Blake Vajgrt. HHP 312 Exercise Prescription. April 23, 2012

Transcription

1 Blake Vajgrt HHP 312 Exercise Prescription April 23, 2012 Hansen, E., Landstad, B., Gundersen, K., Torjesen, P., & Svebak, S. (2012). Insulin sensitivity after maximal and endurance resistance training. Journal of Strength and Conditioning, 26(2),

2 In the gym, an exerciser will put in the work and effort to attain the results him/her is trying to reach. The work in the weight room can only go so far without the help of internal factors. Sleep, proper nutrition, and most importantly, hormones are needed to get the look and performance a client is wanting. Hormones cause the body to regulate its cellular processes and functions. Testosterone, estrogen, insulin, and glucagon are common hormones discussed in any physiology course covering the endocrine system. The role these hormones play in exercise response is not often covered in basic physiology course, but without them, the hard work of any exerciser would be worthless. Insulin is a hormone secreted by the beta cells of the Pancreas. It is the antagonist of the hormone glucagon. It causes body cells to store glucose in the form of glycogen. Insulin is the key director of all absorptive process in the body (Marieb & Hoehn, 2007). It is released by the Pancreatic Islets in response to raises in blood glucose and amino acid levels in the body. Insulin binds to cells and enhances active diffusion of glucose and amino acids, in turn it ramps up the protein synthesis rate in the body, and stops catabolism of amino and fatty acids (occurring through gluconeogensis) (Marieb & Hoehn, 2007). For these reason, many professionals and athletes in the exercise fields regard insulin as equal or second to testosterone. Type I diabetes is an autoimmune disease that attacks beta cells and destroys the body s ability to secrete insulin (Marieb & Hoehn, 2007). Type II diabetes occurs when down regulation occurs by the body s cells, which decreases the amount insulin receptors in the plasma membrane of cells (Marieb & Hoehn, 2007). Down regulation in a type II diabetes patient, occurs from prolonged levels of glucose in the blood stream from excess sugar in the diet or obesity. Diabetes results in hyperglycemia, and causes normal fasting reactions (gluconeogensis, lipolysis, and glycogenolysis) to occur adding to the increase of glucose in the blood stream.

3 Insulin is in the running for Most Valuable Player of hormone for anyone wants to make gains from exercise. Impairment of insulin release and uptake can hinder anyone from progress, and more people need to be educated on how this hormone works. The clinical population and research to follow is important to me because I have interest in the endocrine system. Mastering the functions of insulin and testerone can set any person ahead in their exercise program. By looking at research that investigates the response in the body s sensitivity to insulin after exercise, I can gain practical information to apply to my own and my clients training. The participants in the research study were all classified as suffering from Impaired Glucose Tolerance and at risk for developing Type II diabetes (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). There were eighteen subjects (4 men and 14 women) were who split into two groups. The males and females were randomly split up between two groups (two males and seven females per group). At post intervention measurement, 2 subjects from group two dropped out of the study. The mean ages of the males and females in-group one are 47.5 and 46.5 respectively (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). The mean ages of the males and females in-group two are 60.5 and 44.4 respectively (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Clinical measurements of height, weight, waist circumference, venous blood samples (measuring insulin, glucose, 2-hour delayed glucose and C-peptide levels in the blood). All participants were classified as overweight, with some in the obese category according to BMI. Group One had a mean BMI of and a standard deviation of 4.3, group Two had a mean BMI of and a standard deviation of 4.2 (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). All participants were labeled as sedentary, after not have participating in exercise for the previous six months (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Group

4 one had mean and standard deviation of fasting glucose, insulin, and C-peptide levels of 5.40 mmol/l and 0.75, 60 and 54 pmol/l, and 842 pmol/l and 349 respectively (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Group two had mean and standard deviation of fasting glucose, insulin, and C-peptide levels of 5.29 mmol/l and 0.60, 49 and 32 pmol/l, and 804 pmol/l and 330 respectively (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). C- peptide is protein that is linked to insulin when it is produced. It is used a marker for the levels of insulin in the body, but does not affect blood glucose levels (Thompson, 2012). Exercise and physical activity can lessen the symptoms of people suffering from type II diabetes and can delay or halt the onset of those at risk of developing type II diabetes (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Glucose is used by the muscle cells through glycolysis to produce ATP for muscular contractions. The uptake of glucose by active muscle cells can decrease elevated blood glucose levels present in pre-diabetic or diabetic patients (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Resistance Training may help improve glucose tolerance, although the research is undecided as to how effective resistance training works (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). The researchers of this study believed that resistance training can improve insulin sensitivity and glucose tolerance in individuals. The intent of the research was to determine whether Maximal Resistance training or Endurance Resistance Training were more effective in lessening insulin and glucose related problems in the body. Maximal resistance training involves a high workload with few repetitions and sets, while endurance resistance training involves low workload with high reps and three sets with little rest (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). The researchers used the Bernstein hypothesis to formulate their procedures. The Bernstein hypothesis states that strenuous (maximal) resistance exercise improves insulin

5 sensitivity through anaerobic conditions in the muscle cell (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Participants completed three weeks of technical instruction of the exercises that would be performed in the experiment, and told to avoid alcohol, heavy exercising, heavy meals, smoking, coffee, tea, and large amounts of sugar before working out. Group one in the experiment performed eight exercises of maximal resistance training according to Bernstein s inverted pyramid program. Eight exercises of three to four repetitions with 60-85% of 1RM, three days a week for four months. The endurance resistance-training group performed 45-65% of one RM for repetitions over three sets with seconds in between (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). The muscles targeted were abdominal muscles, lower back, thighs, legs, chest, triceps, upper back, and biceps (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Here is a table of the total pre intervention and post intervention scores of fasting glucose, 2 hour delayed glucose, insulin, and C-peptide levels in the blood. Group One Test Pre Intervention Post Intervention Fasting Glucose (mmol/l) 5.40 ± ± hour delayed glucose (mmol/l) 8.11 ± ± 2.50 Insulin (pmol/l) 60 ± ± 46 C peptide (pmol/l) 842 ± ± 369 Group Two Test Pre Intervention Post Intervention Fasting Glucose 5.23 ± ± hour delayed glucose 6.91 ± ± 1.21 Insulin 49 ± ± 32 C peptide 804 ± ± 304

6 Participants were chosen due to their status as impaired glucose tolerant patients. They had no history of insulin resistance, dysfunctional insulin sensitivity or beta cell function. Maximal resistance training initially improved insulin resistance (by decreasing resistance), but had no effect on insulin sensitivity or beta cell function (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). It also decreased 2 hour delayed glucose levels in the blood, which resulted from enhanced glucose uptake (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Endurance resistance training had a great affect on insulin resistance and sensitivity, and beta cell function. Endurance resistance training reduced blood levels of insulin, decreased insulin resistance and increased sensitivity, and increased beta cell function (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Both resistance training protocols improve insulin resistance; however, endurance resistance training improves additional aspect regarding the body s response to insulin. Resistance training is shown to help improve insulin resistance. For people at risk of type 2 diabetes, this is welcomed news. Both endurance and maximal resistance training can improve insulin resistance (Hansen, Landstad, Gundersen, Torjesen & Svebak, 2012). Endurance resistance training also improves insulin sensitivity. If a patient is look to improve insulin sensitivity and resistance, they should perform endurance resistance training. If I patient would like to decrease insulin resistance and improved glucose uptake and tolerance they should perform maximal resistance training. Sample Program: Monday: Resistance Training- Leg Press 3 x 15 with 45 seconds rest Lat Pulldowns 3 x 15 with 45 seconds rest Chest Press 3 x 15 with 45 seconds rest Step Up 3 x12 with 45 seconds rest

7 Chest Supported Machine Row 3 x 15 with 45 seconds rest Alternating Lunges 3 x 15 with 45 seconds rest Planks 3 x 45 second repetitions Single Legged Glute Bridges 3 x 15 with 45 seconds rest Aerobic Training- Swimming, 20 minutes with a recommended intensity of 14 but a range of 12 to 16 on the Borg Scale Tuesday: Aerobic Training- Water aerobics, 20 minutes with a recommended intensity of 14 but a range of 12 to 16 on the Borg scale Wednesday: Resistance Training- Leg Press 3 x 15 with 45 seconds rest Lat Pulldowns 3 x 15 with 45 seconds rest Chest Press 3 x 15 with 45 seconds rest Step Up 3 x12 with 45 seconds rest Chest Supported Machine Row 3 x 15 with 45 seconds rest Alternating Lunges 3 x 15 with 45 seconds rest Planks 3 x 45 second repetitions Single Legged Glute Bridges 3 x 15 with 45 seconds rest Aerobic Training- Swimming, 20 minutes with a recommended intensity of 14 but a range of 12 to 16 on the Borg Scale Thursday: Rest Friday: Resistance Training- Leg Press 3 x 15 with 45 seconds rest Lat Pulldowns 3 x 15 with 45 seconds rest Chest Press 3 x 15 with 45 seconds rest Step Up 3 x12 with 45 seconds rest Chest Supported Machine Row 3 x 15 with 45 seconds rest Alternating Lunges 3 x 15 with 45 seconds rest Planks 3 x 45 second repetitions Single Legged Glute Bridges 3 x 15 with 45 seconds rest Aerobic- Water aerobics, 20 minutes with a recommended intensity of 14 but a range of 12 to 16 on the Borg scale Saturday: Aerobic- Stationary Bike ride for 30 minutes with a recommended intensity of 12 but a range of 12 to 16 on the Borg Scale Sunday: Rest The participants in this study have gone through four months of resistance training programming. They are no longer classified as sedentary, but a general aerobic base will be added to their programming before they become involved in any interval or higher intensity training. The program includes RPE on the Borg scale for intensity because heart rate maybe be a faulty measurement of intensity for diabetic patients. The subjects will stay under the supervision of personnel so their response to aerobic work can be monitored. They will continue

8 to perform endurance resistance training due to the enhance insulin sensitivity and resistance benefits from the training protocol. The program includes two pulling exercises out of personal preference and the need to get the world out of scapular protraction. Balance is a good thing in resistance training programs, however many individuals sit behind a computer desk, hunched over the key board all day, more pulling exercises are need to return the scapula to neutral position.

9 Hansen, E., Landstad, B., Gundersen, K., Torjesen, P., & Svebak, S. (2012). Insulin sensitivity after maximal and endurance resistance training. Journal of Strength and Conditioning, 26(2), Marieb, E., & Hoehn, K. (2007). Nutrition, metabolism, and body temperature regulations. In S. Beauparlant (Ed.), Human Anatomy & Physiology (pp ). San Francisco: Pearson Benjamin Cummings. Thompson, E. (2012, July 10). C-peptide. Retrieved from