DOMAIN II- EXERCISE PRESCRIPTION AND IMPLEMENTATION

The management of body weight is dependent on energy balance between:

-energy intake (cals consumed) and energy expenditure (cals expended)

Periodization

The systematic variation in training program design, due to the general adaptation syndrome concept (p114) can vary program variables such as choice of exercise, training resistance, # of sets, rest periods between sets, etc.

Advantages and disadvantages of selectorized machines

i. Advantages- easy to use, great muscle isolation ii. Disadvantages- high cost, limited portability, limited functionality, limited exercise variety, high space requirements

Advantages and disadvantages of free weights

i. Advantages- low cost, portable, easy to use, varies in muscle isolation, functionality, exercise variety, variable space requirements ii. Disadvantages-

Type 1 Fibers -what are they/their capacities -what activity are they good for

i. Aerobic/high oxidative capacity and lower contractile force capacity ii. Good for endurance activities

Type 2 fibers -what are their capacities -what are they good for

i. Anaerobic/ high glycolytic capacity and higher contractile force capability ii. Better for strength and power activities

FITT VP for those with dyslipidemia

p235-236 *encouraged to exercise in longer durations to optimize blood lipid concentrations *short term goal of 150min/week or long term goal of 300min/week (5+ days of exercise a week)

Benefits of exercise for pregnant women

p287-288

FITT-VP for Apparently healthy pregnant woman (AEROBIC)

p288-289 recommended 30 min of mod. intensity exercise on all or most days (mod- 40-60% HRR)

Pregnant healthy women FITT for resistance training

p288-289 *avoid supine position and valsalva maneuver

ergogenic aids

substances used to improve exercise and athletic performance

FITT for those with osteoporosis

table 9.12 p270

FITT-VP for individuals with arthritis

table 9.8 p263

reaction time

the amount of time taken to respond to a specific stimulus

f. Specificity

the distinct adaptations that take place as a result of the training program; the adaptations to resistance training are specific to muscle actions, velocity of movement, exercise ROM, muscle groups

fat free mass

the nonfat component of the human body, consisting of skeletal muscle, bone, and water

body fat distribution

the pattern of fat distribution on the body

Power

the rate at which work is done

g. Supervision

the safety and efficacy of exercise programs are maximized when qualified fitness professionals supervise activities while providing instruction and encouragement

Sliding filament theory of muscle contraction

the theory that explains muscle contraction as the result of myofilaments sliding over each other

percent fat

the total amount of weight that is measured as fat tissue

Reversibility

the training principle that fitness improvements are lost when demands on the body are lowered "don't use it, lose it" (2-4 weeks)

Progressive overload

the training principle that progressively increasing amounts of stress on the body causes adaptation that improves fitness Must manipulate frequency, intensity or time of exercise prescription

PARmed-X for Pregnancy

this is a physical activity-specific checklist used by physicians with patients who are pregnant prior to attending prenatal fitness class or performing other exercise (health screening tool necessary for all pregnant women to start or continue exercising during pregnancy)

Myofibril

tightly packed filament bundles found within skeletal muscle fibers; consists of many sarcomeres

4. Dynamic Flexibility

uses slow and controlled, sport-specific movements that are designed to increase core temperature and enhance activity-related flexibility and balance

c) Remodeling phase

weakened repaired tissue; therefore, exercise is to promote hypertrophy and strength of newly repaired tissue; can take 2-4 months for tissue remodeling

Concentric muscle action

when a muscle shortens in length and develops tension; when weight is lifted, muscles normally shorten *when indivdual extends the hip and knees from a parallel squat position to the standing phase, the gluteus maximus and vastus lateralis perform CONCENTRIC muscle actions

What are the three types of PNF stretching?

a) Hold-relax b) Hold-relax with antagonist contraction c) Agonist contraction

Phases of sprain

a) Inflammatory phase b) Repair phase c) Remodeling phase

respiratory rate

higher

Relative oxygen uptake for children

higher for children

Hemoglobion and blood cell count

increase during childhood

Hyperplasia

increase in # of cells or fibers

Hypertrophy

increase in size of cell

Lung function

increases with age, mainly as a function of height

Sprain

injury to a ligament (tissue that connects bone to bone)

Strain

injury to muscle or tendon

Consequences of the following inappropriate weight-loss methods: a. Saunas b. Dietary Supplements C. Vibrating belt d. Body wraps E. Over exercising F. low cal diets G. electric stimulators H. Sweatsuits I. Fad diets

---->

Physiologic changes associated with an acute bout of exercise FOR CHILDREN compared to adults:

---->

Maturational changes in cardiorespiratory function across lifespan:

--->

What are two indications for suggesting water-based exercise?

-Arthritis -Obesity p262-263

Strains are most common on the:

-Calf (gastrocnemius, soleus) -Thigh (quadriceps femoris, biceps femoris, semimembranosis, semitendinosis)

Other suggestions for pregnant women with exercise

-Coach the pregnant client to breath appropriately to avoid the Valsalva maneuver and hypotension/dizziness -Must exercise in cool/ comfortable environment to prevent fetal harm due to hyperthermia -Proper hydration

Methods for modifying body composition

-Diet -Exercise -Behavior modification

What are the different methods for establishing and monitoring levels of exercise intensity?

-HRR -VO2R -Ventilatory Threshold -Respiratory Compensation Point -RPE -METs

Acute training variables

-Load -Volume -Sets -Reps -Rest Periods -Order of Exercises

What are the two types of sensor organs that provide muscular dynamic and limb movement information to the CNS?

-Muscle spindles -Golgi Tendon Organs (GTO)

Dietary needs of pregnant women

-Need additional 300 calories/day to ensure essential nutrients are available for mother and baby -Increased need for protein -Need vitamin for prenatal pusposes = helps provide the increased dietary need for folic acid and iron (folic acid- prevention of serious birth defects Iron- needed to support increased blood supply needed to carry extra oxygen throughout the pregnancy) -Do NOT take herbal or botanical supplements

Chronic Training Variables

-Periodization

Safe and effective core stability exercises

-Plank -Crunches -Bridges -Cable Twists

Common nutritional ergogenic acids

-Proteins/amino acids -Vitamins -Minerals -Herbal Products -Creatine: improves athletic performance -Steroids: increases muscle mass -Caffeine: improves endurance performance

3,500 kcals =

1 lb of fat

Metabolic Calculations Conversions

1 liter = 1000 mL 1 kg = 2.2 lbs 1 mi/hr = 26.8 m/min 1 mi/hr = 1.609 km/hr 1 lb of fat = 3500 kcal 1 MET = 3.5 mL/kg/min 1 Watt = 6 kg/m/min 1 L O2 = 5 kcal 1 in = 2.54 cm = 0.0254 m

Each technique of PNF stretching comprises three phases:

1) passive prestretch b) passive stretch c) contractions

Safe and effective weight loss is how many lbs lost a week

1-2 lb/week

Pulmonary disease- two categories:

1. Chronic Pulmonary Disease (COPD) 2. Chronic Restrictive Pulmonary Disease (CRPDs)

2015 Dietary Guidelines for Americans

1. Follow a healthy eating pattern across the lifespan 2. Focus on variety, nutrient density, and amount 3. Limit calories from added sugars and saturated fats and reduce sodium intake 4. Shift to healthier food and beverage choices 5. Support healthy eating patterns for all

RESISTANCE TRAINING FITT-VP for CVD

1. Frequency- 2-3 2. Intensity- 60-80% 1-RM low to moderate 3. Time- 8-12 exercises 4. Type- elastic bands, light (1-5lb) hand weights, light free weights with wall pulleys, and machines

RESISTANCE TRAINING FITT-VP for DIABETES MELLITUS

1. Frequency- 2-3 2. Intensity- 60-80% 1-RM low to moderate; RPE 14-16 3. Time- 8-12 exercises; 2-3 sets per exercise 4. Type- all major muscle groups

RESISTANCE TRAINING FITT-VP for Pulmonary Disease

1. Frequency- 2-3 (4-5d/week for respiratory muscles) 2. Intensity- 50-80% 1-RM low to moderate; RPE 12-15 or lower depending on severity of COPD 3. Time- 8-12 exercises; 2-3 sets per exercise 4. Type- free weights, elastic bands, body weight exercises, and machine exercises

RESISTANCE TRAINING FITT-VP for PAD

1. Frequency- 2-4, performed on nonconsecutive days 2. Intensity- 60-80% 1-RM low to moderate 3. Time- 8-12 exercise; 2-3 sets per exercise, 8-12 reps 4. Type- all major muscle groups, emphasis on lower limbs if time is limited

E. Over exercising

overuse injury, unhealthy amount of weight loss

FITT-VP for Peripheral artery disease (aerobic)

1. Frequency- 3-5 2. Intensity- 40-59% VO2 reserve or to the exercise intensity in which the patient experiences moderate pain 3. Time- 30-50 min/session 4. Type- weight bearing: walking or treadmill

FITT-VP for pulmonary disease (aerobic)

1. Frequency- 3-5 2. Intensity- prescribed on individual basis, based on GXT with scale for dyspnea 3. Time- 20-60min/session 4. Type- walking and cycling are most strongly recommended

FITT-VP for Diabetes Mellitus (aerobic)

1. Frequency- 3-7 2. Intensity- 50-79% HRR or RPE = 12-16 3. Time- 20-60min/session; at least 150min/week at mod. intensity or 90min/week at vigorous intensity 4. Type- walk, bicycle, jogging, water aerobics activities

d) plyometric exercise

1. Quick, powerful movements that involve a rapid stretch of a muscle (eccentric muscle action) immediately followed by a rapid shortening of the same muscle (concentric muscle action) - jumping, skipping, hopping, etc.

Periodization

1. The systematic variation in training program design, due to the general adaptation syndrome concept (p114) 2. Can vary program variables such as choice of exercise, training resistance, # of sets, rest periods between sets, etc. a. The year is divided into specific training cycles (macrocycle, mesocycle and a microcycle) with each cycle having a specific goal (hypertrophy, strength, or power) p114

If an individual is working at an energy cost of 10 METs, they are working at approximately, _____x the amount of energy at rest

10x

Pregnant healthy women FITT for balance and flexibility

288-289

Weight gain

3-5% reduction in body weight produces health benefits

1 g protein =

4 kilocalories

1 g fat =

9 kilocalories

1 g carbohydrates = _________ kilocalories

= 4 kilocalories

Contraindications/potential risks associated with the following muscular conditioning activities: a. Straight leg sit ups b. Double leg raises c. Squats d. Hurdler's stretch e. Yoga plough f. Forceful back hyperextension g. Standing bent over toe touch h. Behind neck press/lat pulldown

= all of the above place excessive strain on muscles and joints, particularly the spine, lower back, knees neck and shoulders

What are 6 different ways to determine exercise intensity?

a) HRR b) VO2 reserve c) Peak HR method d) Peak VO2 method e) Peak METs method f) RPE scale What is the accuracy of each method above?

metabolic syndrome

A clustering of metabolic risk factors including hyperglycemia, elevated blood pressure, dyslipidemia, and central adiposity based on waist circumference i. Causes are multifactorial where genetics and health behaviors are critical components

3) PNF stretching

A collection of stretching techniques combining passive stretch with isometric and concentric muscle actions designed to use autogenic and reciprocal inhibition responses of the golgi tendon organ *hypothesized that through the responses of the GTO, muscle and tendon are able to elongate and achieve greater ROM and increasing neuromuscular efficiency

Osteoporosis

A condition in which the body's bones become weak and break easily.

Golgi Tendon Organ (GTO)

A sensory organ within a tendon that, when stimulated, causes an inhibition of the entire muscle group to protect against too much force. -encapsulated nerve ending that sense changes in muscle tension

Metabolic syndrome

A syndrome marked by the presence of usually three or more of a group of factors (as high blood pressure, abdominal obesity, high triglyceride levels, low HDL levels, and high fasting levels of blood sugar) that are linked to increased risk of cardiovascular disease and Type 2 diabetes.

FITT-VP for those with Diabetes Mellitus

p 235

Dyslipidemia

Abnormally elevated cholesterol or fats (lipids) in the blood.

Individual differences

All individuals will not respond similarly to a given training stimulus

anorexia nervosa

An eating disorder characterized by an obstinate and willful refusal to eat, a distorted body image, and an intense fear of being fat

What is the most common site for a sprian? Mechanism?

Ankle -mechanism: inversion (foot falls inward)

force-velocity relationship

As speed of contraction increases, the force it is able to exert decreases "As velocity of movement increases, amount of force generated during a concentric muscle contraction decreases" *velocity increases, CONCENTRIC force DECREASES *velocity increases, ECCENTRIC force INCREASES

What is the concern with using static stretching?

Because it is slow and controlled, it does not provide an increase in muscle temperature and blood flow redistribution that is needed before exercise particularly prior to competitive sports performance

H. Sweat suist

Dehydration, only lose water weight, low amount of weight loss, temporary weight loss

Specificity of Training (SAID)

Dependent on type and mode of exercise; specific exercise elicits specific adaptations, creating specific training effects.

Fuel source for aerobic metabolism:

Carbs first, fat later *training helps with substrate shift to use fats first and to save the carbs for when needed (ie- at end of race)

Cardiac disease pathophysiology

Central to CVD is the formation of atherosclerotic plaque in the elastic and smooth lining inside of arteries. Plaque formations in the coronary arteries will obstruct blood flow to cardiac muscle downstream of the obstruction resulting in reduced

Blood flow and oxygen extraction

Children have greater blood flow and oxygen extraction during exercise, BUT they have a greater oxygen cost during exercise than adults (due to immature motor patterns, motor system, and hormone response)

Thermoregulation for children vs. adults through lifespan

Children have less ability to produce sweat; they have more sweat glands, but the output of each gland is lower than adults and the temperature when sweating initiates is higher than in adults *children cannot withstand exercise for as long as adults when temps exceed 100degrees; hydration is KEY especially for children

Precautions to exercise in pregnancy (Contraindications for exercising during pregnancy?)

Contraindicatoins for exercise during pregnancy p289 *if a pregnant woman has none of these contraindications, they are recommended to accumulate 30 min of mod. intensity exercise (40-60% HRR) on all or most days of the week

What injury is most common in sports?

Contusion

Speed

Distance travelled per unit time

How can you periodize a year of training?

Divide it into specific training cycles: macrocycle, mesocycle, and microcycle, each one having a different goal

Contusions are graded by:

DEGREE: 1st degree- superficial tissue damage, no weakness or muscle spasm, mild loss of function, ecchymosis (discoloration) and swelling, and presents no restriction on ROM. 2nd degree- superficial and some deep tissue damage, mild to moderate weakness with no muscle spasm, moderate loss of function, and ecchymosis and swelling; decreased ROM 3rd degree- severe and characterized by deep tissue damage, moderate to severe weakness with possible muscle spasm, severe loss of function, and ecchymosis and swelling; substantial loss of ROM

Acute sprains or strains occur MOST OFTEN during what type of muscle contraction?

ECCENTRIC contraction and/or when tissue is an excessively stretched state

Type 2 Diabetes and pathophysiology

Elevated blood glucose levels, a result of increasing insulin resistance *Leading cause = excessive abdominal fat

Older Adult Flexibility FITT

F- 2-3 days/week I- T- 10 min a session T- 10-30 seconds to a point of tightness or mild discomfort for the major muscle groups; stretches may produce greater benefits when held for 30-60 seconds; Neuromotor exercises

Aerobic FITT-VP for individuals with cardiac disease (p277)

F- 5+ days/week I- varies, but use RPE scale b/c using VO2 or HRR can be difficult due to the effect of the many HR-modifying medication and/or HR altering medical conditions T- varies; goal is to progress to 60min aerobic conditioning/day T-varies

Older adult resistance training FITT

F- At least 2 nonconsecutive days/week I- T- T- target major muscle groups in 8-10 exercises; choose a weight or resistance that can be performed 8-12 times

Older adult FITT aerobic

F- at least 30 and up to 60 min/day moderate on 5 or more days of week or at least 20 min of vigorous activity for 3days/week I- Progress from light to higher intensity activities *b/c of heterogeneity of aerobic capacities of older adult population, a different definition of moderate versus vigorous intensity is required- -----moderate intensity: 5-6 on 0-10 scale and produces a noticeable change in breathing and heart rate ----vigorous intensity: 7-8 on scale and would produce

How are strains graded?

First- few torn fibers Second- almost ½ of fibers torn Third- all fibers torn (complete rupture)

Dynamic Constant External Resistance (DCER)

Fixed resistance -most common for enhancing muscular fitness -weight lifted does not change during the lifted (concentric) and lowering (eccentric) phase of an exercise

Common orthopedic and cardiovascular exercise considerations for older adults

For aerobic exercise in older adults, aerobic capacities vary so much that a subjective rating system must be used to determine the intensity of exercise -----Mod- 5-6 on a 0-10 scale -----Vigorous- 7-8 on this same scale For orthopedic (i.e.- arthritis) concerns - may need different modes of exercise: water based exercise or weight-support machine such as a cycle is better than waling or running for those with poor balance; treadmill with handrail; weight machines b/c they provide more support, etc.

FITT-VP for WEIGHT LOSS

Frequency- > 5 days/week Intensity- mod/vigorous intensity aerobic activity Time- min. 30min/day Type: primary mode-aerobic PA; incorporate resistance training and flexibility for a balanced program

Flexibility FITT-VP

Frequency- 2-3 days/week Intensity- Not determined Time- > 20-30 min/day Type- Motor skill exercises (balance, agility, coordination), proprioceptive exercise training, multifaceted activities (tai chi, yoga) recommended for older adults Volume- optimal not known Pattern- optimal not known Progression- not known

FITT-VP Aerobic training guidelines for CVD:

Frequency- 3-7 days (3 if all are vigorous) Intensity- mod: 40-59% HRR or RPE < 11-14 vig: 60-80% HRR deconditioned: 30-39% HRR Time achieve 1500-2000kcal energy expentidure or 20-60min/session Type- large dynamic muscle group exercises

FITT-VP for apparently healthy clients

Frequency- 5 days/week of moderate or 3 days/week vigorous, or combo of both for 3-5 days week Intensity- mod and or vigorous for most adults; light to moderate for deconditioned; light = 30-39% HRR mod = 40-59% HRR vigorous = 60-89% HRR Time- 150min/week MOD or 75 min/week VIG Type- rhythmic, continuous exercise that involves major muscle groups Volume- product of FITT; recommended more than 500-1000 MET-min/week Pattern- can be performed in one continuous session, one interval session or in multiple sessions of 10+ minutes to accumulate desired duration and volume per day Progression- rate dependent on individual's health status, physical fitness, training responses and exercise program goals

FITT-VP for resistance training for muscular strength

Frequency- each major muscle group 2-3days week Intensity- 60-70% 1RM for novice; >80% 1RM for experienced; 40-50% 1RM for older adult beginnger Time- no specific duration Type- exercises involving each muscle group -multijoint exercises -single joint exercises -variety of equipment and/or bodyweight Repetitions- 8-12 for adults 10-15 for middle and older adult beginners Sets- 2-4 Pattern- 2-3 min rest intervals between sets Rest > 48 hours between sessions for any single muscle group Progression- gradual increase in resistance and/or more reps per set and/or increasing frequency

Both forms of diabetes result in:

INCREASED BLOOD GLUCOSE LEVELS = hyperglycemia *insulin helps absorb glucose from the blood, so if the body doesn't have insulin it can't absorb glucose out of the blood

Maturational changes in body size and composition across lifespan

Increase in body size, weight and height with age ---Rapid growth in infancy, steady increase in early childhood, an accelerated period at puberty (~12 for girls and ~14 for boys), and slow gains until adult height and weight are attained (around 15 and 17) ---Boys' longer period of growth gives them about 10-12cm or 4-5in taller; increase in height due to long bone growth (growth plates)

The physiologic adaptations following chronic exercise training:

Increased SV Decreased HR Increased VO2max Increased venous return Smoother neurological movements = more control

What is the advantage of using static flexibility?

Involves both relaxing and concurrent elongation of the stretched muscle without stimulation of the stretch reflex *Static stretching can lead to both short-term and long-term gains in flexibility, through a decrease in muscle/tendon stiffness and viscoelastic stretch relaxation

2) Ballistic stretching

Involves rapid and bouncing-like movements in which the resultant momentum of the body or body segments is used to extend the affected joint through the full ROM; Is no longer advocated for improving a joint's ROM, but it still used by some coaches and athletes to increase blood flow to the muscle prior to practice or competition

why should the Valsalva maneuver be avoided?

It will not support exercise; all exercises should be performed in a controlled manner through a full ROM of the joint using proper breathing techniques (exhalation during concentric and inhalation during eccentric) -the valsalva maneuver increases bp because it forces expiration against a closed airway; doesn't support back

spotting techniques

Know how the exercise should be performed. Help improve form when necessary Be Physically able to assist with the weight. COMMUNICATE with the lifter, assist when necessary Check weights and collars are secure

Although HR is higher in children, SV is

LOWER; =results in lower CO values than adults

GTOs

Located in the musculotendinous junction and respond to changes in muscle tension and the rate of tension *Plays important role in PNF p128

What is the most preferred method for weeking tracking of body weight?

Measuring bodyweight (preferred over percentage body fat b/c there could be 3-6% error in the estimated value)

Abduction

Movement away from the midline of the body

Adduction

Movement toward the midline of the body

Delayed muscle soreness (DOMs)

Muscle soreness that appears 24-48 hours after resistance training or eccentric exercise

Peripheral artery disease

Occlusion or narrowing of peripheral arteries or vessels of the upper and lower limbs as a result of the buildup of atherosclerotic plaques -this reduced blood flow often leads to a mismatch between oxygen supply and demand leading to the development of ischemia that often manifests as pain and easy fatigability

1. Chronic Pulmonary Disease (COPD)

Progressive airflow limitation associated with an abnormal inflammatory lung response that limits the lung's ability to move air during inhalation and exhalation

What to do if a client experiences a suspected sprain or strain?

Provide immediate care by protecting the joint/area, having the injured person rest or restrict activity, apply ice with compression, and elevate the injured point (PRICE)

Contraindications of a wide variety of cardiovascular training exercises based on client experience, skill level, current fitness level, and goals

Signs of stopping test: i. Onset of angina or angina-like symptoms ii. Drop in SBP > 10 mmHg with an increase in work rate, or if SBP decreases below the value obtained in the same position before testing iii. Excessive rise in BP (SBP > 250 mmHg and/or DBP > 115mmHg) iv. SOB, wheezing, leg cramps, claudication v. Signs of poor perfusion: light-headedness, confusion, ataxia, pallor, cyanosis, or cold and clammy skin vi. Failure of HR to increase with increased exercise intensity vii. Noticeable change in heart rhythm by palpation or auscultation viii. Participant requests to stop ix. Physical or verbal manifestations of severe fatigue x. Failure of the testing equipment

extension

Straightening a joint or increasing the angle between two bones

Balance

The ability to keep an upright posture while standing still or moving.

Coordination

The ability to use two or more body parts together

Type 1 Diabetes and pathophysiology

The body won't produce insulin (Absolute deficiency in blood insulin release b/c of destruction of pancreatic insulin secreting beta cells) Only 5-10% of all patients with diabetes

What two systems work together for gas exchange? What is each system responsible for?

The cardiovascular and pulmonary (respiratory) system *respiratory system- supports gas exchange by promoting movement of oxygen and co2 from the environment into the blood and from the blood back into the body *cardiovascular system- responsible for the delivery of oxygenated blood and nutrients to the cell to make energy in the form of ATP; also responsible for the removal of waste from the cell

resting metabolic rate

The energy required to maintain essential body processes at rest.

1. Static Flexibility

The most commonly used flexibility protocol of all due to the fact that it can be easily administered without assistance, and regardless of the type of static stretching, involves a slow and constant motion that is held in the final position, or point of mild discomfort for 15-30 seconds. *to achieve optimal ROM, repeat each exercise no more than 4 times

Why is there a high risk of injury with ballistic stretching?

This type of stretching produces a rapid and high degree of tension inside the muscle, which may potentially lead to muscle and tendon injuries The risk of injury is further exacerbated by stimulating a myotatic reflex (stretch reflex) *This type of stretching does not provide any added benefit, therefore it is recommended to use techniques that are safer such as static, dynamic and PNF

Unique Dietary needs of children

VITAMIN D -600 IU - 1-18 yrs old CALCIUM 1,000mg/day (4-8 years) and increase to 1,300mg/day (9-18 yr olds)

Unique dietary needs of Older Adults

VITAMIN D -800 IU (71+ yrs)-important in promoting the absorption of calcium and in maintaining serum and calcium levels, which protects bone strength CALCIUM -1,000mg/day (19-50 years) for bone and teeth health/prevention of osteoporosis -Postmenopausal women (51+) experience greater bone loss and absorption of calcium, increasing their need to 1,200mg/day; same with older men VITAMIN B-12

What are safe and effective stretches to enhance flexibility?

Variety of static, dynamic and PNF flexibility exercises can hep improve ROM around a joint safely (p170) *ballistic not recommended as safe

Physiological principles related to warm up and cool down

Warm Up -raise muscle temp -hormone changes -mental prep -increase ROM and vasodilation Cool Down -removes lactic acid -prevents blood from pooling in legs -lowers blood acidity

When does weight gain occur?

When a positive energy balance exists (cals consumed > cals expended)

Isometric muscle action

When muscle is activated but no movement at the joint takes place ie- when weight is held stationary; when weight is too heavy to lift further

Weight management

a healthy diet and regular PA are critical for maintaining a healthy weight

BMI (body mass index)

a person's weight in kilograms divided by the square of height in meters

What are the six motor-skill related physical fitness components?

a) Agility b) Balance c) Coordination d) Reaction time e) Speed f) Power

Two types of body fat distribution patterns and health associated with each

a) Central obesity (abdominal or android obesity) = greater proportion of fat distributed on hips and thighs = associated w/ higher risk of Type 2 diabetes mellitus, dyslipidemia, CVD, and premature death compared to gynod obesity b) Gynoid obesity = excess body fat that is placed predominantly within the hips and thighs

types of resistance training

a) Dynamic constant external resistance (DCER) b) Variable resistance training c) Isokinetics d) Plyometrics

What are the 4 components/sequencing of an exercise session?

a) Warm up- at least 5-10 min of light-to-moderate intensity cardiorespiratory and muscular endurance activities b.Conditioning/sports-related exercise- At least 20-60 min of aerobic, resistance, neuromotor, and/or sports activities (10 min bouts are acceptable if the person gets 20-60min/daily aerobic) c. Cool-down- At least 5-10 min of light-to-mod intensity cardiorespiratory and muscular endurance activities d. Stretching At least 10 min of stretching exercise performed after the WU or cool down phase

Resistance training modalities

a) weight machines- can do both single and multijoint exercises; easy to use b) free weights come in variety of shapes and sizes; takes longer to learn proper exercise technique; offers greater variety than weight machines b/c they can move in different directions; require use of additional stabilizing and assisting muscles to hold the correct body position c) bodyweight exercises -huge advantage is no equipment needed and variety of exercises; difficult b/c hard to adjust body weight to individual's strength level d) stability balls, medicine balls, elastic tubing

Signs and symptoms of common musculoskeletal injuries associated with exercise equipment

a. Exquisite point tenderness b. Pain that persists even when the body part is at rest c. Joint pain d. Pain that does not go away after warming up e. Swelling or discoloration f. Increased pain with weight-bearing activities or with active movements g. Changes in normal bodily functions

Models of periodization

a. Linear: i. Ex- the volume and intensity of training gradually change over time: At start of macrocycle, the training volume may be high and intensity may be low. As year progresses, the volume is decreased and the intensity increases. b. Undulating (nonlinear) i. Daily fluctuations in training volume and intensity ii. Helps minimize the risk of overtraining and maximize the potential for strength and power enhancement

Resistance Training principles (the process)

a. Progression b. Regularity c. Overload d. Creativity e. Enjoyment f. Specificity g. Supervision

d. Creativity

a. The imagination and ingenuity that can help to optimize training-induced adaptations and enhance exercise adherence

c. Overload

a. to enhance muscular fitness, the body must exercise at a level beyond that at which it is normally stressed Basic tenet of all resistance training programs

Agility

ability to move quickly and easily

2. Chronic Restrictive Pulmonary Diseases (CRPD)

aka interstitial lung disease- made up of a small group of diseases that cause inflammation resulting in lung tissue necrosis and decreased lung volume

bulimia nervosa

an eating disorder in which a person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use) or fasting

binge eating disorder

an eating disorder in which people overeat compulsively

a) Inflammatory phase

at least 2-3 days; edema occurs (accumulation of fluid in surrounding tissues that act as brace or immobilizer and protects the damaged tissues)

b) Repair phase

begins within 3-5 days after injury; could last up to 2 months but depends on extent of injury - during this phase, damaged tissue is replaced with scar tissue; exercises done should be low load with no or minimal ROM, so isometric contractions

Flexion

bending a joint to decrease the angle between two bones or two body parts

lean body mass

body weight without body fat

bariatrics

branch of medicine dealing with weight issues

contusion

bruise; a soft tissue hemorrhage and/or hematoma that occurs after disruption of the muscle fibers, with subsequent inflammation edema

Fuel source for anaerobic

carbs first, fat later

Diabetes type 1 and 2

caused inability to produce insulin (Type I) and by the body's resistance (Type II)

Metabolism

children have higher, therefore recover faster from a bout of exercise

Muscle spindles

collection of 3-10 intrafusal specicalized muscle fibers sensitive to change in length of the muscle and the rate of that change *When muscle spindles are simulated, there is a dual response in which a rapid tension development is initiated in the stretched muscle and inhibited in the antagonist muscle. ----The response in the stretched muscle: stretch or myotatic reflex ----The response in the antagonist muscle: reciprocal inhibition *Plays important role in PNF p128

Fascia

connective tissue that surrounds these structures to create a stable and flexible environment; like a rubber-band that stretches and recoils to provide added force to a muscle contraction

Abnormal cardiac response to exercise

decrease in HR

Abnormal hemodynamic responses to exercise

decrease in SBP

Atrophy

decrease in size and function of cell which causes shrinkage of a tissue or organ

Abnormal ventilatory response to exercise

decrease in ventilation

a. Saunas

dehydration, only lose water weight, low amount of weight loss, temporary weight loss

Obesity

excessive accumulation of body fat; BMI > 30

Type 2 Fibers

fast twitch; high glycolytic capacity; high force capability = strength and power

Adipocytes

fat cells

Valsalva maneuver

forcible exhalation against a closed glottis, resulting in increased intrathoracic pressure

Single muscle fiber/muscle cell

groups of myofibrils

Overweight

heavier than the standard weight range for your height; BMI >25

Respiration and HR at birth are:

high -HR of children seated and at rest is 100-110bpm and MAX HR is higher than adults -Respiratory frequency is elevated in children

FITT-VP for those with overweight/obesity

i. At least 5 days/week ii. Slow intensity and duration progression to prevent injuries iii. Have increased risk for orthopedic injury, so low impact or non-weight bearing activities such as water-based, elliptical, and/or recumbent cycling are recommended

Three conditions that occur as result of having COPD

i. Chronic bronchitis à cough lasting for at least 3 months, resulting in chronic pulmonary inflammation which leads to damage of the bronchial lining and impeded lung function and airflow obstruction ii. Emphysema à permanent enlargement of air spaces along with necrosis of alveolar walls, causing an accumulation of air in the lung tissue iii. Asthma à both inflammation and increased smooth muscle constriction in the lungs in response to various stimuli; triggers include environmental, biochemical, autonomic, immunologic, infections, endocrine and psychological factors

Physiology and pathophysiology of obesity

i. Combination of increased caloric consumption and decreased daily physical activity ii. Associated with a multitude of comorbidities, such as insulin resistance, decreased growth hormone, increased cholesterol synthesis and excretion, and increased incidence of all-cause mortality.

FITT for those with pulmonary disease

i. EP-C does not warrant working with those with advanced stages of COPD or CRPD ii. We can work with clients with controlled asthma, therefore the FITT guidelines for aerobic exercise: F- 3-5 days/week I- Intensity has no consensus, so often guidelines for older adults are used (Ch 10); also use dyspnea scale T- At least 20min/session; progress to 60 min continuous aerobic activity

Aerobic-based exercises:

i. Endurance activities requiring minimal skill (walking, cycling) ii. Vigorous intensity endurance activities requiring minimal skill (jogging, running, spinning, etc.) iii. Endurance activities requiring skill (swimming, skiing, skating, etc.) iv. Recreational sports (racquet sports, basketball, soccer, etc.)

Effect of aging on body composition and musculoskeletal function

i. Gain body weight and fat mass during adulthood and lose fat free mass MOST OFTEN LIFESTYE RELATED NOT AGE ii. Loss of muscular strength and physical function; iii. Loss of strength, muscle mass and bone density are larger in women iv. Loss of body weight and body cell mass in the very old adult v. Total body water content decreases = decreases in elasticity and pliability of tissues such as cartilage and connective tissue vi. ROM reduced vii. Deteriorating neuromotor function è a reduction in # of neurons = reduced coordination, slower walking speed and reaction time, shorter stride length, poorer balance and lower agility

Strength- based exercises:

i. Multi-joint exercises (ie- chest press, shoulder press, pull down, rows, push ups, leg press, squats) ii. Single joint exercises (bicep curls, tricep extensions, quadriceps extensions, leg curls, calf raises)

Muscular strength, flexibility, and motor performance maturation during lifespan

i. Muscular strength increases with age (related to the increases in body weight, height, fat free mass, and muscle mass) ii. Performance measures follow the same pattern of physical maturation, with boys having slight advantage (smaller increases for girls may be due to increase in fat mass at puberty) iii. Girls outperform boys in flexibility measures and some measures of balance

What are different behavior modification techniques for modifying body comp?

i. Self-monitoring: keeping food PA logs or monitoring body weight on regular basis ii. Goal setting: setting realistic goals for # of minutes of exercise one will accomplish during the next week or month iii. Stimulus control: modifying one's environment to enhance successful behavior change such as removing "risky" foods from the refrigerator or hanging an exercise adherence calendar in a prominent spot iv. Problem solving: identifying situations that pose a problem for overeating such as holidays and developing a solution to eat healthy and avoid excess caloric intake

Flexibility-based exercises:

i. Static 1. Active 2. passive ii. Ballistic "bouncing" stretches iii. Proprioceptive neuromuscular facilitation (PNF)- isometric contraction of muscle group followed by static stretching of same group (contract- relax) iv. Dynamic (slow movement stretching)

What is the benefit of plyometric training? examples of this type of training:

i. This type of action provides a physiological advantage b/c the muscle force generated during the concentric muscle action is potentiated by the preceding eccentric muscle action ii. Box jumps, leaps, bounds, double leg hops, jumping jacks, skipping, etc.

Contraindications for terminating exercise sessions and testing

i. Unstable angina ii. Uncontrolled HT (resting SBP > 180 mm Hg and/or resting DBP > 110 mm Hg) iii. Orthostatic BP drop of > 20mmHg with symptoms iv. Significant aortic stenosis v. Acute systemic illness or fever vi. Uncontrolled atrial or ventricular dysrhythmias vii. Uncontrolled sinus tachycardia (>120bpm) viii. Uncompensated CHF ix. Third degree atrioventricular block w/o pacemaker x. Active pericarditis or myocarditis xi. Recent embolism xii. Thrombophlebitis xiii. Aortic dissection xiv. Resting ST segment depression or elevation xv. Uncontrolled DM xvi. Severe orthopedic conditions that would prohibit exercise xvii. Other metabolic conditions, such as acute thyroiditis, hypokalemia, hyperkalemia, or hypovolemia

Effect of aging on cardiorespiratory function and thermoregulation

i. Vessels become stiffer, elasticity is lost in cardiac tissue, including the heart valves 1. = higher blood pressure and higher resistance to flow = heart has to work harder ii. During submax exercise à higher ventilation, blood pressure, lower CO and SV, little change in HR and oxygen uptake iii. During maximal exercise à oxygen uptake, ventilation, CO, HR, SV, oxygen extraction and lactic acid concentrations are lower, whereas total peripheral resistance and blood pressure higher than in a young person iv. Less air can be moved per minute (due to loss of elasticity of collagen fibers in lungs and bronchioles lose their tone) v. = OVERALL, older individuals have lower overall exercise capacity and that any given absolute submaximal exercise intensity represents a higher percentage of their maximum vi. Thermoregulation declines with aging

e. Enjoyment

important determinant of long-term participation in recreational fitness activities and structured exercise programs

FITT-VP for those with Type 2 Diabetes (met synd.)

important need to reduce overall body fat/weight loss* F- 5-7 days/week I- 50-80% HRR and V02 reserve (RPE of 12-16) T- 20 min/day and progress to 60 min/day of aerobic conditioning T- Aerobic exercise that targets large muscle groups using rhythmic motion is recommended

Most common symptom of PAD

intermittent claudication = characterized by repeatable aching, cramping sensation, or fatigue affecting the muscles of the calf in one or both legs; triggered by weight-bearing exercises and normally dissipate with the cessation of activity

Both clients with COPD and CRPD have limited _____________

limited gas exchange within the lungs, frequent shortness of breath, and difficulty breathing *other than exercise-induced asthma, and particularly emphysema and CRPD, individuals suffering from pulmonary disease should be referred to more specialized care

a. Progression

loads should gradually become more challenging

diastolic blood pressure

lower

minute ventilation

lower

respiratory exchange ratio

lower

systolic blood pressure

lower

tidal volume

lower

Stroke volume

lower for children

What is the absolute oxygen uptake like for CHILDREN associated with an acute bout of exercise (compared to adult)

lower for children

cardiac output for children

lower for children

SBP and DBP

lower in children -as children age, resting blood pressure, especially systolic, increase mainly due to changes in compliance of vessel walls

F. Low cal diets

may not meet nutrition needs of individual promoting deficiencies in specific nutrients

What are METs? 1 MET =

metabolic equivalents; the energy cost of exercise that can be easily used by the general public to gauge exercise intensity 1 MET = 3.5mL/kg/min (1 MET = relative oxygen consumption at rest)

Stretch reflex

muscle contraction in response to stretching within the muscle

Eccentric muscle contraction

muscle lengthens while contracting; when weight is lowered, muscle lengthens *highest force is produced during an eccentric muscle action

c) isokinetic exercise

muscles contract at a constant rate 1. Dynamic muscular actions that are preformed at a constant angular limb velocity 2. Requires special equipment; not often used in fitness centers, rather in rehab facilities

b. Regularity

must be performed regularly several times per week to make continual gains in muscular fitness (2-3/week; use it or lose it)

G. Electric stimualtors

no change in body comp; bruising and skin irritation

C. Vibrating belt

no weight loss

B. Dietary Supplements

not regulated by FDA, so dosage may not be known; may have nutrient drug interactions, drug-drug interactions, and other side effects such as nausea, dizziness, and racing heart

acute muscle soreness

occurs during and immediately after exercise and is due to the accumulation of lactate, decreased oxygen, and tissue swelling within the muscle

I. Fad diets

often "cut out" a food group, which leads to specific nutrient, vitamin, and mineral deficiencies; not sustainable for long periods of time; could lead to "yo-yo dieting; low carbohydrate diets don't meet min needs for carbs of 130/day; could lead to fatigue and lack of energy; could lead to dehydration

Hypertension

persistent elevation in either systolic blood pressure (SBP) (> 130mmHg) or diastolic blood pressure (> 80mm Hg); categorized as primary (most cases; no est. pathology) or secondary (few cases, pathology is renal disease, stress, etc.) i. Common among patients with CAD ii. Considered the "silent killer" b/c this condition's signs and symptoms often go unnoticed

thermogenesis

production of heat by the cells of the body

Basic purpose of skeletal muscle

provide force to move the joints of the body in different directions

Muscle spindles

receptors sensitive to change in length of the muscle and the rate of that change

Proprioceptors

sensory receptors that monitor the position and movement of skeletal muscles and joints

Type 1 fibers

slow twitch, slow oxidative; high oxidative capacity, lower contractile force capability =ENDURANCE

Motor unit recruitment

small to large = Type 1 recruited first

D. Body wraps

small weight loss; temporary weight loss; skin irritation

Sarcomere

smallest contractile unit of muscle

b) variable resistance exercise

strength training in which the resistance varies throughout the range of motion