Ch 10 Flashcards
Overview
• This chapter addresses physical and physiological changes, the impact of chronic exercise, and relevant exercise prescription and special considerations for
– Children(<13y)and adolescents(13-18y)
– Pregnant women
– Older adults: ≥65 y or those 50 to 64 y who have significant physical or physiological limitations that affect physical movement or capacity
Children and Adolescents: Body Size
• Many of the exercise measurement methods designed for adults are not scalable to children.
• Both weight and height increase with age with rapid growth in infancy.
– Steady increases in early childhood, accelerated period of growth at puberty (about ____years for girls and _____for boys), slow gains until adult height and weight are attained
• Fat free mass, primarily skeletal muscle, increases in a manner similar to____ in both boys and girls
• Lower and upper extremity bone mass increases in childhood with accelerated growth in ______.
Children and Adolescents: CRF
• Young children’s HR at rest, in seated position, between ____beats per minute
– Maximal____higher than adults
• ___ is higher in children,_____is lower
– Results in ____values that are lower than in adults
• Children and adolescents have a greater _____cost during
exercise than adults
– Higher _____at the same absolute intensity because of insufficiency due to immature motor patterns, nervous system differences, and hormone response
• Children recover faster from_____exercise, as HR, VO2, and VE return to resting values quicker
Muscular Strength, Flexibility, and Motor Performance
• In boys & girls, muscular strength increases with age
– Related to the increases in body weight, height, fat
free mass, and muscle mass
• Motor performance measures tend to follow the same pattern of improving with physical maturation
• Girls tend to outperform boys in flexibility measures and some measures of _____
.12,14, height, adolescence, 100-110
HR,HR,SV, Q, oxygen , VO2, acute
Balance
Perceived Exertion
• Children rate exertion _____than adolescents &; adults
– Adolescents rate exertion ____ than adults
• Children may not be as able to reproduce an exercise _____ that corresponds to a particular exertion rating as are adults
– Using the child-friendly scale may help
–______ is a 0 to 10 rating scale with pictures corresponding to different levels of effort for both walking/jogging and for cycling
Thermoregulation
• Children have more sweat glands but ability to produce sweat is_____ than adults
– output of each gland is _____
– temperature where sweating starts (sweat onset) is ____
Impact of Chronic Exercise
• Children performing exercise and training for sport can improve motor performance and efficiency, and increase muscular strength and endurance
– For those who include more intense aerobic activity, there is improved cardiorespiratory fitness and aerobic performance
• There is no evidence that exercise, including resistance training, weightlifting, and plyometric training, has any adverse effects on children and adolescents when performed and supervised properly
Exercise Programming
• Obtain ≥_____min of mod or vig activity daily with vig activity included on at least ____days per week.
– Mod: RPE ____on a 0-10 scale
• Brisk walking, hiking, casual biking
– Vig: RPE ____on a 0-10 scale
• Running, skipping, jumping, chasing games, sports
Children and Adolescents Exercise Prescription Muscle and Bone Strengthening Exercise Frequency: ≥\_\_\_\_\_d/wk Time: As part of their ≥\_\_\_\_\_min/d Type: Activities that engage \_\_\_\_ musculature of \_\_\_\_ body • Can be unstructured
.lower2x, intensity, OMNI, less, lower, higher
60, 3, 5-6,7-8,3, 60, large, whole,
Exercise Programming
Muscle strengthening: moving against a resistance
• Body weight, free weights, weight machines
• Jungle gym, climbing walls, tree climbing, tug of war
Bone strengthening: physical impact on skeleton
• Jumping, running, hopping, jumping rope, gymnastics
Exercise Programming
In general:
• Include 5-10 min warm-up and end with cool-down
• For each exercise – 1 to 3 sets
– ______repetitions to fatigue (not exhaustion or failure) – on ______ days
• EP-C should monitor proper form, start with light weights, and progress intensity gradually by ____-___
• If a child consistently fails to perform resistance exercises safely, the child may not be emotionally mature enough to safely engage in resistance training
– Ability to follow directions is most important
PA Selection for Children
• Families should be encouraged to engage in active and fun activities together to establish lifelong PA habits
• It is recommended that games are chosen where children are not eliminated from play based on poor performance
• Activities should have intermittent rest opportunities
– Allow children to_____intensity and duration
– Especially important for obese children whose cost of locomotion is higher than a smaller child
• Overall the goal should be to limit sedentary behavior and sedentary activities to
.6-15, non consecutive , 5-10,
Self regulate,2, 8, biological, 12,26
Center of gravity, supine, 150, 300
Relaxin , decreases, hypotension
Higher, lower, declines, higher,
Edema, eclampsia,
Table
Impact of Chronic Exercise During Pregnancy (for Fetus)
• Aerobic, resistance, and combination training confer many benefits to the fetus/offspring:
– improves cardiovascular and ____ maturation before and after birth
– studies find increased cardiac autonomic maturation and decreased likelihood of fetal complication
– Less complications during delivery and similar fetal birthweights compared with non-exercisers
• Many types of exercise can be encouraged during pregnancy for improved maternal health, delivery outcomes, and possible benefits to the child
Pregnancy - Exercise Prescription
• Exercise recommendations during pregnancy are consistent with recommendations for healthy adults
• Modify according to the woman’s symptoms, discomforts, and abilities during pregnancy
• Screen pregnant women before their participation in exercise:
• Physical Activity Readiness Medical Examination for
Pregnancy (PARmed-X for Pregnancy)
• electronic Physical Activity Readiness Medical Examination
(ePARmed-X+
Forms
Pregnancy
Exercise Testing
• Maximal exercise testing not recommended unless medically necessary
• If a maximal exercise test is warranted, the test should be performed with physician supervision after the woman has been medically evaluated for contraindications to exercise
• Collaborate with health-care provider
Table 10.1
Exercise Programming: Pregnancy (cont’d)
• Exercise Prescription:
– F = _____days/week minimum
– I = moderate, _____ RPE (6-20 scale), talk test,_______%HRR or specific zone (see PARMedX for Pregnancy)
– T = _______minutes per session (beginner’s start with 15 minutes and build to 30 minutes)
– T = both aerobic and resistance training
– Include warm-up and cool-down for every session
Aerobic Exercise Pregnancy Exercise Prescription Type: • Dynamic, rhythmic, large muscle groups • Variety of weight - and non - weight - bearing activities are well tolerated
Pregnancy
Exercise Prescription The optimal time to progress is after the ____ trimester
–discomforts and risks of complications lowest at that time
Mo. 1 Mo. 2 Mo. 3 Mo. 4 Mo. 5 Mo. 6 Mo. 7
1st trimester
Exercise routine should be flexible
Substitute new activities when necessary (substitute jogging with spinning)
graph
.nervous system,
3-4, 12-14, 40-60, 30-60
First,
Pregnancy
Exercise Prescription
• 2 – 3 nonconsecutive d/wk
Pregnancy
Exercise Prescription
Resistance Exercise
Intensity:
• Prescribe load that permits multiple-_____ repetitions
Volume:
• Beginners: 1 set
• Intermediate and advanced: 2 – 3 sets
• 8-10 or 12- 15 repetitions (muscular endurance)
• Performed to moderate fatigue (not ____)
Pregnancy
Exercise Prescription • Incorporate all large major muscle groups
• Variety of machines, free weights, and body weight exercises are well-tolerated during pregnancy (e.g., upright chest press, lunges, dumbbell exercises)
Resistance Exercise
Type:
Pregnancy
Exercise Prescription
PA in supine position should be avoided/modified after 16 wk of pregnancy
– Due to weight of fetus, exertion or prolonged periods in supine position may reduce venous return and subsequent cardiac output
Avoid Valsalva maneuver, prolonged isometric contraction, & motionless standing
Pregnancy
Exercise Prescription
• to strengthen the pelvic floor muscles (muscles under uterus, bladder, & bowel)
Resistance Exercise
Kegel exercises
• help & prevent problems with urine leakage or bowel control
Finding the pelvic floor muscles:
• Imagine voiding the bladder and stopping midstream
• Imagine that you are trying to keep yourself from passing gas
The exercises:
• Contract pelvic floor muscles
• Hold for 8 s, relax for 10 s
• 10 repetitions
• 3 times per day
.submaximal, failure,
Pregnancy
Special Considerations
Women who are pregnant should avoid
• _____sports
• any activities with risk of losing _____
– (can cause ____ to the mother or fetus)
Pregnancy
Special Considerations
PA can be resumed after pregnancy, but should be done so gradually because of normal deconditioning in the initial postpartum period
Gradual exercise may begin
– ~____wk after a normal vaginal delivery
– ~_____wk after a cesarean section delivery (with medical clearance)
Women with higher CRF levels and more rigorous exercise routines prior to and during pregnancy may be able to resume exercise sooner
Light-to-moderate intensity exercise in postpartum period
– is important for return to prepregnancy BMI
– does not interfere with breastfeeding.
Postpartum Period
Exercise Programming: Pregnancy (cont’d)
• Special Considerations:
– Teach proper ______to avoid Valsalva Manuever, hypotension and dizziness
– Avoid supine exercise after the ____ trimester
– Avoid activity that may cause trauma to the abdomen or be a risk for falling
– Avoid overheating and hydrate well
– Avoid exercise at altitude over _____ feet if not
acclimated
Exercise Programming: Pregnancy (cont.) • Exercise should be terminated and a physician consulted if any of the following occur: • vaginal \_\_\_\_\_ • shortness of \_\_\_\_prior to exertion • dizziness • headache • chest pain • muscle weakness • calf pain or swelling • preterm labor • decreased fetal \_\_\_\_\_ • leaking of \_\_\_\_\_\_fluid
- Older adults and those who are younger but severely deconditioned present the fitness professionals with unique challenges.
- Older adult populations tend to have more disease conditions and also tend to be further progressed in those conditions.
- This chapter focused on a healthy older adult population who may be deconditioned.
.contact, balance , trauma , 4-6, 8-10
Breathing, first, 6,0000, bleeding, breath
Movement, amniotic,
Older Adults: CRF & Thermoregulation
• Vessels become stiffer & elasticity is lost in cardiac tissue including the heart values
• During submaximal exercise, expect higher _____; and lower ____ and ____ with aging
• During maximal exercise, expect lower ____________ and oxygen extraction; and higher BP and ______
• Older individuals have a lower overall exercise capacity
– Any given submaximal exercise intensity represents a _______of their maximum
• The number and activity of _______ glands decrease with age, and ______ density also decreases
Impact of Chronic Exercise: Older Adult
• Exercise can
– lower risks for several cancers, CVD, some metabolic diseases, and premature ______ in older adults
– improve ______
– can prevent or delay the -________ changes that often occur with aging
– prevent falls, reduce injury from falls
– preserve fat-free mass, strength, and motor performance
• Benefits can still be reaped even in sedentary older adults who initiate an exercise program late in life
Exercise Programming: Older Adult
• The EP-C should perform proper baseline assessments, health screenings, and risk factor stratification for an older adult to determine any contraindications
– Also important for determining the safe type, intensity, and quantity of exercise
• Individualized approaches to promoting exercise should be designed based on _____
Aerobic Activity for the Older Adult
• Older adults should strive for the same amount of aerobic activity that is recommended for all adults:
– ≥_____ min of moderate intensity activity on ____ or more days
– ≥____ min of vigorous activity on ____ days, or
– a combination of vig and mod on 3 to 5 days/week
• For older adults, a ______ rating system is used to determine the intensity of exercise
– Moderate intensity is _____ RPE on a 0-10 scale
– Vigorous intensity is _____RPE on a 0-10 scale
Older Adults Exercise Prescription Aerobic Exercise Type: • Any modality that does not impose excessive \_\_\_\_\_ stress – walking (most common) – stationary cycling – aquatic exercise
.VE & BP, Q, SV,
VO2, VE, Q, HR, TPR,
Higher percent, sweat, capillary,
Death, sleep, negative cognitive
Risks, 30, 5, 20, 3, subjective
5-6, 7-8, orthopedic,
Muscle Strengthening: Older Adult
• ______ nonconsecutive d/wk
• Target the major muscle groups
• Choose resistance that can be performed ______ times which produces a level of effort that is moderate to high
• A lighter initial weight with a focus on proper form followed by progressively increasing loads based on each person’s ability is recommended
Older Adults
Exercise Prescription
Flexibility Exercise
Frequency: ______d/wk, after general warm-up
Intensity: Stretch to the point of feeling tightness or slight discomfort
Time: Hold stretch for ______s (greater benefits with______
________Exercises can improve balance, coordination, agility, gait, & proprioception
– can reduce the number and severity of falls, aid in functional tasks, and improve the quality of life
_______ Exercises
• Tai chi, qigong, and yoga have been studied and shown to reduce falls
– Insufficient evidence for frequency, intensity, or duration
Thermoregulation: Older Adult
• Conduct exercise in a thermo-neutral environment and encourage clients to avoid exercise in the____ times of day.
– Important due to decline in _______ number and activity
• For exercise in the cold, older adults should dress in layers for increased warmth and for the ability to add or remove layers as needed.
– Important due to decline in ability to shunt blood away from ________ and loss of _________
Summary
• Exercise is beneficial for all individuals regardless of age or activity status; however, the EP-C must be aware of the unique concerns of older individuals, the young, and women who are pregnant.
• Benefits can be achieved for each of these populations once exercise type, quantity, and intensity have been adjusted based on unique individual needs.
.2-3, 8-15, 2-3, 10-30, 30-60,
Neuromotor 2x, hottest, sweatgland ,
Extremities, subcutaneous fat,
