Exercise Prescription and Assessment Exam 3
Training Volume
A combination of (a) the number of exercises performed per session, (b) the repetitions performed per set, and (c) the number of sets performed per exercise. ACSM recommends that apparently healthy adults should train each muscle group for two to four sets to achieve muscular fitness goals Multiple set training is more effective than single set training for strength enhancement in untrained and trained population. Balancing high- and low-volume training allows for proper recovery
Intensity
A combination of moderate (40% to 59% VO2R) and/or vigorous-intensity (60% to 84% VO2R) exercise is recommended for most healthy individuals. Intensity may be prescribed using multiple methods -Examples include heart rate reserve, rating or perceived exertion, percent VO2max, and percent of age-predicted maximal HR.
Individuals who regularly perform moderate or vigorous PA have a lower risk of CVD than inactive people.
A dose response relationship exist between exercise and reductions in chronic disease
Resistance Load Used (cont.)x2
A percentage of an individual's 1 RM also can be used to determine the resistance training intensity. Beginners: reasonable to use a resistance training intensity of ~50% to 60% 1 RM while developing motor skill. Research shows that 60% 1RM and 8-% 1RM produced the largest strength increases in untrained and training adults, respectively. When prescribing percentages of 1 RM for an exercise, it is important to consider the muscle being worked, relative to strength levels.
Resistance Training for Adults With Heart Disease
A physician should review each patient's health history Start with light weight and focus on controlled movements (start around 50% of 1RM) Begin with 1 set of 10 to 15 reps on 8 to 10 different exercises (RPE 11-13) Resistance train 2 or 3 nonconsecutive days per week Gradually increase the weight as strength improves Avoid straining and the Valsalva maneuver Don't grip the weight handles or bars tightly Stop exercise in the event of any warning signs and symptoms such as dizziness, abnormal shortness of breath, or chest pain
Resistance Load Used (cont.)
A repetition range between 8 and 12 (~60% to 80% 1 RM) is commonly used to enhance muscular fitness in novice to intermediate exercises. Using lighter weights (e.g., <50% 1 RM; 15-20 repetitions) will have more effect on muscular endurance. Consistent training at high intensities (e.g., ≥80% 1 RM) increases the risk of overtraining.
Training Frequency
A resistance training frequency of 2 to 3 times per week on nonconsecutive days is recommended for beginners. Allows for adequate recovery between sessions (48 to 72 hours) and has proven to be effective for enhancing muscular fitness Although an increase in training experience does not necessitate an increase in training frequency, a higher training frequency does allow for greater specialization characterized by more exercises and a higher weekly training volume.
Periodization (cont.)x2
A second model of periodization is referred to as an undulating (nonlinear) model because of the daily fluctuations in training volume and intensity Example: 2 or 3 sets with 8 to 10 RM loads on Monday 3 or 4 sets with 4 to 6 RM loads on Wednesday 1 or 2 sets with 12 to 15 RM loads on Friday
Resistance Training
A specialized method of physical conditioning which involves the progressive use of wide range of resistive loads and a variety of training modalities designed to enhance muscular fitness. The term resistance training should be distinguished from bodybuilding and powerlifting, which are competitive sports
Structure/Function
Agonists: primary joint movers Synergists: accessory joint movers Antagonists: muscles that oppose movement Only muscles that are used during exercise will adapt to the stress. Different training loads stimulate different muscle fibers
Type
All types of PA are beneficial as long as they are of sufficient intensity and duration Rhythmic, continuous exercise that involves major muscle groups is the most typical Intermittent exercise such as interval training or stop-and-go sports may be used to accumulate the recommended frequency, intensity, and time needed for cardiorespiratory fitness.
Senior Fitness Test (SFT)
Assesses the key physiological parameters (i.e., strength, endurance, agility, and balance) needed to perform common everyday physical activities that often become difficult for older individuals Two specific tests included in the SFT, the 30 sec chair stand and the single-arm curl, can be used to safely and effectively assess muscular strength and endurance in most older adults Good for ages 60-94
Special Considerations: Youth
Assessment of muscular strength and local muscular endurance Obtain informed consent from the parent or legal guardian before initiating muscular fitness testing or participating in a formalized exercise program Qualified fitness professionals should demonstrate the proper performance of each skill, provide an opportunity for each child to practice, and offer guidance and instruction when necessary Can use push-up and curl-up tests, and 10 RM There are standardized testing procedures for young people
Resistance Training for Seniors (continued)
Begin training on weight machines and gradually progress to free weight exercises They should perform exercises within a pain-free range of motion Qualified fitness professionals should provide guidance and offer assistance as needed Seniors should resistance train at least twice per week Principle of reversibility -Increases in strength and bone density will return to pre-exercise levels during prolonged inactivity
Modes of Resistance Training (cont.)
Body weight is one of the oldest modes of training. It can be hard to adapt body weight exercises to one's strength level Additionally, obese/sedentary persons may not be able to perform body weight exercises which can be a deterrent to exercise. Stability balls and medicine balls help train balance and core strength and have been used by therapists for many years
Measuring Cardiorespiratory Fitness and the Maximal Oxygen Uptake
CRF testing can assist an exercise professional in determining the following variables associated with exercise programming: -Intensity -Duration -Mode CRF can also serve as motivation for individuals to continue regular exercise programs. CRF testing can also assist in identifying, diagnosing, and prognosis of comorbid conditions
Exercise is Medicine: Reduction in BP
CV exercise has been noted for its ability to lower resting blood pressure. Resistance training has been discouraged for its potential to increase BP Meta-analysis performed by Carnelissen et al. revealed that resistance training decreased BP with a mean reduction of 3.9 mm Hg in normo- and prehypertensives. Hypertensives saw approximately the same mean decrease; however, it was not statistically significant
Benefits of Assessment
Can be assessed by a variety of laboratory and field-based measures. Provide valuable information about an individual's baseline fitness Highlight a client's progress and provide positive feedback that can promote exercise adherence. Adults who undergo fitness testing should complete a health history questionnaire and individuals at cardiovascular or orthopedic risk should be identified
Interpreting Results
Can compare strength assessments of people who have different body masses - use a strength ratio (ratio of strength to body weight) 1. Determine 10 RM 2. Convert 10 RM to 1 RM by dividing weight load by 0.75 3. Divide estimated 1 RM by person's body weight = strength ratio Key is to periodically recheck to determine the status of the person and to adjust the program
Plyometric Training
Characterized by quick, powerful movements that involve a rapid stretch of a muscle (eccentric) immediately followed by a rapid shortening of the same muscle (concentric). The amount of time it takes to change direction from the eccentric to the concentric phase of the movement is a critical factor in plyometric training This time period is called the amortization phase as should be as short as possible (<0.1 second) to maximize training adaptations. Plyometric exercises can place a great amount of stress on the involved muscles, connective tissues, and joints. This type of training needs to be carefully prescribed and progressed to reduce the likelihood of musculoskeletal injury The importance of starting with basic movements or establishing an adequate baseline of strength before participating in a plyometric program should not be overlooked by the HFS
Resistance Training for Special Populations
Children Seniors Pregnant women Adults with heart disease
Resistance Training for Children (continued)
Children should perform 8 to 15 on different exercises that use all the major muscle groups Increase the weight gradually Train 2 or 3 nonconsecutive days each week Adult spotters should be nearby Children should stay hydrated
Resistance Training Program Variables
Choice of exercise Order of exercise Resistance used Training volume (total # or number of sets and reps) Rest intervals between sets and exercises Repetition velocity Training frequency
Types of Muscle Action
Concentric contractions occur when the muscles are shortening. Eccentric contractions occur when the muscles are lengthening Isometric, or static, action occurs when the muscle is loaded, however no movement at the joint takes place. Static action typically happens during the "sticking point" of an exercise when the force produced by the muscle equals the resistance
Gross Versus Net Cost of Jogging or Running
Consider a 160 lb (72.6 kg) person who jogs at 6 mi · hr-1 (9.7 km · hr-1 ) for 10 min: Gross (total) cost pre mile = 123 kcal Net cost = gross cost - cost of rest for 10 min (12 kcal) Net cost = 111 kcal x min^-1
Gross Versus Net Cost of Walking
Consider a 160 lb (72.6 kg) person who walks at 3 mi · hr-1 (4.8 km · hr-1 ) for 20 min: Gross (total) cost per mile = 79 kcal Net cost = gross cost - cost of rest for 20 min (24 kcal) Net cost = 55 kcal x min ^-1
Modes of Resistance Training
Decisions should be based on an individual's health status, training experience, and personal goals Major modes include: -weight machines, free weights, body weight exercises, and a broadly defined category of balls, bands, and elastic tubing. A combination of single joint and multi joint exercises should be performed Free weights are more beneficial for recruiting accessory muscles and utilize balance
Rest Intervals
Determine energy recovery and strength gains made. To maximize gains in muscular strength, heavier weights and longer rest intervals (e.g., 2 to 3 minutes) are needed To increase muscular endurance, lighter weights and shorter rest periods (e.g., <1 minute) are required. The same rest interval does not need to be used for all exercises Fatiguing from a previous exercise should be taken into consideration when planning rest time.
BP and HR Assessment cont.
During graded exercise testing, BP and HR should be assessed at each exercise intensity. HR should be assessed at least two times at each stage to ensure it is appropriate to move to the next workload BP should be assessed during the last minute of each exercise stage. BP and HR should be assessed for a minimum of 5 minutes of recovery or until each become stable
Types of Resistance Training
Dynamic constant external resistance (DCER) Variables resistance training Isokinetics Plyometrics
Isokinetics
Dynamic muscular actions that are performed at a constant angular limb velocity Used by PT's and certified athletic trainers for injury rehabilitation The speed of movement—rather than the resistance—is controlled during isokinetic training The best approach is to develop increased strength and power at different movement speeds
Metabolic Calculations: Energy
Energy can be presented using many different terms in the field of exercise physiology, such as: Absolute oxygen consumption (L/min or mL/min) Relative oxygen consumption (mL/kg/min) Metabolic equivalents (METs) kilocalories
Musculoskeletal Injuries Associated with CR Exercise
Exquisite point tenderness Pain that persists even when the body part is at rest Joint pain Pain that does not go away after warming up Swelling or discoloration Increased pain with weight-bearing activities or with active movement Changes in normal bodily functions
FITT Framework!
FITT (F=Frequency, I=Intensity, T=Time or duration, and T=Type or mode FITT principle may be customized to meet the unique goals and needs of the individual Adopted from the most recent recommendations from the American College of Sports Medicine (ACSM), American Heart Association (AHA), and the 2008 Physical Activity Guidelines for Americans.
Local Muscular Endurance
Field Tests Abdominal curl-up (crunch test) Push up test YMCA Bench Press test The tests can screen for muscle weakness - and are a practical way to evaluate muscle fitness Can be used with other types of muscle fitness evaluations
Is the Energy Cost of Walking and Running a Mile the Same?
First determine the costs of each activity, given the information below. Gross cost includes resting energy expenditure Net cost includes the cost of the activity alone Resulting energy expenditures = 1 kcal x kg—1 x hr^-1
Time
For substantial health benefits, individuals should accrue at least one of the following: 150 minutes/week of moderate-intensity exercise 75 minutes/week of vigorous-intensity exercise An equivalent combination of moderate and vigorous aerobic exercise For additional and more substantial health benefits, moderate-intensity exercise may be increased to at least one of the following: 300 minnutes/week increasing vigorous-intensity exercise to 150 minutes/week An equivalent combination of moderate and vigorous PA
Frequency
Frequency Moderate-intensity aerobic exercise should be done at least 5 days/week Vigorous-intensity aerobic exercise done at 3 days/week A combination 3 to 5 days/week of moderate and vigorous-intensity aerobic exercise.
When to Use Submaximal and Maximal Tests
GXT protocols can used for submaximal tests (early in the testing sequence) or maximal tests (for active people who have reached minimal fitness levels) Both use the same GXT protocol, but the criteria for stopping the tests differ Sub-maximal tests: stop at 85% max HR Maximal tests: the person reaches voluntary exhaustion
Repetition Velocity
Gains in muscular fitness are specific to the training velocity. Beginners need to learn how to perform each exercise correctly and develop an adequete level of strength before optimal gains in power performance are realized It is likely that the performance of different training velocities and the integration of numerous training techniques may provide the most effective training stimulus.
Periodization (cont.)
Goal is to constantly challenge training demands. The general concept of periodization is to prioritize training goals and then develop a long-term plan that varies throughout the year The year is divided into specific training cycles (e.g., a macrocycle, a mesocycle, and a microcycle) with each cycle having a specific goal (e.g., hypertrophy, strength, or power). The classic periodization model is referred to as a linear model because the volume and intensity of training gradually change over time
Repetition Maximum Testing
Gold standard of dynamic strength testing Good indicators of strength Need to follow proper guidelines under a qualified supervision When the purpose of testing is to define an initial training load - use multiple RM- limits error e.g. 10 RM
HR, SV, and CO Responses to GXT
HR increases linearly with increasing workload until HR max is reached. SV increases with workload, but only up to approximately 40-60% of VO2 max -As SV increases with training, RHR tends to decrease. Cardiac Output (SV x HR) increases steadily during GXT
Effects of Heat
Hot environments reduce the body's ability to dissipate heat and thus, promote an increase in core body temperature In an effort to maintain a neutral body temperature when exposed to a hot environment, sweat rate and skin blood flow increase to promote heat loss. Increased sweat rates can cause a reduction in plasma volume and increase the risk of dehydration Increased sweat rates may lead to a decrease in SV, which then prompts an increase in HR to maintain cardiac output at submax workloads.
Cold Stress
If core temperature is challenged, the body attempts to increase heat production and limit heat loss via shivering and vasoconstriction of blood vessels in the skin. Those with greater subcutaneous fat mass have an advantage at limiting heat loss in cold environments The HR and cardiac output responses to exercise in a cold environment are similar to those of a thermo-neutral environment Respiratory rate is higher at a given submaximal intensity and VO2max may be lightly lower
Overload
In order to enhance muscular fitness, the body must exercise at a level beyond that at which it is normally stressed Overload is typically manipulated by changing the exercise intensity, duration, or frequency.
Balke protocol
Inactive adults Start at a higher MET level Walk slowly and increase 1 MET per 3 min stage
Potential Benefits of Resistance Training for Adults With Heart Disease
Increase muscle strength Favorably affect cardiac risk factors Reduce rate-pressure product during daily activities Enhance psychological well-being Improve quality of life
Potential Benefits of Resistance Training for Seniors
Increase muscle strength Increase muscle mass Increase resting metabolic rate Enhance bone mineral density Reduce risk of falling
Effects of Heat on physiological response
Increased blood flow to the skin circulation comes at the expense of reduced blood flow to the working muscle. The HFS should expect higher HR values at a given workload during exercise in the heat compared to the exercise in a thermo-neutral environment Heart rate may not reach a steady state during prolonged, submaximal intensity exercise due to the increased sweat rate, leading to cardiovascular drift. During CV drift, HR climbs over time, thereby decreasing overall performance
Drawbacks to Maximal Testing
Increased risk and discomfort while exercising to exhaustion Increased costs and time Specialized personnel and supplies
Contraindications to CR Exercise
Individuals with cardiac, respiratory, metabolic, or musculoskeletal disorders should be supervised by clinically trained personnel when beginning an exercise program. A thorough pre-exercise screening, obtaining informed consent, and review of medical history are necessary for the HFD to identify potential contraindications and to ensure the safety of the client Apparently healthy individual experiencing signs and symptoms should stop exercise and be referred to a professional.
Muscular Fitness Tests (cont.)
Initial assessment of muscular fitness and a change in muscular strength or muscular endurance over time can be based on the absolute value of the weight lifted or the total number of repetitions performed with proper technique. When strength comparisons are made between individuals the values should be expressed as relative values (per kilogram of body weight)
Effects of Altitude
It is the change in barometric pressure that causes the partial pressure of oxygen to decrease at altitude and reduces our ability to provide oxygen to working muscles. In response to lower PO2 at altitude, pulmonary ventilation increases During the initial days of high altitude exposure, SV decreases yet HR increases to a greater extent, causing an increase in cardiac output at a given submaximal exercise intensity. There is typically no change note in BP
Order of Exercise
Large muscles before small muscles; multijoint before single joint. More challenging exercise done in the beginning when fatigue in minimal Experienced individuals may choose to utilize a split routine. Ultimately, training time availability and personal preference should help determine type of routine
Deconditioned protocol
Low MET level, walk slowly, increase 1 MET per 3 min stage
When to Use Submaximal and Maximal Tests continued
Maximal tests are more effective in identifying ischemic heart disease Submaximal tests ae useful to assess fitness and are relatively inexpensive to administer Can estimate VO2 max with submaximal tests but it is not as accurate (off by + 4 - 5 ml/kgXmin) Submaximal tests are useful in evaluating changes in CRF due to an exercise program
Peak VO2 Method
May be used if the HFS has measured or estimated the VO2 max of the client in a laboratory or field setting. Caution using estimates due to the expected error in extrapolating HR
VO2 Reserve (VO2R) Method
May be used when the HFS has directly measured or estimated the client's VO2 max and resting VO2 in a laboratory setting. The VO2R is the difference between VO2max and resting VO2
Metabolic Equivalents
Metabolic equivalents (METs) are simple energy equivalents that can be used by the general public to gauge exercise intensity. One MET is equal to the relative oxygen consumption of rest, which is approximately 3.5 mL/kg/min Using METs as energy cost units allows for the energy cost of exercise to be presented in multiples of rest. In addition, METs can be calculated energy expenditure over time ([MET x 3.5]/200)=kcal/min
Bruce protocol
More active or younger adults Start at a moderate MET level, increase by 2-3 METs per 3 minute stage
Maximal heart rate
Most common equations to predict Hrmax in adults 220 − age (yr) 208 − (0.7 x age)
DCER
Most common method of resistance training for enhancing muscular fitness Describes a type of training in which the weight lifted does not change during the lifting (concentric) and lowering (eccentric) phase of an exercise. Different types of training equipment, reps and sets can be used in DCER training Commonly used to enhance motor performance skills and sports performance. The weight lifted does not change throughout the ROM The heaviest weight that can be lifted throughout a full ROM is limited by the strength of a muscle at the weakest joint angle DCER exercise provides enough resistance in some parts of the movement range but not enough resistance in others. To overcome this, variable resistance machines provide a specific movement path that makes the exercise easier to perform
Assessing Muscular Endurance
Muscular endurance is the ability to perform repeated contractions over a period of time as is typically assessed with field measures. These tests can be used independently or in combination with other tests of muscular endurance to screen for muscle weaknesses and aid in the exercise perescription Certain populations (e.g., overweight) may find these tests difficult to perform. -Poor results obtained during testing may discourage further participation.
Introduction to Muscular Strength and Muscular Endurance Assessments and Exercise Programming for Apparently Healthy Participants
Muscular strength and muscular endurance are two components of health related fitness Resistance training has become a fitness trend. Can improve quality of life for all ages Recommendations by ACSM now recognized by WHO for health benefits of resistance training. Reductions in mortality, CVD risk factors and improved body composition are some of the benefits gained
Key Points for Muscular Fitness Testing
Muscular strength is best assessed by using a resistance that requires maximum or near maximum tension with few repetitions Muscular endurance is assessed by using lighter resistance with a greater number of repetitions Both can and should be assessed safely since they provide important information for individualized exercise prescription Ideally, to ensure valid and reproducible results, standardized procedures should be used Changes over time should be evaluated
Jog/run test
Must be long enough to minimize anaerobic energy contribution, but not too long so that subject runs close to 100% VO2max 1.5 mile or 12 min runs are good examples The VO2max estimates are reasonable for adults who jog or run the entire 12 min. or 1.5 mile The time for the 1.5 mile is used to determine average speed- can then use formula to calculate VO2max VO2max is underestimated in children (they have a higher cost of running) and overestimated in trained runners because of their better running economy
Resistance Load Used
One of the most important variables is weight selection. Adaptations to resistance training programs are linked to the intensity of the training program It is recommended that training sets be performed to muscle fatigue but not exhaustion using the appropriate resistance. RM LOADS ≤6 are most beneficial to muscular strength RM Loads ≥20 are most beneficial to muscular endurance.
Determining Exercise Intensity
Options range from direct measurements in clinical or laboratory settings, to more subjective ratings based on feelings of exertion or fatigue. Methods: -HRR Method/Karvonen -Talk test -Peak Heart Rate Method -Perceived Exertion -Peak MET method -Peak MET method -VO2 reserve (VO2R) method
Summary of ACSM's Resistance Training Guidelines for Apparently Healthy Adults*
Perform a minimum of 8 exercises for each of the major muscle groups Perform at least 1 set of each exercise Choose a repetition range between 3 and 20 (e.g., 8-12) Resistance train 2 or 3 days a week Perform each exercise at a moderate velocity through the full range of motion Maintain a normal breathing pattern Exercise with a partner for assistance and motivation
Functional Strength Assessments
Preserving mobility and independence through maintenance of strength, endurance, agility, and balance is primary goal for all aging populations These clinical assessments should be: -Time-efficient -Cost-effective -Easy to implement Functional strength assessments accomplish both of these goals; some examples include the following: -Fullerton Senior fitness test -Timed up and go -Short physical performance battery
Contraindications to Exercise Testing
Prior to initiating a test, the risk of performing the test must be weighed against the potential benefits.
Program Design Considerations
Programs should be based on a participant's health status, current fitness level, personal interests and individual goals. Identify "at-risk" persons and those who may need medical clearance Consider current fitness status and previous exercise experience. As individuals gain experience with resistance training, more complex programs are needed in order to make continual gains in muscular fitness
Metabolic Calculations: Oxygen Consumption
Rate at which oxygen is consumed by the body. It can be expressed in absolute (L/min) or relative (mL/kg/min) Absolute oxygen consumption is the raw volume of oxygen consumed by the body. Relative oxygen consumption is the volume of oxygen consumed relative to body weight, and can serve as a useful measure of fitness between individuals
Specificity
Refers to the distinct adaptations that take place as a result of the training program. The principle of specificity is often referred to as the SAID principle (specific adaptation to imposed demands) The adaptations that take place in a muscle or muscle group will be as simple or as complex as the stress placed on them. Important that exercised performed are consistent with the target activity (i.e., a certain sport)
Periodization
Refers to the systematic variation in training program design Based on Selye's general adaptation syndrome After a period of time, adaptation to a new stimulus will no longer take place unless the stimulus is altered For all individuals with different levels of training experience who want to enhance their health and fitness
HRR/Karvonen Method
Requires the HFS to determine the resting heart rate and maximum heart rate of the client. The HRR is the difference between maximum heart rate and resting heart rate.
Special Considerations: Cardiovascular Disease
Resistance training could benefit the majority of people with CHD or for cardiac rehabilitation Both moderate or high intensity (40-80%) resistance training can be performed by this population If patients are suspected of having CHD or hypertension, one must do preliminary work to establish appropriate weight loads for testing Probably best to do 5 or 10 RM (not 1 RM) Be conservative with initial weight Need proper instructions including demonstrations Careful screening and astute monitoring of abnormal signs or symptoms, such as angina, are important to minimize any potential risks while simultaneously maximizing the benefits of resistance training for persons with and without cardiovascular disease Should monitor BP
Additional Benefits
Resistance training has been proven to cause increases in bone mass, counteracting the degenerative disease of osteoporosis Enhances physical function. Helps to decrease age-related weight gain
General Recommendations
Resistance training has the potential to offer unique benefits to men and women of all ages and abilities. Designing an effective program can be complex Programs should be individualized and consistent with one's personal goals. Safe and effective programs utilize good instruction, proper progression and consistent evaluations Effective leadership and continual motivation help maintain consistency within a program.
Frequency
Resistance training must be performed regularly several times per week in order to make continual gains in muscular fitness. Two or three training sessions per week on nonconsecutive days is reasonable for most adults Proper recovery is still crucial. Long-term gains in muscular fitness will be realized only if the program is performed on a regular basis
Interpreting results of CRF Assessments
Results should be shared with client and are therefore placed into categories that are easier to understand. Additionally, normative standards provide percentiles from data collected within a specific population If there is discrepancy within the populations, normative data are not appropriate for comparisons.
Resistance training for children
Review each child's health history - completed by parents or legal guardians Supervise youth fitness activities The exercise area should be safe Children should use a light weight when learning a new exercise
Exercises to Enhance CRF
Rhythmic, continuous, and uses large muscle groups There is no shortage of exercise options for the HFS to choose from. The ACSM has created a classification scheme in order to help the HFS make an appropriate exercise selection. Weight bearing and NWB activities should be considered based on the clientele (i.e., orthpedic limitations)
BP Response to GXT
SBP increases linearly with work -A function of increasing Q. DBP remains relatively stable with increasing work
Functional Strength Assessments: Short Physical Performance Battery (SPPB)
SPPB is a composite measure of lower extremity function utilizing standing balance, walking speed, and ability to rise from a chair measures
Choice of Exercise
Select exercises that are appropriate for an individual's exercise technique experience and training goals. Promote muscle balance across joints and between opposing muscle groups Closed kinetic chain: distal joint segment is stationary; mimic everyday activities. Open kinetic chain: distal joint is free to move Strengthen the abdominals, hip, and low back for postural control. Include multidirectional exercises that utilize stability
Peak METs Method
Since 1 MET is equivalent to 3.5 mL/kg/min, an individual's peak MET level can be determined simply by dividing one's measured or estimated VO2 max by 3.5 This is an absolute measure Target METs= (% intensity desired)[VO2max in METs)-1]+1
Muscular Fitness Tests
Specific to the muscle groups being assessed, the velocity of movement, the joint range of motion and the type of equipment available. Tests need to be individualized for each client Each client should have a familiarization session before participating. Large amplitude dynamic movements (also known as dynamic stretching) and test-specific activities should precede muscular fitness testing
Functional Strength Assessments: Timed Up and Go Test (TUG)
TUG is a simple, short duration, and widely used performance-based assessment of lower extremity function, functional mobility, and fall risk
Assessing Muscular Strength
The 1 RM is the standard muscular strength assessment -The heaviest weight that can be lifted only once -Assumes proper technique. Proper familiarization is necessary and increases reliability of testing A 10 RM can also be used to assess muscular strength. Can estimate 1 RM by determining 10 RM and dividing by 0.75
BP and HR Assessment
The HFS should assess BP and HR before, during, and after exercise Pre-exercise BP and HR are assessed in the exercise position. -Pulse palpation, if used, should be counted for a minimum of 15 seconds -Radial pulse is a superior choice to carotid pulse.
Peak Heart Rate Method
The HFS to determine the client's maximal HR May be accomplished from direct measurement, such as a VO2 max treadmill test, or maximum heart rate may be estimated from age-predicted formulas
Cardiorespiratory Fitness (CRF)
The ability of the circulatory and respiratory systems to supply oxygen to the muscles to perform dynamic PA
Four fundamental principles that determine the effectiveness of all resistance training programs: Progression
The demands placed on the body must be continually and progressively increased over time to achieve long-term gains in muscular fitness. Over time, physical stress on the body must become increasingly challenging. This principle is particularly important after the first few months of resistance training when the threshold for training-induced adaptations in conditioned individuals is higher. A reasonable guideline for a beginner is to increase the training weight about 5% to 10% per week and decrease the repetitions by 2 to 4 when a given load can be performed.
Exercise Test Protocols
The duration, starting points, and increments between stages vary with the person The same three groups should increase by 2 to 3, 1 to 2, and 0.5 to 1 MET respectively Time per stage is usually 2 or 3 minutes
CRF Assessment: Maximal Oxygen Uptake
The gold standard used to measure cardiorespiratory fitness is the assessment of VO2 max via open circuit spirometry. Although considered the Gold Standard, this technique requires expensive equipment, technical expertise, and maximal intensity exercise performance by the client VO2 max estimates from submaximal exercise increase prediction error.
Muscle Action
The highest force produced occurs during an eccentric muscle action. Maximal force produced during an isometric muscle action is greater than seen during a concentric contraction As the velocity of movement increases, the amount of force that is generated decreases during a concentric muscle contraction and increases during an eccentric muscle action. Progression during e!!
Formulating the Exercise Prescription Intensity : Guidelines
The intensity threshold for a training effect for people who are sedentary (adults who are deconditioned) is low (40-60% VO2max) For people who are physically active and have high CRF, the threshold is high (> 80% VO2 max or R) For most people (average person) the threshold s 60-80% VO2max or VO2R The duration of the exercise should be balanced with the intensity so a person can expend 150-400 kcal/day If intensity is too high, the person may not be able to exercise long enough to reach their goals
Metabolic Formula
The metabolic formula calculates gross energy expenditure, which refers to the sum of energy utilized at rest and during exercise. In contrast, net energy expenditure refers to the energy cost of exercise that exceeds the energy required to support the body at rest Can be used for application purposes, such as weight loss or weight gain goals.
CRF Assessments: Field Tests
The most common include assessment of time required to cover a set distance or the distance covered in a set amount of time Can utilize many modes of exercise, are short in duration, and require little equipment. -Step test, 1.5 miles run, etc. Are more subjective, largely due to the dependency on client effort
Overload Principle
The overload principle is at the foundation of all exercise prescription. In order to improve cardiorespiratory fitness, the individual must exercise at a level greater than accustomed to induce adaptation The HFS can implement the overload principle by manipulating the frequency, intensity, or time of the exercise prescription.
Perceived Exertion Method
The perceived exertion method is another subjective rating of how hard one may be working Measured through Borg's Rating of Perceived Exertion (RPE) Scale, which ranges from 6 to 20, 6 meaning no exertion at all, and 20 meaning maximal exertion. The RPE range of 11 to 16 is recommended to improve cardiorespiratory fitness Borg's Scale (CR-10): 0 to 10 scale; moderate (CR 5 to 6) and vigorous (CR 7 to 8).
Principle of Individual Differences
The principle of individual differences states that all individuals will not respond similarly to a given training stimulus
Principle of Reversibility
The principle of reversibility can be viewed as the opposite of the overload principle "Use it or lose it" Once cardiorespiratory training is decreased or stopped for a significant period of time, previous improvements will reverse and decrease, and the body will readjust to the demands of the reduced physiological stimuli.
Specificity Principle
The specificity principle, also known as the SAID principle (Specific Adaptations to Imposed Demands), is dependent on the type and mode of exercise. The specificity principle states that specific exercise elicits specific adaptations, creating specific training effects
Talk Test Method
The talk test is a subjective measure of relative intensity, which helps differentiate between moderate and vigorous physical activity. If an individual is able to talk, but not sing, the PA is considered moderate Once the intensity of the activity increases to a point at which an individual is not able to say more than a few words without pausing for a breath, the intensity would be considered vigorous.
Summary
There are numerous means of assessing cardiorespiratory fitness, so that the HFS can accommodate a wide range of clientele safely. The FITT principle provides a framework of prescribing exercise that also allows for tremendous individual variation Properly assessing and prescribing exercise can play a significant role in helping individuals initiate an enjoyable exercise program.
30 Sec Chair Stand Test
This test indicates lower-body strength Safe and sensitive in detecting the effects of physical training in older adults Can detect normal age related declines in strength Count the number of times within 30 sec that an individual can rise to a full stand from a seated position without pushing off with the arms
Single-Arm Curl Test
This test is an indication of upper-body function that is important in executing many everyday activities It involves determining the number of times a dumbbell (5 lb, or 2.3 kg, for women; 8 lb, or 3.6 kg, for men) can be curled through a full range of motion in 30 sec Start holding the weight in a handshake grip at full ext, then supinate, and flex arm Most older adults should be able to do it
Resistance Training for Seniors
Use careful pre-participation health screening Perform warm-up activities Maintain proper breathing patterns Begin with 1 set of 10 to 15 reps with minimal resistance during the first few weeks Perform 8 to 10 different exercises Allow ample time to adjust to postural changes and balance during the transition between exercises
Oxygen Uptake During Graded exercise testing
VO2 increases slowly within the first few minutes of exercise -Eventually reaches a steady state at each submaximal exercise intensity Steady state increases linearly until maximum VO2 is reached A higher maximal VO2 indicates a higher level of aerobic training and a greater capacity to produce ATP
Submaximal Exercise
VO2 is proportional to workload Steady state defines the point at which VO2 plateaus during submaximal aerobic exercise. -Energy production is equal to the energy required The duration of time required to reach steady state is influenced by training state and the magnitude of the increase in exercise intensity.
1 mile walk test
Walk as fast as possible on a measured track (only walking is allowed) Measure time for 1 mile and HR at end of walk Use with age, weight, and sex to estimate VO2max
Prediction of Maximal Aerobic Power: Treadmill Test
check HR at end of each stage
Gains and Risks of Increasing PA!!
optimal training intensity, frequency, and duration 60-80% VO2max 3-4d/wk 20-30 min/day
Contrasting Recommendations for Health, Fitness, and Performance
put in chart info