高血压英文ppt精品课件special

Special Populations Special Populations nObese nCardiac nDiabetes nHypertension nOsteoporosis nChronic Obstructive Pulmonary Disease n Asthma n Bronchitis n Emphysema nArthritis nPregnancy The Obese Client Effects on the Exercise Response nLow physical work capacity. nHigher risk for coronary artery disease and may exhibit myocardial ischemia during exercise (testing). nHypertensive response may occur during exercise despite the absence of hypertension at rest. nMust consider glucose intolerance as well. Effects of Exercise Training nExercise training is effective in decreasing the BW in moderately obese clients. nHowever, it may not be effective in the morbidly obese. nWhen body weight is reduced through regular exercise, body fat is reduced and lean tissue is maintained or increased. nThose with the least lean mass to begin with have the most lean mass to gain during training. Effects of Exercise Training nObese individuals may already have a significant amount of lean mass (beneath the adipose) due to the overload from the excess fat increases in lean mass may not be as significant. nUltimately, resistance training can increase the lean mass of almost any population. nExercise affects body fat distribution by promoting regional fat loss in the abdominal sites. Effects of Exercise Training nFat loss through exercise is more efficient for clients with upper body fat distribution (significantly decreases risk of diseases). nExercise may be one of the most important factors in the maintenance of weight loss. nExercise has profound effects of glucose metabolism in the obese client: n Decreased fasting glucose and insulin n Decrease insulin resistance n Increased glucose tolerance nThe primary objective of obesity management is the reduction of fat weight with the preservation of lean body weight. nThe client most likely to be successful is: n Slightly or moderately obese n Has upper body fat distribution n Has no history of weight cycling n Has a sincere desire to lose weight n Became overweight as an adult Management also injury history. n Thermoregulation, neutral temp emphasize duration vs. intensity n Use of low-impact or non-wt-bearing exercise; pool? n Adequate hydration n Clothing should be loose fitting n Equipment modification might be needed n Frequent follow ups The Cardiac Client With focus on the Post-myocardial infarction Cardiovascular Diseases n Myocardial Infarction n Coronary Artery Bypass Graft Surgery n Angina RPE (rated perceived exertion 11-15 (Borg) n Need longer warm-up however, it may increase the risk of a fracture. Which Type of Exercise Is Best to Prevent Osteoporosis? nWeight bearing Exercises (min of 4 days/wk) n Activity that is done with your feet in contact with the ground so the force of gravity acts through the skeleton. n Activities that involve carrying your own body weight. n Walking Jogging Hiking n Dancing Stair Climbing n Racquet Sports n These activities apply tension and pressure to the muscles and bones. n Stimulates the body to increase/maintain bone density in response to the additional stress. Resistance Training Offers Protective Benefits nResistance training appears the offer the most benefits for increases in muscular strength and bone density even in the elderly. nPatients with severe osteoporosis should initially be supervised to ensure proper form and technique. nIncreases muscular strength minimize falls. nCurrent recommendations include: n 1 set of 15 repetitions n 8-10 exercises (avoid spinal flexion, maintain upright posture) n Performed 4 days per week Effectiveness of Exercise nThe effectiveness of exercise in the prevention of osteoporosis is dependant upon principle of Progressive Overload. nThe amount of exercise needed to obtain increases in bone mass depends upon the persons current level of physical activity Sedentary vs. Active Effectiveness of Exercise nGains made in bone mineral density will only be maintained as long as the exercise is continued. (ACSM) n Individuals should not assume that a short period of exercise (weeks or months) will achieve long-term effects on their bones. nApproximately 9 months to 1 year are required to detect a significant change in bone mass. (ACSM) Basic Exercise Recommendations nPrograms should be individualized & enjoyable nSelect a variety of exercises to avoid boredom nConsider Cross Training: n Ensures that different body parts are being used. n Minimizes risk of injury by decreasing repetitive activities. nFind a exercise partner nLink exercise with regular activities nKeep an exercise log to monitor progress Exercise Recommendations (ACSM) nThe following areas of focus are quite appropriate for those with osteoporosis: nCoordination & Balance Training nStrength Training nFlexibility Training Exercise Recommendations nWalking program n Safe mode of exercise n Should provide the needed benefits nNon Weight Bearing Activities n For those with significant fragility n Should consider pool activities as an alternative to weight bearing exercise n Minimal improvements in bone mineral density noted Exercise “No Nos” For Osteoporosis n Avoid jerky, rapid movements while performing exercises. n Avoid high impact exercises that impart high loads to the skeleton: n Jogging/Running High impact aerobics Jumping n Avoid exercises involving forward bending or excessive twisting at the waist: n LiftingRowing machine Golf n Sit ups Bowling Tennis n Avoid activities that increase risk of falling: n Trampolines Step aerobics n Slippery floors Skating Safety Tips Around the House nProper mechanics during lifting is absolutely critical - avoid forward bending nBe careful vacuuming, sweeping, mopping, and gardening due to the high degree of bending and twisting of the spine nUse straddle stance with knees slightly bent. nUse rocking motion to shift body weight, keep straight back. Osteoporosis Begins In Childhood! nThe optimal time to begin exercise training to increase bone mineral density is before puberty. n Want to reach the highest peak bone mass possible thus decreasing the risk of fractures later in life. nParticipation in athletics also has potential for increasing bone mineral density. n Those sports/exercise that involve a high degree of impact (gymnastics/volleyball) are more beneficial to bone than those activities without impact loading (swimming, biking). Osteoporosis nIt is never too early or too late to start a prevention program. nResistance training combined with cardiovascular training is the best exercise program for a patient with osteoporosis. nExercise cannot substitute for hormones at menopause. A program of Hormone Replacement Therapy & Exercise combined is most effective in preventing further bone loss. Osteoporosis nNon-weight bearing exercises are more appropriate for those who have severe osteoporosis. nTo protect ones bone mass density, an exercise program must be life long and performed consistently. nHabitual inactivity results in a downward spiral in physiologic functions. Special Considerations nBe aware of clients anxiety about falling. nKeep environment free of hazards. nWall railing are helpful. nMonitor balance drills closely to avoid mishaps during exercise sessions. The Arthritic Client nThere are more than 100 rheumatological diseases, each having varying degrees of articular and systemic involvement. n2 most common: nOsteoarthritis a.k.a. Degenerative joint disorder nRheumatoid arthritis inflammatory disease due to an autoimmune response against joint tissue. Overview Effects on the Exercise Response nInflammatory rheumatic diseases can affect cardiac and pulmonary function. nThis must be considered before performing any vigorous exercise. nIf current flare-ups are occurring, post-pone exercise. nPain, stiffness and BM inefficiency can increase metabolic cost of exercise by 50%. Effects of Exercise Training nThese clients are able to participate in regular, conditioning exercise to improve all aspects of fitness and health. nThe most immediate benefit of exercise for this group is to diminish effects of ina