect CVD risk? Does past vs. present exercise matter? • Exercise lowers risk of CVD • Relative risk for CVD related death is 1.7 for men lowest in fitness group o Smoking 1.6 o High blood pressure (>140 mmHg) 1.3 o High cholesterol 1.6 o Family History 1.2 • A review of 20 prospective cohort studies (1995-2007) found that compared to the least active subjects, the most active subjects had a 30-35% reduction of risk in developing CVD o The SAME reduction in CVD risk with exercise is found in older individuals! (based on studies on 60-80-year olds) § Similar reduction in women and men • What studies provided evidence for this? Unit 2 Lecture 5 • What is VO m2x and how does it relate to CVD? VO2max – maximal consumption of O2 o Higher the VO2max, the lower the risk of CVD o What is the critical VO 2ax level for CVD benefit in men and women? § Males: 8-9 METs (28-32 ml/kg/min) • Moderate biking, stair climbing, rowing vogorous § Females: 6-7 METs (21-25ml/kg/min) • Resistance training vigorous, dance dance rev, rowing moderate o How does sedentary behavior affect CVD risk? *Lecture 6* Higher level of sitting time = increased risk for CVD o What are treatment options for CVD? • Exercise training in subjects with heart failure or type 2 diabetes increases nitric oxide-mediated vasodilatation in response to acetylcholine • Short-term exercise training attenuated abnormal vasoconstriction of coronary arteries in CAD patients 1) Bypass surgery a. Go around blockage 2) Angioplasty and stent a. Open up blockage and put in mesh wire with frame • Exercise o To improve CV fitness safely • Education o About heart disease and improving modifiable risk factors • Encourage healthy eating • Improve psychological well being • Cardiac Rehab Phases o Phase I § Inpatient hospital phase beginning in the CCU o Phase II § Outpatient hospital-based phase for 2 to 4 months o Phase III § Maintenance phase for 4 to 6 months or even up to 12 months. • 1 MET increase in work capacity = 8-14% reduction in death • Exercise o Hospital for 2 weeks o Home 20 min/day 1x/week for 60 min in hospital o 88% had event-free survival o $3708 spent • Percutaneous Coronary Intervention (PCI) with stenting o Surgery, stent o 12 months o 70% PCI group had event-free survival o $6086 ▯ Obesity o What are obesity trends? Charts on Lecture 7 1960-1962: 13.3% Obese 2003-2004: 33.9% Obese o How is obesity defined/classified? Excess body fat with multiple organ specific pathological consequences (negative health effects) • Energy in > Energy out • Excess calories and lack of PA Hypertrophy Cells = enlargement of fat cells (worse for disease risk) Hyperplasia Cells = multiplication of fat cells • Know guidelines and methods of measurement 1) Weight 2) BMI (weight (kg)/ht (m )) a. Not best fro measure because does not differentiate lean mass from fat mass 3) % body fat 4) Waist circumference a. Visceral fat (fat in abdominal cavity) b. Women > 88cm, 35cm c. Men > 102cm, 40cm 5) Waist-to-hip ratio a. Women: Low <0.8, Mod = 0.81-0.85, high >0.85 b. Men: Low <0.95, Mod = 0.96-1.0, high >1.0 o What health risks is obesity tied to? • Type 2 diabetes, heart disease, high blood pressure, stroke, certain types of cancer (colon, rectal, prostate, gall bladder, uterus, cervix, ovaries) • Gall bladder, fatty liver disease, acid reflux • Osteoarthritis • Breathing problems • Reproductive problems • Psychological and social problems • 44% of the diabetes, 23% of the ischemic heart disease and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity. o What causes obesity? Types of Fat • Subcutaneous • Fat directly under the skin • Visceral • “deep fat”, surrounds organs • Abdominal fat • “belly fat” a combination of visceral and subcutaneous • White fat • most of the fat we have – energy storage • Brown fat • more metabolically active, can burn calories Pear Shape body is better than Apple Shape because of more fat concentrated in the lower body not near organs. Visceral Adipose Tissue (VAT) 1. more inflammatory cytokines 2. more adipokines (factors released by fat cells that influence inflammation, metabolism, insulin sensitivity, satiety, vascular function) 3. more lipid metabolites 4. arterioles display endothelial dysfunction Causes • Genes o Adopted from parents • Energy Balance o Energy expenditure o Energy intake • Environmental Influences o Access to places to walk and access to healthy foods o High ‘walkability’ vs. Low ‘walkability’ neighborhoods § High walkability • Grid like streets • More sidewalks • Stores, restaurants, groceries available along the main corridor of the neighborhood § Low walkability • Few sidewalks • More cul-de-sacs (less street connectivity) • Commercial establishments concentrated in one location in the periphery of the neighborhood o Health implications due to continuous sitting at work o Sitting time and work patterns: indicators of overweight/obesity § Sitting for > 7.4 hrs/day: 1.6 times more likely to be overweight/obese than those who sat for <4.7hrs/day o Occupational sitting and overweight/obesity in Australians § Sitting for >6 hrs/day: 1.5 times more likely to be overweight/obese • Social factors o Education o Poverty o What is the best intervention method for treating obesity? • Diet alone and diet + exercise show similar weight reduction effects • More vigorous/amount of exercise is needed for greater weight-loss • SAT and VAT are reduced with diet+ exercise with women showing lower reductions with diet + exercise interventions. *See Lecture 3 Charts and slides* Food Restriction/Diet • Decreased o Resting metabolic rate o Thermic effect of food o Thermic effect of activity/energy expenditure due to physical activity o Total daily energy expenditure Difficulty with Weight-loss 1. Reductions in weight cause changes in energy metabolism that make energy expenditure more difficult 2. Exercise may cause changes in spontaneous physical activity 3. Reductions in weight lead to lower energy expenditure with exercise. 4. Exercise may cause changes in intake Weight Maintenance Predictors 1. engaging in high levels of physical activity 2. eating a diet that is low in calories and fat 3. eating breakfast 4. maintaining a consistent eating pattern 5. self-monitoring weight on a regular basis 6. catching "slips" before they turn into larger regains 7. TV viewing < 10 hrs/week **(INFORMATION ON THIS CAME FROM THE LECTURE SLIDES IN CLASS)**   Studies: Remember that this is not an exhaustive list. Make sure to go through your notes and review any key findings from studies that were discussed in class. o Framingham Heart Study o Longshoreman Study o Harvard Alumni o Morris et al. o Paffenberger et al. o ACLS o Blair et al. o Katzymark et al. o Cancer Prevention Study o Hambrecht et al. o Britton et al. o Ravussin et al. o Wadden et al. o National Weight Control Registry o Pima Indians


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