Exercise and Disease Study Guide 3 1 Cystic Fibrosis 1 Pathophysiology Cystic fibrosis resembles COPD in that it lowers lung function and severely shortens one s life It is a recessive disorder meaning both recessive genes have to inherit from each parent If someone has one they don t have the condition but they are a carrier If one inherits both genes a protein that controls Na intake in and out of the cells is altered This results in a thick mucus that affects lung function It will also increase Na in the sweat since the movement with the cells is messed up 2 What are the other complications The thicky mucus is the main symptom of cystic fibrosis and this causes loss of pulmonary function by clogging the lung So just like COPD they can t exhale all the air with every breathe like healthy people and thus their residual volume will increase bad which will lower their lung capacity This can lead to bronchiectasis which is inflammation of the bronchioles and present flabby and dysfunctional aveoli They can get a collapsed lung or infection or polyps The pancreas is also affected because the excess Na clogs the release of the digestive enzymes Since the pancreas can t release the enzymes food can t be digested leading to malabsorption Insulin also can t be released since it is released from the pancreas so they can become indirectly diabetic This will also present liver problems since the bile duct is blocked from the mucous With the liver problems intussusception can happen intestine fold onto itself this is not good The vas deferens can be blocked tube that send sperm to outside body so men can become infertile Osteoporosis is possible since vitamin D can t be absorbed There are electrolyte problems because Na regulation is messed up 3 What is the diagnostic testing To diagnose one with cystic fibrosis you would want to test for the recessive genes You could also do a sweat test which is more practical or a spirometry test to determine lung function A blood test would be a IRT test 4 What are the management and medication Tony Berardi 2 There is no cure but with medication one can manage their symptoms You could take antibiotics mucolytics thin the mucus hypertonic saline this will absorb water into the airway based on osmosis bronchodilators and some pancreatic enzymes since the mucus blocks the bodys An easy way to manage could be to perform an airway clearing technique This will help dislodge some of the mucus This just involves forcefully hitting someone s chest to loosen up the mucus 5 What are the exercise testing and prescription guidelines In this population pulmonary declines they will be have malnutrition so this means they are probably pretty deconditioned already For testing you would want to be aware that we would have to perform a maximal test to get their heart rate because everyone s lungs might be clogged differently You would want to monitor their oxygen saturation level just like you would for COPD clients again you want it to be above 90 For aerobic testing you could go with a cycle test or treadmill and for endurance a 6 min walk would be best A wingate test would be best for anaerobic o For prescription Aerobic you want 3 4 days for 10 min Obviously cardiopulmonary function is severely limited o For resistance you want the regular 2 3 days with light weight As always modify the exercise with their symptoms Arthritis 1 What is the pathophsyiology This is basically inflammation of the joints There can be multiple forms such as osteoarthritis rheumatoid and ankleloying This is a degenerative disease and there is no cure The disease affects the synovial joints which is the space between every joint that contains fluid and the fluid serves as a lubricant so the bones don t rub together With arthritis the synovial fluid is absent This can leads to bone spurs and cysts or a build up of useless tissue Some possible causes our thought to be the normal wear and tear of simply aging and a possible autoimmune disorder Injury obesity and a history in the family also seem to predispose one o With osteoarthritis literally meaning inflammation of the bone and joints there is a loss of cartilage leading to bone rubbing together This forms the bone spurs and cysts This seems to be from the normal wear and tear of aging o Rheumatoid is also inflammation of the joints and it forms pannus tissue in the joints affected Individuals with this form have a high amount of rheumatoid antibodies so we think it might be of an autoimmune origin Tony Berardi o Anklylosing involves the spine and sacroiliac joint lower back There will be a spinal fusion when healing occurs 3 2 What are the signs symptoms and what are the diagnostic tests Individuals could be classified as having acute chronic or chronic acute arthritis Acute would be someone displaying the symptoms and signs but they are reversible Chronic is ongoing pain stable that is irreversible Chronic acute is chronic pain but there are periods with increased pain and a decreased ROM The signs and symptoms would a restricted ROM because of the bone rubbing The axis of the joint would be tender to the touch fusion of the joints and synovitis You can test with radiography to look at the joints With osteoarthritis you could see the bone spurs to help diagnose There bone space would narrow because of the lack of synovial fluid With rheumatoid you could see erosions of the joint margins And with ankylosing you could see the vertebra squaring on the sides 3 What are the management and medication The obvious goals are to improve the clients QOL by maintaining their function improve the disease impairment and to control the inflammation You would prescribe analgesics pain relieve medicine NSAIDS no steroidal like ibuprofen corticosteroids important to only take every 4 6 months side effects anti rheamatics biologic response modifiers and maybe sulfate 4 What are the complications in exercise Because their arthritis symptoms they will have limited exercise capacity This limited capacity will make them stop because of the pain from the arthritis so if they have CVD problems going on these will not be able to be seen You would want to avoid vigorous and high rep exercise I would think because this increases the force of the bones Also avoid morning testing because of stiffness 5 What are the exercise testing and prescription guidelines For aerobic testing you could use a treadmill test very light because of symptoms 3mph or a cycle test If