Final Flash Cards
What is a MET (ml/kg/min)
Energy expenditure at rest which is equal to 3.5 ml/kg/min
Sedentary MET
Less than 1.5 ml/kg/min
Light MET
1.5-2.9 ml/kg/min
Moderate MET
3.0-5.9 ml/kg/min
Vigorous MET
6.0+ ml/kg/min
Training Principles
- Progressive Overload
- Specificity
- Reversibility
- Individuality
- Law of Diminishing returns
- Rest/ Recovery/ Regeneration
Warm up for Aerobic Exercise (Fat Loss Program)
General First 1. Low-intensity exercise to increase muscle temp 2. Psychologically prepare 3. Half of target intensity Specific Second 1. Specific to exercises in workout
Required rest for Resistance Training
48 hours
Required rest for Moderate - Vigorous Aerobic Training
12-24 hours
Information needed for Aerobic Exercise
- Client’s goals and expectations
- Pre participation screening
- Current PA and sedentary behaviours
- Current level of fitness, strength, weaknesses
- Current lifestyle demands
Very light intensity aerobic training %HRR, %HR, RPE
HRR = less than 30% HR = less than 57% RPE = 9/20
Light intensity aerobic training %HRR, %HR, RPE
HRR = 30-39% HR = 57-63% RPE = 9-11
Moderate intensity aerobic training %HRR, %HR, RPE
HRR = 40-49% HR = 64-76% RPE = 12-13
Vigorous intensity aerobic training %HRR, %HR, RPE
HRR = 60-89% HR = 77-95% RPE = 14-17
Max intensity aerobic training %HRR, %HR, RPE
HRR = more than 90% HR = more than 96% RPE = more than 18
HR max equation
HRmax= 208 - (0.7 x age)
Strength Training Warm Up
General Low Intensity = 2-10’
Specific Mod Intensity = 2-10’
Max Strength Freq, Intensity, Reps, Rest, Sets, Tempo, Time, Method of progression
2-3x/week 80-100% 1-8 Reps 2-3' Rest 3-6 Sets 1s Con - 2s Ecc <10s per set Progress Load
Hypertrophy Freq, Intensity, Reps, Rest, Sets, Tempo, Time, Method of progression
3-6x/ week 70-85% 6-12 Reps 1-2' Rest 2-5 Sets 1s Con - 2s Ecc 10-30s Sets Progress Reps first then Load
Endurance Freq, Intensity, Reps, Rest, Sets, Tempo, Time, Method of progression
2-3x 50-75% 12-25 Reps 0-1' Rest 2-3 Sets Tempo: slow for 10-15 reps, fast for >15 reps 30-60+ seconds per Set Progress Reps or Sets
Physiological benefits of warm up for RT
- warm up muscles
- specific warm up activates same joints/muscles as exercises
- reduce chance of injury
- inc blood flow
- reduces muscle viscoelasticity
Warm up for RT
- general aerobic 2-10 minutes
- specific 2-10 minutes
- warm up set
Foam rolling
- can be used in warm up or cool down
- distal to proximal or proximal to distal
- greater improvements are achieved with longer duration (30-60s)
Dynamic stretching
- controlled movement through the ROM of active joints
- uses momentum to create the stretch
- neck circles, arm circles, body weight squat, ankle circles
Muscular Strength
The ability for a muscle or group of muscle to voluntarily exert a maximal external force
Muscular Hypertrophy
excessive development of an organ or part, specifically increase in bulk (as by thickening of muscle fibres) without multiplication of fibre parts
Muscular Endurance
- The ability to sustain performance and resist fatigue
- The ability of a muscle or group of muscles to sustain repeated contractions against a resistance for a sustained period of time
General Benefits of RT
- increase muscle mass
- maintain or increase metabolism
- reduce risk of mortality
- increase physical function
- maintain mm during fat loss program
- inc bone mineral density
- imp insulin sensitivity
- im cardiovascular health (in combination with aerobic)
- improve mental health
Clinical Benefits of RT
Combined training = inc VO2max, muscle strength, lean body mass, and dec blood pressure
RT Adaptations
Neural = 2-4 weeks
-inc motor neuron output (motor unit recruitment and firing rate)
-inc cortical and spinal excitability
-reduce inhibition in descending drive
Morphological = 6-8 weeks
-inc CSA (inc contractile proteins (myofibrils)
-in tendon-ligament stiffness
-positive changes in BMD (young inc, old attenuates dec)
-inc mm capillary density
Paradigm of Hypertrophic response
Proper resistance stimulus and nutritional intake > muscle activation to produce force > hormone and immune response > satellite cell activation > protein synthesis > muscle growth
Acute Effects of a Single RT session
- alters activity of ~70 genes
- protein synthesis increases and peaks 24h post exercise, elevated for 36-48 hrs
- optimal hypertrophy involves compromising mechanical and metabolic stimuli
Endocrine response to RT training
- Acute inc in anabolic hormones (testosterone, growth hormone, cortisol) within 15-30 mins of RT
- Greatest acute hormonal elevations occur with the following RT stimulus:
- moderate volume
- moderate to high intensity
- shorter rest intervals
- large muscle mass
Resistance Training Status: Beginner/novice
Training age: <2 months Goal of Program: PA as a habit, safety, technique Frequency: 1-2x per week Training Stress: Low to none Technique: None or minimal
Resistance Training Status: Intermediate
Training age: 2-6 months Goal of program: improve health outcomes and/or performance Frequency: 3+ Training Stress: Medium Technique: Some or Extensive
6 Steps of CSEP-PATH required for writing a RT program
- Ask- gather information about the client
- Assess relevant aspects of ftiness
- Advice client on their results
- Agree on an action plan
- Assist client if necessary
- Assist client by planning progression/variations
Intensity - RM
1RM = 100% 1RMmax 2=95% 3=93 4=90 5=87 6=85 7=83 8=80 9=77 10=75 12=70
Disadvantage to using %1RM
- can’t measure for each exercise
- novice improve strength very quickly and for long periods of time
- hard to get true accurate %1RM in novice
Disadvantage of using RM
- assumes linear relationship between %1RM and number of reps to fatigue
- not accurate with endurance prescriptions
- use of different equipment changes relationship (free weights/machine exercise)
Progressing Intensity and Volume
Progress workload
- resistance lifted
- volume (sets X reps X resistance lifted)
- Duration of session to complete all exercises in a set or total training session
T or F: Multiple sets are better than single sets for Hypertrophy
True
Acute Program Training Variables
- Exercise Selection and Order
- Intensity and Volume
- Rest intervals
- Lifting Velocity
- Frequency
T or F: Intentionally slow lifting tempo is superior to the typical 1-0-2
False. Slow tempo (<10sec/rep) is inferior
T or F: It is optimal for muscle groups to be trained on at least 2 sessions per week in order to maximize muscle growth
True. But not all clients should start at 2. Training goal, training status, recovery ability, nutritional intake should all be considered
Rest and Recovery Principle - RT
48-72 hrs between muscle group workouts as long as intensity is moderate+
2 for 2 rule
Exceed rep goal by 2 reps in all sets in consecutive sessions
Major progression after 2 for 2 rule has been satisfied
- increase sets, resistance lifted, exercise, # of sessions/muscle group
- reduce rest between sets
- change focus of RT program
- vary tempo
then repeat 2 for 2 rule
General rule for progressing RT plans
first increase by # of sessions to = 24H movement guideline
then increase # of sets, then increase intensity
T o F: All SS lead to decrements in subsequent performance and muscular force
Likely true IF held for 60s or longer, no other general/specific warm up performed, and performance is immediately after
Likely false IF warm up includes general + specific
FIT recommendations for static stretching
F = 2 - 7 days. week I = midpoint of discomfort T = 2-4 reps, 10-30+ stretch T = at least 1 exercise for each major muscle group performed after general warm up
=> time progresses first
FIT for PNF
F = 2 - 7 days. week I = midpoint of discomfort T = 2-4 reps, 10-30+ stretch T = at least 1 exercise for each major muscle group performed after general warm up
PNF = initial passive static stretch of TM, isometric contraction for 5-6s against immovable resistance, 10-30s passive static stretch of TM, repeat
Flexibility adaptations happen faster with PNF than static
GTO
- response to increase in mm tension
- GTO activated when TM contracts
- TM inhibited mm and antagonist stimulated to contract
- further stretch obtained in TM muscle
- bases of PNF CR and CRAC
- mm tension increases and activates GTO after 5-6s
Muscle Spindle
-responds to rate of change of length
-activated with fast stretch of TM
-invokes reflexive contraction in TM and relaxation in ANTmm
-enter stretch slowly to reduce discharge of MS
=hold stretch for longer to reduce activity of MS
Overweight BMI
25-29.9 kg/m2
Obese BMI
> 30 kg/m2
Percent Canadians 18 and older classified as obese
26.8%
Costs of obesity
- 48,000 - 66,000 Canadians die from conditions inked to excess weight
- billions paid annually in health care and lost productivity related to obesity
- increase risk morbidity, mortality, premature death
- dec quality of life
When is weight loss recommended?
When: -overweight + 1 indicator of increase CV risk OR -obese OR -WC in males is >100cm, females >90cm AND client has it as a goal
T or F: Clinically significant weight loss occurs with 10% reduction in body mass
False. 5%
Quick and significant fat loss is the goal
Severe caloric restriction achieve the fastest results
This may also result in
- severe weakness
- depression
- fatigue
- anemia
- bradycardia
- edema
- dec thyroid
- reduce BM EE
Weight loss through PA alone
- both PA groups compensated with greater energy intake
- those with greater compensation reported increased appetite, particularly cravings for sweet foods
If sustainable fat loss and prevention of disease is the goal
caloric restriction and exercise is recommended
exercise despite BMI has a protective effect on disease / premature death
- maximizes fat loss (visceral)
- minimizes muscle loss
- reduces risk of comorbid conditions like CVD, diabetes, some cancers
- improves psychological function
Weight loss can result in..
- increase appetite and energy intake
- reduction of basal EE
- change in behaviours (e.g., sleep and sit more)
Energy content of 1lb of fat (~0.5 kg)
3500 kcal
Physical activity accounts for __ total energy expenditure
30% (light PA and MVPA)
Thermal effect of feed accounts for ___ of total energy expenditure
10%
Basal Energy Expenditure accounts for __ of total energy expenditure
60% (vital organs, etc.)
T o F: Energy Balance occurs when food intake is greater than energy out
False. Energy Balance: food intake = energy out
T or F: A prescribed negative energy deficit of 3500 kcal will always result in weight loss
False. Energy balance is dynamic and there are many biological and behavioural factors influencing both sides of the energy equation
Compensatory Model of Energy Management
- As activity EE increases, BMR decreases
- reflects discrepancy between amount of weight loss predicted from energy deficit and actual weight loss
- could be due to: increased drive to eat, reduced basal EE, changed behaviours (reduced overall PA, adherence, more sleep)
- controversial but may explain weight regain
How much near-daily PA per week is required to achieve clinically significant weight loss
225-420 min/week or ~2000 kcal/week
Healthy weight loss of __ per week is recommended
1-2lb, or 3500-7000 kcal/week (500-1000/day)
This should be achieved by dec energy intake and inc PA
Energy deficit based on PA alone should be
1000 kcal/week progressing to 2000 kcal/week
-must also include strategies to dec overall energy intake and increase light PA
QEP Nutrition Advise should be to the level of
Canada Food Guide
- foods within each food group
- serving sizes
- recommended servings relative to clients age and activity level
- refer to dietitian if necessary
Ideal vs. Best weight
Best weight = sustainable and allows client to enjoy life, health benefits are achieved by moving to this weight
Ideal weight = predicted by BMI
Better to approximate weight loss goals based on 5% reduction of body mass
Aerobic Prescription for Weight Loss (FITT)
F: 3 to 5-7 days/week
I: light-moderate to moderate-vigorous (ensure variety of types and intensities)
T: 10 to 60+ minutes/day (150 min/week to 300+ min/week)
-general goal to progress to 2000 kcal/week expended through PA
T: large muscle activities that reflect ADLS. Mixed modes is best.
MSK Prescription for Weight Loss (FITT)
F: 2 days per week (ideally)
I: Moderate (50% or 70-85%)
T: 6-12 reps, more if endur, 2-5 sets (less if endur), 1-2 min rest
T: if appropriate, choose multi-joint high calorie consuming exercises over single-joint isolation exercises. Minimize excessive passive rest.
Effect of Resistance training and caloric restriction on the Metabolic Syndrome
Weight loss: -RT + CR = 5.7% loss -RT only = 0.2% loss Waist Circumference: -RT + CR = 5% decrease -RT only = 1% dec Metabolic Syndrome: reduced prevalence in RT and CR only
T or F: Sedentary behaviour does not need to be addressed during weight loss programs
False. Individuals who maintained their weight loss for more than 1 year spent more time in MVPA and MVPA was greater than 10’/day, spent more time in light PA, and less time sedentary
2 hours of light PA = ___ minute walk
30 minute walk
Guidelines for preventing weight regain
- progress to 90 min near-daily activity
- PA is one of th ebest predictors of weight maintenance after weight loss
T or F: Behavioural interventions are not a key part of a comprehensive exercise program
False. Need to address behaviour and understand the root causes that contributed to fat gain and roadblocks to fat loss
Benefits of using METS to describe intensity
- Simple for general public to understand
- METS are provided on most ‘cardio’ equipment (accessible)
- easy to calculate EE once you know MET value for activity
- physicians understand what is means to exercise at a given MET
Disadvantage of using METs to describe intensity
- assumes resting VO2 is the same for all people
- is an absolute measure that does not take into account an individuals VO2max
- it does not take into account environmental conditions (more accurate in lab conditions)
MET equation for weight loss program
1 MET = VO2 at rest = 1kcal/kg/hour
EG: a 60kg male is walking on a treadmill for 1 hour at 3.5 mph at 4.3 METS, what is their estimated EE?
60 x 4.3 x 1 = 258 kcal
3 Important factors for weight loss program design
- Determine total fat loss goal for initial phase of PA (5% = clinically significant improvement in health outcomes)
- Choose weekly fat loss rate (1-2 lbs/ week, 3500-7000 kcal)
- Ensure 1000-2000 kcal/week expended through PA
24 Hour Movement Guidelines for Youth
Sweat:
-60 min MVPA/day involving a variety of aerobic activies
-Vigorous PA and bone strengthening exercises should each be incorporated at least 3 days per week
Step:
-several hours of a variety of structured and unstructured light PA
Sleep:
-14-17 years = 8-10 hours
-consistent bed and wake-up times
SIT
-less than 2 hrs per day of recreational screen time; limited sitting for extended periods
__ % of Canadian children and youth accumualte at least 60min of MVPA on at least 6/7 days and __ % achieve a weekly average of at least 60 min per day
7%, 33%
Before PHV in youth focus on:
fundamental motor skills, speed, aerobic capacity
After PHV in youth increase emphasis on:
aerobic power, speed
When to focus on strength for boys and girls?
Girls; immediately after PHV
Boys: 12-18 months post-PHV
PRE-PHV Changes in Muscle Strength
- inc. muscle CSA primarily reflects inc. in contractile protein (GH, IGF-1
- inc. strength (above and primarily neural changes)
BMD in Youth
- bone density inc linearly until 18 (girls) and 20 (boys)
- 39% total bone mineral is acquired within 4 years of PHV
- while influenced by genetics and diet, increased osteogenic response occurs in all ages primarily due to PA
Key Priorities for Exercise Prescription for Children and Youth
- focus on making PA fun and positive
- prescription should reflect development age and training age
- provide qualified instruction and supervision
- involve the parents
Aerobic Prescription in Children/ Youth
F: Daily
I: Progress from moderate to higher intensities; RPE recommended
T: 60 min MVPA
T: Variety of types, intensities, & environments
+ several hrs/day of a variety of structured and unstructured LPA
Moderate and Vigorous Intensity for Youth, 7-17 (%HRmax)
Mod = 55-70% Vigorous = 70-90%
RT Training Prescription in Youth (FITT)
F: 2-3 times/week on non-consecutive days
I: less than 60%1RM progressing to 80%1RM once technique is mastered
T: 1-2 sets of 8-15 reps progressing to 4 sets of 8-15reps, rest 1-3 min (longer when intensity higher)
T: extended focus on technique and safe training procedures to start over amount or load lifted
T or F: There is a higher incidence of injuries in youth who take part in RT
False. Children had LOWER risk of RT related joint sprains and muscle strains than adults
Most injuries were the results of accidents that are potentially preventable
T or F: RT stunts growth via damage to epiphyseal growth plates
False
RT leads to repetitive soft tissue injuries in youth?
Rates are no different than adults
T or F: RT is ineffective in children
False. Children can and will get stronger
What is the optimal weekly exercise prescription ?
- 5+ days of aerobic exercise to = at least 150 MVPA with at least 1 session at vigorous intensity or higher
- 2 + sessions of RT / week
- several hours+ per day of light PA; particularly break up periods of prolonged SB with movement
Concurrent training
- Compromise in adaptation resulting from simultaneous training of strength and aerobic exercise
- more often strength gains are compromised
Does concurrent training matter if maximal strength gains are the priority?
Yes
- order matters, do priority exercise first
- space out RT and MVPA as much as possible (8+ hrs)
- mode may matter, cycling less interference than running
Does concurrent training matter if aerobic fitness gains are the priority or if RT adaptations are for health outcomes?
Likely not
- some may benefit doing MVPA first if that is their priority
- endurance athletes can benefit from RT if appropriately periodized
Concurrent training in Older Adults
Concurrent training is efficacious for the improvement of a broad range of health related parameters
Difference between 1RM and p1RM
1RM
- Direct
- Safe
- Requires spotter
- Value specific to muscle being tested
- Time consuming for novice (not so much advanced)
p1RM
- Indirect
- Safe
- Doesn’t necessarily require spotter
- Value specific to mm tested
- Not usually time consuming
p1RM Protocol
- Ensure proper warm up
- Review technique with client
- Do at least 1 warm up set
- Choose load that allows for client to complete 6-10 reps with no loss of form
- should be obtained in less than 3 attempts (sets)
- if a 2nd or 3rd set is needed, provide at least 2 minutes rest between attempts
- if p1RM cannot be achieved in 3 attempts, try again next session
p1RM equation
Predicted 1RM (lbs or kgs) = weight (lbs or kg) / (%1RM value /100)
p1RM compared to normative data equation
Lower body or Upper body Weight Ratio = weight lifted (lb) / body weight (lb)
lb to kg conversion
1kg = 2.2lbs
