Ch 16 Exercise Prescription for Health and Fitness

What are the general guidelines for improving fitness?

screening progression warm-up cool-down

The ACSM/CDC recommendation (1995):

"Every U.S. adult should accumulate thirty minutes or more of moderate-intensity (3-6 METs) physical activity on most, preferably all, days of the week."

active men only have _____% of the risk for cardic arrest of sedentary men

40%

Exercise programs for previously sedentary persons should start with moderate-intensity activities and focus on increasing...

frequency and duration to gain additional health benefits before intensity is increased

What does FITT-VP principle consist of?

frequency, intensity, time, type volume (frequency x intensity x time) progression (transition from easier to harder exercise)

Other than endurance activities what else is important for a complete fitness program?

muscular strength and flexibility (dynamic exercise done on a routine basis)

cool-down: gradual recovery from the higher metabolic loads allows for...

-HR and BP to return to resting values, preventing dizziness and hypotension -facilitates heat dissipation -rapid removal of lactate -prevents rise in catecholamines -transient decrease in venous return -reducing coronary BF and Q -increase the incidence of CV complications -72% of complications occur during warmup and cool down

Regular PA is associated with...

-lower rates of all cause mortality, total CVD and CHD incidence and mortality -increased weight loss and reduced weight regain -lower incidence of obesity, type 2 diabetes and metabolic syndrome -lower risk of colon and breast cancer -improved ability to complete activities of daily living and reduced risk of falls -reduction in depression and cognitive decline -favorable changes in cardiovascular disease risk factors

Sequence of PA for sedentary individuals...

-walking first, start at a comfortable speed for 15 mins and then gradually increase duration and speed -start by adding some jogging when walking and then gradually increase the speed and duration -games and sports are intermittent higher intensity activities within THR range

subjects with CAD increase ____ fold in cardiac arrest with _______ exercise

100 fold vigorous

Overall, to realize health-related benefits of PA, adults should do ____-_____ mins of moderate-intensity PA per week or ____-_____ mins of vigorous intensity PA per week or some combination of the 2 resistance training (___-____exercises, ___-___ reps) should be done on 2 or more non-consecutive days per week

150-300 mins of moderate-intensity PA per week 75-150 mins of vigorous intensity PA per week 8-10 exercises 8-12 reps

What are the ACSM recommendations for CRF?

3-5 sessions per week 20-60 mins per session intensity of 40-89% HRR or VO2R moderate=40-59% HRR vigorous=60-89% HRR

risk of MI is ___-____ fold higher with _______ exercise

2-6 fold vigorous exercise

people who participate in regular PA=their risk of chronic disease is reduced by___-___% and the greatest gains are in those who....

20-40% those who went from no activity to some activity

cardiac arrest during exercise is ____ x greater in sedentary men and ____ x in active men

58 5

What are the progression guidelines for a novice who is doing strength training?

60-70% of 1-RM for 8-12 reps 1-3 sets with 2-3 min rest between sets 2-3 days per week

What are the progression guidelines for an intermediate (6 months of training) who is doing strength training?

60-70% of 1-RM for 8-12 reps multiple sets with 2-3 min rest between sets 3-4 days per week

death rate increases ___ fold during ______ exercise (>___ METS) as compared to more sedentary activities in asymptomatic individuals

7 fold vigorous exercise >6 METS

What are the progression guidelines for an advanced (years of training) who is doing strength training?

80-100% of 1-RM Multiple sets with 2-3 min rest between sets 4-6 days per week

Exercise prescription for CRF? Intensity?

Describes the overload needed to bring about a training effect CRF improvements at 60-80% of VO2 max Lower in those with low initial fitness level Prescribed using target heart rate range

How do you determine Target Heart Rate Range? Direct and Indirect method?

Direct method: THR range determined from maximal GXT HR at 60-80% VO2 max Indirect method: Heart rate reserve (Karvonen) method Subtract resting HR from maximal HR to obtain HRR Take 60% and 80% of HRR Add each HRR to resting HRR to obtain THR range Percentage of maximal HR Take 70% and 85% of maximal HR as THR range Use RPE scale in addition to HR RPE of 12-17 is about 40-89% HRR

What does Dose consist of in Dose-Response for Exercise?

FITT principle Frequency (days per week, times per day) Intensity (% VO2 max, % maximal HR, RPE, lactate threshold) TIme (number of minutes of exercise) Type (resistance, cardiovascular endurance)

What are some environmental concerns and how do they impact the individual during exercise? How do you combat?

Heat and humidity= Increases blood circulation to skin Altitude= Decreases oxygen bound to hemoglobin Cold= dress appropriately and avoid dangerous cold/wind conditions adjust exercise intensity in adverse environments (THR), decrease in exercise intensity will counter the effects of high environmental temperature and humidity to allow one to stay in the target HR zone

Exercise prescription for CRF? Time/Duration?

Must be considered with intensity Greater time required at lower intensities Many sedentary people can more easily complete longer duration exercise at lower intensity

What are the ACSM recommendations for strength training?

One set of 8-10 exercises (major muscle groups) 8-12 reps per set 2-3 sessions per week

What acts as a guide to adjust exercise intensity in adverse environments such as high temperature and humidity or altitude

THR

What is recommended for maximal gains in strength?

Untrained: four sets at 60% 1-RM, three days/week Trained: four sets at 80% 1-RM, two days/week Athletes: eight sets at 85% 1-RM, two days/week

pattern of responses to exercise: occur with one or several exercise bouts but do not improve further

acute response

ACSM/AHA recommendations 2007

all healthy adults aged 18-65 years need moderate-intensity aerobic (endurance) PA for a minimum of 30 mins 5 days each week or vigorous intensity aerobic PA for a minimum of 20 mins 3 days each week included resistance training (8-10 exercise, 8-12 reps, 2 or more non-consecutive days per week)

warm-up: light exercise and stretching performed when?

beginning and end of exercise session warmup, stretch, cooldown, stretch

screening: risk of cardiovascular complications is related to...

degree of pre-existing cardiac disease

pattern of responses to exercise: occur only after weeks of training

delayed

An exercise dose and exercise response reflects what?

dose reflects the interaction of the intensity, frequency, and duration to yield the volume of exercise response to an exercise intervention can include both functional changes (increase in VO2max) and health outcomes (decrease in BP) independent of each other

Exercise prescription for CRF (chronic renal-failure) focuses on what kind of activities?

dynamic, large muscle activities (walking, jogging, running, swimming, cycling, rowing, dancing)

a subset of PA that is planned, with a goal of improving or maintain fitness

exercise

US PA Guidelines

health-related benefits of PA= 150 to 300 mins of moderate intensity PA per week or 75 to 150 mins of vigorous intensity PA per week, or some combination of the two more PA is better Pa can be done in multiple intermittent bouts (10 mins) to meet the goal

strenuous exercise increases the risk of...

heart attach during the activity, but reduces the overall risk

Optimal characteristics of an exercise program=

intensity = 60-80% VO2 max; frequency = 3-4 times per week; duration = minutes needed to expend about 200-300 kcal.

in sedentary subjects, small changed in PA result in...

large health benefits with only minimal risk

progression: start with.... then....

light to moderate increase duration and or intensity (walk, walk/jog, jog) increase about 10%

pattern of responses to exercise: gains are made continuously over time

linear

_______ are more effective for improving strength and ________ is sufficient when maximal strength gain is not the primary goal

multiple sets single set

any form of muscular activity can reduce risk of death from all causes

physical activity

set of attributes that relate to ability to perform PA

physical fitness

has been classified as a primary risk factor for coronary heart disease

physical inactivity

pattern of responses to exercise: benefits occur early and plateau

rapid responses

What does Response consist of in a Dose-Response for Exercise?

specific changes (VO2 max) health related changes

__________ PA was associated with reducd risk of CHD compared to ________ (CHD risk factors also lower, less sick leave)

vigorous intensity PA lower intensities

What is the most important variable linked to health?

volume

if you engage in regular PA doe the benefits outweigh the risks?

yes

Exercise prescription for CRF? Frequency?

≥5 days/week for moderate intensity exercise ≥3 days/week for vigorous intensity exercise Minimum of 2 days/week Gains level off after 3 to 4 sessions/week Higher frequencies associated with increased risk of injury