Exam 2 Review

American Heart Association 1992 Position Statement on Exercise

"Inactivity is recognized as a risk factor for coronary artery disease."

Definition of Health

"a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity."

Health-Related Physical Fitness

**Cardiorespiratory endurance** Muscular endurance Muscular strength PowerFlexibility Body composition

Neuromotor assessments

- 4 stage balance test (picture provided) - Standing reach test - Agility T-Test -Balance

Health Behavior theories and models

-**Transtheoretical Model ** -** Self Determination** •Social Ecological Model -Social Cognitive Theory •Theory of Reasoned Action -Theory of Planned Behavior

Cardiorespiratory Endurance

-Ability of the lungs, heart, and blood vessels to deliver adequate amounts of oxygen to the cells to meet the demands of prolonged physical activity. -Oxygen uptake (VO2) -Maximal oxygen uptake (VO2max)

Prevalence of stress

-About 75% of adults indicate they have experienced moderate to high levels of stress in the past month -Nearly half report that their stress level has increased in the past year -Stress has been linked to 50-70% of all illnesses

skill-related physical fitness

-Agility -balance -coordination -speed -reaction time

what assessment do you use for shoulders flexibility

-Back-scratch test

How can I get involved?

-Become a certified Physical Activity in Public Health Specialist (PAPHS) -Community organizations -Professional organizations -Sign up for newsletters -Attend conferences -Attend webinars -Volunteer -Network

Type 2 Diabetes Risk Factors

-Excessive weight -Fat storage (central vs peripheral) -Physical inactivity -Family history -Race • Age • Gestational diabetes • Type 1 diabetes • PCOS • Prediabetes

Warning Signs of a Stroke

-Facial dropping - part of face is dropping, weak, numb, or hard to move -Arm weakness, inability to raise arm dropping - part of face is dropping, weak, numb, or hard to move -Speech difficulties - understand or speak -Time - time is of the essence -Sudden severe headache, confusion, dizziness, difficulty walking, loss of balance, sudden visual difficulty -Call 911 and seek medical attention immediately!

Complications from excessive weight during pregnancy

-Gestational Diabetes • 5-9% of pregnancies in the US -Preeclampsia • 2-7% of pregnancies in the US -Polycystic Ovarian -Syndrome -Miscarriage -Hemorrhage, Venous thrombosis, pulmonary embolism -Unplanned Cesarean delivery • Fetus • Birth defects • Fetal macrosomia, future obesity • Stillbirth • Premature birth • Perinatal mortality

Factors influencing high level performance

-Health-related fitness, skill-related fitness, specific motor skills -Practicing specific skills -Endurance sports require high aerobic capacity -Anaerobic capacity -Genetics

Health problems with excessive stress

-Heart disease and stroke -Impaired immune system -Insomnia -Gastrointestinal problems -Accelerated aging

Gestational Diabetes

-High blood sugar during pregnancy -Affects 5-9% of pregnancies -PA reduces risk of developing GD, with 150-300 min MPA per week

Walking and Walkable Communities Report Card Methods

-Identified factors -Defined factors -Selected surveillance system -Defined standard -Assigned grade A 90-100%B 70-89%C 50-69%D 30-49%F < 30%INC - incomplete

Components of Muscular Fitness

-Muscular Strength Muscular Endurance -Power

Components of muscular fitness

-Muscular strength: Ability to exert maximal force in a single effort. -Muscular endurance:Capacity of skeletal muscles to continue contracting over long period of time -power:Ability to exhibit maximum effort in very short period of time • Strength x Spee

Why promote physical activity in preschool and childcare settings?

-Over 60% attend childcare -Low levels of PA while in care -Prevalence of obesity in 2- to 5-y- olds: 13.9% -PA is important for development and FMS

Transtheoretical Model Stages of Change

-Precontemplation (don't want to change) -Contemplation (I am thinking about change) -Preparation (im getting ready to make a lifestyle change) -Action (I have made some lifestyle changes) -Maintenance (I regularly practice healthy lifestyle)

Expanding Awareness of the NPAP

-Presentations at scientific and professional meetings -Exhibits at national conferences -Monthly e-newsletter (n = 5800) -E-Blasts -Commentaries -Implementing Physical Activity Strategies

Neuromotor training exercise guide/exercises

-SEMI-TANDEM STANDING WITH DIAGONAL REACH -Single leg forward reach - 4 square agility -lunge with forward reach

What assessment do you use for hamstring flexibility

-Sit and reach test -Seated sit and read test

Guidelines for safe and effective resistance training

-Start with lighter weights -Use proper technique to reduce risk of injury -Lift in slow, controlled manner -Allow time to recover -Include all body parts and balance strength of antagonistic muscle groups -Customize program to fit your needs -No safe shortcuts to strength development or muscle fitness

Environmental Supports for Physical Activity

-Street pattern design & connectivity -Pedestrian Infrastructure -Bicycle Infrastructure -Public transit infrastructure and access -Mixed land use -Increased residential density and proximity to community destinations -Parks

Why measure fitness components

-To educate -To motivate To form a foundation for exercise prescription -To monitor changes

Health related fitness

-cardiorespiratory endurance -muscular strength -muscular endurance -Power -flexibility body composition

Dimension of wellness

-physical -emotional/ mental - intellectual -social -spiritual

What is a low impact Neuromotor training exercises

-tai chi -yoga

Time Management

1. Establish priorities 2.Monitor current time use 3.Analyze time use 4.Make a schedule

circuit exercises for a fitness center

1. Hips and legs 2.Quadriceps 3.Hamstrings 4.Chest 5.Back 6. Shoulders 7. Biceps 8. Triceps 9. Low back 10. Abdominal muscles

Basic eight for calisthenics

1. Push-ups 2. Modifiedpull-ups 3. Dips 4. Crunch(curl-up) 5. Trunklift 6. Sidelegraises 7. Step-ups 8. Lungewalk

Benefits of Aerobic Training

1.Higher VO2max 2.Increase in red blood cell count 3.Decrease in resting heart rate 4.Increase in cardiac muscle strength 5.Lower heart rate at given workloads 6.Increase # of functional capillaries 7. Faster recovery time 8. Ability to recover quickly from exercise 9. Lower blood pressure & blood lipids 10. Increase in number, size, and capacity of mitochondria 11. Increase in fat-burning enzymes

Percent of Youth Meeting PA Guidelines, Measured by Accelerometry

6-11 y olds: total highest In males higher than female

What is a Physical Activity Plan?

A comprehensive set of strategies including policies, practices, and initiatives aimed at increasing physical activity in all segments of the population.

Which states have the highest rates of obesity?

AL,MS,LA,AR, WV

Which states have the highest rates of physical inactivity?

AR,MS

Cardiorespiratory Endurance

Ability of the lungs, heart, and blood vessels to deliver adequate amounts of oxygen to the cells to meet the demands of prolonged physical activity. -Oxygen uptake (VO2) -Maximal oxygen uptake (VO2max)

Health related physical fitness component

Aerobic fitness Muscular fitness Neuromotor/functional fitness FlexibilityBody composition

SKILL- RELATED PHYSICAL FITNESS

Agility Balance Coordination Speed Reaction time

Practice and skill learning

Agility and coordination • dribbling and kicking skills

Arteries vs. Veins

Arteries pump oxygenated blood and have muscular, elastic walls that promote good circulation Veins carry de-oxygenated blood and rely on pumping action of muscles to move blood

Definition of physical Activity

Bodily movement produced by skeletal muscles which requires energy expenditure

Business and Industry Strategy 1

Businesses should provide employees opportunities and incentives to adopt and maintain a physically active lifestyle.

Self management skills for predisposing factors

Changing predisposing factors Overcoming barriersBuilding self-confidence and motivation Balancing attitudesBuilding knowledge and changing beliefs

waist to hop ratio example

Client #1 - Female Waist-to-Hip Ratio Waist: 29" Hip: 40" 29"/40" = 0.725 Disease Risk = Very Low

Community Recreation, Fitness and Parks Strategy 1

Communities should develop new, and enhance existing, community recreation, fitness, and park programs that provide and promote healthy physical activity opportunities for diverse users across the lifespan.

Transportation, Land Use and Community Design Strategy 1

Community planners should integrate active design principles into land-use, transportation, community, and economic development planning processes.

Who study Aerobic Center Longitudinal

Dr. Steven Blair

Health behaviors

Engaging in regular physical activity (PA) Eating well Managing stress Avoiding destructive habits Practicing safe sex • Wearing face coverings & social distancing • Managing time • Being an informed consumer • Adopting good health habits • Adopting good safety habits • Learning first aid

FITT-VP for Flexibility

F at least 2-3 days per week for at least 10 minutes I As far as possible to mild tightness without discomfort T 15 to 30 seconds T static and dynamic stretching VP 2 to 4 times per joint = 60 sec/joint

Faith-Based Settings Strategy 1

Faith-based organizations should identify effective applications of their health ministries to promote physical activity.

Body composition assessment

Field Measurement -Skin fold -Waist circumference -waist to hip ratio -BMI Laboratory Measures -Bod Pod -Bioelectrical Impedance -hydrostatic weighing -DEXA

Mass Media Strategy 1

Government health agencies, in collaboration with national non-profit health organizations, should launch a national physical activity campaign to educate individuals about effective behavioral strategies for increasing physical activity.

Target Heart rate zone

HR Max= 196 bpm Calculate 65% and 80% of HR Max for Target Zone: 65% of HR Max = .65 x 195 = 127 bpm 80% of HR Max = .80 x 195 = 156 bpm Target HR Zone 127 - 156 bpm

Healthcare Strategy 1

Healthcare systems should increase the priority of physical activity assessment, advice, and promotion.

Basic Cardiorespiratory Physiology

Heart pumps oxygenated blood through circulatory system to all organs and tissues in body • Oxygen uptake (VO2): Amount of oxygen consumed by the body • Capacity of body to deliver and utilize oxygen • Higher capacity = greater efficiency • Maximal oxygen uptake (VO2max): Maximum amount of oxygen the body is able to use per minute of physical activity, expressed in L/min or mL/kg/min

Calorie Calculation - example

Heather consumes 2000 calories per day and wants to obtain 20% of her calories from fat: • 9 calories = 1 gram of fat • 2000 calories x 20% = 400 calories from fat per day • 400 calories from fat / 9 = 44 grams of fat per day

Dietary Guidelines - Key Recommendations for Healthy Eating Patterns

LIMIT • < 10% of calories/day from added sugars • < 10% of calories/day from saturated fats • < 2,300 mg/day sodium

Determinants of Health

Little or No Control • Heredity • Age • Disabilities • Health care • Environment Greater Control • Behaviors, interactions, cognitions • Engaging in physical activity • Eating well • Managing stress • Avoiding destructive habits

Determinants of health

Little or No Control • Heredity • Age • Disabilities • Health care • Environment Greater Control • Behaviors, interactions, cognitions • Engaging in physical activity • Eating well • Managing stress • Avoiding destructive habits

Six Essential Nutrients

Macronutrients • Carbohydrates • Fat• Protein • Water Micronutrients • Minerals • Vitamins

what is neuromotor training

Neuromotor training is a recognized and necessary component of a comprehensive exercise training program

Anxiety

Normal: Common fear, typically manifested by mood disturbances, irrational thinking, behavior, and physiological activity Clinical: Behavioral & cognitive changes, without eliciting event, unmanageable, interferes with normal functioning • PA can prevent and treat anxiety

Which states have the highest rates of Type 2 Diabetes?

OK,AR,TN,KY,*WV*,SC,GA,AL,MS,LA

How does PA produce health benefits?

PA & the Healthy Heart • Produces a strong heart muscle• Promotes good collateral circulation

principles of resistance training

Progressive overload • Must exercise at a level beyond the point to which your muscles are accustomed • Increase # of repetitions - 8 to 12 reps recommended • Increase # of sets - 2 to 4 sets recommended • Increase resistance Regularity - must exercise several times per week on a regular basis to improve fitness Specificity - distinct adaptations that occur with resistance training

Principles of Resistance Training

Progressive overload • Must exercise at a level beyond the point to which your muscles are accustomed • Increase # of repetitions - 8 to 12 reps recommended • Increase # of sets - 2 to 4 sets recommended• Increase resistance Regularity - must exercise several times per week on a regular basis to improve fitness Specificity - distinct adaptations that occur with resistance training

Recommended % of Calories

Protein 10-35%(200-700 calories) Fat 20-35% (no more than 10% saturated fat)(400-700 calories) (saturated fat < 200 calories) Carbohydrate 45-65%(900-1300 calories)

Physical Activity during Pregnancy and Postpartum

Public Health Problem • Prevalence of maternal obesity is rising • 50% of women exceed recommendations • Excessive weight gain during pregnancy AND failure to lose weight during postpartumlong-term obesity

Why measure cardiorespiratory fitness?

Rationale for Cardiorespiratory Assessment -To educate participants about current cardiorespiratory fitness levels -To motivate individuals to participate in exercise programs -To provide a foundation for exercise prescription -To evaluate improvements achieved through exercise programs and make adjustments -To monitor changes in fitness over time

Physical Activity Guidelines for Young Children

Recommendation 3-1: Child care regulatory agencies should require child care providers to provide infants, toddlers, & preschool children with opportunities to be physically active throughout the day. Institute of Medicine (United States), 2011 "Provide opportunities for light, moderate, and vigorous PA for at least 15 min/hr while children are in care" Chief Medical Officers of England, 2011 "Be physically active daily for at least 180 minutes, spreadthroughout the day" Canadian Society for Exercise Physiology, 2012 "Accumulate at least 180 minutes of PA at any intensity spread throughout the day" Department of Health & Ageing, Commonwealth of Australia, 2010 "Be physically active every day for at least 3 hours, spread throughout the day"

Percent of U.S. High School Students Meeting PA Guidelines in 2015, by sex and grade, Self-Report

Sc: females= 13.6% Males=34% 9th grade(highest)

SMART Goals

Specific - what do you want to accomplish? Measurable - perform assessments to track progress, can you measure it? Action-oriented - a behavior Realistic - if you put in time & effort, you should be able to achieve it Timely - set a date to complete your goal Self-determine-define your own goals

Sport Strategy 1

Sports organizations should collaborate to establish a national policy that emphasizes the importance of sports as a vehicle for promoting and sustaining a physically active population.

Education Strategy 1

States and school districts should adopt policies that support implementation of the Comprehensive School Physical Activity Program model.

Stress management

The first step in managing stress is to recognize the causes and to be aware of thesymptoms

why measure fitness components?

To educate To motivate To form a foundation for exercise prescription To monitor changes

Maximal Heart rate for target zone

max HR = 208 - (.7 x age) Example for a 40-y-old: Max HR = 208 - (.7 x 40) = 208 - 28 = 180.0 = 180 beats per minute (bpm) Calculate 65% and 80% of HR Max for Target Zone: 65% of HR Max = .65 x 180 = 117 bpm 80% of HR Max = .80 x 180 = 144 bpm

Maximal heart rate calculation

max HR= 208 -(.7 x age) example: 22 yr old Max HR=208-(.7x22) = 208-15.4 =192.6 =193 beats per min

5 specific elements of well-being

purpose, social, financial, community, physical

Stretch lower back

supine rotational stretch

Body Mass Index (BMI) calculations

weight (kg)/height (m^2) 1 kg=2.2lb 1 in= 2.54 cm example: person is 6'0" and 170lbs Weight 170 lb / 2.2 = 77.27 kg Height 6'0" = 72 in72 in x 2.54 = 182.88 cm 182.88 cm / 100 = 1.8288 m (1.8288 m)^2 = 3.3445 m2 BMI = 77.27 kg / 3.3445 = 23.1 kg/m^2

What is aerobic fitness

• "Aerobic" - with oxygen • Ability of the body to deliver and utilize adequate amounts of oxygen

2nd Edition of PA Guidelines, 2018 Guidelines for Preschool-Aged Children

• "Preschool-aged children (ages 3 through 5 years) should be physically active throughout the day to enhance growth and development." • "Adult caregivers of preschool-aged children should encourage active play that includes a variety of activity types.

Prevalence of Osteoporosis

• 10 million people per year in the US • 80% are women • Highly prevalent among White, Asian, thin, sedentary women • Least prevalent among Black, overweight, or obese women • Risk of a fracture: • Women over 50→ 40-50% • Men over 50 → 13-22%

PA Recommendations for Women with Normal Pregnancies

• 150 to 300 minutes per week of moderate-intensity PA 2008 PA Guidelines for Americans • From 2007-2014, only 29% American women did ≥ 100 minutes of PA per weekHesketh et al. 2016

Alzheimer's disease

• 6th leading cause of death in US • Affects over 5 million Americans • Major public health challenge -Regular PA has positive health benefits on cognitive function

Health Complications due to Diabetes

• 7th leading cause of death in US • Increased risk of • Cardiovascular disease • Kidney failure • Blindness • Circulatory problems

Public Health Burden of Type 2 Diabetes

• >20 million have diabetes • 86 million have prediabetes • Rates doubled in past 20 years: 5.5% in 1994 to 9.3% in 2012 • 25.9% those 65+ have diabetes • In 2016, SC ranks 6th in diabetes among adults: 13.0% in 2016 • 1995 - 6.0% • 2005 - 9.3% • 2015 - 11.8%

Definition of exercise

• A type of physical activity that requires planned, structured, and repetitive bodily movement with the intent of improving or maintaining one or more components of physical fitness.

what is Flexibility

• Ability of a joint and surrounding muscle to move through a full or optimal range of motion • Joint specific Important for -day to day activities -recreational activities -sports -dance

What is agility?

• Ability to change body position and direction quickly and efficiently

What is balance

• Ability to maintain the body in proper equilibrium • Vital in activities • Gymnastics • Diving • Ice skating • Skiing

components of flexibility

• Ability to move a joint through a full range of motion • Loss of flexibility can limit ability to carry out activities of daily living • Maintaining flexibility is important • Stretching exercises

what is Speed

• Ability to rapidly propel the body or part of the body from one point to another • Activities requiring speed: • Soccer • Basketball • Sprints in track • Stealing base in baseball • Speed can be important in everyday life in emergency situations

cancer

• Abnormal, uncontrolled cell growth • Benign tumors • Malignant tumors • 85% are carcinomas • Adenocarcinomas • Sarcomas • Metastasize • 4 most prevalent types: • Lung (#1 M and F) • Breast (#2 F) • Prostate (#2 M) • Colon (#3 M and F)

Physical activity and stress management

• Adapt to stressful situations • Relief from stress, reduces muscle tension • Reduces reactivity to stress • Improves mental health

PA Guidelines for Americans

• Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic activity • Additional benefits are gained by engaging in PA beyond 300 minutes of moderate-intensity PA • *Should do muscle-strengthening activities that involve all major muscle groups on 2 or more days a week* • Move more and sit less throughout the day

PA Guidelines for Americans, 2nd Edition, 2018

• Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic activity • Additional benefits are gained by engaging in PA beyond 300 minutes of moderate-intensity PA • Should do muscle-strengthening activities that involve all major muscle groups on 2 or more days a week • Move more and sit less throughout the day

Physical Activity Recommendations

• Aerobic Exercise • Walking • Swimming • Aerobics classes • Yoga • Resistance Training • Machines • Resistance bands • Body weight activities • Pilates and yoga • Flexibility • Warm-up and cool down • Target at least 10 minutes of stretching 2-3 days per week

Aerobic Exercise

• Aerobic exercise: Exercise that requires oxygen to produce the necessary energy to carry out the activity • Primary type of exercise that stimulates improvements in the cardiorespiratory system. -Walking -Jogging -Swimming • Cycling • Cross-country skiing • Water aerobics • Rope skipping • Aerobics

Components of a complete exercise program

• Aerobic fitness • Muscular fitness • Flexibility • Neuromotor exercise training

Risk Factors for Arthritis

• Age • Sex • Overweight and Obesity • Previous joint injury • Occupation • Smoking -PA recommendations: Aerobic fitness Resistance training Flexibility Neuromotor Training

Factors influencing flexibility

• Age, sex, joint structure, and physical activity level • Muscles, tendons, and ligaments

Coronary Heart Disease (CHD)

• Arteries that supply blood to heart muscle with oxygen are narrowed or blocked by fatty deposits

2018 PA Guidelines for Women during Pregnancy and Postpartum

• At least 150 minutes moderate-intensity aerobic activity per week during pregnancy and postpartum • Women who were vigorously active before pregnancy can continue during pregnancy and postpartum • Women who are pregnant should be under care of a health care provider

Skin cancer

• Avoid excess amounts of sun or UV ray exposure (tanning beds) • Use clothing to protect skin from sunlight • Use sunblock when exposing skin to sunlight • Know your ABCDEs

physical activity

• Benefits of regular PA: • Cardiorespiratory endurance • Heart function • Increase HDL • Decrease LDL • Decrease & control blood pressure • Reduce body fat • Motivate toward smoking cessation • Alleviate tension and stress

Blood pressure

• Blood pressure - measure of force exerted against walls of vessels by blood flowing through them • Hypertension - chronically elevated blood pressure • Systolic BP - pressure during contraction (systole) of heart • Diastolic BP - pressure during relaxation (diastole) of heart - 60000 miles of blood vessels run through the body

NPAP Alliance

• Board of Directors • Objectives: - Support NPAP's strategies & tactics - Expand awareness of NPAP - Evaluate NPAP - Periodically revise NPAP • Committees

Diabetes Mellitus

• Body does not produce or utilize insulin efficiently • Type 1- insulin-dependent, pancreas produces little or no insulin • Type 2- non-insulin-dependent, condition in which insulin is not processed properly • Insulin resistance - inability of cells to respond appropriately to insulin

Bone Health

• Bone Mineral Density (BMD) • Dual Energy X-Ray Absorptiometry (DEXA)

Warning Signs for Cancer

• CAUTION: •C •A •U •T • I •O •N Changes in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump (e.g., breast) Indigestion or difficulty swallowing Obvious change in a wart or mole Nagging cough or hoarseness

Synonyms of Cardiorespiratory Endurance

• Cardiorespiratory fitness • Cardiovascular endurance • Cardiovascular fitness • Aerobic fitness

Muscular endurance Assessment

• Chair Stand Test for Older Adults • Number of times over 30 sec • Arm Curl Test for Older Adults • Number of curls in 30 sec• Men 8 lbs.• Women 5 lbs.

Warning Signs of a Heart Attack

• Chest pain, discomfort, pressure, or squeezing that lasts for several minutes; may go away & return later -Pain or discomfort in shoulders, neck, arms, between shoulder blades -Chest discomfort with shortness of breath, lightheadedness, cold sweats, nausea and/or vomiting, feeling of indigestion, sudden fatigue or weakness, fainting • Call 911 and seek medical attention immediately!

Health Benefits of PA for Youth

• Children 3-6 years • Bone health • Reduced risk of excessive weight gain • Insufficient evidence about cardiometabolic health • Youth 6-17 years • Cardiorespiratory & muscular fitness • Bone health • Favorable weight status • Cardiometabolic health • Improved cognitive function for 6-13 year olds

Children and adolescents

• Children and adolescents should do 1 hour or more of PA every day. • Most of the 1 hour or more a day should be either moderate- or vigorous- intensity aerobic PA. • Vigorous-intensity activity on at least 3 days per week. • Muscle-strengthening and bone-strengthening activity on at least 3 days per week.

nd2 Edition of PA Guidelines, 2018 Guidelines for 6- to 17-y-olds

• Children and adolescents should do 60 minutes (1 hour) or more of moderate-to vigorous PA every day. • Most of the 1 hour or more a day should be either moderate- or vigorous- intensity aerobic PA and include vigorous-intensity activity on at least 3 days per week. • Muscle-strengthening activities on at least 3 days per week. • Bone-strengthening activities on at least 3 days per week.

Arthritis

• Chronic disease affecting joints and muscles • Common forms • Osteoarthritis • Rheumatoid arthritis • Fibromyalgia •Spondyloarthropathies • Causes • Trauma to joint • Abnormal biomechanics • Repetitive joint stress

Physical Activity and Prevention of Cancer

• Colon • Breast • Bladder• Endometrium • Esophagus • Stomach • Kidney • Lung

Barriers to physical activity

• Common barriers reported during pregnancy • Fatigue • Lack of time • Morning sickness • Increased physical and joint discomfort • Fear of hurting baby • Lack of childcare

Depression

• Common chronic health condition that negatively affects physical, emotional, and social health • Interferes with daily functioning • Major depressive disorder is most common • Public health burden • 350 million people worldwide people suffer from depression • Leading cause of disability and global disease burden in industrialized nations (World Health Organization) • Economic effects

Neuromuscular system

• Complex and interconnected network that links • Brain, spinal cord, and extremity nerves with sensory receptors and muscles • Role of neuromuscular system • To integrate sensory information, and based on this information, to coordinate appropriate muscle actions needed to produce desired movement

what is the neuromuscular system

• Complex and interconnected network that links• Brain, spinal cord, and extremity nerves with sensory receptors and muscles • Role of neuromuscular system • To integrate sensory information, and based on this information, to coordinate appropriate muscle actions needed to produce desired movement • Essential for maintaining balance, agility, coordination, and body awareness • Coordinates every motor task • Getting dressed• Tying shoes • Helps people navigate their surroundings efficiently, effectively, and safely• Improving neuromuscular function - reduce risk of falls and musculoskeletal injuries

Stroke

• Condition in which a blood vessel that feeds the brain is clogged, disrupting blood flow to brain • Leading cause of death in US • Significant contributor to mental & physical disability in US • Burden

Neuromuscular system and orchestra

• Conductor (brain and spinal centers)• Musicians - muscles• Correct notes with clarity, pitch, precision, tempo - sensory information • Precisely orchestrated musical performance - desired motor task

self-efficacy

• Confidence in one's own ability • Task self-efficacy - belief you can do a specific activity • Barriers self-efficacy - belief you can do that behavior when faced with a barrier (obstacle, challenge)

ABC Grow Healthy Project PA Standards:

• Create & implement written PA policy • Child dressed in clothes & shoes that allow for PA -Attend training on promoting children's PA ≥1 time/year -Encourage children to be active indoors & outdoors at appropriate times • Offer teacher-planned physical activities of 5- 10 min ≥ 2 times a day -Do not withhold PA as punishment & do not use PA as punishment -Provide daily outdoor play for all children, weather permitting, across 2-3 separate occasions totaling 90-120 min -Provide a variety of play materials that promote PA indoors & outdoors

Symptoms of Depression

• Depressed mood or feelings of sadness • Loss of interest or pleasure in activities • Changes in appetite • Changes in sleep • Fatigue, low energy • Hopelessness, worthlessness • Difficulty thinking or concentrating • Agitation, restlessness • Thoughts of suicide -Affect daily activities Continue for 2+ weeks Not related to other medical condition

What is motivation

• Determination, drive, or desire with which you approach a behavior

Reducing Risk for Type 2 Diabetes

• Diabetes Prevention Program • Adults at high risk for T2DM • Fasting plasma glucose 95-125 mg/dL • Randomized controlled trial • Placebo • Metformin • Lifestyle-modification program • Followed ~ 3 years Knowler et al. 2002

Guidelines for a safe and effective Flexibility program

• Do not force the stretch to the point of pain • Choose safe exercises • Avoid overstretching weak muscles • Use good technique

Reducing Risks of Cancer

• Do not smoke or chew tobacco • Eat a healthy diet • Get regular physical activity • Decrease exposure to environmental factors • Radon, asbestos, carbon monoxide, pollution, pesticides, X-rays, and sunlight

Nutriton

• Encourage healthy choices• Adult modeling of healthy eating habits • Variety of foods • "Clean plate club"eat only until full • Areas of diet to increase in youth • Whole fruit instead of fruit juice • Replace starchy vegetables with dark green and orange vegetables • Increase low-fat/skim milk in place of soda • Eat breakfast • Areas of diet to decrease in youth • Grain desserts • Sodas, fruit juices, sports drinks • High-fat fried foods • Limit fast-food meal

step test

• Estimates VO2max based on a 3-minute step test • Step height = 16 1⁄4" • Take a 15-sec heartrate between 5 and 20 seconds into recovery • Advantages • Short amount of time • Little equipment • Can be administered to almost anyone

Calculations - Protein

• Example with total calories per day = 2,000 • To calculate 10% of calories per day • Multiply total calories by 0.10 • 2000 * 0.10 = 200 calories • To calculate 35% of calories per day • Multiply total calories by 0.35 • 2000 * 0.35 = 700 calories • Target range of calories from carbohydrates: 200-700 • To convert target range of calories (200-700) to grams • 4 calories in 1 gram of protein • Divide calories by 4• 200 calories / 4 = 50 grams• 700 calories / 4 = 175 grams • Target range of grams from protein: 50 to 175 grams grams

Neuromotor Training

• FITT-VP • Varies depending on individual levels of • physical conditioning • presence of preexisting injuries • personal goals, and • needs • No consensus for optimal number of repetitions, intensity, or methods of progression • General exercise recommendations

Neuromotor Training

• FITT-VP: F at least 2-3 days per week to improve balance & mobility. I Increasing duration & difficulty, movement qualities. T 30-45 minutes per week. T specific to goals and needs. V perform with best form and technique. P gradually challenge. NEUROMOTOR TRAINING • Varies depending on individual levels of • physical conditioning• presence of preexisting injuries• personal goals, and • needs • No consensus for optimal number of repetitions, intensity, or methods of progression • General exercise recommendations

FITT-VP- general recommendations

• FREQUENCY • 3-5 days/week • INTENSITY • Moderate-vigorous • TIME • At least ≥ 20-30 min/session • TYPE • Large muscle group activity Volume- total amount of PA Progression- gradual progression

Risk Factors for Depression

• Female • Family history • Previous bout of depression • Low social support or social isolation • Having a chronic condition • Stressful life events • Low levels of physical activity

Skill related fitness and skill learning

• Fitness and skills interact to influence high-level performance

Managing CVD

• Focusing on Nutrition • Heart-healthy diet recommendations • Wholegrains • Fiber • Leanprotein • Variety of fruits and vegetables • Fat and cholesterol • Dietary sodium < 2,300 mg/day • Focusing on PA • Precautions • PA Guidelines • Medications • Lipid-lowering • Blood Pressure-lowering

1.0 Mile Walk Test

• For individuals unable to run because of low fitness levels or injuries • Estimates VO2max based on a prediction equation that requires: • Time to walk the 1.0-mile course • Heart rate of at end of test • Body weight • Gender VO2max = 88.768 - (0.0957 x W) + (8.892 x G) - (1.4537 x T) - (0.1194 x heart rate) W = Weight in pounds G = Gender (0 for women, 1 for men) T = Total time in minutes HR = Heart rate (bpm) at end of walk

Organizational Development

• Formal non-profit organization (March, 2013) • Mission: to maintain and expand the impact of the National Physical Activity Plan, a comprehensive strategic plan for increasing physical activity in all segments of the U.S. population.

Progressive Resistance Exercise

• Frequency - days per week • Intensity - percentage of 1 repetition maximum (1RM) • Time - number of repetitions and sets • Type - specific mode

progressive resistance exercise, the FIT formula

• Frequency - days per week • Intensity - percentage of 1 repetition maximum (1RM) • Time - number of repetitions and sets • Type - specific mode

components of neuromotor exercise trainging

• Functional fitness • Activities that improve balance, coordination, gait, agility, and one's perception of physical location within space (i.e., proprioception)

Factors affecting aerobic Fitness

• Genetics • Sex • VO2max in men is 15%-30% higher than women • Age • VO2max ↓ 1% per year starting at age 25 • But only ↓ 0.5% per year for active people • Training State

Progressive resistance exercise

• Gradually and systematically increases overload of skeletal muscles • Improves muscle fitness

Areas needing stretching

• Hamstrings • Inner thigh • Calf • Hip flexors • Lower back • Chest / shoulders

Managing Type 2 Diabetes

• Healthy diet • Maintain healthy weight • Regular physical activity

Elements of cardiorespiratory endurance

• Heart • Vascular system • Respiratory system • Muscle tissues

benefits of skill related fitness

• Helps you stay active • Improves work efficiency • Helps in emergencies • Helps in learning new activities

Components of muscular fitness

• How muscles contract & allow lifting, pushing, pulling, & holding objects • Muscular strength • Muscular endurance • Resistance training

PA & Heart Attack

• Improves coronary circulation • More "stress resistant" • Effective means of recovery for a person whose had a heart attack

Best measure of cardiorespiratory fitness

• In the laboratory! • Gas analysis which measures the difference in oxygen between the person's exhaled air and theatmosphere • Field tests to measure VO2max

what is coordination

• Integration of the nervous and muscular systems to produce correct, graceful, and harmonious body movements • Important in: • Golf • Baseball • Karate • Soccer • Racquetball

Hypertension

• Known as "silent killer" • Leads to atherosclerosis • Damages inner lining of blood vessels • Leads to fatty deposits inside blood vessels • Restricts blood flow

National Cholesterol Education Program Guidelines for Hypercholesterolemia

• LDL-C (mg/dl) • Optimal < 100 • High 160-189 -LDL "Bad" Cholesterol - increases blood cholesterol • HDL-C (mg/dl) • High (low risk) • > 60 • Low (high risk) • < 40 -HDL "Good" Cholesterol - clears cholesterol from the blood

Barriers to behavior change

• Lack of time • Social influence • Lack of energy • Lack of motivation • Fear of injury • Lack of skill • Lack of resources • Weather conditions • Travel • Family obligations • Retirement years

Major stressors

• Major Stressors • Create emotional turmoil or require adjustment • Examples: Personal and family Job and school Major age-related transitions • Minor Stressors • Shorter-term or less severe stressors • Examples: Traffic hassles Peer/work relations Time pressures

Ways a family can develop healthy eating patterns

• Make half grains whole • Vary your veggies • Focus on fruits • Eat calcium-rich foods • Go lean with protein • Change your oil - fish, nuts, corn, soybean, canola, olive oil • Don't sugarcoat it • Eat meals together!

MyPlate Food Plan

• Make half your plate fruits and vegetables • Make at least half your grains whole grains • Choose fish and lean or low-fat meat and poultry • Switch to fat-free or low-fat (1%) milk

Revising the Plan 9 Sectors

• Mass Media • Public Health • Education • Healthcare • Sport • Business and Industry • Faith-Based Settings • Community Recreation, Fitness and Parks • Transportation, Land Use and Community Design

Ways to increase self efficacy

• Mastery experiences • Vicarious experiences • Verbal Persuasion • Physiological feedback

cardiovascular disease (cvd)

• Medical conditions that affect the heart and blood vessels • Coronary heart disease • Stroke • Peripheral vascular disease • Atherosclerosis • Arteriosclerosis • Congestive heart failure • Congenital heart disease • Leading cause of death in US - both men & women • Leading cause of sudden cardiac deaths • Over 50% of adults have NO previous symptoms • Burden • Health care expenditures - treatment • Lost productivity -32% of all deaths in US are attributable to CVD

Physical Activity Alliance

• Mission - "to lead efforts to create, support, and advocatepolicy and system changes that enable all Americans to enjoy physically active lives." • Vision - "We envision an active and healthy nation wherethe opportunity for PA is easily available in the daily lives of all Americans."

Combining moderate & vigorous PA to achieve guidelines

• Moderate PA • Walking 20 minutes at 4 METs • MET minutes = 20 x 4 = 80 MET minutes • Vigorous PA • Jogging 30 minutes at 10 METs• MET minutes = 30 x 10 = 300 MET minutes • At least 500 MET minutes/week

static stretching

• Most common • Safer and less likely to cause injury • Stretch slowly until mild tension • Hold stretch for 15 - 30 sec • Relax the muscle • Repeat 2 to 4 times

Dynamic Stretching

• Moving parts of body through full range of motion while gradually increasing reach and speed of movement in a controlled manner -Example: arm circles -Does not involve bouncing or jerking -Repeat 5 to 12 times for total of 30 to 60 sections

Risk factors for cardiovascular disease

• Non-modifiable • Sex • Age • Race/ethnicity • Family history • Modifiable • Smoking • High blood pressure • High cholesterol • Physical inactivity • Obesity • Prediabetes, diabetes • Diet

High level performance

• Not necessary for health or enjoyment from activity • Requires more rigorous training • More dependent on genetics than health • Requires health- and skill-related fitness

postpartum

• One year after delivery • Recovery time varies • Cesarean deliveries require 4-6 weeks of recovery • Challenges: pre-pregnancy weight and postpartum depression • Postpartum depression affects 10% of women, 25% of those in treatment after 1st year

Field Tests of Cardiorespiratory Endurance

• One-mile Walk Test • Step Test • Astrand Rhyming Bike Test • 12-minute Run Test • 12-Minute Swim Test

Factors that influence health behaviors

• Personal and Social Factors • Predisposing Factors • Enabling Factors • Reinforcing Factors

what is Intensity

• Physical effort required to perform a physical activity or exercise • Amount of energy expended • Levels • Light • Moderate • Vigorous • MET - Metabolic equivalent • 1 MET = 3.5 ml/kg/min (at rest) • Heart rate is a measure of intensity

Reactions of stress

• Physiological • Fatigue • Headaches, indigestion, insomnia, etc. • Cognitive • Impaired concentration and attention • Emotional • Anxiety and apprehension • Behavioral • Nail-biting • Altered eating and sleeping habits • Smoking, alcohol, drug use • Less physical activity

How PA may affect mental health

• Placebo effect • Distraction • Increases confidence • Opportunities for social support • Exercise effects on brain chemicals

Cancer risk factors

• Poor dietary habits • Tobacco • Physical inactivity • Pollutants • Alcohol • Work-related hazards -Nearly 65% of all cancers are attributable to diet and tobacco

Public Health Burden of Hypertension

• Prevalence of HTN in US in 2017: 34% • 86 million Americans • Prehypertension prevalence in US: 36% • By 2030, 41% US adults will have HTN • From 2010-2030, • Total direct costs will triple: $130.7 to $389.9 billion • Lost productivity will double: $25.4 to 42.8 billion

Health benefits of flexibility

• Prevents low-back pain • Increases elasticity of muscles and connective tissue • Improves quality of life

Time Management

• Prioritize • A - Must be done.. and soon! • B - Should be done soon • C - Could be done

principles of resistance training

• Progressive overload • Must exercise at a level beyond the point to which your muscles are accustomed • Increase # of repetitions - 8 to 12 reps recommended • Increase # of sets - 2 to 4 sets recommended • Increase resistance • Regularity - must exercise several times per week on a regular basis to improve fitness •Specificity - distinct adaptations that occur with resistance training

what is wellness

• Quality or state of being healthy in body and mind • Balancing many dimensions of life to promote health • Continuum

PA Recommendations during Postpartum

• Recommend that women resume pregnancy exercise routines gradually after birth as soon as it is physically and medically safe ACOG 2015

Cardiorespiratory endurance & health benefits

• Reduces risk of • Early death • Coronary heart disease • CHD risk factors • Protection against the health risks associated with obesity • Enhances the ability to perform various tasks • Improves ability to function • Associated with a feeling of well-being

Cardiorespiratory endurance & health benefits

• Reduces risk of • Early death • Coronary heart disease • CHD risk factors • Protection against the health risks associated with obesity • Enhances the ability to perform various tasks • Improves ability to function • Associated with a feeling of well-being

cardiorespiratory endurance and health benefits

• Reduces risk of • Early death • Coronary heart disease • CHD risk factors • Protection against the health risks associated with obesity • Enhances the ability to perform various tasks • Improves ability to function • Associated with a feeling of well-being

Benefits of Physical Activity

• Reduces symptoms of depression • Reduces likelihood of future episodes • Can treat depression • Improves sleep quality & decreases fatigue • Improves cognitive function • Decreases pain and somatic complaints • Improves self-esteem and self-efficacy • Improves quality of life and daily functioning

PA and Prevention of Type 2 Diabetes

• Regular physical activity decreases the risk of developing Type 2 Diabetes • At least 150 minutes of moderate-intensity aerobic activity

Flexibility Program Consideration

• Regular stretching is needed to improve flexibility • Specific to muscle groups and joints that are stretched • Begin with a 5-min warm-up • Apply FITT-VP principle

Body composition

• Relative amounts of fat and fat-free tissues in the body • Fat and nonfat components of human body

Collaboration with DHEC, DSS, and USC

• SC ABC Child Care Program • Child care subsidies for low-income children • Centers voluntarily enrolled are reimbursed • ~ 700 centers • Collaboration with SC DSS, SC DHEC, and USC ASPH & College of Education • Revision of PA standards in ABC centers

Prevention

• Self-assessments and regular medical exams • Staying current with new health information • Adhering to sound medical advice

developing a resistance training program

• Setting goals • Type of program • Choice of equipment • Muscle groups • Order of exercises - large groups first • Number of sets, reps per set

Assessment for range of motion

• Sit-and-reach test - hamstring flexibility • Adults, youth, chair sit-and-reach test for older adults

Key PA tips Alzheimer's disease

• Start now • Regular activity • Move more • Set goals • Mix it up • Add resistance training • Be social • Consult a professional

Resistance Training

• Strength-training activities • Free weights • Weight machines • Elastic tubing • Medicine balls • Stability balls • Body weight

Definiton

• Stress • Physical, mental, and/or emotional result to a perceived threat, altering the state of balance or equilibrium • Response of the body to any demand made on it in order to maintain equilibrium • Stressors - Things that place greater than routine demand on body Eustress- • Positive, motivational type of stress

Health Benefits of physical activity children and adolescents

• Strong Evidence: • Improved cardiorespiratory endurance & muscular fitness -Favorable body composition -Improved bone health -Improved cardiovascular & metabolic health biomarkers • Moderate Evidence: • Reduced symptoms of anxiety & depression

What is reaction time?

• Time required to initiate a response to a given stimulus • Important for: -Track and swimming -Tennis -Ping pong -Boxing -Karate -MMA

National Cholesterol Education Program Guidelines for Hypercholesterolemia

• Total cholesterol (mg/dl) • Optimal < 200 mg/dl • Borderline 200-239 mg/dl • High ≥ 240 mg/dl -36 million American adults have total cholesterol levels ≥ 240 mg/dl • Triglycerides (mg/dl) • Normal < 150 • High 200-499 • Very high ≥ 500 -67 million American adults have borderline total cholesterol levels

the modes of training

• Two types of training methods to improve strength: • Isometric (static): strength gains are specific to angle of muscle contraction. • Dynamic (isotonic): Muscle contraction with movement • Full range of motion • Improvements measured easily by amount lifted • Two action phases: • Concentric - shortening of a muscle (+) • Eccentric - lengthening of a muscle (-)

Types of Diabetes Mellitus

• Type 1 • Type 2 (95%) • Gestational diabetes

Regional Fat Deposition Visceral Fat

• Visceral body fat poses greater health risks because it is more active and has greater access to the circulation • Fat stored in the abdominal region presents more risk than fat stored in the lower or upper extremities

workout components

• Warm-up - 5 to 10 min low-mod intensity aerobic exercise • Muscle conditioning phase • Exercise choice • Exercise order • Number of repetitions • Number of sets • Repetition velocity • Rest period between sets • Cool-down

PA for Bone Health

• Weight-bearing exercise • Walking • Aerobic exercise • Resistance training

Public health Strategy 1

•Public health organizations should develop and maintain a workforce with competence and expertise in physical activity and health and that has ethnic, cultural, and gender diversity.