Exercise Prescriptions for Health and Fitness

1. Chapter 16 Exercise Prescriptions for Health and Fitness

2. Physical Activity • Any form of muscular movement • Related to physical fitness • Exercise • A subset of physical activity for the purpose of maintaining or improving physical fitness • Can reduce the risk of death from all causes • Physical inactivity is a primary risk factor for coronary heart disease

3. The Dose-Response Relationship of Drugs

4. Dose-Response Relationship of Drugs (an example) • The effect (response) of the amount of a drug (dose) • Potency – how much an amount can effect • Slope – change in effect from change in dose • Maximal effect – the most it can do • Variability – different for different people • Side effect – other unwanted action

5. The Dose-Response Relationship for Exercise @ 60-70% of max capacity

6. The Dose-Response Relationship for Physical Activity

7. The Exercise Dose – F.I.T. • Frequency • Number of days per week • Number of times per day • Intensity • Percent VO2max or VO2 reserve • Percent maximal HR or heart rate reserve • Rating of perceived exertion • Lactate threshold • Time (duration) • Number of minutes of exercise • Total kcals expended • Total kcals per kg body mass

8. The Response to Exercise • Improving fitness • Thereby improving health • Improving fitness and health • Simultaneously or separately • Improving fitness • But not a specific health outcome • Improving a specific health outcome • But not improving fitness

9. Patterns in the Response to Exercise • Acute responses • Occur within one or several exercise bouts but does not improve further • Rapid responses • Benefits occur early and plateau • Linear • Gains are made continuously over time • Delayed • Occurs only after weeks of training

10. Physical Activity and Health • The benefits of physical activity may be more related to total number of calories expended than exercise intensity • The “Exercise Lite” recommendation “Every U.S. adult should accumulate thirty minutes or more of moderate-intensity (3-6 METs) physical activity on most, preferably all, days of the week.”

11. Benefits of Improving Fitness • In previously sedentary subjects • Small changes in physical activity result in large health benefits with minimal risk • Strenuous exercise • Increases the risk of a heart attack during activity • Reduces overall risk (rest + exercise) • Moderate to high levels of fitness • Reduce the risk of death from all causes

12. General Guidelines for Improving Fitness • Screening • Health status screening (PAR-Q) • Progression • Start with low-intensity exercise (walking) • Then increase duration and/or intensity • Warm-up, cool-down, and flexibility • Light exercise and flexibility performed at beginning and end of exercise session

13. Exercise Prescription for Cardiorespiratory Fitness • 200-300 kcals per session • Considerations • Weight loss • Improved fitness • Injury prevention • Frequency • Intensity • Time (duration)

14. Optimal Training Intensity, Duration, and Frequency

15. Exercise Intensity . • Corresponding to 60-80% VO2max • Target heart rate (THR) range • Direct method • HR at percentage of maximal work rate found during GXT • Indirect method • 70-85% of maximal HR • 60-80% of HR reserve (Karvonen) method

16. Target Heart Rate Range Determined From GXT

17. Sequence of Physical Activity • Walking • Start at a comfortable speed for 15 minutes • Gradually increase duration and speed • Jogging • Start by adding some running when walking • Gradually increase speed/duration of running • Games and sports • Intermittent higher-intensity activities within THR range

18. Strength Training • Muscular strength is an important component of physical fitness • Strength to do everyday tasks • Strength for “extraordinary” tasks

19. Strength Training • Recommendations (health-related) • Dynamic resistance exercises • Full range of motion • 8-10 different exercises • 8-12 repetitions per exercise • Weight that corresponds to 60 - 85% of 1RM • Large muscle groups first • Alternate muscle groups for rest • Progress with success

20. Flexibility • Normal joint Range of Motion (ROM) • Limited by bony structures • Limited by connective tissue • Limited by muscle tension • “Re-set” tension / length • Hyper mobility

21. Flexibility • Training to improve • Principles of exercise apply (O, S, R) • Corollary applies too (consistency) • Training variables apply (F, I, T) • Best done when muscles are “warm” • Best done - not to the point of pain • Best done slowly – static not ballistic

22. Body Composition • What makes up the body? • Water • 99 out of every 100 molecules • Bone • Skeletal, teeth • Protein • Membranes, organs, muscle • Fat • Membranes • Nervous tissue • Pericardial • Intramuscular • Intra-abdominal • Subcutaneous

23. Body Composition • Body fat • Stored carbons • Adipose cells • Increase volume to store carbons • Multiply when they reach a particular size • @ ~ 60 lb fat increase • Do not “un-multiply”

24. Body Composition

25. Body Composition • Estimation vs. Measurement • Hydrostatic weighing • Skin fold calipers • Electrical impedance • Infrared absorbance • Dual X-ray Absorbtometry (DEXA)

26. Body Composition • Energy Consumption vs. Energy Expenditure • Handout

27. Body Composition • 144,000 bariatric surgeries expected in 2004—up from 16,200 in 1992 • Severely obese are increasingly turning to this life-altering measure. • Most lose weight quickly and continue to lose for up to two years. • Also seeing improvements in almost all their obesity-related conditions. • 1 in 100 who have gastric bypass dies • 10 - 20 percent of all bariatric surgery patients require follow-up operations to correct complications. • Almost 30 percent develop nutritional deficiencies, including osteoporosis, anemia, and metabolic bone disease. —Cate Lineberry - National Geographic

28. Remember…….. URWATU8

29. Questions?

30. END