Course: Exercise and Aging for Special Populations

Transcription

1 Copyright EFS Inc. All Rights Reserved. Course: Exercise and Aging for Special Populations Session 2: Cardiovascular and Metabolic Disease Considerations for Exercise Program Design Presentation Created by Cody Sipe,, M.S.

2 Session Objectives Describe the etiology and pathology of cardiovascular disease and related conditions. Understand established exercise guidelines for the management of cardiovascular disease and its related conditions. Describe the etiology and pathology of common metabolic diseases and disorders. Understand established exercise guidelines for the management of common metabolic diseases and disorders. Identify signs and symptoms of and appropriately respond to potentially life-threatening situations. Be able to develop an exercise program for the effective management of these conditions.

3 Cardiovascular Disease Pathology

4 Myocardial Infarction

5 Signs and Symptoms of CVD Pain, discomfort in the chest, neck, jaw, arms or other areas Women: back pain Diabetics: no pain Shortness of breath (dyspnea)) at rest or with mild exertion Dizziness or syncope Ankle edema Palpitations or tachycardia Intermittent claudication Known heart murmur Unusual fatigue with usual activities

6 Terminology Myocardial ischemia Coronary Artery Bypass Grafting (CABG) Balloon Angioplasty (PTCA) Stent Congestive Heart Failure Pacemaker Arrhythmia Normal Sinus Rhythm Bradycardia (<60bpm) Tachycardia (>100bpm) Atrial Fibrillation Ventricular Fibrillation

7 Cardiovascular Disease Aerobic Exercise No Event: Monitor for SxS s within THRR Post-MI or Post-procedure Extended warm-up and cool-down Keep below anginal threshold Monitor HR, BP, SxS s pre, during and post exercise Pre-exercise exercise BP below 200/110 Exercise BP below 225/105 May need to use RPE if on Beta-blocker Time before intensity Terminate session if warranted

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9 Cardiovascular Disease Resistance Training Okay unless physician orders state otherwise Minimum of 5 weeks post-mi or post-procedure procedure IF they have been in cardiac rehab for 4 weeks Minimum of 3 weeks following angioplasty IF in supervised cardiac rehab for 2 weeks Avoid valsalva maneuvers Start with one set of reps at low weight Progress gradually Be mindful of incision wound healing and continue flexibility exercises for anterior torso

10 Peripheral Artery Disease

11 Peripheral Artery Disease Interval training on treadmill or track is most effective 3-55 d/wk Walk until pain reaches moderate severity then rest until symptoms resolve Repeat until minutes of intermittent walking is achieved Goal is minutes of continuous walking Resistance training and flexibility exercises are also recommended as part of a well-rounded program for patients with PAD

12 Common Cardiovascular Medications Blood pressure lowering medications Beta-Blockers Blockers Calcium Channel Blockers ACE (Angiotensin( Converting Enzyme) Inhibitors Diuretics ( water pills ) Anti-anginal Nitrates Lipid lowering agents Statins,, Fibrins Anti-coagulants ( blood thinners ) Aspirin Anti-arrhythmics Inotropics

13 Metabolic Impairments Type I Diabetes (insulin-dependent) Pancreas does not secrete insulin Person must take insulin (oral, shots, pump) Type II Diabetes (non-insulin insulin-dependent) Insulin is produced but doesn t work effectively Managed by medications and lifestyle including diet and exercise Thyroid (under or over-active)

14 Diabetes Pathology Beta cells of pancreas produce insulin which controls blood glucose Type I no insulin Type II lack of insulin High levels of blood glucose cause damage to: Nerves Eyes Kidneys neuropathy retinopathy nephropathy High insulin levels promote fat storage, increases blood pressure

15 Metabolic Syndrome Characterized by: Abdominal obesity Hyptertension Dislipidemias Impaired glucose tolerance/reduced insulin sensitivity High risk for cardiovascular disease Cardiometabolic Risk Initiative from the American Diabetes Association

16 Exercise for Diabetes Monitor blood sugar pre and post exercise Watch for signs/symptoms of hypoglycemia Keep light snack on hand (e.g. 6oz juice, raisins) Moderate intensity cardio training Avoid exercise late at night Increased frequency at similar time of day Be mindful of balance problems related to peripheral neuropathy

17 Hypoglycemia Signs and Symptoms include: Disorientation Severe acute hunger Weakness Hot flashes Profuse sweating Rapid heart rate

18 In the event of a hypoglycemic emergency: Have person stop activity and sit or lie down Give them 6oz of juice, small box of raisins, some candy or a similar sugary item without much fat Monitor heart rate, blood pressure and how they are feeling If they pass out call 911 immediately, lie them down on a soft surface, monitor heart rate and breathing

19 Diabetes Complications Retinopathy Neuropathy Kidney failure Hemodialysis Transplant Obesity

20 Thank you!!!