Overview
Introduction
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Energy system for muscular contractionHealth benefits of exercise
Types of exercises
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Exercise prescription
Introduction
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`Therapeutic' relates to the treatment of disease/physical
disorder
`Exercise' refers to bodily exertion for the sake of
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training/improvement of health.? Use of activities requiring physical exertion in the
prevention/treatment/rehabilitation of il ness and disabling
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conditions.Energy Systems
Al three energy systems supply energy at all times but
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one energy system may predominate during a particular
activity.
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Energy Systems
q ATP in skeletal muscles lasts approximately 5 to 10 seconds of
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high-intensity workq Creatine phosphate system lasts for approximately 25 seconds of
high-intensity work.
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This provides energy for activities such as sprinting and weightlifting.
q Rapid Glycolysis starts along with high-intensity exercise and
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dominates for approximately 1.5 to 2 minutes.Energy Systems
Aerobic Oxidation System:
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Unlimited ability to regenerate ATP depending upon amount of
fuel and oxygen available to the cell.
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Maximal oxygen consumption (VO2max) is a measures powerof the aerobic energy system and the best indicator of aerobic
fitness.
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Prolonged exercise ( >30 minutes) of low to moderate intensityshifts substrate utilization from carbohydrate toward fat.
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Health benefits of exercise? Primary and Secondary Prevention of Cardiovascular Disease
? Blood Pressure Regulation
? Weight Control
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? Type 2 Diabetes Mellitus Prevention? Improved Psychological Well-being
? Maintenance of Bone Density
? Increased Fibrinolytic Activity
? Decreased Inflammatory Marker
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? Improved Endothelial Function? Improved Sleep
? Reduced Cancer Risk
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The activity pyramidTypes of exercise
q Cardiovascular Exercise (Aerobic exercise)
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q Strengthening exercise
q Flexibility
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q ProprioceptionCardiovascular Exercise
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Pulmonary Ventilation (Ve)q Volume of air exchanged per minute.
? At rest Approximately 6 L/min in an average sedentary
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adult man.
? At maximal exercise, increases 15- to 25-fold over
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resting values.? Increases in Ve are directly proportional to an increase
in oxygen consumption (VO2) and carbon dioxide
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produced (VCO2).Anaerobic (ventilatory) threshold
The anaerobic threshold signifies the peak work rate or oxygen
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consumption at which the energy demands exceed thecirculatory ability to sustain aerobic metabolism.
At critical exercise intensity Ve increases disproportionately
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relative to the VO2 (paralleling an abrupt increase in serumlactate and VCO2).
Determined by
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? serial measurements of blood lactate? assessment of expired gases during exercise testing, specifical y Ve
and carbon dioxide production (VCO2).
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Maximal Oxygen Consumption
? VO2max defined physiologically as the highest rate of oxygen
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transport and use, that can be achieved at maximal physicalexertion.
? The resting oxygen consumption (250 mL/min) divided by
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body weight (70 kg) gives the resting energy requirement, 1MET (approximately 3.5 mL/ kg per minute).
? METs is considered the best index of physical work capacity
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or cardiorespiratory fitness.Symptoms of Overtraining Syndrome
? Sudden decline in quality of work or exercise performance
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? Extreme fatigue? Elevated resting heart rate
? Early onset of blood lactate accumulation
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? Altered mood states
? Unexplained weight loss
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? Insomnia? Injuries related to overuse
Physical Activity Readiness
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Questionnaire
1.
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Has your doctor ever said that you have a heart condition and that you should only do physicalactivity recommended by a doctor?
2.
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Do you feel pain in your chest when you do physical activity?3.
In the past month, have you had chest pain when you were not doing physical activity?
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4.
Do you lose your balance because of dizziness or do you ever lose consciousness?
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5.Do you have a bone or joint problem that could be made worse by a change in your physical
activity?
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6.Is your doctor currently prescribing drugs (e.g., water pil s) for your blood pressure or heart
condition?
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7.Do you know of any other reason why you should not do physical activity?
A "yes" answer to any of the questions indicates a pre-exercise
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evaluation before the individual begins or increases physical activity
Major Symptoms or Signs Suggestive of
Cardiopulmonary Disease
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? Pain and discomfort in the chest, neck, jaw, arms, or other areas that may be
ischemic in nature
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? Shortness of breath at rest or with mild exertion? Dizziness or syncope
? Orthopnea or paroxysmal nocturnal dyspnea
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? Ankle edema
? Palpitations or tachycardia
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? Intermittent claudication? Known heart murmur
? Unusual fatigue or shortness of breath with usual activities
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Components of an Exercise Prescription
? Mode is the particular form or type of exercise.
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? Intensity is the relative physiologic dif iculty of the exercise.Intensity and duration of exercise interact and are inversely
related.
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? Duration or time is the length of an exercise session.? Frequency refers to the number of exercise sessions per
day and per week.
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? Progression (overload) is the increase in activity during
exercise training, which, over time, stimulates adaptation
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ACSM Recommendations for
Cardiorespiratory Endurance Training
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Mode: large muscle groups are engaged in rhythmic aerobicactivity.
? Activities includes walking, jogging, cycling, rowing, stair
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climbing, aerobic dance ("aerobics"), water exercise, and cross-country skiing etc.
Intensity: minimal exercise of moderate intensity (i.e., 40% to
60% of VO2max that increases HR and breathing).
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? A combination of moderate and vigorous exercise (60% of
VO2max results in increases in HR and breathing) is ideal for
improvements in health and fitness.
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Intensity Calculation
q Heart Rate Methods
v MAXIMUM HEART RATE METHOD:
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? HRmax = 220 - age (with a standard deviation of 10 beats/min)
? Using 70% to 85% of an individual's HRmax provides the stimulus
needed to improve or maintain cardiorespiratory fitness.
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v HEART RATE RESERVE METHOD:
q Rating of Perceived Exertion:
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? The RPE is a subjective grading of how hard individuals feel theyare exercising. The most commonly used scale of perceived
exertion is the Borg Scale.
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ACSM Recommendations forCardiorespiratory Endurance Training
q Duration
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? Physical activity may be continuous or intermittently
accumulated during a day through one or more sessions of
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activity lasting greater than 10 minutes.? The ACSM recommends physical activity for healthy adults: 1000
kcal/ week (or approximately 150 min/wk or 30 min/day).
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q Frequency
? The ACSM recommends exercise 3 to 5 days per week.
? Less conditioned people can benefit from lower intensity, shorter
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duration exercise performed at higher frequency.
q Progression
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? The ACSM notes a 5- to 10-minute increase every 1 to 2 weeksover the first 4 to 6 weeks.
Types of Muscle Contraction
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Isometric contractions are contractions in which there is no
change in the length of the muscle. No joint or limb motion
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occurs.Isotonic contractions occur when the muscle changes length,
producing limb motion.
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Concentric contractions occur when the muscle shortens.
Eccentric contractions occur when the muscle lengthens.
More fast-twitch fibers are recruited during eccentric
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contractions.
Isokinetic contractions occur when muscle contraction is
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performed at a constant velocity. This can be done only withthe assistance of a preset rate-limiting device.
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Resistance ExerciseTraining program include increasing the amount of weight lifted,
increasing repetitions, or increasing the velocity of training.
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One-repetition maximum (1-RM) is maximum amount of weight that
a person can possibly lift for one repetition.
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q Progressive resistance exercise? DeLorme method: The weight for the first set is 50% of the 10-RM;
the second set, 75% of the 10-RM; and the third set, 100% of the
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10-RM.
q Regressive resistive exercise
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? Oxford technique: an individual starts with 10 repetitions at 100%of the 10-RM, then 10 repetitions at 75% of the 10-RM, then a third
set of 10 repetitions at 50% of the 10-RM.
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Recommended Guidelines for Strength
Training
Flexibility
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"The total achievable excursion (within limits of pain) of a body part
through its range of motion."
? Even smal reductions in range may result in biomechanical
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accommodations that place abnormal stress on tissues elsewhere in
the body.
? Benefits from stretching:
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I. Prevention of musculoskeletal injuries
I . Improved performance in sports
I I. Reduced post-exercise muscle soreness
IV. Improved general wel -being
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Factors affecting range of motion
? Tightness of soft-tissue structures such as muscle, tendon, ligament,
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and joint capsule.? Involuntary muscle contraction i.e. spasm
? Bony contour of the joint
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? Abnormal bone growth around a joint
? Intra-articular loose bodies (e.g., bone or cartilage)
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? Excessive fluidStretching techniques
1) Bal istic: repetitious bouncing movements, where the momentum of a
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moving body segment is used to generate forces producing a rapidstretch.
v Greater risk for injury
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2) Static: a slowly applied stretch that is held for several secondsv Easy to perform
v Can be done voluntarily or received passively
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v Little associated risk of injury
3) PNF (proprioceptive neuromuscular facilitation): The concept is to
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enhance relaxation of the muscle to be stretched through reciprocalinhibition and the stretch reflex.
Proprioception
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q It denotes the process by which information about theposition and movement of body parts is related to the
central nervous system.
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? Proprioceptive organs: including muscle (particularlyintrafusal spindle fibers), skin, ligaments, and joint capsules
? Proprioceptive exercises used after an injury to a joint
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resulting in a deficit in proprioception.
e.g. Tilt or wobble board training, carioca (sideways
running) and backward walking or running.
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Thank you