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Flashcards in Environmental Considerations for Exercise Prescription Deck (64)
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1
Q

As we go higher in altitude, performance will…

A

decrease (in relation to aerobic performance)

2
Q

How much Physical performance decreases with increasing altitude >3,937 ft (1,200 m) depends on…

A

1) How they become acclimatized to the environment, 2) How much time they are at elevation, 3) Greater physical activity, 4) The higher the altitude, 5) The larger the individual (muscle mass increases)

3
Q

A progressive decrease in atmospheric pressure associated with ascent to higher altitudes reduces the…

A

partial pressure of oxygen in the inspired air, resulting in decreased arterial oxygen levels; (Low altitude <3,937 ft (1,200 m), Moderate altitude 3,937 and 7,874 ft (1,200–2,400 m), High altitude between 7,874 and 13,123 ft (2,400–4,000 m), Very high altitude >13,123 ft (4,000 m))

4
Q

Altitude Acclimatization Prevention and Treatment

A

The best countermeasure to all altitude sickness; Takes 7-14 days, Minimizing sustained exercise/physical activity, Adequate hydration and food intake will reduce susceptibility to altitude sickness; Descend when possible! (only cure)

5
Q

Primary Acclimatization

A

Increased Red blood cell production which helps in delivery, also water retention

6
Q

Before Acclimatization occurs…

A

Altitude sickness is a problem

7
Q

As elevation increases,

A

Time to perform physical task increases

8
Q

Exercise in High Altitude Environments Medical considerations

A

Altitude Illnesses (Rapid ascent to high and very high altitude increases individual susceptibility to altitude illness)

9
Q

The primary altitude illnesses are…

A

Acute mountain sickness (AMS), High altitude cerebral edema (HACE), High altitude pulmonary edema (HAPE)

10
Q

Acute Mountain Sickness (AMS)

A

Initial and most common illness; Symptoms include headache, nausea, fatigue, decreased appetite, and poor sleep and, in severe cases, poor balance and mild swelling in the hands, feet, or face; Develops within the first 24 h of altitude exposure; Its incidence and severity increases in direct proportion to ascent rate and altitude;
If ascent is stopped and physical exertion is limited, recovery from AMS occurs over 24–48 h after symptoms have peaked.

11
Q

Chronic Acute Mountain Sickness (AMS)

A

Can turn into High altitude cerebral edema (HACE) (less common), High altitude pulmonary edema (HAPE) (more common)

12
Q

High Altitude Cerebral Edema (HACE)

A

Potentially fatal, although not common, illness that occurs in <2% of individuals ascending >12,000 ft (3,658 m); An exacerbation of unresolved, severe AMS; Most often occurs in individuals who have AMS symptoms and continue to ascend.

13
Q

High Altitude Pulmonary Edema (HAPE)

A

Potentially fatal, although not common, illness that occurs in <10% of individuals ascending >12,000 ft (3,658 m); Individuals making repeated ascents and descents >12,000 ft (3,658 m) and who exercise strenuously early in the exposure have an increased susceptibility to HAPE.

14
Q

Rapid Ascent

A

Using any HR-based exercise prescription (relative intensity rather than absolute intensity) at altitude as at sea level provides a similar training stimulus as long as the weekly number and durations of the training sessions are also maintained.

15
Q

During the first few days at high altitudes, individuals should…

A

Minimize their exercise/PA to reduce susceptibility to altitude illness; After this period, individuals whose Ex Rx specifies a THR should maintain the same exercise HR at higher altitudes. The personalized number of weekly training sessions and the duration of each session at altitude can remain similar to those used at sea level for a given individual.

16
Q

For the same perceived effort, jogging or running pace will be…

A

reduced at altitude relative to sea level, independent of altitude acclimatization status.

17
Q

Absolute Intensity

A

Setting a pace for the individual (METS, MPH, etc)

18
Q

Many factors determine cold temperature effects on physiological strain including:

A

Environment, Clothing, Body composition, Health status, Nutrition, Age, Exercise intensity (In most cases, exercise in the cold does not increase cold injury risk)

19
Q

Relative Intensity

A

Such as HR based exercise prescription (possibly RPE), so individual can self monitor at changing altitudes.

20
Q

Does altitude effect anaerobic exercise?

A

No it does not effect strength or power but aerobic is used for recovery); May still need to be adjusted because of this

21
Q

Exercise in Cold Environments (sub-freezing or close to freezing)

A

Inability to maintain thermal balance/ cord body temperature (i.e., immersion, rain, low ambient temperature with wind) will increase exercise-related cold stress (Hypothermia, frostbite, Diminished exercise capability / performance)

22
Q

Exercise-related cold stress may increase the risk of…

A

Morbidity and mortality in at-risk populations (CVD and asthmatic conditions)

23
Q

Risk Factors for Hypothermia:

A

Immersion, Rain, Wet clothing, Low body fat, Older age (i.e., ≥60 yr), Hypoglycemia.

24
Q

Frostbite

A

Occurs when tissue temperatures fall lower than 0° C (32° F). (Air temperature, Wind speed, and Wetness); Be sure to account for man-made wind (e.g., running, skiing; Most common in exposed skin (i.e., nose, ears, cheeks, and exposed wrists) but also occurs in the hands and feet; Contact frostbite may occur by touching cold objects with bare skin, particularly highly conductive metal or stone that causes rapid heat loss. (Offset w clothing)

25
Q

Negative effect health conditions on exercise in Cold environments

A

Low body fat, Older age, Low body sugar (hypoglycemia)

26
Q

Non- Freezing Cold Injuries (NCFI’s) (More Common)

A

Typically occur when tissues are exposed to cold-wet temperatures between 0-15 °C (32-60 °F) for prolonged periods of time; These injuries may occur due to actual immersion or by the creation of a damp environment inside boots or gloves, as often seen during heavy sweating; The most common NFCIs are trenchfoot and chilblains.

27
Q

Trenchfoot and Chilblains.

A

The initial skin color is red but soon becomes pale and cyanotic if the injury is more severe.

28
Q

Clothing Considerations for Exercise in Cold Environments

A

Adjust clothing insulation to minimize sweating, Use clothing vents to reduce sweat accumulation, Do not wear an outer layer unless rainy or very windy, Reduce clothing insulation as exercise intensity increases, Do not impose a single clothing standard on an entire group of exercisers, Wear appropriate footwear to minimize the risks of slipping and falling in snowy or icy conditions.

29
Q

Shoveling snow

A

↑ HR to 97% HRmax and systolic BP to 200 mm Hg. (Walking in snow that is either packed or soft significantly increases energy requirements and myocardial (Individuals with atherosclerotic CVD)

30
Q

Swimming in water <25° C (77° F) may be a threat to individuals with…

A

CVD

31
Q

When the amount of metabolic heat exceeds heat loss,

A

Hyperthermia (i.e., elevated internal body temperature) may develop; Sweat that drips from the body or clothing provides no cooling benefit.

32
Q

Sweat losses vary widely when exercising in Hot environments depending on…

A

Gender, Hydration status, Amount and intensity of PA, Clothing, Protective equipment and environmental conditions.

33
Q

Heat acclimatization (1-2 weeks)

A

Results in higher and more sustained sweating rates; Aerobic exercise training has a minimal effect on sweat rate responses

34
Q

Heat acclimatization vs Cold

A

Cold: clothing and expectations need to be modified, Heat: Physiological changes take time to occur

35
Q

During exercise-induced heat stress, Dehydration increases…

A

Physiologic strain
Core temperature, HR, and RPE
Cardiac Drift

36
Q

Dehydration will exacerbate core temperature elevations

Increases of…

A

0.1 °C to 0.2 °C (0.2 °F to 0.4 °F) with each 1% of dehydration.

37
Q

Dehydration of ≥2% loss in body mass negatively impacts…

A

Endurance exercise performance, while strength and power are negatively affected to a smaller degree.

38
Q

Special Considerations for

Heat acclimatization adaptations

A

Decreased rectal temperature, HR, and RPE; Increased exercise tolerance time, Increased sweating rate, A reduction in sweat salt.

39
Q

Acclimatization results in the following:

A

Improved heat transfer from the body’s core to the external environment, Improved cardiovascular function, More effective sweating, Improved exercise performance and heat tolerance.

40
Q

Seasonal acclimatization will occur gradually during…

A

late spring and early summer months with sedentary exposure to the heat. However, this process can be facilitated with a structured program of moderate exercise in the heat across 10–14 d to stimulate adaptations to warmer ambient temperatures

41
Q

Counteracting dehydration

A

Fluid replacement (males sweat more than females)

42
Q

Fluid Replacement Guide

A

Measuring body weight before and after exercise

43
Q

Active individuals should drink…

A

0.5 L (1 pint) of fluid for each pound of body weight lost; A paler urine color indicates adequate hydration; a darker yellow/brown color, the greater the degree of dehydration

44
Q

Sweating more and sweating sooner=

A

Acclimatization which is good!

45
Q

Fluid Replacement Recommendations Before Exercise

A

Drink 5-7mLkg at least 4 hours before exercise (12-17oz for 154lb individual); If urine is not produced or is very dark drink another 3-5mLkg 2h before exercise (Sodium containing beverages or salted snacks will help retain fluid)

46
Q

Fluid Replacement Recommendations During Exercise

A

Monitor individual body weight changes to estimate sweat loss; Composition of fluid should include 20-30mEqL of sodium, 2-5mEqL of potassium, and 5-10% carbs; Prevents a >2% loss in body weight (Amount and rate of fluid replacement depends on individual sweating rate, environment, and exercise duration)

47
Q

Fluid Replacement Recommendations After Exercise

A

Consumption of normal meals and beverages will restore euhydration, If rapid recovery is needed drink 1.5L*kg of body weight lost (Goal is to fully replace fluid and electrolyte deficits; Consuming sodium will help recovery by stimulating thirst and fluid retention)

48
Q

Typical Cause of Hyponatremia

A

Overdrinking Hypotonic Fluid; Altered normal blood sodium concentration (typically <135 mEq · L−1)

49
Q

Hyponatremia is most common in…

A

Long duration physical activities; Fluid replacement by hypotonic fluid (water) alone in excess of sweat losses (typified by body mass gains).

50
Q

Prevention of Hyponatremia

A

Over-drinking leads to an excess of sweat rate; Consume salt-containing fluids or foods

51
Q

Exertional Heat Illnesses – Heat Cramps Multifactorial Cause

A

May be more related to muscle fatigue and neuronal excitability compared to hydration status or electrolyte concentrations; Water loss, and significant sweat sodium may be a contributing factors

52
Q

Exertional Heat Illnesses – Heat Syncope

A

Temporary circulatory failure caused by the pooling of blood in the peripheral veins, particularly of the lower extremities; Occurs more often among physically unfit, sedentary, and nonacclimatized individuals; Caused by standing erect for a long period or sudden cessation of strenuous exercise

53
Q

Heat Syncope Symptoms and Recovery

A

Light headedness to loss of consciousness; Recovery is rapid once individuals sit or lay supine

54
Q

Exertional Heat Illnesses – Heat Exhaustion

A

Occurs during exercise/PA in the heat; Body cannot sustain necessary cardiac output needed to support skin blood flow for thermoregulation and blood flow for metabolic requirements of exercise; Fatigue and progressive weakness without severe hyperthermia; Oral fluids are preferred for rehydration in individuals who are conscious (Intravenous fluid)

55
Q

Intravenous fluid administration facilitates…

A

Recovery in those unable to ingest oral fluids or who have severe dehydration.

56
Q

Exertional Heat Illnesses – Exertional Heatstroke

A

Caused by hyperthermia
Elevated body temperature (>40 °C or 104 °F); Profound central nervous system dysfunction, Multiple organ system failure that can result in delirium, convulsions, or coma.

57
Q

Greatest Risk for Heatstroke

A

Very high intensity exercise of short duration OR Prolonged exercise when the ambient wet-bulb globe temperature (WBGT) exceeds 28 °C (82 °F). (It is a life-threatening medical emergency)

58
Q

Exercise Prescription in Hot Enviroments

A

Individuals whose Ex Rx specifies a target heart rate (THR) will achieve this THR at a lower absolute workload when exercising in a warm/hot versus a cooler environment; As heat acclimatization develops, a progressively higher exercise intensity will be required to elicit the THR; The first exercise session in the heat may last as little as 5–10 min for safety reasons but can be increased gradually; Allow at least 3 h, and preferably 6 h, of recovery and rehydration time between exercise sessions

59
Q

Rhabdomyolysis

A

a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation.

60
Q

Rhabdomyolysis is

caused by a number of items…

A

Genetic defects, trauma, muscle hypoxia…HYPERTHERMIA, EXERCISE

61
Q

Rhabdomyolysis is characterized clinically by…

A

Myalgias, red to brown urine due to myoglobinuria, and elevated serum muscle enzymes (including creatine kinase) . The degree of muscle pain and other symptoms varies widely
Muscle pain, when present, is typically most prominent in proximal muscle groups
Also present  fever, tachycardia, nausea and vomiting, and abdominal pain

62
Q

Rhabdomyolysis CK Rise

A

2 – 12 hours following exercise…peak within 24 – 72 hours

Continued muscle injury or the development of a compartment syndrome may be present.

63
Q

Common Complication of Rhabdomyolysis

A

Acute kidney injury (AKI, acute renal failure)

64
Q

The reported frequency of AKI ranges from…

A

15 to over 50 percent

↑ Risk: Dehydration, sepsis, and acidosis (Compartment Syndrome, Muscle wasting)