Primary Physical Activity Recommendations from 2008 Physical Activity Guidelines Advisory Committee
Report - ✔✔-Everyone should participate in 150 min/week of moderate aerobic activity, 75 min/week of
vigorous aerobic activity, or a combo if both. Additional health benefits are generated with more than
,300 min/week of moderate or 150 min/week of vigorous aerobic activity. Should perform muscle
strengthening activities ≥2 days/week.
Health Benefits of Improving Muscular Fitness - ✔✔-High levels are associated with significantly better
cardiometabolic risk factor profile, lower all-cause mortality risk, fever CVD events, lower risk of
developing physical function limitations, and lower risk of nonfatal disease. Also, improved body comp,
blood glucose, insulin sensitivity, and BP in people with mild/moderate HTN. Benefits people with T2DM
(type II diabetes mellitus) and PAD (peripheral artery disease). Exercises enhancing muscle strength and
mass also increase bone mass (BMD) and strength, which helps combat/prevent/reverse osteoporosis.
Benefits of Regular PA and/or Exercise - ✔✔-Cardiovascular/Respiratory Improvements: ↑ VO2 max.
↓minute Ventilation at given absolute submax intensity. ↓myocardial O2 cost at given absolute
submax intensity. ↓ HR & BP at submax intensity. ↑ Capillary density in skeletal muscle. ↑ exercise
threshold for blood lactate accumulation. ↑ exercise threshold for the onset of disease signs or
symptoms (angina, ischemic ST depression, and claudication).
Benefits of Regular PA and/or Exercise - ✔✔-Reduction in Cardiovascular Disease (CVD) Risk Factors: ↓
Resting SBP/DBP, ↑ serum HDL and ↓ triglycerides, ↓ TBF (total body fat), intra-abdominal fat, insulin
needs, ↑ glucose tolerance, ↓ blood platelet adhesiveness/aggregation, inflammation
Benefits of Regular PA and/or Exercise - ✔✔-Other benefits of Regular PA and/or Exercise: ↓ anxiety
and depression, ↑ cognitive function, enhanced physical function & independent living in older
individuals, enhanced feeling of well-being, enhanced work/recreational/sport performance, ↓risk of
falls and injuries in older individuals
Preparticipation health screening: 2 Stage Process - ✔✔-1. Need for medical clearance before
initiating/progressing exercise programming is determined using updated & revised ACSM screening
algorithm & the help of a qualified exercise/healthcare professional. In absence of professional
assistance, individuals may use self-guided methods
2. If indicated during screening, medical clearance should be sought from respective healthcare
providers (primary care/cardiologist, etc.). Manner of clearance should be determined by clinical
judgement and discretion of provider.
Signs/Symptoms Suggestive of CVD, Metabolic, and Renal Disease - ✔✔-Shortness of breath (dyspnea)
@ rest or with mild exertion
,Dyspnea (abnormally uncomfortable awareness of breathing). Commonly occurs during strenuous
exercise in healthy/well-trained people & in moderate exercise in healthy/untrained people. *should be
regarded as abnormal if experienced at level of exertion not expected to evoke symptom*
Abnormal exertional dyspnea suggests presence of Cardiopulmonary. disorders, in particular left
ventricular (LV) dysfunction (LVD) or COPD
Signs/Symptoms Suggestive of CVD, Metabolic, and Renal Disease - ✔✔-Pain; discomfort (or other
anginal equivalent) in the chest, neck, jaw, arms, or other areas typical of myocardial ischemia
Key features favoring ischemic origin:
Character: constricting, squeezing, burning, "heaviness" or "heavy feeling"
Location: substernal, across midthorax, anteriorly; one/both arms, shoulders; in neck, cheeks, teeth; in
forearms, fingers
Provoking factors: post-exercise, provoked by a specific body motion
Signs/Symptoms Suggestive of CVD, Metabolic, and Renal Disease - ✔✔-Dizziness/Syncope
Syncope (loss of consciousness). Dizziness or Syncope during exercise may result from cardiac disorders
that prevent normal rise of CO. Potentially life-threatening & include severe CAD, Hypertrophic
Cardiomyopathy (HCM), Aortic Stenosis (AS) [narrowing/aortic valve doesn't open fully], & Ventricular
Dysrhythmias (Ven DysRhyth)
Post Exercise: dizziness/syncope should not be ignored, but these symptoms may occur even in healthy
individuals due to ↓ venous return to heart
, Signs/Symptoms Suggestive of CVD, Metabolic, and Renal Disease - ✔✔-Orthopnea/Paroxysmal
Nocturnal Dyspnea (PND)
Orthopnea (dyspnea at rest in recumbent position.) Usually relived by standing/sitting upright. PND
begins 2-5 hours after onset of sleep (relieved by sitting on side of bed/getting out of bed). Both are
symptoms of LVD. Nocturnal Dyspnea may occur in patient's w/ COPD, it differs because it is relieved
after a bowl movement rather than sitting up.
Signs/Symptoms Suggestive of CVD, Metabolic, and Renal Disease - ✔✔-Ankle Edema (AE)
Bilateral AE most evident at night is *a characteristic sign of heart failure (HF) or bilateral chronic venous
insufficiency. Unilateral AE of limb often results from venous thrombosis (clot) or lymphatic blockage in
limb. Generalized edema (anasarca) occurs in individuals w/ nephrotic syndrome (kidney disorder; too
much protein in urine), severe HF, or hepatic (liver) cirrhosis.
Signs/Symptoms Suggestive of CVD, Metabolic, and Renal Disease - ✔✔-Palpitations/Tachycardia
Palpitations (unpleasant awareness of forceful/rapid beating of the heart). Can be induced by various
disorders of cardiac rhythm. I.E. Tachycardia (Tachy [HR >100 bpm]), Sudden onset Bradycardia (Brady
[HR <60 bpm]), Ectopic beats (disturbance of the cardiac rhythm related to electrical conduction of
heart) [PAC or PVC], compensatory pauses, & accentuated (more prominent) SV from valvular
regurgitation.
Can also see palpitations anxiety, ↑ CO states (such as anemia, fever, thyrotoxicosis [overactive
thyroid], arteriovenous fistula [abnormal connection between artery and vein], and idiopathic
hyperkinetic heart syndrome [hyperactivity of the heart])
Signs/Symptoms Suggestive of CVD, Metabolic, and Renal Disease - ✔✔-Intermittent Claudication (IC)
IC refers to pain occurring in lower extremities (LE) w/ an inadequate blood supply (typically from
atherosclerosis [hardening/narrowing of arteries]) that is brought on by exercise. Pain doesn't occur w/
sitting or standing, reproducible from day to day, more severe when walking @ incline (stairs, hill) & is
described as a cramp, which disappears 1-2 min after exercise. CAD is more prevalent in individuals with
IC. Patients w/ Diabetes Mellitus (DM) are more at risk for IC.
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