Session 2-Part 1: Specific Components for Designing Exercise Prescriptions

Transcription

1 Session 2-Part 1: Specific Components for Designing Exercise Prescriptions Course: Designing Exercise Prescriptions for Normal/Special Populations Presentation Created by Ken Baldwin, M.ED, ACSM-H/FI Copyright EFS Inc. All Rights Reserved.

2 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

3 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

4 Influence of Gender, Initial Fitness Level, and Genetics Men and women respond similarly to training programs Training improvement is always greater in individuals with lower initial fitness Genetics plays an important role in how an individual responds to training

5 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 stretching Light exercise and stretching performed at beginning and end of exercise session

6 Training Principles Overload Increased capacity in response to training overload Specificity Specific muscle involved Energy systems that provide ATP Reversibility When training is stopped, the training effect is quickly lost

7 Specific Components of Exercise Prescription General: Taking objective measurements prior to program and throughout program are crucial Define program around client goals "Stages of Change" Questionnaire responses Initial intake form and clients short and long-term goals

8 5-Step Approach to Designing a Specific Exercise 1. Identify the component and training method What are client's goals? What type of training will you do to accommodate these goals? 2. Target the muscle(s) What muscle (s) do you need to focus on to achieve the client's goals 3. Determine the appropriate joint movements or positions What types of movements? 4. Design and/ or modify What specific exercise? 5. Finish with a safety check Check your design for safety high risk, potential for overuse, and then proper execution

9 Specific Components to Consider when Prescribing an Exercise Program 1. Mode: Type of exercise, and type of mechanism Resistance: Isometric (no change in muscle length) versus dynamic (concentric - shortening of muscle) or eccentric (lengthening of muscle), constant resistance versus variable resistance, isoinertial versus isokinetic Cardiovascular: various mechanisms - bike, walk, swim, run, stairs, aerobics class, etc Flexibility Posture/ Alignment Balance/ Coordination

10 Specific Components to Consider when Prescribing an Exercise Program 2. Intensity: Degree of overload that a muscle/system encounters during exercise Cardiovascular: 60 90% of max HR; 50 85% of VO2 max Resistance: 6 20 repetitions, beginning at 30-60% of peak strength Volume: Total amount of exercise at each training session Cardiovascular: minutes Resistance: 1-6 sets per muscle group

11 Specific Components to Consider when Prescribing an Exercise Program 3. Progression: Increase overload stimulus to muscle / system Dependent on your objective measures Resistance: approximately 5% increase in weight at next training session when client exceeds prescribed # of reps Cardiovascular: enough to maintain prescribed training heart rate 4. Frequency: Number of training sessions per week Recommended: 2-6 times per week; dependent on condition, muscle group, system Frequency may vary dependent on stage

12 Specific Components to Consider when Prescribing an Exercise Program 5. Duration: Length of a training program Initial Stage: 4-5 weeks Improvement Stage: 6-27 weeks Maintenance Stage: weeks minimum for resistance program to see morphological changes in muscle 0-12 weeks - primarily neural changes 12+ weeks - primarily morphological (hypertrophy) NOTE: Frequent changes and variety in all components of exercise are recommended for optimal gains

13 The Exercise Dose Intensity Percent VO 2max or VO 2 reserve Percent maximal HR or heart rate reserve Rating of perceived exertion Lactate threshold Frequency Number of days per week Number of times per day Duration Number of minutes of exercise Total kcals expended Total kcals per kg body mass

14 The Dose-Response Relationship for Exercise

15 The Dose-Response Relationship for Physical Activity

16 Optimal Training Intensity, Duration, and Frequency

17 Exercise Progress Report Particularly important for special populations Send to referring source (eg, physician, physical therapist, etc) after initial session, mid-point, and end-point of program One page to a half-page maximum report to allied health medical professional - keep it simple- or mail Essential Elements of Progress Report: Subjective: Brief history on client and their current symptoms Objective: Objective measures show in table or figure format if possible Assessment: Your assessment of progress to date Plan: What you plan to do

18 Sample Progress Report January 31, 2007 Susan Smith, M.D La Jolla Village Drive La Jolla, CA RE: Debra Jones DOB: 07/27/1961 Dear Dr. Smith, Ms. Jones reported to our facility for personal fitness training for a total of 12 visits between December 5, 2006 and January 20, During this time period, Ms. Jones performed cardiovascular, resistance, and flexibility exercises designed to specifically improve her posture, reduce body fat, increase flexibility, and gain more lean muscle tissue. The values on her body fat percentage have gone from 28% to 22%, overall joint range of motion has improved by 18%, and her posture has improved, reducing her upperback indicated in her initial health/medical questionnaire. Please contact me with any questions. Thanks for referring Ms. Jones to our facility. Sincerely, John Workout