Chapter 11 - Exercise Programming Flashcards
Evidence Based Practice
Personalized exercise programming should be based on 3 things: 1) client attributes, goals and preferences, 2) PT experience and expertise, 3) the latest research finding
The 5 Steps
1. Formulating a question
2. Searching for health & fitness research that answers that question
3. Scrutinizing the quality of the research
4. Incorporating the research evidence into exercise program design & implementation
5. Evaluating outcomes and reevaluating research
How to Interpret Scientific Research
- Search for bias (ulterior motives)
- Read the research
- Evaluate for truth
- Look for consensus
Six Steps to Exercise Programming
- Establish rapport and identify client goals
- Administer an exercise preparticipation health screening (is medical clearance necessary?)
- Identify barriers and collaborate on next steps (SMART goals, how will you move forward today?)
- Determine if assessments are necessary (physiological or movement)
- Determine which phase of ACE IFT model to begin
- Prioritize program design and select exercise order
Programming for Base Training
- No assessment needed, this could demotivate client
- Focus on moderate-intensity, RPE 3-4, emphasize enjoyment
- Keep below VT1 (use talk test)
- Increase duration and frequency
- Client is ready for Fitness Training when can complete 20 min of cardio at below VT1
- Add no more than 10% duration/week
Programming for Fitness Training
- Progress cardio based on clients goals and time available
- Integrate vigorous intensities - work at, below and above VT1 (just below VT2)
- Focus is on enhancing client’s aerobic efficiency by progressing duration, frequency, and intensity
- Add intervals starting with a hard to easy ratio of 1:3 (1 min/3min) progressing to 1:2 and then 1:1 ratio
- Increase load by no more than 10% weekly
HIIT Considerations
May provide superior ability to improve cardio fitness and cardio metabolic health for a lesser weekly time commitment.
SIT - Sprint Interval Training (supramaximal sprints)
REHIT - Reduced Exertion High Intensity Interval Training (more time efficient, uses fewer and shorter sprints, still supramaximal)
Performance Training
- Goal to increase speed, power and endurance
- Program sufficient volume to meet client goals
- Integrate vigorous intensity (RPE 7-10) to improve aerobic capacity, speed and performance
- Periodized training allows for appropriate time in each zone. 70-80% in Zone 1, 10% in Zone 2 and 10-20% in Zone 3
- Increase volume up to 10%/week
- Rule of threes - total weekly training volume = 3 times the event length client is training for.
- Check for overtraining syndrome
Functional Training
- Focus on establishing/reestablishing postural stability, kinetic chain mobility - POSTURE, FLEXIBILITY, BALANCE
- Exercises to improve muscular endurance, flexibility, core function and static & dynamic balance
- Progress volume and challenge as function improves
Movement Training
- Focus on good movement patterns without compromising posture or joint stability
- Include exercises for all 5 movement patterns in all planes
- Integrate functional exercises to help maintain stability & mobility
Load/Speed Training
- Focus on adding loads to movements to create increased force production & meet client goals
- Integrate 5 movement patterns with loads in different planes & combinations
- Continue to integrate functional training
- Add enough load to meet clients goals for strength, endurance, and hypertrophy
- Add speed, quickness, agility, power, skill training for clients with such goals
Elasticity Considerations
- The property that allows tissue to return to its original shape when force is removed.
- Ballistic & dynamic stretching are examples
- No permanent lengthening but they do prepare muscles for activity.
Static Stretching - Plastic Stretch
- Improves tissue extensibility
- When load is past elastic limit
- Viscosity aids extensibility - warm up is important
Autogenic Inhibition
- Activation of the Golgi Tendon Organ (GTO) inhibits muscle spindle response allowing further stretching. Stress Relaxation.
- 7-10 seconds of low force stretch activates GTO
- Repeating stretch multiple times results in gradual lengthening of muscle
Reciprocal Inhibition
The reflex inhibition of the motor neurons of antagonists when the agonists are contracted.
Static Stretching
- Moving joints to put muscle in and end-range position and hold for up to 30 seconds
- Most commonly practiced flexibility training. easy, doesn’t require partner.
- Can be passive or actively (partner)
Proprioceptive Neuromuscular Facilitation (PNF)
Capitalizes the Autogenic and Reciprocal inhibition - combines stretch/relax. Three different types but all begin with a partner providing a 10 sec passive pre-stretch
1. Hold-Relax - 1) 10 sec passive pre-stretch by trainer, 2) 6 sec client holds while trainer tries to stretch, 3) client relaxes for 30 sec stretch by trainer
2. Contract-Relax - 1) 10 sec passive pre-stretch by trainer, 2) Client moves joint through ROM with resistance from trainer, 3) client relaxes for 30 sec stretch by trainer
3. Hold-Relax-Agonist Contraction - 1) 10 sec passive pre-stretch by trainer, 2) 6 sec client holds while trainer tries to stretch, 3) client relaxes for 30 sec stretch by trainer then adds concentric action of muscle at end.
Most effective as it uses both autogenic & reciprocal inhibition