Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
PHED 302 1
| Question | Answer |
|---|---|
| Importance of Physical Activity | Regular Physical activity(PA) confers may health benefits and helps prevent chronic disease. |
| Importance of Physical Activity (cont1) | National health objective is to increase the number of U.S adults engaging in regular PA to 30 % |
| Importance of Physical Activity (cont2) | Target PA goal for the national health objective (USA,similar in Canada. See CSEP guidelines below):Minimum of 30 minutes,Moderate intensity,Most if not all days of week |
| Importance of Physical Activity (cont3) | <50% of U.S adults meet minimum moderate-intensity activity recommendations. |
| Importance of Physical Activity (cont4) | ~25% of U.S adults report no leisure time physical activity (LTPA) |
| Importance of Physical Activity (cont5) | Fewer women than men meet recommendation |
| Importance of Physical Activity (cont6) | Younger adults(18-24yr) are more likely than elder(>_65 yr) to meet recommendation |
| Global Challenge | Physical inactivity is a global problem |
| Global Challenge (cont1) | Your goal:educate and motivate clients to adopt a physically active lifestyle |
| Global Challenge (cont2) | Physical inactivity may be the most important health problem of the 21st century. |
| CDC and ACSM Recommendations | 1995 recommendation:Every U.S adult should accumulate:>_30 min, moderate-intensity PA, on most,preferable all, days of the week. |
| CDC and ACSM Recommendations (cont) | The 1995 recommendation was updated in 2007:Recommended PA is in addition to ADLs, Intensity is expressed in METs, Definitions for moderate-and vigorous-intensity PA |
| AHA and ACSM Definitions | Moderate intensity:3 to 6 METs or 5 to 6 on 10 point rating of perceived exertion (RPE) scale, Results in noticeable increase in heart rate (HR) and lasts >10 min |
| AHA and ACSM Definitions (cont) | Vigorous intensity:>6 METs or 7 to 8 on 10-point RPE scale,Results in rapid breathing and substantial increase in HR |
| Current AHA and ACSM Recommendations | Adults (>_ 18 yrs): At least 30 minutes moderate-intensity aerobic PA 5 days a week or, 20 minutes vigourous-intensity aerobic PA 3 days a week, Minimum 2 days a week moderate to high-intensity resistance training |
| moderate to high-intensity resistance training | - 8 to 12 repetitions maximum (RM) for 18 to 64 years -10 to 15 RM for older (>_ years) adults |
| Current AHA and ACSM Recommendations (cont1) | Balance and flexibility for those >_ years |
| Current AHA and ACSM Recommendations (cont2) | -8 to 12 repetitions maximum (RM) for 18 to 64 years -10 to 15 RM for older ( 65 >_ years) adults |
| 2008 PA Guidelines for Americans | -Key message:150 minutes a week of moderate-intensity(~1,000Kcal/week)or 75 minutes a week vigorous-intensity aerobic exercise = substantial health benefits for adults. |
| 2008 PA Guidelines for Americans(cont1) | Adults of all ages should include muscle strengthening at least 2 days a week. -Children need 60 min PA daily |
| Children need 60 min PA daily | -Primarily moderate -or vigorous-intensity PA -Minimum 3 days a week vigorous-intensity PA -Minimum 3 days a week muscle- and bone- strengthening PA |
| Health Benefits of PA | 1.Lower risk of premature death and chronic conditions 2.Reduces depression,anxiety,abdominal obesity 3. Helps control weight 4. Improves sleep quality |
| Health Benefits of PA (Cont) | 5. Improves cognitive function 6.Maintains and improves bone density 7.Prevents falls 8.Increase fuctional health |
| How much PA is Enough ? | -Benefits based on training volume, Dose-response relationship:what kcal/week expenditure required for specific improvement, Additional potential benefits for exceeding minimum recommended PA levels |
| Dose-Response Relationship | 1,000 Kcal/wk |
| 1,000 Kcal/wk | Sufficient to reduce disease risk, A great initial goal for some, Enough to move from sedentary to low PA level, Insufficient to maintain healthy body weight, Insufficient to experience full health benefits |
| Institutes of Medicine (IOM) Recommends | Greater dose(~2,000 kcal/wk) required to: maintain healthy body weight, prevent weight gain, provide additional health benefits, and move a person from a secondary to active PA level |
| Cardiovascular Disease (CVD) | Major cause of death in U.S and Europe, Includes Hypertension, heart disease, congestive heart failure,and stroke, No longer a disease of men or the elderly, Associated with inactivity and sedentarism (lack of cardiorespiratory fitness) |
| Coronary Heart Disease (CHD) | CHD is more prevalent for African Americans and Latino Americans than Whites, a resulting imbalance between coronary oxygen supply and demand, attributable to physical inactivity and sedentarism, and |
| Coronary Heart Disease (CHD) (Cont1) | more favorable countered by high cardiorespiratory fitness level than by a physically active lifestyle. |
| Coronary Heart Disease (CHD) (Cont2) | Imbalance between O2 supply and demand:Attributed to atherosclerosis, May result in angina pectoris(chest discomfort and paid) and myocardial infarction (heart attack) |
| CHD Risk Factors | Age,Family history, Hypercholesterolemia, Hypertension, Current cigarette smoking, Prediabetes, Obesity, Physical inactivity |
| Hypertension | High blood pressure:Major contributor to stroke and heart attack, SBP >_ 140 mmHg or DBP >_ 90 mmHg or on medication(s) for blood pressure, Prehypertension |
| Hypertension - Prehypertension | -SBP between 120 and 139 mmHg or, DBp between 80 and 89 mmHg |
| Hypertension (Cont) | Likelihood of having hypertension increases with ages, race, geographic location Inverse relationship exists between hypertension and PA level |
| Hypercholesterolemia and Dyslipidemia | Hypercholesterolemia = high total cholesterol (TC) Also known as hyperlipidemia (high blood lipid levels) Dyslipidemia = abnormal blood lipid level:High TC and/or,high low-density lipoproteins(LDL-C) and/or low high-density lipoproteins(HDL-C) |
| Cigarette Smoking | Largest preventable cause of disease and premature death -Smokers' risk of heart attack is 2 times nonsmokers', -Smoking is linked to CHD, stroke, chronic lung disease, and several cancers |
| Cigarette Smoking (Cont) | Risk for CHD declines rapidly with quitting -Risk declines 50 % in the first year -Relative risk of stoke and CHD death is similar to that of nonsmoker in 15 years |
| Type 1 (IDDM) Diabetes - No insulin produced (autoimmune disease) | -Usually occurs before age 30 -However, can develop at any age -Not as common as type 2 -Exercise prescriptions should follow specific guidelines |
| Type 2 (NIDDM) Diabetes - No response to insulin (chronic disease) | -Most common form of DM -Risk factors for NIDDM related to age, family history, diet, above-normal body weight and body fat -Healthy lifestyle choices decrease risk |
| Obesity and Overweight | Categories defined by body mass index (BMI) - BMI = [kg/(m2)] -Overweight = BMI between 25 and 29.9 kg/m2 -Obese = BMI >_ 30 kg/m2 |
| Obesity and Overweight (Cont) | Obesity shortens life expectancy and increase risk for the following:CHD,DM,Hypercholesterolemia,Hypertension, Osteroarthritis,Some cancers |
| Causes of Obesity and Overweight | -Some evidence for genetic source -Majority of evidence points to environment -Restricting caloric intake and increasing caloric expenditure are good ways to control weight,decrease body fatness,and normalize blood lipids and blood pressure |
| Metabolic Syndrome | -Cluster of specific CVD risk factors -Must have a least 3 of those risk factors -Increases risk of CHD and DM -Prevalence highest for older (>60 yr) and obese people |
| Cancer | -A leading cause of death worldwide -Key risk factors include physical inactivity -To reduce cancer risk |
| Cancer (Cont) - To reduce cancer risk | -45 to 60 minutes a day of moderate-intensity PA, at least 5 days a week for adults -60 minuts a day, moderate - to vigorous-intensity PA at least 5 days a week for children and adolescents -Maintain healthy weight |
| Musculoskeletal Issues | -Sedentarism and physical inactivity contribute to musculoskeletal diseases and disorders -Osteoporosis -Osteopenia -Low back pain |
| Low Back Pain | -Origins may be functional, not structural -Poor lifestyle choices increase the likelihood of experiencing low back pain. |
| Preliminary Health Screening and Risk Classification | Objectives 1.Understand the importance of classifying client's health status and lifestyle 2. Know the variables evaluated by and focus of the various screening methods |
| Preliminary Health Screening and Risk Classification(Cont) | 3. Understand the importance of information obtained form clinical tests ad which ones require and MD 4.Introduce procedures for hemodynamic assessment |
| Preliminary Health Evaluation | Twofold purpose:1. Detect the presence of disease 2. Assess initial disease risk of client |
| PAR-Q | -Physical Activity Readiness Questionnaire - 7 questions - Identifies who needs medical clearance before fitness testing and/or exercise program initiation -One single "yes" means that medical clearance is rquired |
| Medical History Questionnaire | -Very detailed queries:Personal medical history, Recent diagnoses and signs and symptoms (S/S) of disease, Family medical history |
| Medical History Questionnaire (Cont) | Allows identification of :risk factors, absolute and relative contraindications for exercise testing, and medications |
| Signs and Symptoms of Disease | -Check for signs and symptoms of cardiovascular, pulmonary, metabolic, and musculoskeletal problems or disorders protects you and the client. |
| Lifestyle Evaluation | -Helps you develop a well-rounded, individualized exercise program -Rounds out risk factor profile -Identifies lifestyle patterns and habits -Highlights possible challenges to adherence |
| Informed Consent | -A legal document (both parties sign) -Explains purpose of and procedure for each assessment -Itemizes possible risks and expected benefits |
| Informed Consent (cont) | -Ensures confidentiality in terms of data collected -Indicates client participation is voluntary -Allows parental approval(as appropriate) |
| Paperwork's Done Now What? | Coronary risk factor analysis: -Dose client meet the threshold values for positive CHD risk factors? -Does client meet the threshold value for negative CHD risk factor? -What is the net risk factor count? |
| After Risk Factors Are Assessed | Disease risk classification: -Likelihood of an untoward event during testing or exercise -Who needs medicals clearance? |
| Disease Risk Classification | -Low risk:Asymptomatic and young and <2 net risk factors for CVD -Moderate risk: Asymptomatic and >1 net risk factor for CDV; applies to both younger and older groups -High risk:Symptomatic or known cardiovascular, pulmonary, or metabolic disease |
| Clinical Tests | 1.Physical examination:recommended for moderate-and high-risk clients 2.Blood chemistry profile: allows insight into blood glucose and lipid levels |
| Clinical Tests (Cont) | 3. Resting blood pressure: allows insight into pressure the heart is generating or withstanding when filling and emptying at rest 4. Graded exercise test:allows ability to monitor physiologic responses to a stressor |
| Physical Examination | -Focus should be S/S of CHD -Should also include assessment:Weight,Orthopedic issues, Cardiac fuction (rate,regularity),Blood pressure (Various positions), Heart, lung, and major artery sounds |
| Physical Examination (Cont) | -Signature authority from MD indicating approval to start or continue |
| Blood Chemistry Profile | -If values are out of normal ranges, refer client to their medical provider. -NCEP recommends: Fasting lipoprotein profile assessment every 5 years, LDL-C goals based on risk category |
| Blood Chemistry Profile (Cont) | -Refer clients for professional help if they have high or very high LDL-C levels |
| Resting Blood Pressure | -SBP:arterial pressure during systole(ejection,emptying;higher number) -DBP: arterial pressure during diastole (relaxation,filling;lower number) -Pulse pressure :SBP - DBP |
| Graded Exercise Test (GXT) | -Helps assess functional aerobic capacity -Beneficial for setting exercise prescriptions -Should be administered by trained, certified personnel |
| Graded Exercise Test (GXT) (Cont) | -Use risk stratification to determine contraindications, need for MD presence, and level of exertional effort |
| Monitoring Hemodynamic Responses | -During GXTs, monitor blood pressure (BP) and heart rate (HR) -Monitor HR and BP before, during, and after GXT -Additionally, monitor electrical activity of heart (ECG) during maximal exertion GXTs |
| Blood Pressure Assessment | -Select proper cuff size for your client -Minimize sources of error -Follow standard technique -Practice,practice, practice! |
| Blood Pressure Assessment(Cont) | -Take BP near the end of each GXT stage -Deflate cuff fully between measurements -Wait 30 sec before reassessment |
| Heart Rate Assessment | -Like BP assessment, record HR at rest, during exercise, and after exercise -For exercise and recovery, count for 6 or 10 second interval -Know when to count starting at 1 |
| Heart Rate Assessment (Cont) | -Available methods:Palpation (with fingertips), Auscultation (with stethoscope),Heart rate monitors,Electrocardiogram (ECG) |
| Electrocardiogram (Figure 2.1) | -Most informative method for assessing HR -Can assess electrical activity of heart chambers, myocardial ischemia, and acute or previous myocardial injury |
| Electrocardiogram (Figure 2.1) (Cont1) | -A good prep job is a must -Repeated cardiac cycles as seen on an ECG tracing: P-wave: atrial depolarization -Monitored through various leads |
| Electrocardiogram (Figure 2.1) (Cont2) :Repeated cardiac cycles as seen on an ECG tracing: P-wave: atrial depolarization | P-wave: atrial depolarization PR interval:delay of impulse at AV node QRS complex: ventricular depolarizaton ST segment:early ventricular repolarization T-wave:ventricular repolarization |
| Responsibilities of a Fitness Pro | Education, Screening, Selection, Design, Lead, Critique, and Motivate |
| Cardiorespiratory Endurance | Aerobic capacity (VO2 max is maximal amount), ability of circulatory systems to work together to deliver O2 and nutrients to muscles. Can be measured or estimated. |
| Musculoskeletal Fitness | muscles and bones ability of muscle strength (force/tension), endurance (maintain submaximal force over time) and bone strength (force/tension) relates to bone density |
| body weight and composition | BW = Mass of person, Composition = BW in terms of fat, muscle and bone. Absolute = weight of that component 15 lbs of fat. Relative = percent of that component to the body 10% fat. |
| Flexibility | ability of joint to move through entire range of motion. Limited by: bony structure of joint, size and strength of related musculature, associated connective tissue. |
| Balance | Ability to keep ones COG within base of support while: Maintaining a static position, performing voluntary movements and reacting to external disturbances. |
| Physical Fitness test sequence | 1. Resting BP and HR 2. Body Composition 3. Cardiorespiratory endurance (VO2 max) 4. Muscular fitness 5. Flexibility. |
| Test Validity | assesses accuracy of measure, R at least .80 is good |
| Test Reliability | assesses repeatability of measure, R at least .90 is good |
| Test Objectivity | interrater reliability = comparison of scores by multiple technicians. Influenced by training, practice, standard procedures. r at least .90 is good |
| Pre-test instructions | appriopriate clothing, hydration 24 preceding test, no consuming food/drinks or use of drugs 3 hours before, no PA on day of test, lots of rests the night before. |
| Test Administration | Prepare setup in advance, follow standardized procedures, have good practice with preparation to improve confidents. |
| Test Interpretation | Use established normative values, use understandable language, be positive, stay confident. |
| Principles of Program design 1 | Specificity - muscle group, intensity, contraction. Overload - increase workload to make gains. Progression - gradual/systematic. Initial Values - low start = biggest gains |
| Principles of Program design 2 | Individuality - everyone is different. Diminishing Returns - closer to goal, change Reversibility - use it or lose it |
| Elements of Exercise Prescription | Mode (how it is done run/lift..), Rate of progression (switch it up one at a time), Frequency (how often), Intensity (how hard), and duration (how long) |
| Initial conditioning | Usually 4 weeks, low intensity, increased duration at first, may skip for advanced participant |
| Improvement | 4-8 months, faster progression, moderate intensity |
| Maintenance | Usually starts at 6 months, lasts the rest of your life, cut back on main activities add variety |
| What influences Adherence | Biology, psychology, social support, environment, and behaviour |
| Who is likely to Drop out | overweight, low self motivation, anxiety about PA, lack of partner support, inconvenience of access, activity is too hard, no social support during or after the work out. |
| Behaviour Modification:Your Task | Three pertinent theories 1. Behaviour modification theory, 2.Social cognitive theory, 3. Stages of readiness theory |
| 1.Behaviour modification theory | Clients are actively involved in the process:Goal setting, Strategies to attain goal(s), Contract, Reassess, review, revise Helpful techniques: journaling ,incentives, celebrating the successes |
| 2.Social cognitive theory | -Based on client's self-efficacy and outcome expectation: How confident am I that I can do this? ->70% confidence score equals high self-efficacy -Help your client recognize and overcome barriers |
| 2.Social cognitive theory (cont) | -Helpful techniques:skill mastery,modeling,positive reinforcement, education |
| 3. Stages of readiness theory | -Change comes when client is intellectually and emotionally ready to change. -Five stages |
| 3. Stages of readiness theory (cont) : 5 stages | 1. Precontemplation:not even thinking about it 2. Contemplation:thinking about it, intends to do it 3. Preparation:starting to do something,exercising 4. Action: been exercising <6 moths 5. Maintenace:been exercising >_6 months |
| Other Theories | Decision-Making Theory,Theory of Reasoned Action, Theory of Planned Bahaviour, Self-Determination Theory |
| Decision-Making Theory | -People decide to engage in a behaviour by weighing the behaviour's perceived benefits (advantages) and costs (disadvantages). -If benefits>costs, then client is likely to exercise. |
| Decision-Making Theory(cont) | -Position in stages of motivational change influences perceptions of benefits and costs --Early stages:perceived costs outweigh benefits --Later stages:perceived benefits outweigh costs |
| Theory of Reasoned Action | -Intention is the most important determinant of behaviour and is highly influenced by one's attitudes and subjective behavioural norms. -Belief that exercise yields positive outcomes is a favourable attitude about being physically active. |
| Theory of Reasoned Action(cont) | -Subjective behavioural norms are perceptions about what others think or believe about exercise. |
| Theory of Planned Behaviour | People intend to perform a specific behaviour (e.g. exercise) if they: -evaluate it positively -believe that others think it is important, and perceive the behaviour to be under their control. |
| Theory of Planned Behaviour(Cont) | An extension of Theory of Reasoned Action, it considers the client's perception of behavioural control |
| Self-Determination Theory | -Describes how presence or absence of specific psychological needs (i.e. autonomy, competence, and relatedness) impacts behaviour through a continuum of motivation. -Four levels of motivation |
| Four level of motivation 1 | 1. Amotivation: no intention or desire to engage in exercise |
| Four level of motivation 2 | 2. Other-determined motivation:exercise motivation from outside factors(e.g. rewards,guilt, fear, or pressure); long-term adherence is unlikely |
| Four level of motivation 3 | 3. Self-determined extrinsic motivation:person values exercise;extrinsically motivated by factors like improved health or fitness gains;one freely chooses exercise without a sense of outside pressure |
| Four level of motivation 4 | 4. Intrinsic motivation:exercise for sheer enjoyment and satisfaction brought to sense of well-being;enjoying exercise for its own sake leads to adherence |
| Using Technology to Promote Physical Activity | -Pedometers:step counter;accuracy varies;proper placement is critical -Accelerometers:minute-by-minute tracking of acceleration;can monitor frequency, duration, intensity, and patterns of movement |
| Using Technology to Promote Physical Activity (cont1) | -Combined pedometry and accelerometry:improves energy expenditure prediction -Heart rate monitors:assess and monitor exercise intensity; more suitable for certain exercising subgroups |
| Using Technology to Promote Physical Activity (cont2) | -Global positioning system (GPS):uses satellites, ground-based stations, and physical location of the signal origin (the exerciser) to track altitude, distance, time, and average velocity during activity |
| Using Technology to Promote Physical Activity (cont3) | -Geographic information system (GIS):computer system that stores information about location and the surrounding environment |
| Interactive video games | increase energy expenditure;may produce positive health benefits;well suited for solo or group play;requires little training or skill;good exercise alternative during bad weather |
| Interactive video games(cont) | ;may help transition to actual participation in sports and physical activities |
| Persuasive technology | a computer system,device, or application intentionally designed to change one's attitude or behaviour through use of tools, media, and social interaction |
| Persuasive technology(cont) | Experts suggest that clinicians should use internet-based physical activity interventions to promote and change exercise behaviour |
| Accreditation, Certification, and Licensure | -indicates high degree professionalism -Increases employment opportunities ($$$) -Increase awareness of issues pertaining to safety of clientele during exercise sessions |
| Accreditation, Certification, and Licensure(Cont) | -May reduce liability lawsuits against you -Tailor your certifications toward your professional goals |
| Accreditation | -Awarded to organizations and programs that meet or exceed standards established by an independent, third-party accrediting agency |
| Accreditation (cont) | -In 2009 the number one trend was having more fully accredited educational programs and certification programs for health and fitness and clinical exercise professionals |
| Certification | -Obtained by passing examinations developed by professional organizations -Certifications are generally good for 2 years period and maintained through continuing education |
| Certification(cont1) | -Numerous certifications currently available -No governing entity overseeing development of certification examinations and eligibility requirements |
| Certification(cont2) | -Inequalities exist among the preparatory rigor and certifications available to exercise science professionals |
| National Boards | -Standardized tests assessing the knowledge, skill, and competence or professionals -Most medical and allied health professions use National Boards |
| National Boards(Cont) | -National Board of Fitness Examiners (NBFE):currently defining scopes of practice for all fitness professionals and determining standards of practice for them |
| Licensure | -May be better for protecting consumers and for enhancing the credibility and professionalism of exercise science and fitness professionals -Determined at the state level |
| Licensure(cont) | -Louisiana was the first U.S state requiring licensure for clinical exercise physiologists. -More U.S states are considering requiring licensure for clinical exercise physiologists and personal trainers. |
| Statutory Certification | -Regulates usage of titles(e.g. exercise physiologist, personal trainer) and qualifications needed to obtain the titles |
| Statutory Certification(cont) | -Only certified professionals with the required credentials are allowed to use the specific title. -Professionals without necessary credentials may still practice in the state but under a different |
| Metabolism and Energy Systems | -Energy:the capacity to do work -Potential Energy:energy stored in chemical bonds; energy that could work if it were released. Breaking chemical bonds releases energy. |
| Metabolism and Energy Systems(cont) | -Kinetic Energy:does work and moves matter -Heat Energy:energy that flows between objects of different temperatures |
| How is Energy Measured? | -Energy is defined as the capacity to do work -Measured in calories 1 Calories = 1000 calories (1 kilocalorie) Note the capital C |
| What is Energy? | -Food represents potential energy -1 gram of carbohydrate = 4 Calories -1 gram of protein = 4 Calories -1 gram of fat = 9 Calories |
| Storing Energy in the Body | -Energy is stored in the body in the form of adenosine triphosphate (ATP) -ATP contains a pair of high energy bonds |
| Storing Energy in the Body(cont) | -When a bond is broken, energy is released -Energy is used to fuel processes in the body (e.g muscle contraction) |
| How do we generate ATP? | ATP can be regenerated from ADP in three ways:1.Creatine Phospate (Alactic) 2. Anaerobic Respiration 3. Aerobic Respiration |
| Creatine Phosphate | -CP (PCr) is another hgih-energy phosphate stored in the muscles -CP donates its P to regenerate ATP -Approx. 5 times more CP than ATP -Process lasts for up to 8-10 seconds of max contraction |
| Anaerobic Respiration | -Does not require oxygen -Results in the breakdown of glucose to yield ATP and Lactic Acid -Metabolic pathway called glycolysis is shared by anaerobiv and aerobic respiration |
| Anaerobic Respiration(cont) | -Require 2 ATP, but generates 4 ARO --Net of 2 ATP -Sustained energy production for up to 3 minutes |
| Aerobic Respiration | -Requires oxygen -Breaks down glucose to produce: ATP, Carbon Dioxide, Water |
| Aerobic Respiration(cont) | -Can produce up to 36 ATP for each glucose, but is slower than CP or anaerobic metabolism -Can also use protein and fatty acids to produce ATP (not via glycolysis) |
| Cellular Respiration | -Cellular respiration can be either anaerobic or aerobic -Not either/or- both systems work concurrently -When we refer to exercise, anaerobic and aerobic refer to which energy system predominates |
| The Energy Continuum | -ATP-PC system predominates in activities lasting 10 seconds or less -ATP-PC continues to provide small amounts of energy for maximal activities up to 2 min. |
| The Energy Continuum(Cont1) | -Glycolysis predominates in supplying energy for exercise lasting 2-10 minutes -The aerobic (O2) system is the dominant system 5 minutes into exercise |
| The Energy Continuum(Cont2) | -The longer the exercise, the more important aerobic metabolism it becomes |
| Lactic Acid & Lactate Production | -Lactic acid is produced in muscle cells in the absence of oxygen -NADH transfers its hydrogen to pyruvic acid forming lactic acid -Amount of lactic acid depends on the balance between its production and its removal |
| Lactic Acid & Lactate Production(Cont) | -What conditions lead to lactic acid production ? --Muscle contraction --Fast twitch fibers --Insufficient amounts of O2 |
| Lactate Removal | -Lactate is removed from the bloodstream relative quickly following exercise |
| Lactate Removal(Cont1) | -Lactate can be used by the heart as an energy source -Lactate can be converted to glucose in the liver via the Cory cycle -Working muscles can convert lactate back into pyruvate and use it as an energy source |
| Lactate Removal(Cont2) | -Generally, half of the total lactate is removed in about 15-25 minutes -Near-resting levels can be achieved in 30 - 60 minutes -Evidence suggest that lactate removal occurs more quickly when individual exercise during recovery |
| Lactate Removal(Cont3) | -Intensity of the exercise should not exceed 40 % Vo 2 max -Higher intensities can deplete glycogen stores and delay re-synthesis |
| Slow & Fast Fibers | -Not all muscle fibers are alike -Slightly different forms of myosin exist with different properties -Results in fast-twitch and slow-twitch fibers -Force Production in Fast & Slow twitch Fibers |
| Slow Twitch Fibers | Slow-twitch oxidative (SO) Fibers (AKA Type I Fibers) -Contract slowly -Smaller diameter -Greater blood supply |
| Slow Twitch Fibers (Cont) | -More mitochondria -More fatigue-resistant -Respond slowly to nervous stimulation -Myosin heads break down ATP slowly -Aerobic respiration is primary source of ATP -Large amount of myoglobin |
| Fast Twitch Fiber | -Fast-Twitch Fibers (AKA Type II fibers) -Responds rapidly to nervous stimulation -Myosin breaks down ATP more rapidly |
| Fast Twitch Fiber(Cont1) | -Less blood supply -Fewer mitochondria -Fatigue quickly -Fast Twitch Fibers -Cross bridge formation, release, and reformation occurs more rapidly |
| Fast Twitch Fiber(Cont2) | -Little myoglobin -Large deposits of glycogen |
| Two types of fast twitch fibers: | -Type IIa-Fast-twitch oxidative glycolytic (FOG) -Type IIb-Fast-twitch glycolytic (FG) |
| Distribution of Fast & Slow Twitch Fibers | -Most muscles have a combination of both fast-twitch and slow-twitch muscle fibers -Speed & power athletes tend to have a larger proportion of fast-twitch fibers -Endurance athletes tend to have a larger proportion of slow-twitch fibers |
| Size Principle | -Describe how motor units are recruited during exercise -Recruitment during isometric and concentric contractions is controlled by the size of the motor unit |
| Size Principle(Cont) | -Small motor units have the lowest firing threshold and are recruited first -As force requirements increase, the larger fast-twitch motor units are recruited -The largest motor units (type IIb) have the highest threshold and are recruited last |
| Assessing Cardiorespiratory Fitness:Objectives | 1.Differentiate between VO2 max and VO2 peak 2.Differentiate between relative and absolute VO2 3.Understand general exercise testing guidelines |
| Assessing Cardiorespiratory Fitness:Objectives(cont) | 4.Understand similarities and differences between maximal and submaximal exertion testing |
| Cardiorespiratory Endurance | -Ability to perform dynamic exercise involving large muscle groups at moderate-to-high intensity for prolonged periods (ACSM 2000) -Criterion measure is VO2max |
| Cardiorespiratory Endurance(cont) | -VO2max is the most valid measure of the cardiorespiratory system's functional capacity -VO2max reflects :maximal ability of cardiorespiratory system deliver O2 and nutrients to muscles and ability of muscles to use them |
| VO2peak Versus VO2max | Peak criteria VS Max criteria |
| Peak criteria | -HR fails to increase with increasing workload -Blood Lactate >_ 8 mmol/L -Respiratory Exchange Ratio (VCO2/VO2)>_ 1.15 -Rating of Perceived Exertion >_ 17 on Borg 6 to 20 scale |
| Max criteria | -All of the above plus --<_150 ml/min change with increasing workload(plateau attained) -Children, older adults, sedentary people, and those with know disease are likely to attain VO2peak, but not max |
| Absolute VO2 | -A discrete volume of O2 consumption in reference to time -Expressed in L/min or ml/min -Used for nonweight-bearing modalities -Directly related to body weight |
| Relative VO2 | -A volume of O2 consumption relative to unit of body mass and time -Expressed as ml/kg/min -Used for weight-bearing modalities -Best for comparing people of different body size -Rest is 3.5 ml/kg/min or 1 MET(Metabolic Equivalent) |
| Graded Exercise Testing (GXT) | Are required for anyone starting a vigorous exercise program - Vigorous is >60% VO2max or >6METs |
| Graded Exercise Testing (GXT) (Cont1) | And for anyone meeting the following criteria: -Men(>_45 yrs) and Women (>_ 55 yrs) -Individuals with >_ 2CHD risk factors (moderate risk) -High CHD risk with >_1 sign/symptom of CVD or pulmonary disease |
| Graded Exercise Testing (GXT) (Cont2) | -HIgh CHD risk with know CVD, pulmonary metabolic disease |
| Selecting a GXT | -Consider the following... -Client's characteristics (i.e. agem training state) |
| Selecting a GXT(cont1) | -Client's abilities (i.e. skilled vs. unskilled) -Client's preferences for aerobic activity (athletes sport) -Facilities available |
| Selecting a GXT(cont2) | -Your level of expertise with test administration -Reliability of submaximal test's prediction equation for your client's age and training state |
| GXT Guidelines | -Review contraindications to exercise testing -Use maximal or submaximal GXT as appropriate -If goal is diagnosing CAD,use max GXT |
| GXT Guidelines(cont) | -Little difference exists in danger levels (max vs submax) -Use multiple stages (hence"graded") -For non-ramp protocols, stages usually last to 3 minutes each -Know GXT termination criteria |
| Procedures for Conducting GXTs | 1. Pretest instructions 2. Paperwork 3. Resting baseline data (HR,BP,EKG) 4. Instructions and warm-up stage |
| Procedures for Conducting GXTs (cont) | 5. Periodic (and continual) 6. Stage changes (depend on protocol) 7. Termination (criteria depend on protocol, client,S/S) 8. Cool-down (recovery) |
| Rating of Perceived Exertion (RPE) | -Original 6 to 20 scale was revised to 0 to 10 scale. -Both highly related to HR and VO2 -Subjective scales of overall exertion |
| Rating of Perceived Exertion (RPE) (cont) | -Moderate intensity is 12 to 14 on original scale and 6 on revised scale -OMNI pictorial scales may also be used for children through adult age groups. |
| Maximal Exertion Protocols | -Choose protocol and modality wisely! -Individualized protocol is best -Highest VO2 is with uphill running;lowest is with arm ergometry |
| Maximal Exertion Protocols(cont) | -Usually lasts 8 to 12 minutes long -Can be a continuous or discontinuous protocol -Discontinuous protocols take longer |
| Submaximal Exertion Protocols | -Choose protocol and modality wisely! -Similar to maximal exertion GXTs -May or may not involve stage change(s) |
| Submaximal Exertion Protocols(cont) | -Monitor constantly for signs and symptoms and proper hemodynamic response -Generally terminated based on predetermined criteria (e.g. :85% age-predicted maximal HR) -Result can be used to estimate exercise tolerance and VO2max |
| Treadmill Protocols | -Manipulate workload via speed (mph) and grade (%) -Many treadmill protocols exist : choose best one for your client -Many have their own equation to calculate VO2 -Some use nomograms |
| Cycle Ergometer Protocols | -Manipulate workload through cadence (rpm) and resistance (kp, W). -Electrically braked ergometers allow variable cadences for any workload. -Mechanically braked ergometers require close monitoring of cadence |
| Cycle Ergometer Protocols(cont) | -Cadence based on client fitness level and cycling experience -60 rpm produces highes VO2 max compared to other specific cadences |
| Other Testing Protocols | -Step tests:Several exist;require use of metronome;VO2 calculations are based on step height and cadence -Recumbent stepper:Alternative for testing those with neuromuscular conditions affecting gait,coordination, and balance |
| Other Testing Protocols(cont) | -Stair stepper:Good for aerobic step practitioners. -Rowing ergometer:One exists for noncompetitive or unskilled rowers. |
| Submaximal Protocols | -Not direct assessments of cardiorespiratory capacity -May be more practical than maximal exertion protocols -Can be performed on many modalities -Can involve multiple stages or just one |
| Submaximal Protocols(cont) | -Can determine VO2 via calculations or nomograms -Rely on underlying assumptions |
| Submaximal Assumptions | -Steady-state HR is achieved and is consistent for work rate -Relationship between HR and VO2 is linear for HRs between 110 and 150 bpm. -Mechanical efficiency is the same for all tested. -HRmax is similar for all of same age. |
| Field Tests | -Practical -Inexpensive -Expedient -Easy to administer -Good for assessing numerous people simultaneously |
| Field Tests(cont) | -Suitable for a variety of settings -Generally based on postexertion HR measures -Least desirable manner of assessing cardiorespiratory fitness -Not for diagnosing CHD |
| Testing Children | -Treadmills are a better modality than cycles. -ACSM recommends modified Balke or modified Bruce protocols with 2- minute stages -Field tests may be used. |
| Testing Older Adults | -Use an extended warm-up at a low exertion starting stage. -Be ready to adjust treadmill speed for client safety. -May need to adjust grade and not speed. -Target a total test time of 8 to 12 minutes. |
| Testing Older Adults(cont) | -Extend stage duration to allow steady-state HR achievement -Cycle ergometry may be preferable for client safety comfort. -Field tests are also a possiblity |
| Designing Cardiorespiratory Exercise Programs :Objectives | 1. Identify the basic components of a cardiorespiratory (CR) exercise program. 2. Tailor exercise prescriptions to meet an individual's goals 3. Identify exercise modalities for CR programming |
| Designing Cardiorespiratory Exercise Programs :Objectives(cont) | 4. Differentiate between various CR programming techniques 5. Understand dose-response relationships for frequency, intensity, and duration as they pertain to aerobic fitness |
| The Art of Exercise Prescription | -Exercise program must meet client's needs and interests;what is the client's goal? -Programming for improved health is different than programming for cardiorespiratory fitness. -The key is individualization |
| Elements of CR Workout | 1. Warm-up:increase blood flow (5-10min) 2. Endurance:aerobic conditioning (20-60 min) 3. Cool-down: reduce cardiovascular complication risk (5-10 min) |
| Elements of CR Workout (cont) | 4. Stretching :reduce change of soreness and cramps (>_10min) |
| Prescription for Improved Health | FITT Principle |
| FITT Principle | -frequency:most, preferable all days of the week -Intensity:moderate-intensity (3-6 METs) -Time:150 to 300 minutes/week;varies related to intensity -Type:modality of endurance-type activities |
| Prescription for CR Fitness | -Frequency:3 to 5 days a week -Intensity:related to initial fitness status;use %heart rate reserve (HRR) or VO2reserve (Vo2R) -Time: 20 to 60 minutes continuous exercise |
| Prescription for CR Fitness(cont) | -Mode:rhythmic,aerobic, large muscle groups -Progression:based on conditioning effect |
| Modalities for CR prescriptions | -Large muscle groups -Rhythmic -Provide mechanism to initially monitor intensity |
| Modalities for CR prescriptions(cont) | -Progress from type A modalities to types B and C as skill and fitness levels increase -Include type D modalities in addition to regular program;great for adding variety |
| Alternative CR Modalities | -Options are available beyond traditional modalities -Varying levels of perceived exertion(RPE) exist for a given HR or %VO2max response -Cycling has high localized fatigue in legs |
| Alternative CR Modalities(cont1) | -Some result in hihger HR than when on a treadmill exercising at a similar %VO2max -At the same RPE, a treadmill produces greater energy expenditure |
| Alternative CR Modalities(cont2) | -Some modalities cause exaggerated HR responses -This can cause your target HR's to be over/underestimated |
| How to Progress CR Workload | -Increase treadmill speed and incline. -Increase cycling rpm and resistance. -Increase step cadence and height for aerobic bench stepping. |
| How to Progress CR Workload(Cont) | -Include upper body component or use light hand weights with lower body exercise. -Increase velocity for in-line skating. |
| Selecting CR Modality for Older Adults | -Focus on functional,enjoyable, convenient exercise. -Waling and tai chi are good options -Consider the following:Deteriorating Vision, Neuromuscular coordination challenges,Musculoskeletal challenges |
| Selecting Intensity | -ACSM recommends using %VO2reserve(%VO2R)over other options -What is VO2R? |
| VO2R=(VO2max(or peak) - VO2rest) | -Directly related to aerobic fitness -Forms the basis of exercise prescription -Equates (1:1) with Heart Rate Reserve (HRR) -Can also substitute METS for VO2 -Rest =3.5 ml/kg/min = 1 MET -Any VO2(ml/kg/min) can be converted to METs by dividing by 3.5 |
| Prescribing Exercise by VO2R | -For sedentary or individuals with poor initial fitness:Start in range 30% to 45% VO2R |
| Prescribing Exercise by VO2R (cont) | -For healthy individuals:Start in range 40 % to 85% VO2R -To improve CR fitness:Exercise in range 55% to 80 % VO2R -To keep improving CR fitness:Systematically increase % VO2R |
| Words of Caution About METs | -MET value estimates for different activities can vary greatly -MET values differ for youth and adults -Values are estimates of energy expenditure |
| Words of Caution About METs(cont) | -Environmental factors and skill level can influence actual energy expenditure -Better to use METs plus either HR or RPE to keep client safe. |
| Exercise Intensity Using HR | -Prescribing exercise based on HR is easy, but comes with limitations-especially when estimating maximal HR(HRmax) from age or given certain environmental or medical factor. |
| Exercise Intensity Using HR (cont) | -Three methods to chose from: HR versus MET graphing method, HRR method, %HR max method |
| HR Versus MET Graphing | While conducting a GXT, dot he following: -Record and plot steady-state HR for each stage -Plot HR on y-axis;MET levels or VO2 on x-axis -If not a maximal exertion GXT, extrapolate to HRmax |
| HR Versus MET Graphing(cont) | -Determine desired %VO2R range -Locate corresponding HRs -Can now determine HR range -Remember, some modalities produce higher HR responses. |
| Heart Rate Reserve (HRR) | -No actual GXT for HRmax? Use this method! -Target HR = [%exercise intensity x (HRmax - HRrest)] + HRrest -HRR also called Karvonen method |
| Heart Rate Reserve (HRR) (cont) | -%HRR approximates %Vo2R -Set programs in range 40 to 85 %HRR |
| %HRmax | -Can also just use a percentage of maximal HR -Set program in range 64% to 94% HRmax -Approximates 45% to 85% VO2R or HRR |
| %HRmax (cont) | -Program in lower end of range for those of lower levels of CR fitness. -This method gives lower value than does %HRR, but recommended for older clients. -If no actual HRmax is available, you must estimate it. |
| Exercise Intensity Using RPE | -RPE values are valid and reliable measures. -Subjective interpretation of effort by client. -Client "scores" effort required by each stage of GXT using an RPE or Omni scale value. |
| Exercise Intensity Using RPE(cont) | -RPE range of 12 to 16 approximates 40 % to 84 % HRR -May use RPE instead of or with HR |
| Monitoring Exercise Intensity | -Necessary to maintain client's safety -HR -RPE -Talk test:If client can't talk comfortably while exercising, the intensity is too high. |
| Exercise Frequency | -Depends on client's goals, fitness level, preferences, and time availability. -Health benefits at 5 days a week -If CR fitness is low , 5 days a week of low-to- moderate-intensity exercise |
| Exercise Frequency(cont) | -To improve moderate to excellent CR fitness, 3 to 5 days a week of moderate- to vigorous-intensity exercise -May incorporate several short-duration(10min) bouts in same day |
| Exercise Duration | -Duration is inversely related to intensity. -ACSM recommends 20 to 60 minutes continuous or discontinuous exercise. |
| Exercise Duration (Cont1) | -In improvement stage, increase duration every 2 or 3 weeks until reaching 30 minutes continuous exercise. -Alternatively, use the caloric cost of exercise to determine duration. |
| Exercise Duration (Cont2) | -Target caloric threshold is 150 to 400 kcal/day for minimum of 1,000 kcal/week |
| Exercise Duration by Caloric Cost | -Initial conditioning phase:long enough to expend 200 to 600 kcal/day -Improvement stage:long enough to expend 1,000 to 2,00 kcal/day --Gradually change intensity,frequency,duration |
| Progression of Exercise | -Improvement of CR fitness is a result of overload. -Greatest improvement in first 6 to 8 weeks. -Overload comes from adjustments in intensity and duration -Extent of improvement is on individual basis. |
| Progression of Exercise (cont) | -Must continually overload the CR system. -The lowest starting point equals the highest gain. -Common gains in VO2max range from 5%to 20% |
| Stages of Progression | -Initial conditioning -Improvement -Maintenace |
| Initial conditioning | 1 to 6 weeks , based on individual -Low to moderate-intensity exercise early on -Include warm-up and col-down (emphasize stretching) -3to5 days a week |
| Initial conditioning (cont) | -1 to 6 weeks, depending on rate of adaptation -Target is 20 to 30 continuous minutes -Once client exercises for 30 continuous minutes at 55% to 60 % HRR, client is ready to move to improvement stage. |
| Improvement | usually 4 to 8 months -See rapid changes in CR function and aerobic capacity -Continue changing duration,frequency, and intensity independently of each other. |
| Improvement (cont1) | -Increase duration and frequency before intensity -Goal is a minimum of 20 continuous minutes of moderate - to vigorous- intensity exercise 5 days a week -Then increase 5 % HRR Every 6th session -May last 4 to 8 months |
| Improvement (cont2) | -When target fitness level is attained, progress to maintenance stage. |
| Maintenance | for the rest of their life -Goal is to maintain all that was attained in improvement stage. -If intensity stays the same, you can reduce frequency to 3 days a week. |
| Maintenance(cont) | -Use type C and D activities for the other 2 days Include variety to reduce the possibility of boredom. |
| Method or Modes of Aerobic Exercise | -Continuous or discontinuous -Walking,jogging, cycling -Aerobic dance -Step aerobics -Step ergometry and stair climbing |
| Method or Modes of Aerobic Exercise (cont1) | -Elliptical trainers -Water-based exercise -Numerous new options -Continuous exercise maintains an elevated HR |
| Method or Modes of Aerobic Exercise (cont2) | -Discontinuous exercise allows higher exercise intensity and higher total caloric expenditure -Discontinuous exercise is also called intermittent training. |
| Discontinuous Aerobic Exercise | Examples:Interval training, Spinning, CIrcuit resistance training, Treading |
| Discontinuous Aerobic Exercise(cont1) | Circuit resistance exercise -Results in fewer improvements in aerobic fitness compared to other modalities -Should not be used to improve aerobic fitness |
| Discontinuous Aerobic Exercise(cont2) | -Good for maintenance phase -Can add cardio stations between resistances stations (super circuit resistance training) |
| Personalizing an Aerobic Program | -Must meet client's goals and incorporate client's interests. -Need to consider client's demographic profile (age, gender,fitness level, exercise preferences). -Start by evaluating client's risk factor profile then stratify client's CVD risk level |
| Personalizing an Aerobic Program(cont1) | -Round out picture via lifestyle evaluation. -Conduct GXT and record the data. -Must meet client's goals and incorporate client's interests -Needs to consider clients' demographic profile (age,gender,fitness level,exercise preferences) |
| Personalizing an Aerobic Program(cont2) | -Start by evaluating client's risk factor profile -Then stratify client's CVD risk level -Round out picture via lifestyle evaluation -Conduct GXT and record the data -Use their measured (or estimated) VO2max |
| Personalizing an Aerobic Program(cont3) | -Determine if initial conditioning period is required. -Compute target range for exercise intensity (%VO2R or %HRR). -Determine range of HRs that match exercise intensity anchor points. |
| Personalizing an Aerobic Program(cont4) | -Progress exercise prescription by increasing duration first. -Then increase exercise intensity -Compute caloric cost of prescribed exercise -At initial conditioning phrase target is 752 to 1,040 net kcal/week. |
| Personalizing an Aerobic Program(cont5) | -At improvement phase target 1,040 to 1,874 net kcal/week. -During improvement phase client meets ACSM's >1,000 kcal/wk recommendation. |
| Personalizing an Aerobic Program(cont6) | -During maintenance phase, add variety. -Multimodal exercise (cross-training) programs are popular methods for increasing CR fitness. -Difficult to prescribe program based on specific MET levels;use range of MET levels. |
| Personalizing an Aerobic Program(cont7) | -HR will vary based on modality utilized. -HR response during weight-bearing exercise at the same exercise intensity is higher compared to nonweight-bearing modalities. -RPE is good way to monitor intensity |
Created by:
CZ19