Pamela O’Mara PT, MS, CWS         November 27, 2012CHRISTUS St. Catherine Sports Medicine
   Hypertension         Family history   Diabetes             Age   SMOKING              Gender   Stress           ...
   DO NOT SMOKE     Vasoconstriction, increase BP, increase HR, 1:5 deaths   GET ACTIVE     Stress reduction, increase...
   AVOID STRESS     Cortisol is a hormone released in response to stress. It      functions to increase blood sugar, sup...
Increased use of alcohol                   Nausea or stomach pain      or drugs                                Shallow or ...
EXERCISE OR ANY PHYSICAL ACTIVITY !!!GET PLENTY OF SLEEP !!! (but not too much)Eat regular, well balanced mealsTake time e...
Face – Squinch up your face. Clench your teeth. Purse your lips. Push   tongue to the roof of your mouth. Lift eyebrows wi...
   All cause mortality              YES   Coronary heart disease           YES   Cardiovascular disease           YES ...
CARDIOVASCULAR AND    OVERALL ALL CAUSEMORTALITY ARE REDUCED INPOST HEART ATTACK PATIENTSWHO PARTICIPATE IN REGULAR     PH...
   Cardiovascular Endurance       Ability to supply oxygen during sustained activity   Body Composition       Relative...
   Agility       Ability to move with speed and accuracy   Coordination       Ability to move the body parts smoothly ...
MODIFIED BORG RATE OF PERCEIVED EXERTION SCALELEVEL                   DESCRIPTION 0                     NOTHING0.5        ...
MODIFIED BORG RATE OF PERCEIVED EXERTION SCALELEVEL                   DESCRIPTION 5                      HARD 6 7         ...
   AHA Recommendation     Pacing yourself is paramount when beginning a new      exercise program     Target heart rate...
Maximum Heart Rate Men: 220 - Age = Max Heart Rate Women: 226 – Age = Max Heart RateTarget Heart Rate (50-85%) Maximum ...
Average Maximum           Target HR Zone             Heart RateAge        50–85 %                    100 %20 years   100–1...
What if I can’t stop to take my pulse during my   exercise program ??Try using a conversational pace to monitor your   eff...
   Warm up       5-10 minutes, low to moderate intensity, RPE 2-3   Stretching       10 minutes, can be done after war...
   Low Intensity                 Moderate Intensity       Minimal skill                 Minimal skill       Minimal f...
  Resistance training should focus on the major musclegroups of the chest, shoulders, back, abdomen, hips, and legs. Ave...
   Types of resistance training equipment     Weight stack     Cable pulleys     Free weights     Elastic bands     ...
   Improves range of motion, physical function   Insufficient data to prove that stretching prevents    injury, but it d...
   Hot environments       Dehydration       Heat illness – disorientation, headache, dizziness, wet and pale skin,     ...
   Unstable angina   Resting systolic BP >200 and/or   Resting diastolic BP > 110   Acute systemic illness or fever  ...
STOP ALL EXERCISE AT THE FIRSTSIGN OF  ANGINA  SEVERE FATIGUE  SHORTNESS OF BREATH
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
Mended Hearts - Exercise & Cardiovascular Disease
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Mended Hearts - Exercise & Cardiovascular Disease

  1. 1. Pamela O’Mara PT, MS, CWS November 27, 2012CHRISTUS St. Catherine Sports Medicine
  2. 2.  Hypertension  Family history Diabetes  Age SMOKING  Gender Stress  Race Elevated lipids  Obesity Stress  Sedentary lifestyle
  3. 3.  DO NOT SMOKE  Vasoconstriction, increase BP, increase HR, 1:5 deaths GET ACTIVE  Stress reduction, increase oxygenation, increase HDL, decrease BP, reduced insulin needs, reduced platelet aggregation EAT RIGHT  Heart healthy diet low in fat, cholesterol, salt; focus on lean protein, fruits/veggies, grains AVOID OBESITY  Decrease risk of HTN, high cholesterol, and diabetes, reduced body fat
  4. 4.  AVOID STRESS  Cortisol is a hormone released in response to stress. It functions to increase blood sugar, suppress the immune system, and decrease bone formation. SLEEP  Adequate sleep is necessary for health, fitness, and stress reduction REGULAR MEDICAL CHECK-UPS  See your physician to monitor your risk factors
  5. 5. Increased use of alcohol Nausea or stomach pain or drugs Shallow or rapid breathing Increased smoking Not sleeping or sleeping Muscle tension too much Heart palpitations Need to urinate Fear / panic Pacing Diarrhea or constipation Headaches Cold or sweaty hands/feet Grinding teethIs it surprising that stress is a risk factor for obesity, cardiac arrhythmia,diabetes, depression, hypertension, etc.
  6. 6. EXERCISE OR ANY PHYSICAL ACTIVITY !!!GET PLENTY OF SLEEP !!! (but not too much)Eat regular, well balanced mealsTake time every day to do something you enjoyListen to your body. Stop and rest when you feel tiredAvoid stimulants if possible. Smoking, caffeine, alcoholTake a mini vacation in your mind Relax and do mental imagery of a favorite place or eventPractice slow deep breathingListen to slow, calming music or soundsDo stretching exercises daily to relieve that muscle tensionIntimate relationshipsIf you feel depressed, fearful, or hopeless for an extended period of time, talk to your doctor.
  7. 7. Face – Squinch up your face. Clench your teeth. Purse your lips. Push tongue to the roof of your mouth. Lift eyebrows with your eyes still closed. Hold. Release.Shoulders – Hunch up your shoulders to your ears. Pinch shoulder blades together. Hold. Release.Chest – Tense your chest by taking a deep breath and hold for 5 sec.Back – Arch your back. Hold. Release.Abdomen – Tense your stomach muscles by bearing down.Thigh/Buttocks – Tense up thighs/buttocks by pressing feet into the floor and pinching buttocks together.Toes – Curl your toes up. Hold. Release.Hands – Clench your fists. Feel the tension. Release.RECOGNIZE THE DIFFERENCE IN TENSION AND RELAXION.
  8. 8.  All cause mortality YES Coronary heart disease YES Cardiovascular disease YES Hypertension YES Stroke YES Obesity YES Osteoporosis/Osteoporotic Fx YES Type 2 Diabetes YES Colon cancer YES Breast cancer YES Gallbladder disease YES Anxiety / Depression YES Independent living (Geriatric) YES AND…….drum roll please…….
  9. 9. CARDIOVASCULAR AND OVERALL ALL CAUSEMORTALITY ARE REDUCED INPOST HEART ATTACK PATIENTSWHO PARTICIPATE IN REGULAR PHYSICAL ACTIVITY
  10. 10.  Cardiovascular Endurance  Ability to supply oxygen during sustained activity Body Composition  Relative amounts of muscle, fat, bone, etc. Muscular Strength  Ability of muscle to exert force Muscular Endurance  Ability of a muscle to continue to perform without fatigue Flexibility  Range of motion available at the joint
  11. 11.  Agility  Ability to move with speed and accuracy Coordination  Ability to move the body parts smoothly and accurately Balance  Maintaining equilibrium while stationary or moving Power  Ability or rate one can perform work Reaction Time  Time elapsed between stimulation and reaction Speed  Ability to perform a movement within a period of time
  12. 12. MODIFIED BORG RATE OF PERCEIVED EXERTION SCALELEVEL DESCRIPTION 0 NOTHING0.5 EXTREMELY EASY 1 VERY EASY 2 EASY 3 MODERATE 4 SOMEWHAT HARD 5 HARD
  13. 13. MODIFIED BORG RATE OF PERCEIVED EXERTION SCALELEVEL DESCRIPTION 5 HARD 6 7 VERY HARD 8 9 VERY VERY HARD10 MAXIMALLY DIFFICULT
  14. 14.  AHA Recommendation  Pacing yourself is paramount when beginning a new exercise program  Target heart rates allow you to monitor your fitness progression over time.  Requires you to measure your pulse (radial or carotid) periodically as you exercise to ensure you remain within 50-85 % of your maximum heart rate.  This range is called your Target Heart Rate.  How do I calculate this ????
  15. 15. Maximum Heart Rate Men: 220 - Age = Max Heart Rate Women: 226 – Age = Max Heart RateTarget Heart Rate (50-85%) Maximum Heart Rate x 0.5  50% is best when starting a new exercise program Maximum Heart Rate x 0.85  Progress, as you can tolerate, to 85% over a period of at least 6 months.
  16. 16. Average Maximum Target HR Zone Heart RateAge 50–85 % 100 %20 years 100–170 beats per minute 200 beats per minute25 years 98–166 beats per minute 195 beats per minute30 years 95–162 beats per minute 190 beats per minute35 years 93–157 beats per minute 185 beats per minute40 years 90–153 beats per minute 180 beats per minute45 years 88–149 beats per minute 175 beats per minute50 years 85–145 beats per minute 170 beats per minute55 years 83–140 beats per minute 165 beats per minute60 years 80–136 beats per minute 160 beats per minute65 years 78–132 beats per minute 155 beats per minute70 years 75–128 beats per minute 150 beats per minute
  17. 17. What if I can’t stop to take my pulse during my exercise program ??Try using a conversational pace to monitor your efforts during moderate activities.If you can talk and walk at the same time, you aren’t working too hard.If you can sing and maintain your level of effort, you’re not working hard enough.If you get out of breath quickly, you’re probably working too hard, especially if you have to stop to catch your breath.
  18. 18.  Warm up  5-10 minutes, low to moderate intensity, RPE 2-3 Stretching  10 minutes, can be done after warm up or cool down Conditioning  20-60 minutes, aerobic/resistance/neuromuscular/sport  Moderate to vigorous intensity for health/fitness benefits, RPE 5-6 Cool down  5-10 minutes, low to moderate intensity, RPE 2-3
  19. 19.  Low Intensity  Moderate Intensity  Minimal skill  Minimal skill  Minimal fitness  Average fitness  Walking  Jogging/running  Leisurely cycling  Pilates **  Aquatic aerobics  Aerobic class  Slow dancing  Spinning  Tai chi **  Elliptical exercise  Yoga **  Stepping exercise  Gardening  Fast dancing  Housework **Neuromuscular exercise
  20. 20.  Resistance training should focus on the major musclegroups of the chest, shoulders, back, abdomen, hips, and legs. Average fitness individual  2-4 sets for each muscle group  8-12 repetitions for each set  2-3 minute rest between each set Deconditioned individual  1-2 sets for each muscle group  10-15 repetitions for each set To avoid muscle imbalances that could lead to injury, trainthe opposing muscle groups…..  Low back and abdomen (back extension and abdominal crunches)  Biceps and triceps (bicep curls and triceps dips)  Quadriceps and hamstrings (leg press and leg curls) And, perform the exercise with the proper technique.  Controlled movement, regular breathing pattern (exhale with exertion)
  21. 21.  Types of resistance training equipment  Weight stack  Cable pulleys  Free weights  Elastic bands  Grocery bags  Lawn mower  Toddlers  Pets
  22. 22.  Improves range of motion, physical function Insufficient data to prove that stretching prevents injury, but it does warm the muscle group in preparation for the activity for optimal performance. Stretch should involve the major muscle tendon groups of the body (i.e. neck, shoulders, back, hips and legs) Stretch should be performed to the limits of discomfort (mild tightness) for 4 or more repetitions per muscle group and held for a minimum of 20 seconds each.
  23. 23.  Hot environments  Dehydration  Heat illness – disorientation, headache, dizziness, wet and pale skin, muscle cramps, vomiting  Tools: gradual acclimatization, hydrate, cooler hours, loose clothing, caution with low salt diet Cold environments  Frostbite  Numbness (miss angina symptoms) High Altitude  Altitude illness – altered mental status, headache, nausea, fatigue, bronchitis, coughing spasms  Expect a significant decrease in physical performance due to decreased ATM pressure.
  24. 24.  Unstable angina Resting systolic BP >200 and/or Resting diastolic BP > 110 Acute systemic illness or fever Uncontrolled tachycardia > 120 bpm Uncompensated CHF 30 AV block w/o pacemaker Peri or myocarditis Recent embolism ST segment elevation Uncontrolled diabetes Severe orthopedic conditions that would prevent exercise Other acute systemic metabolic conditions (thyroiditis, hypokalemia, hyperkalemia, hypovolemia) Symptoms of exercise intolance
  25. 25. STOP ALL EXERCISE AT THE FIRSTSIGN OF  ANGINA  SEVERE FATIGUE  SHORTNESS OF BREATH

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