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PA Options for Older Adults with health conditions - M.Jemni - Coggle…
PA Options for Older Adults with health conditions - M.Jemni
Cardiovascular diseases
: CVD is one of the top leading cause of death globally. Most CVDs can be prevented by adressing behavioral risk factors such as tobacco use, unhealthy diet, physical inactivity and too much alcohol.
Peripheral arterial disease
: Plaque is formed in the peripheral arteries of the arms or legs > arteries can't dilate enough to supply O2 to working muscle > painful tightness and squeezing in the legs
CVD risk factors
: body weight, glucose control, BP and lipd levels
Coronary heart disease:
Plaque is formed in the inner walls of arteries > decrease the size of artery > angina > myocardial infarction
Exercise guidelines and contraindications
High risk patients should be supervised closely
-Include arm up and cool down, -Intensity gradually increased
Resistance exercise is important due to the muscle breaakdown
Balance exercise is also recommended for those with high risk of falling
Contraindications
: Unstable angina, resting BP>180, orthostatic intolerance, uncontrolled diabetes, uncompensated HF
Hypertension
: SBP>140 mmHg, DBP>90 mmHg
Medicaitons are important for exercise program
Many HT patients are under drug to decrease BP
Heart must work harder to eject the blood > enlarged heart, stiff arteries
Recommendations: - Emphasize warm up, - Increase effort gradually, -Some medicaitons lower HR so monitor the intensity by HR.
Expected benefits
Regular exercise can reduce body weight, fat %, blood glucose level, total and LDL cholesterol and HR.
regular exercise can increase the aerobic fitness of the patients
It increase the muscle strenght and muscle mass
Diabetes
: 422M people worldwide have Type 2 Diabetes.
Microalbuminuria and nephropathy
: protein in the urine anddisrupted kidney function
Light to moderate exercise for diabetic kidney patients
Exercise program guidelines and containdications
Intensity: moderate intensity aerobic exercise; brisk walking
Duration: 150 min of moderate-high intensity exercise /week
Mode: Combining aerobic, resistance and flexibility exercises with large muscle groups
Tips: CHO intake during exercise, fluid intake, foot care
Contraindications:
fatigue, pain on the feet, blood glucose level>300 or <70, blurred vision
Retinopathy & Autonomic neuropathy
Retinopathic patients > aerobic and resistance training
Cautions for Rethinopathy: no head down or arms over head positions and no excessive jarring
Autonomic neuropathy: damage to nerves in ANS
Exercise expected benefits
Reducing the blood glucose level
Improving the insulin sensitivty, muscle strenght, lower blood pressure, improving quality of life and peripheral circulation
Peripheral arterial disease
: see section CVD
Diabetic neuropathic foot ulcers
: Nerve damage changes the foot structure, frequent complication in diabetes
Wearing proper shoes > reduce the pressure
No weight bearing and aquatic exercises!
Regular skin examination
Blood glucose control
T2DM >> poor control of blood glucose level
Hypoglycemia is more dangerous than hyperglycemia during exercise.
Both exercise and insulin decrease the blood glucose.
-Doses of insulin can be reduced before PA, -Extra CHO can be consumed before session
Frailty
: an elderly person facing some sort of fucntional disability
Exercise evaluation
Slowness - timed walk
PA: questionnaires
Balance - one legged stance
Flexibility - sit and reach
Exercise prescription:
muscle strentgh, endurance, physical activity, daily activities and balance
Issues and concerns
One or more disabilities (hearing and vision)
Presence of other medical conditions
High risk of falls and fractures
Confusion and agitation
Expected outcomes
: Improved muscle strength, endurance, increase in PA energy expenditure, improved balance