Fitness

1. Fitness Implications for Adapted Physical Education

2. Definitions and Issues ACSM Four Component Definition Cardiovascular endurance Body composition Muscular strength and endurance Flexibility Fifth Component ? Beliefs, Attitudes, and Intentions that lead to fitness

3. Ecological Approach Stresses lifestyle and involving parents, siblings, and other supports Fitness Goal for Adapted PE: persuade persons with low fitness that regular exercise can ameliorate problems and increase quality of life

4. Concerns for the Adapted Educator poor body alignment/inefficient movement patterns = fatigue and reduction in job efficiency mechanical inefficiencies negatively affect energy level reduced sensory input spasticity use of crutches or prostheses loss of functional mass

5. Concerns for the Adapted Educator Architectural and Attitudinal Barriers Low self-worth Poor body image and self concept due to poor balance-coordination-timing Can find success in walking, jogging, cycling, swimming, and weight lifting

6. Fitness 1950’s Kraus-Weber American children less fit than Europeans 6 items straight/bent-knee sit-ups double-leg lift - supine/prone trunk lift prone toe touch from stand

7. AAHPERD Tests Many revisions since 1950’s 1988 Revision: Four Components one mile walk/run (10-14min) body comp (sum or tri +calf) 25mm-36mm muscular strength/endurance bent knee sit-ups (60sec) pull-ups (1-5) lower-back/hamstring flexibility sit and reach 25cm

8. Other Tests President’s Council on Physical Fitness and Sports (Five Components) 1mi walk/run curl ups V-sit reach shuttle run pull-ups Rewards for 85th percentile Use of NORMS? YMCA

9. Testing for Adapted PE AAHPERD tests for individuals with mental retardation and other impairments What do you think about norms? Yes, separate tests are no longer valid AAHPERD philosophy - Minimal standards for health-related fitness tests are applicable to everyone

10. Rarick’s Findings Individuals with MR performed 2 to 4 years behind peers Suggested same items but different set of norms 1990’s Holistic Approach - Wellness 1990’s Issues: self-esteem, self-motivation beliefs, attitudes Best Practice - A lifespan, ecological approach

11. Exercise Prescription F.I.T. principle F.I.T.-M.R. Guideline for individuals with disabilities Frequency - Daily Time - at least 30 minutes Intensity and Modality- Four components

12. I - Intensity Muscle strength/endurance - number of pounds (weight / resistance) lifted, pushed, pulled or propelled Flexibility - distance a muscle is stretched beyond normal length Body composition - caloric expenditure in relation to caloric intake Cardiorespiratory fitness - distance and speed

13. M - Modality Muscle strength/endurance - isotonic, isometric, or isokenetic Flexibility - static stretch, independent (active) or assisted (passive), PNF Body composition - diet, aerobic exercise, and counseling Cardiorespiratory fitness - type of rhythmic, large muscle activity, continuous or discontinuous (intermittent)

14. R - Rate of Progression Three stages of progression 1) initial conditioning (4 to 6 weeks) 2) improvement conditioning (5 to 6 months) 3) maintenance

15. Cardiovascular/Aerobic Endurance Considerations: Modality (high impact or low?) VO2max or MET’s? Metabolic Equivalents are easier to understand and comprehend 1 MET equals 3.5 ml*kg*min, the amount of energy expended at rest MET’s can be used for assessment and prescription

16. MET’s, RHR’s, MHR’s, THR’s Good fitness = performing at an 11 MET level or appx 40 ml*kg*min VO2max RHR - resting heart rates newborn 110-200 1 to 24 months 100-200 2 to 12 years 80-150 13 years/older 60-100 RHR can be used for assessment or evaluation

17. MET’s, RHR’s, MHR’s, THR’s MHR’s - maximum heart rate Calculated by 220-age in years Use MHR to determine target heart rate or THR THR 60-90% of max For persons with low fitness, 55-70% THR is recommended Approximately a THR of 110 (55% of 200) is appropriate for initial conditioning stage

18. Factors that can cause higher HR Heat Humidity Stress Medications Overweight Heart Conditions Infections with fever

19. Factors that can cause lower HR Paralysis amputations Heart conditions ANS damage Medications

20. Aerobic Exercise Plan THR’s and use of RPE’s Key Points: Low-impact Continuous For Addressing HR factors Use of RPE scale can be very beneficial 6-20 corresponds to HR (11-16 training range) Increase intensity gradually so that discomfort is minimal

21. Body Composition Genetics? Exercise and nutrition play critical roles Better indication of wellness than overall weight Key factor for individuals with disabilities

22. Body Composition Determined by: skin fold calipers hydrostatic weighing bioimpedence MRI Average percentages 18-30% for women 10-25% for men

23. Body Composition Body Mass Index (BMI) - alternative measure ratio of body weight to the square of body height BMI = Body weight Height(2) Reduction of Fat loss - 2 factors aerobic conditioning (FITMR) nutrition (P,F,C)

24. Muscular Strength/Endurance Assessment principle of specificity Choices must be made about most important muscle groups to test abdominal (bent-knee sit-ups) upper arm/shoulder (pull-ups/push-ups) hip/thigh (jump or sprint)

25. Muscular Strength/Endurance Exercises At least 2 days a week Games and activities can facilitate Principle of overload Strength/endurance can be developed by isotonic (eccentric / concentric) isometric (no movement, but contraction) isokinetic (constant resistance machines) Most common - use of weights

26. Muscular Strength/Endurance Use of machines, various objects, and activities---- CREATIVITY! Contraindications Valsalva Effect increase in pressure (intraabdominal and intrathoracic) slower HR, decrease blood to heart, increase blood pressure Breath holding can lead to ruptured tissues, (abdominal region) hernias, eyes

27. Flexibility ROM is measured with a goniometer CP, MD, arthritis, paralysis- ROM needed almost everyday Proprioceptive Neuromuscular Facilitation (PNF) Sit-and-reach test used for assessment

28. Flexibility Considerations Purpose maintain elasticity warm-up and cool-down correct pathological tightness Static versus Ballistic Seconds to hold stretch? Key areas: lower back, hamstrings, and ?

29. Specific Considerations Severe Developmental Disabilities Instructional Strategies/Considerations Typically, rely on caregivers Full physical assistance Goals: ROM to prevent contractures and stimulate CNS integration functional ability to perform movement patterns exercise capacity tolerance

30. Specific Considerations Spinal Paralysis Instructional Strategies/Considerations Postural fitness: imbalances is strength and flexibility cause postural deviations, mechanical inefficiencies, coordination, control, and balance problems Weight control and aerobic endurance Strength*

31. Spinal Paralysis * Associated with ROM: 5 normal, full ROM full resistance 4 good, full ROM moderate resistance 3 fair, full ROM only 2 poor, full ROM with positional mod. 1 trace, contraction can be seen, no movement gravity eliminated 0, zero, complete paralysis Used in sport classification for SCI

32. Specific Considerations Other Health Impairments Instructional Strategies/Considerations Low MET classification by ACSM *Usually are not aware of low level of fitness until brought to attention Weight control and aerobic endurance

33. Specific Considerations Limited Mental Function Instructional Strategies/Considerations weight control and cardiorespiratory endurance partner or role model to set pace play and game behaviors related to fitness for ecological validity