AGREE Flashcards
AGREE goals
- dev SMART goal, and use tools such as first step planner, decision balance, barriers to PA, and alt for action to help clients strat to reach goals
- build a PA/exercise program to meet the goals by including primary prescription principles (overload, progression, specificity, reversibility, and individuality), aerobic training prescription (FITT), res training prescription (FITT), flexibility prescription
AGREE current knowledge and considerations
- client’s strengths, areas needing improvement, personal goals and expectations, level of commitment to change since we want adherance
- begin small and build on success over time, watch for barriers (time, resources), ensure the program is not overwhelming
- make sure there is change talk before proceeding with action plan dev; will be challenged physically and mentally and may be uncomfortable
SMART goals
- Specific well defined clear actions
- measurable as objective and quantifiable so it is known when goal is achieved
- actionable, realistic for the client to do
- relevant, goal must be important and meaningful to client
- timed with est set deadline that is reasonable given goaal
principles of prescription: overload principle
- training stim must be greater than that to which the body is accustomed which will acutely decrease capacity to train but with sufficient recovery will stimulate adaptation to increase baseline capacity
- increase freq, intensity, duration or number of reps/sets in program
- check capabilities with testing for continued progression
principle of prescription: rest principle
- body needs time for adaptive processes to occur so that capacity can improve to higher level prior to overload
- optimum spacing between workouts depends on overall stress of workout (closer to VO2max or 1RM greater rest), type of exercise, current training status (trained more capacity for recovery), fitness level, nutritional status
principle of prescription: reversibility of detraining
discontinuing or lowering intensity or vo will have detraining effect but the losses can be regained by resuming the program
principle of prescription: progression/initial values
initial workload must increase to ensure continued improvement
1. initial conditioning: 4 weeks, low intensity, eases into training, familiarity period, neurological adaptation
2. improvement:2-6 months, more rapid progression, hypertrophy
3. maintenance: long term, can decrease vol since already reached higher level of HBR
principle of prescription: specificity principle
training effects are specific to energy sys that have been utilized, specific muscle groups, joint actions, type of contraction, speed of contraction
principle of prescription: individualization principle
each person has unique response to same training stimulus; response dependent on genetic endowment, biologic age (less adaptation with age), training state (low fitness level respond at higher rate and mag), health status (less adapatation when ill), fatigue (follow proper recovery strat)
reasons to include aerobic prescription
- one of the strongest predictors of health and longevity based on mortality rates for various risk factors; fitter people are less likley to die from risk factors and live longer
- foundation of a well-balanced training program; determines CV function, work together with resistance to increase muscle mass for greater overall fitness
- Canadian 24 hour movement guidelines, 150+ mins mod to vig PA and several light PA/ADL to break up sedentary behaviour
aerobic training variables
1. considerations
2. FIIT
3. prescribing activity
- why is client exercising, what is client’s goal, how much time do they have available and design program accordingly
- frequency (sessions/week), intensity (%HRR, %HRmax, RPE, speed, time), time (duration of session), type (mode and structure)\
- use prescription card table summarizing FIIT with warm-up and cool-down
warm up
5-10 mins, low intensity to transition the heart and respiration rates to req intensity, dynamic movements at lower intensity/res mimicking exercise to be down
cool-down
2-10 mins, reduce intensity to allow physiologic varibales to gradually safety return to normal levels, add flexibility to end of cool down
prescribing type of exercise
is mode of activity, consider:
1. skill required
2. effort involved
3. fitness level of client
4. weight-bearing nature (depending on client’s fitness level, physical condition)
5. interest of the client
6. access to equipment and facilities
4 categories of CV activities
- walking, cycling, and aqua-aerobics are low to mod intensity continuous, req minimal skill and fitness
- jogging, running, rowing, spinning, and stepping are mod to vig continuous, req minimal skills and basic fitness
- cross-country skiing, swimming, and skating are mod to vig, req level of skill to activity constant intensity, req acquired skills and baseline fitness
- recreational sports req mod fitness and acquired skills to handle the vigorous and variable nature of the workload (consider how to monitor and stick to intensity due to variable nature)
CPT methods of intensity prescription for aerobic exercise: HR
1. HRmax
2. HRR
- not very practical for all activities and can over or underestimate HRmax due to individual differences using the predicted HRmax but is convenient, HRmax accurate at high intensity (85-100 HRmax; 64-76% is mod) but not low
- difference between HRmax and rest for a training intensity range within 10% of each other (intensity * (HRmax-rest) + HRrest)
CPT methods of intensity prescription for aerobic exercise: %VO2R
correlated with HRR, equivalent formula, can use ACSM equations for estimating VO2max for different modes of exercise, is good for activities with set workloads such as machines but harder to use for outdoor/less structured
CPT methods of intensity prescription for aerobic exercise: RPE and talk test
both subjective, RPE is valid and reliable for continuous aerobic (Borg 6-20 corresponding to intensity range and %HRR), mod RPE 12-13 is 40-57% HRR, vigourous 14-17 is 60-87 HRR; talk test is easy for clients, mostly accurate
talk test scale
- very light: breathing unchanged from rest
- light: easy to breathe and talk
- moderate: breathing more heavily, can carry converation but not sing
- vigorous: verge of being uncomfortable, conversation req max effort
- very hard: cannot maintain exercise or speak
- max: cannot speak
high or low intensity for aerobic?
- either can improve aerobic fitness and health
- intensity is inversely related to duration
- high: greater risk of inj and delayed onset muscle soreness
- low: exercise longer to achieve same health benefit
- beginner 30-40% HRR, intermediate 40-60%, advanced 60-85%
frequency for aerobic
number of training sessions per week considering resistance prescription, recommended 3-5 days, if intensity is mod higher freq, vigorous 3 days to allow recovery
time for aerobic
duration of session measured in minutes, recommended 20-60/session depending on client’s goals (weight loss or performance) and intensity
structure for aerobic
- continous: sustain single intensity for duration of session
- interval: intermittent, characterized by alt intense effort and recovery within single session
- circuit: series of stations with relatively brief intervals between each station to keep HR elevated near target intensity for variety of exercises\
- cross training: variety of different forms of aerobic and resistance training within each session or day to day, good for preventing in plateaus and overuse injuries to boost overall fitness
HIIT for health
typically charactered by submax effort at ~80% HRmax, different from SIT which (efforts at >=100% intensity VO2max), HIIT can elicit superior cardiometabolic helath benefits and enjoyment compared to MICT despite less time for all individuals but does have higher risk of acute MI an sudden cardiac death in susceptible indiivudals; why ned appropriate medical pre-screening
considerations when designing HIIT workout
- work within SOP: avoid SIT and use caution for those who are deconditiioned or complex medical histories
- appropriate warm up and cool-down
- modality
- be aware of effects of fatigue, will have increased HR at start of each new interval with lower intensity if HR based measure
- start where client is now
- look for automatic timers and apps
- can be enjoyed by beginners, use lower intensity and longer recovery and work intervals; intermediate higher intensity with shorter work and recovery intervals
progression in aerobic prescription
1. rate of improvement
2. modifying FITT
- greatest conditioning effects in 1st 6-8 weeks, rate of improvement depends on age, health, and initial fitness, 5-20% change in VO2max with training, up to 40% in very sedentary but healthy and young
- focus on increasing duration before intensity or frequency, moderate intensity can change any FIT 5-10% per week, maintenance preventing detraining, consider reassessment times based on fitness level
reducing sedentary behaviour
any behaviour lower than 1.5 METS, health risks are independent of those associated iwth too little PA, using PASBQ to evaluate, encourage client to reduce sedentary time by substituting sedentary time with standing or ADLs
8 benefits of MSK fitness
- reduced muscle/joint inj or disabilities
- fewer fall and fractures
- increase in bone health and FFM (need to build bone and muscle early in life since hard to build bone mass after 40 when clast activity > blast)
- improved mobility and prolonged independent living
- improved self-esteem and psychological wellbeing
- ability to perform req daily and occupational activities
- take part in rec or competitive activities
- improved glucose metabolism, decreased BP, lipids, and premature mortality
MSK training adaptations to RT
1. first 8-10 weeks
2. 10 + weeks
3. factors of adaptations
- rapid increase in strength due to neural adaptations (increasing rate of force dev and MU recruitment), no difference in relative gains between sex, week 5-12 mostly muscle hypertrophy
- continued strength gains mostly due to cellular adaptations (increase number of myofibrils esp fast twitch, greater MPS, greater myofibre CSA, CT adaptation increase strength and tensile properties and prevents CT inflitration/replacement of muscle) with greater hypertrophy in males due to testosterone
- depend on initial strength, training program, genetics, and greater age slows adaptation; sex no difference in results of RT based on physiological levels of testosterone, same relative strength increase
demonstrating RT technique
- explain proper tech, the importance of balanced muscle dev, and progressive overload
- explain and demonstrate each exercise prescribed and have client perform movement feedback until they reliably perform the correct technique and they know how to monitor their form for errors
progression and RT safety
- warm-up before each session, exhale on effort, use proper tech, keep training record, and vary routine
- start training for muscular endurance before progression to strength beginning with light weights and high reps and progress to heavier weights which make it difficult to complete 8-12 reps
5 types of common movement patterns
balanced resistance program should have exercises from each movement pattern:
1. horizontal push and pull
2. vertical push and pull
3. quad dominant
4. hamstring dominant
5. elbow flexion and extension
muscle balance
1. importance of strength balance
2. muscle group balance ratios
- maintain joint stability and prevent inj, difference muscle balance ratios between muscle groups
- hip ext/flex, elbow ext/flex, trunk ext/flex, ankle inv/evr are 1:1, shoulder flex/ext are 2:3, knee ext/flex and shoulder int/ext rot are 3:2, plantar/dorsi are 3:1
- right and left side should be within 10-15% difference of 1RM, upper to lower body should be 40-60%
core training
important since core muscles supply strength and coordination for ADLs, exercises for hip, low back, and abdomen strengthen and condition to improve stability of trunk which transfers to extermities
typical strength prescription
F: 2-3 times/week if full body, good mix of upper and lower when first starting out
I: 50-70% 1 RM (12 RM)
T: at least 2 sets, 8-12 reps, 2-3 mins rest between sets to allow full PCR recovery
T: 8-10 exercises
RT training variables for endurance
F: 2-3 times/week full or half-body split
I: 50-75% 1RM
T: >12-15 reps for 30-60 seconds per set, 2-3 sets, 0-60 seconds rest to induce aerobic adaptation, slow <10-15 reps or mod fast >15 reps tempo
progression using reps or sets
RT training variables for hypertrophy
F: 3-6 times/week full or half-body split
I: 70-85% 1RM
T: 6-12 reps for 10-30 seconds per set, 2-5 sets since harder to maintain training vol by completing more reps per set with higher intensity, 1-2 mins rest for some PCR but tax glycolytic, slow moderate tempo
progression using reps then load
RT training variables for strength
F: 2-3 times/week full or half-body split
I: 80-100% 1RM
T: 1-8 reps for <10 seconds per set, 3-6 sets since harder to maintain training vol by completing more reps per set with higher intensity, 2-3 mins rest for full PCR recovery, slow controlled tempo
progression using load
low rep/high weight vs. high rep/low weight
- low and high rep RT experience same hypertrophy if done until failure; however high rep can cause more lactic (pain) > consider client goals
- if 1 RM testing done periodically, similar increasing in strength
frequency, sets, and rest during RT
- have 48 hrs rest b/w muscle groups workouts, can use split routines to target different muscle groups on consecutive days for those who have limited time/day or those who want to target specific muscles
- mixed evidence for optimal number, health benefits for chronic adaptations achieved with 1-2 sets, advanced lifter may perform multiple sets to achieve training load bc high intensity/low reps
- multi-joint exercises, large muscle mass with heavy loads rest 2-3 mins, smaller muscle mass and endurance 1-2 mins, power 4-5 mins for full PCR recovery
progressing RT
- goal is 1-2 sets of 8-12 reps
- increase reps before sets, and drop reps after increase in set or reps
- progressions made eveery 1-2 weeks for adults, 2-4 weeks for older adults
- increases in load should be gradual (5%)
RT exercise order
- at least 1 exercise per major muscle group
- recommend large muscle groups or multi-joint exerccises first
- alt upper and lower body exercises to max recovery
- alternate agonist/antagonsist exercises
lifting techniques
- warm up/cool down: light aerobic exercises for 5-10 mins
- perform exercise through full ROM (1-2 seconds for CON and ECC phases)
- breathe normally throughout ROM, inhale during ECC
RT equipment types
machine for controlled ROM, free weights (have to pay attention to form but greater ROM), tubing/bands are versatile and easy to use at home, body weight have to know modifications for progression, soup cans (anything can be used as weights)
5 types of conditioning methods
- simple or straight sets
- pyramids: challenge both slow and fast twitch, trad start with low intensity high rep, reverse for trained start with high intensity low rep
- supersets: increase intensity, less time, no rest between sets, but switch to set of antagonist or same muscle to promote strength and hypertrophy
- plyometric training: jump training, utilizing SSC to increase power and speed, for people with some RT and used to dynamic movements
- circuits: can train strength, endurance, and aerobic at same time, 2-3 sets of 10-15 stations/circuit, do as many reps in allotted time but may not reach volintional failure in all stations, passive or active rest between exericses
adapting FITT prescription for individuals 60+, frail individuals, deconditioned people
- over 60 and frail individuals: 1 set 10-15 reps. progressions every 2-4 weeks
- decondiitoned: 30-40% 1 RM upper body, 50-60% 1 RM lower body
non resistance balance training
safe but challenging simple stational position and movement on stable surface by using
2 legs or one, tandem, vary planes, open/closed eyes, add movement to stationary postitions, progress to body weight ransference (walking, lunging, hopping), unstable surfaces, and height (walking beams, slackline)
resistance based balance training
- incorporate challenging closed kinetic chain movements such as lunges, step-up, split stance postitions by transferring weight
- unilateral RT
- unstable environments or sufaces with traditional resistance movement such as back extension, curls, or squats
FITT for balance and stability
- mixed evidence, ca be performed 2-3 times/week for 10-15 mins druing routine, warm-up, cool-down, or RT
- safe to incorportate in aerobic or RT but with high activation of trunk with low res
- higher intensity lifts req more stable surface for safety
