ACE Personal Trainer Manual, 4 th edition Chapter 13: Mind-Body Exercise

1. ACE Personal Trainer Manual, 4th edition Chapter 13: Mind-Body Exercise 1

2. Learning Objectives • This session, which is based on Chapter 13 of the ACE Personal Trainer Manual, 4th ed., reviews many of the popular forms of mind-body exercise and offers practical suggestions for how trainers can incorporate mind-body techniques into training sessions. • After completing this session, you will have a better understanding of: • The neurological foundations of mind-body exercise • The classical forms of mind-body exercise—yoga, tai chi, and qigong • The roots of contemporary forms of mind-body exercise, including Pilates and Nia • The role of mind-body exercise in chronic disease management • The general precautions associated with each of these types of exercise

3. Introduction • Any form or level of physical activity can be “mind-body.” • Mind-body exercise is physical exercise executed with a profound inward mental focus. • Regular participation in mind-body exercise has been associated with: • Improved muscular strength, flexibility, balance, and coordination • Increased mental development and self-efficacy

4. Neurobiological Foundations of Mind-body Exercise • Muscle afferents have direct access to mechanisms of perception. • Projections of the muscle afferent pathways to the cortex • Muscle fiber–brain pathways are involved in affective responses to muscular contraction. • The hypothalamus–pituitary CRH interface is truly the consummate “mind-body connection.”

5. Roots of Contemporary Mind-body Exercise Programs • The Asian yoga and tai chi disciplines are at the root of most contemporary mind-body exercise programs. • Yoga • A complex system of physical and spiritual disciplines that is fundamental to a number of Asian religions • Tai chi • Derived from the practice of qigong (also called chi kung) • Best described as a moving meditation

6. Differentiating Characteristics of Mind-body Exercise • Mind-body exercise is attentive to the present moment and is process-oriented. • Mind-body exercise generally relies on self-monitoring of perceived effort, breathing, and nonjudgmental self-awareness. • Conventional aerobic and resistance-training programs can manifest mind-body qualities. • Mind-body exercise can assist in the management of a number of chronic diseases, including: • Cardiovascular disease (CVD) • Diabetes • Arthritis

7. Benefits of Mind-body Exercise • Hatha yoga has been helpful in improving: • Arthritis • Asthma • Low-back pain • Postural problems • Tai chi has been helpful in improving: • Anxiety • Blood pressure • Depression

8. Common Components of Mind-body Exercise Programs • Meditative/contemplative • Proprioceptive and kinesthetic body awareness • Breath-centering or breathwork • Anatomic alignment or proper choreographic form • Energycentric

9. Yogic Breathing • Yogic breathing training (pranayama) • The practice of voluntary breath control, consisting of conscious inhalation, retention, and exhalation • The fundamental purpose of breathwork is to develop the ability to: • Sustain relaxed attention to the flow of the breath • Refine and control respiratory movements • Integrate awareness and breathing to reduce stress and enhance psychological functioning

10. General Precautions With Hatha Yoga Programs • Hemodynamic and cardiac ventricular responses • Those who are initially deconditioned or have a chronic disease should: • Minimize acute rapid changes in body position in the early stages of hatha yoga training • Use slower transitions from one yoga pose to the next • Ashtanga, Iyengar, and Bikram yoga asanas and sequences are appropriate for higher-functioning clients. • Clients with cardiovascular or pulmonary disease should avoid breath retentions and breath suspensions.

11. Qigong Exercise • Qigong is a system of self-healing exercise and meditation that includes healing: • Postures • Movement • Visualization • Breathwork • Meditation • There are two general categories of qigong: • Active, or physical, qigong exercise (dong gong) • Tranquil, or passive, qigong (jing gong) • Many qigong styles are named after animals whose movements they imitate.

12. Tai Chi • Tai chi chuan is a complex martial arts choreography of 108 flowing graceful movements. • It is commonly accepted that all tai chi styles follow three similar essential principles: • Major distinguishable styles of tai chi: • Original Chen style • Yang style • Chang style • Wu style • Sun Style

13. Contemporary Mind-body Exercise Programs • Pilates • A form of movement re-education in which the exerciser learns to overcome faulty compensatory movement patterns • Alexander Technique • Corrects unconscious habits of posture and movement that may be precursors to injuries • Feldenkrais Method • Awareness Through Movement (ATM) and Functional Integration • Combination of verbal direction and manual-contact techniques to enhance kinesthetic awareness and coordination • Nia • Classes blend movements and concepts from a variety of mind-body programs • Includes a moderate-level aerobic component that fosters spontaneity • Native American and Alaskan Spiritual Dancing • Ethnic mind-body routines that integrate nature into the movements

14. Assessing Outcomes • There are a variety of methods, other than muscular strength and flexibility measures, available to objectively measure the response to mind-body exercise. • Quality of life • Blood pressure • Pulmonary function • Balance control • Anxiety and tension • Spirituality

15. Quality of Life and Blood Pressure • Quality-of-life measures are reasonably well suited for characterizing the overall functional response. • www.qmetric.com • Blood pressure • Baseline and serial resting blood pressure measurements after four to six weeks of mind-body exercise are appropriate outcome measures.

16. Pulmonary Function and Balance Control • Pulmonary function measures • FEV1 (maximum forced expiratory volume in one second) is a valid assessment outcome when baseline FEV1 is less than 80%. • Balance control • Balance assessment is appropriate for evaluating the response to mind-body exercise programs in which balance control is a primary component.

17. Anxiety and Spirituality • Anxiety measures • May be helpful in evaluating stress and tension • The Spielberger State Trait Anxiety Inventory (STAI) assesses anxiety-proneness (trait) and the current level of anxiety (state). • The STAI Computer Program is an inexpensive administration and scoring program that is an alternative to paper-and-pencil versions. • www.mhs.com • Spirituality • Spirituality assessment tools may be used before and after a period of mind-body exercise training. • Brief Serenity Scale • Mindful Attention Awareness Scale • Spirituality Index of Well-Being

18. Indications for Mind-body Exercise • Two key considerations for selecting mind-body exercise for clients with chronic disease management: • Only use forms where the intensity of effort begins with very low physical effort and can be graduated slowly. • Only those with stable chronic disease states should consider mind-body exercise. • Characteristics of mind-body exercise programs that are helpful for those with stable chronic disease include: • Can be taught at a relatively low-intensity level and can be individualized • Decrease real-time cognitive arousal and stress hormone activation • Enhance proprioception and kinesthesis • Can improve muscular strength, posture, and balance • Can improve self-efficacy and confidence

19. Personal Trainers and Mind-body Exercise • Personal trainers can teach a client to use two mind-body techniques that are the focuses of nearly all stress-reduction programs: • Sustained attention to the present • Internal awareness • Meditation and yogic-breathing exercises can be integrated with existing warm-up and cool-down exercises. • Personal trainers can incorporate muscle sense and breathing work into the aerobic phase of an exercise session. • Personal trainers can incorporate select yoga poses into the flexibility and strength-training components of the program. • The popular tree pose can be included as part of a circuit of exercises to help stimulate balance control. • Diaphragmatic breathing work can be presented to clients, many of whom will find it very therapeutic.

20. Summary • Mind-body exercise continues to emerge as an effective fitness and health-enhancement modality. • This session covered: • Neurobiological foundations of mind-body exercise • Roots of contemporary mind-body exercise programs • Differentiating characteristics of mind-body exercise • Benefits of mind-body exercise • Mind-body exercise modalities and programs • Contemporary mind-body exercise programs • Assessing outcomes • Indications for mind-body exercise • Personal trainers and mind-body exercise