Download - Chronic Disease Management and Exercise
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MISS VICTORIA HYLAND & MR DAVID WEBB
COLEG LLANDRILLO CYMRU
Chronic Disease Management and Exercise
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Overview and Aims
Outline common Illnesses & Chronic Disease
Management of Illnesses & Chronic Disease through the prescription and life style changes
Pros and cons of Exercise prescription for these illnesses and health conditions
To be able to manipulate exercise to fit in with specific populations and life styles
Exercise Myths
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Determinants of Health
Living and working conditions and access to facilities and services
Support and influence within communities which can sustain or damage health
Economic, cultural and environmental conditions such as standards of living
Personal behaviour and lifestyle
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Lifestyle Factors
Lifestyle factors are responsible for most of the illness and deaths- Smoking Stress Alcohol Improper diet Overeating Lack of exercise
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Obesity
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What is obesity?
Excessive development of body fat. (Bailliere’s 2002)
BMI – Body Mass Index BMI – Weight (Kg) Height 2
(m2)Densitometry - Provides measurements of body density -body pod-Hydrostatic weighing Duel energy x-ray absorptiometry-DXA scanBioelectrical impedanceSkin fold measurements
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Obesity & Physical activity facts
Average person gains 1lb (0.45kg) of fat/year after age 25 and loses 0.5 kg lean body weight/year resulting in a net gain of 0.7kg (1.5lb) of fat per year
Inactivity is a major cause of obesity, probably more important than overeating
Physical activity increases energy expenditure during the activity and for some time after when the metabolic rate remains high
Physical activity can cause a loss in fat weight/maintenance or a gain in fat free mass
ACSM (2010)
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Weight Loss / Fat Reduction
To lose weight you have to create a calorie To lose weight you have to create a calorie deficit. You can do this by deficit. You can do this by decreasingdecreasing your your calorie intake and calorie intake and increasingincreasing your exercise your exercise work output.work output.
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Coronary Artery Disease (CAD)
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CAD
Coronary arteries are the vessels that supply oxygen rich blood to the heart.
Plaque builds up in these arteries and cause restricted blood flow to the heart.
This build up can cause plaque reduces the oxygen to the working heart muscle •Angina•Increased BP•Arrhythmias •Myocardial Infraction (MI)•Heart Failure
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Reduce Risk of CAD. How?
Reduced blood pressure (Duncan et al, 1985, ACSM 2010 )
Increases HDL (Goldberg & Elliot; 1987, ACSM 2010)
Decreases LDL (Sady et al 1986; Work; 1987, ACSM 2010 )
Reduces obesity ( Bray; 1986, ACSM 2010)
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WHAT ARE THE BENEFITS OF EXERCISE?
Regular aerobic exercise protects against CAD; possibly with increasing benefits as the amount of exercise increases (ACSM 2010)
Even after an MI regular exercise reduces the risk of a subsequent MI by 25% (Dargie & Grant; 1991)
Decreased risk of diabetic complications (Boule et al; 2001)
GP referral to exercise!
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DIABETES
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DIABETES
WHAT IS DIABETES?
Insulin Dependant Diabetes Mellitus (IDDM) or Type I Diabetes
Non-Insulin Dependant Diabetes Mellitus (NIDDM) or Type II Diabetes
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IDDM
Characterised by a lack or absence of endogenous insulin production
Regular subcutaneous injections of insulin are required to prevent hyperglycaemia
Fact:Prior to the discovery of insulin Type I patients usually died
within 2 years, from ketoacidosis. (high blood glucose; often caused by illness or taking too little insulin, ketones accumulate in the blood
ACSM(2010)
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NIDDM
Impairment of the pancreatic beta cells to secrete insulin in response to elevated plasma glucose concentrations
A reduced sensitivity to insulin in target organs (such as muscle, liver and adipose tissue)
Often goes undiagnosed!
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PHYSIOLOGICAL IMPLICATIONS
HYPERGLYCAEMIA - elevated concentration of glucose in the blood
CAN BE CONTROLLED WITH EXERCISEOccurs if the liver releases glycogen (glucose) into
the blood stream without the presence of insulinHYPOGLYCAEMIA - Low blood sugar levels, often
causing confusion, light headedness and irritabilityCAN BE MADE WORSE BY EXERCISEOccurs if the individual has used too much insulin or
not consumed enough CHO
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RISKS ASSOCIATED WITH EXERCISE
HypoglycaemiaCardiac implicationsRetinal bleedingProtein excreted in the urineChanges to BPIncreased risk of foot ulcersPossible problems with thermo-regulation
GP referral to exercise!
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BENEFITS OF EXERCISE
Increase insulin sensitivity
Improved functional capacity
Enhanced sense of well-being
Reduced risk of CADReduced risk of MIDecreased ‘stickiness’ of
blood plateletsReduced risk of High BPCan reduce high BP
Decreased triglyceride levels
Increased HDL levelsDecreased LDL levelsImproved HDL / LDL
ratioDecreased Body FatDecreased risk of
OsteoporosisDecreased risk of
Diabetic associated complications
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Older Population
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What do you think is meant by the term “older adult” ?
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ACMS (2010)
The term “Older Adult” is defined as a person
>65 years and people 50-64 years with clinically significant conditions or physical limitations that affect movement, physical fitness, or physical activity.
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Benefits of physical activity
Slow physiologic changes of ageing that impair exercise capacity
Optimizing age related changes in body composition
Promoting psychological & cognitive well-beingManaging chronic diseasesReducing the risk of physical disabilityIncreasing longevity
(ACSM 2010)
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However…………………
Older adults are the least physically active of all age groups.
Exception……..http://www.youtube.com/watch?v=iUvjXQHt6
QQ&feature=fvw
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Exercise Recommendations
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WHAT ARE THE BENEFITS OF EXERCISE?
Reduce the risk of Health Complications Reduces risk of osteoporosisReduced Body FatIncrease cross sectional muscle Decreases risk of injury Improves confidence and self esteemImproves body image
ACSM (2010)
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Exercise PrescriptionExercise Prescription
Recommended by the ACSM (2010):Recommended by the ACSM (2010):
Frequency: Frequency: at least 3-4 days a week / preferably daily.at least 3-4 days a week / preferably daily.
Intensity: Intensity: Moderate (physical activity that noticeably Moderate (physical activity that noticeably increase breathing, sweating, and HR) to vigorous increase breathing, sweating, and HR) to vigorous (physical activity that substantially increase breathing (physical activity that substantially increase breathing sweating, and HR) intensity.sweating, and HR) intensity.
Time: Time: 30 minutes a day of moderate exercise build to an 30 minutes a day of moderate exercise build to an hour. hour.
Type:Type: A variety of actives that are enjoyable and A variety of actives that are enjoyable and developmentally appropriate for the developmentally appropriate for the INDIVIDEALINDIVIDEAL..
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Strength
Recommended by the ACSM (2010):Recommended by the ACSM (2010):Frequency = at least 2 days a weekIntensity = Moderate and vigorous Type = Progressive weight training - Major
Muscles groups
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Flexibility
Recommended by the Recommended by the ACSM (2010):ACSM (2010):Min 2 days a weeksIntensity = 5-6 intensity scaleType: Any activities that maintains orincreases flexibilityMajor muscle groupsHold for minimum 15-30 sec
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SMART Goals Applied to Exercise
S - specific, significant, stretchingM - measurable, meaningful, motivationalA - attainable, agreed upon, achievable,
acceptable, action-orientedR - realistic, relevant, reasonable, rewarding,
results-orientedT - time-based, timely, tangible, trackable
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What exercise do you do in a day?
In small group discuss your daily activities.
Make a list of activities.
Make a note of these activities duration.
Do they fit in with the recommendations?
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Exercise Myths
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Performing exercise for a specific area in an Performing exercise for a specific area in an attempt reduce body fat in that area alone.attempt reduce body fat in that area alone.
But does this work? What do you think?But does this work? What do you think?
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Resistance training is any type of exercise Resistance training is any type of exercise using additional resistanceusing additional resistance
The main aim is to improve muscle strength The main aim is to improve muscle strength and endurance, usually by weight trainingand endurance, usually by weight training
Will it make females look masculine?Will it make females look masculine?
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FACTS on RT
Resistance training increases Basal Metabolic rate (Mc Cartney 1993)
Alexander (2002) RT/circuits – improve body composition and weight loss. Also has a higher energy expenditure post exercise then walking and jogging.
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Summary
Life style factors contribute to illness and chronic disease.
Manipulation of life style can help to maintain a health life style and prevent/manage illness and chronic disease.
Exercise provides benefits to reduce and prevention of illness and chronic disease.
Make exercise enjoyable and specific i.e. SMART Goal setting
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Be happy!
Video Clip Be Happy with What You
Have.WMV
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Any Questions