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STARTING AN EXERCISE PROGRAM

STARTING AN EXERCISE PROGRAM. Mary Ann Burke, P.T., M.S., G.C.S. BENEFITS OF EXERCISE. Weight Control Combat Health Conditions & Disease Improve Psychological Well-Being Boost Energy Improve Sleep. WEIGHT CONTROL. Non-Dieting/Overweight Controls gained weight

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STARTING AN EXERCISE PROGRAM

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  1. STARTING AN EXERCISE PROGRAM Mary Ann Burke, P.T., M.S., G.C.S.

  2. BENEFITS OF EXERCISE Weight Control Combat Health Conditions & Disease Improve Psychological Well-Being Boost Energy Improve Sleep

  3. WEIGHT CONTROL • Non-Dieting/Overweight • Controls gained weight • Low-amount exercise groups lost weight/fat • High-amount exercise group lost more of each in a dose-response manner Slentz CA, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE-a randomized controlled study. Arch Intern Med 2004 Jan;164(1):31-9

  4. BLOOD PRESSURE • A single episode of exercise reduces BP in hypertensive subjects • Regular aerobic exercise reduces BP in hypertensive subjects. • No proof of resistance training reducing BP Cardoso, CG, et al. Acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure in normotensive and hypertensive subjects. Clinics 2010 Mar;65(3):317-25

  5. TYPE 2 DIABETES Structured interventions combining exercise and weight loss have been shown to lower type 2 diabetes by up to 58% in high risk populations. Most benefits of physical activity on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. Colberg SR, et al. Exercise and type 2 diabetes. Diabetes Care 2010 Dec;33(12):e147-67

  6. CANCER 66% of cancer mortality in the USA can be linked to tobacco use, poor diet and lack of exercise. Moreover, only 5-10% of most types of cancer are caused by defects in single genes that run through families, and only a similar small percentage are because of occupational and environmental factors. Havard Report on Cancer Prevention. Vol. 1: Causes of Human Cancer. Cancer Causes Control 1996

  7. CANCER • Mounting evidence indicates that exercise may significantly reduce the risk of some cancers. • The strongest evidence comes from research on colon cancer, where physical activity has been shown to reduce the risk by up to 50%. Shepard RJ & Shek PN. Associations between physical activity and susceptibility to cancer. Sports Med 1998;26:293-315.

  8. OSTEOPOROSIS A number of studies with postmenopausal women have shown that exercise can increase bone density or prevent further bone loss when compared to non-exercise controls. Dalsky GP, Stocke KS, & Ehsani AA, et al. Weight bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med 1988;108:824-28.

  9. IMPROVE PSYCHOLOGCAL WELL-BEING Exercise is a lifestyle that leads to improved physical and mental health throughout life. Hillman CH, et al. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci 2008 Jan;9(1):58-65

  10. DEPRESSION Although antidepressant medication may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment, exercise was equally effective in reducing depression among patients with major depressive disorder. Blumenthal JA, et al. Effects of exercise training on older patients with major depression. Arch Intern Med. 1999 Oct 25;159(19):2349-56.

  11. MEMORY Study on 120 older adults, half of whom started a program of moderate aerobic exercise. After 1 year, MRI scans showed that the brains of subjects who exercised increased their volume, while non-exercising subjects brains lost up to 1.5% of their volume. Further testing showed that increased brain volume translated into better memory. NPR Report of a study by researcher Art Kramer.

  12. BOOST ENERGY Sedentary people who completed a regular exercise program reported improved energy levels compared to groups that did not exercise. Puetz T. News release of a study review from the University of Georgia, 2006.

  13. IMPROVE SLEEP Exercise is a healthy, safe, inexpensive, and simple means of improving sleep. Youngstedt SD. Effect of exercise on sleep. Clin Sports Med 2005 Apr;24(2):355-6

  14. DEFINITIONS • Aerobic/Cardiovascular Activity • Exercises that speed up breathing and heart rate • Running, Cycling, Walking, Swimming, Dancing • Typically performed for long durations

  15. Definitions • Heart Rate (HR) • Measured in beats per minute (BPM) • Rate of Perceived Exertion (RPE) • A measure of how hard you’re working • Rated on a Borg Scale

  16. Borg Scale • 6 – 20% effort • 7 – 30% effort – Very, very light (Rest) • 8 – 40% effort • 9 – 50% effort – Very light (Gentle walking) • 10 – 55% effort • 11 – 60% effort • 12 – 65% effort • 13 – 70% effort – Somewhat hard – steady pace • 14 – 75% effort • 15 – 80% effort – Hard • 16 – 85% effort • 17 – 90% effort – Very Hard • 18 – 95% effort • 19 – 100% effort – Very, very hard • 20 - Exhaustion

  17. Definitions • Flexibility Training/Stretching • Enhances range of motion of joints

  18. DEFINITIONS • Strength/Resistance Training • Improve strength and function of muscles • Weight lifting, Resistance bands • Body weight (push-ups, squats) • Set • Repeating the same exercise a certain # of times • Repetition • Number of times an exercise is performed during a set

  19. DEFINITIONS • Warm Up • Preparing for the stress of exercise • Light intensity aerobic activity • Increase blood flow and heat up muscles • Cool Down • Less strenuous exercise after more intense workout • Slow down breathing and heart rate • Stretching

  20. BASIC TRAINING GUIDELINES(ACSM/Centers for Disease Control and Prevention) • Warm Up • Reduce the risk of injury • 10-15 minutes • All major joints and muscles should be engaged • Walking, stretching, calisthenics

  21. BASIC TRAINING GUIDELINES(ACSM/Centers for Disease Control and Prevention) • Aerobic Training • Frequency: 4-7 days/week • Intensity: RPE 12-14 • Duration: 10-60 minutes • Mode: Aerobic activities • Progression: • Phase 1: 6 weeks, low intensity • Phase 2: 6 months, gradual increase • Phase 3: Maintenance

  22. BASIC TRAINING GUIDELINES(ACSM/Centers for Disease Control and Prevention) • Strength Training • Frequency: 2-3 days/week • 48 hrs of rest between • Intensity: RPE of 12-14 • Repetitions: 15 • Sets: 1-3 • Rest: 90-120 seconds between sets • Progression: RPE of 12-14 • reassessed every 2-4 weeks

  23. BASIC TRAINING GUIDELINES(ACSM/Centers for Disease Control and Prevention) • Flexibility Training • Frequency: 2-7 days/week • Intensity: Range gently increased in each position • Mild muscular tension, not pain • Duration: Position held for 5-40 sec • Repetitions: 1-5 per stretch • Progression: Develop fuller ranges naturally with time and practice

  24. BASIC TRAINING GUIDELINES(ACSM/Centers for Disease Control and Prevention) • Cool Down • Reduce the risk of injury • 10-15 minutes • Slowed down movements • Continue until heart rate is < 100 bpm

  25. LAND BASED EXERCISE PROGRAMS • Gym Programs • Aerobic and strengthening equipment • Exercise classes • Areas for stretching • Trainers

  26. LAND BASED EXERCISE PROGRAMS • Home • Exercise Equipment • Treadmill • Stationary Bike • Weights • Exercise Ball • DVD’s • Walking • Biking • Hiking

  27. POOL EXERCISE PROGRAMS • Aqua-kinetics/Aqua-aerobics • Group exercise • Swimming

  28. FIVE TIPS TO HELP YOU GET STARTED

  29. 1. Assess Your Fitness Level • Consult with your physician • Record Baselines • Heart rate before and after walking 1 mile • Time to walk 1 mile • # of push-ups • Forward reach • Waist circumference • Body Mass Index (BMI)

  30. 2. Design Your Fitness Program • Set goals • Balanced routine • Aerobic activity • 150 minutes of moderate intensity or 75 minutes of vigorous activity per week • Strength training • 2 or more days/week • Go at your own pace • Schedule time

  31. 2. Design Your Fitness Program • Include different activities • Keep boredom at bay • Decrease risk of injury • Emphasize different body parts • Allow time for recovery • Put it on paper

  32. 3. Assemble Your Equipment • Athletic shoes • Pick shoes designed for the activity in mind • Pick shoes that are right for your foot • Choosing Equipment • Practical • Enjoyable • Easy to Use

  33. 4. Get Started • Start slowly, build gradually • Warm up and cool down • Speed up to a pace you can continue for 10 min • Gradually increase amount of time • Work up to 30-60 min of exercise • Break things up • Shorter but more frequent exercise has aerobic benefits too

  34. 4. Get Started • Be Creative • Include various activities (walking, cycling, rowing) • Take a weekend hike • Evening dancing • Listen to your body • If you feel pain, shortness of breath, dizziness, nausea, take a break • Be flexible • Give yourself permission to take a day off

  35. 5. Monitor Your Progress • Reassess • 6 weeks after you start • Every 3-6 months • You may need to increase exercise time to keep making fitness gains

  36. SAFETY!!! • Don’t over exert yourself • 4-6 weeks of light intensity, then increase • Develop the habit • Develop a schedule and stick to it • Make adjustments • Listen to your body • If you feel pain, shortness of breath, dizziness, STOP. • Moderately challenging but tolerable

  37. Common Exercise Injuries Shoulder Pain/Rotator Cuff Tendonitis Discrepancy between overworking the power muscles of the shoulder at the expense of the smaller rotator cuff muscles Chest and incline press Overhead press Lateral raises

  38. Common Exercise Injuries Back and Neck Pain Improper weight lifting technique Overloaded compressive forces Weak musculature Poor posture Jarring activities Exercises that compress the spine Flexion/extension machines

  39. Common Exercise Injuries Elbow Pain/Golfer’s Elbow/Tennis Elbow Gripping & pulling a load that is too heavy Improper lifting technique (wrist motion) Cable pull downs Rows Biceps curls Triceps extension

  40. Common Exercise Injuries Plantar Fasciitis/Achilles' Tendinitis Improper foot wear Weak hip musculature Over training Running Inclined Walking/Hiking Jumping

  41. Common Exercise Injuries Knee Pain Anterior knee pain Tendinitis Meniscus tear Arthritis Deep squats Knee extension Bias toward quadriceps strengthening Neglecting hamstrings and hip abductors

  42. Treatment Strategies for Minor Injuries Decrease exercise intensity Make sure all 3 components are present Cardiopulmonary Strengthening Flexibility

  43. Treatment Strategies for Minor Injuries Ice affected area 10-15 min/2-3 x day If swelling is involved…RICE Rest Ice Compression Elevation

  44. Treatment Strategies for More Severe Injuries Physician Physical Therapist Orthopedic Specialist

  45. HAVE FUN!

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