1. Coronary risk factors, on meds 2. HBP > 140/90 3. Cholesterol levels 4. Smoking (now or past) 5. Fasting glucose > 100 mg/dL 6. Obesity Waist girth >34" women; >40" men 7. Family hx 8. Sedentary

Exercise Prescription Flashcards by Alex Stein

Exercise Prescription

Refers to the specific plan of fitness-related activities that are designed for a specified purpose, usually developed by a fitness or rehab specialist for the client or patient

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Goal of exercise prescription

successful integration of exercise principles and behavioral techniques that motivates the participant to be compliant, thus achieving their goals

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Components of Exercise Prescription

Types of exercise or activity
Specific workloads
Duration and frequency
Intensity guidelines (THR, RPE)
Precautions regarding certain orthopedic concerns or related comments

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ACSM - 4 components of exercise programs

Cardiorespiratory fitness
Resistance exercise
Flexibility
Neuromotor (balance, propio,

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ACSM Recommendations

Moderate Intensity Cardiorespiratory Exercise

> /= 30 min 5 times a week (150min/wk)

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ACSM Recommendation Vigorous Intensity Cardiorespiratory Exercise

> /= 20 min 3 times a week (75 min/wk)

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ACSM Recommendation Vigorous Intensity Cardiorespiratory Exercise

Combination >/= 500-1000 MET min/wk

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ACSM Recommendation Resistance Exercise

2-3 times/wk for each major muscle group (8 muscle groups)

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ACSM Recommendation Flexibility Exercise

2-3 day/wk for each major muscle tendon group (total of 60 sec per exercise)
Could do this everyday too

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ACSM Recommendations Neuromotor Exercise

2-3 times/wk for balance, agility and coordination

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ACSM for those with chronic diseases or conditions

Use same recommendations
Modify to adapt their current activity level, health status, physical function, exercise response and to their individual goals

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Health Benefits of physical activity in adults

Dec risk of chronic disease
Improve body comp
Improve immune funct
Less depression and better self image
Predictor of longevity
Inc bone health, HDL, metabolic health
Dec LDL

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Risks to exercise

Coronary risk factors, on meds
HBP > 140/90
Cholesterol levels
Smoking (now or past)
Fasting glucose > 100 mg/dL
Obesity Waist girth >34” women; >40” men
Family hx
Sedentary

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How do we asses risk?

Low risk

Apparently healthy; no testing needed prior to training

Males

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How do we assess risk?

Moderate risk

Males > 45
Females > 55
2 or more coronary risk factors
For vigorous exercise (70-80% max HR) need medical exam and exercise testing
For moderate exercise (60-70%) okay to exercise if no signs or symptoms of CV, pulmonary or metabolic disease

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How do we assess risk?

High risk

One or more signs or symptoms of known CV, pulmonary or metabolic disease
Medical exam and exercise testing per physician for moderate or vigorous exercise

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Cardiorespiratory Fitness Low Risk

3-5 days/wk
65-90% Max HR
20-60 min continuous or intermittment - large muscle groups

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Vigorous Exercise

High intensity interval training
3 min WU, :45 max speed and resistance, 1:15 recovery at 50% pace
Total 8 intervals, 2 min cooldown = 20 min workout
2-3 times/wk
Metabolic and aerobic effects have been shown

Muscular Fitness

8-10 exercises per session
>/= 1 set 8-12 reps to volitional fatigue 
- For those above 50-60 yo: 10-15 reps 
2-3 days per wk; non consecutive 
Major muscle groups

Muscular Fitness

Teach correct technique thru full ROM
Concentric/Eccentric 3 sec each
Maintain normal breathing
Good to go with partner for safety and motivation

Muscular Fitness - How much resistance - Novice and Intermediate

60-70% of 1 rep max - moderate to hard intensity

Muscular Fitness - How much resistance - Experienced

80% 1RM (hard to very hard)

Muscular Fitness - How much resistance - Older and very deconditioned

may want to initiate at 40-50% 1 RM and inc reps

Selected resistance should permit 8-12 complete reps

One rep max

gold standard of dynamic strength testing

Heaviest weight that can be lifted once

One rep max procedure

1. Light warm up 5-10 reps at 40-60% perceived max 2. After 1 min rest, with light stretching, have client lift 3-5 reps at 60-80% perceived max 3. Add small amount of weight and attempt to lift - if successful rest 3-5 min and lift next weight up (goal is to reach 1 RM in 3-5 max efforts) 4. 1 RM is last successful weight lifted

8 Rep Max

for patients 50-60 yo and above = reduce chances of injury | Use same procedure and get 8 rep max

Flexibility

``` Goal is to develop full ROM in major muscle tendon groups Use static or PNF techniques 2-3 days/wk (ideal is 5-7/wk) 10-30 sec for static 2-4 reps, 60 sec total time each ```

Dynamic warm up is

superior to flexibility exercises

Neuromotor training

Functional fitness training Combines balance, coordination, gait, agility, proprioceptive training Tai Chi is studied the most

Exercise Adherance

Ask patients about their preferences Start with intensity below their ventilatory threshold Individualized programs Set goals, social support, reinforcement

Risks of Exercise

1. Musculoskeletal injury 2. Rhabdomyolysis 3. Acute myocardial infarction

Exercise and Rhamdomylosis

Unaccustomed exercise Hot ambient conditions Reduce risk with warm up, cool down, stretches and prgression

Exercise and MI

Regular exercise dec risk Identify risk factors Get medical approval for moderate and high risk

Special Populations

1. Hypertension 2. Diabetes 3. Obesity 4. Pregnancy 5. Asthma

HTN - standard exercise protocol

Freq 3-7 d/wk 30-60 min Moderate to hard intensity Resistance training lower resistance higher reps

Hypertension as a special population

- no exercise if BP >200/115 mmHg - proper meds at normal times - emphasize cool down - Diuretics - low K may cause arrythmias, med clearance - avoid vasalva

Diabetes as Special Population

Postpone if blood glucose >300 mg/dL Monitor blood glucose before during and after Might need to adjust CHO intake/insulin Use caution in hot water

Protocol for diabetic patients

4-6 d/wk low to moderate intensity use RPE

Obese as a special population

increased risk, take precaution Orthopedic injury Hyperthermia (keep hydrated) CVD (monitor them)

Protocol for obese population

``` 5-7 d/wk work up 30 min/session Dec joint stresses Start low intensity and progress to moderate Use target HR or RPE With absence start back at 50% previous ```

Pregnancy as a special population (without complications)

Can continue to exercise mild to moderate Avoid supine position No exercise to exhaustion Morphologic changes to modify to non-wt bearing Use RPE For new exercises, get physician approval

Asthmatics as special population

``` Proper use of inhalers and postures Check for environmental triggers Swimming may be safest Use scarf or mask in cool dry air Long warm up UE strengthening important part of program for pulmonary ```

Protocol for asthmatics

3-5 d/wk 20-30 min Intensity within tolerated limits

Perceived Exertion Scale

0-10 | No exertion - very very hard