Lecture 12 Flashcards
as a reminder, an average decline of about ____% per decade in VO2max occurs from ________ y/o.
10% and 25 to 65 y/o
Benefits of AET in OA (3)
- VO2 max can be improved by 15-17% in women in their 80-90’s after 24-32 weeks of exercise training.
- AET can improve ability to sustain exercise at a fixed & submax level of energy expenditure.
- AET can improve functional ability significantly (especially in later years)
Energy cost for dressing and undressing?
Can represent as much as ?
2-3 METS or 7-10,5 ml/kg/min
50 to 75% of a frail 80 y/o woman’s VO2max
What are the physiological benefits of AET ? (5)
Direct or indirect effect ?
Help prevent risk of:
- CHD
- Stroke
- Hypertension
- Diabetes
- Osteoporosis
Direct
Exercises based cardiac rehab results in ______ lower death rate
20-25%
What are the difference for physiological benefits of AET in frail OA ? So it helps what ? (4)
AET plays less a role in disease prevention and more a role in symptoms alternation
- Counter well-known age-related physiological changes
- Control chronic disease
- Maximize psychological health
- Preserve ability to perform ADLs
Principles of AET: Specificity
- Specificity exercises elicit specific metabolic & physiological adaptation
- Exercises must be specific to both the energy system targeted aerobic vs anaerobic and functional tasks of everyday life (climbing a hill during a walk to the store)
Principles of AET: Interval training, what is it ?
Medical clearance recommended for? (5)
Alternating effort-recovery patterns
- Classic method (HIIT): Periods of max or near max effort (more than 80% HR max) followed by a recovery (40 to 50% mx HR)
smoker, hypertension, diabetes, abnormal cholesterol levels, obesity
Is HIIT recommended for OA ?
What are the main advantages vs continuous training ? (3)
Yes
- Enables OA to work harder for a longer period of time with greater comfort (varying period of jogging and walking)
- More realistic to daily energy demands
- Works well with varied fitness levels (deconditioned, mod, high)
Principles of AET: Continuous Training (4)
- More than 6 min of uninterrupted activity
- Usually performed at a constant submax intensity
- More aerobic in nature (vs anaerobic)
- Must improve on aerobic capacity prior engaging in an anaerobic exercise
Internal or continuous training study (text, hint %)
88% of patients received their first diagnostic of heart failure at more 65 y/o and 49% at more than 80 y/o
Internal or continuous training study
Participants, Exercise program, Exercise protocols 1. (4) 2. (1), home sessions
Participants: OA 75 y/o having post infraction heart failure
Exercise program: Uphill treadmill walking over a 12 week period, frequency of 2 supervised session / week + 1 home session / week
Exercise protocols
- Interval training (AIT)
- WA 10min at 60% to 70% peak HR
- Intervals 4min at 90%-95% peak HR
- Activities pauses 3 min at 50 to 70% peak HR
- Total exercise time = 38min (5x intervals + active pause + 3min cool-down) - Moderate continuous training (MCT)
- 47 min at 70 to 75% peak HR
Home sessions performed by both groups
- MCT = outdoor walking (47 min without breathing heavily)
- AIT = performed 4min intervals with exercise activities that made them breath heavily without becoming too stiff in their legs)
Internal or continuous training study RESULTS
hint: training intensity (4), improvement (3), both
AIT showed difference in training intensity
- Increase exercise intensity (4.6 vs 4.0)
- Increase treadmill slope (12.1 vs 4.7)
- Increase % peak HR (93 vs 73)
- Increase RPE (17 vs 12)
AIT improved
- VO2 peak by 46% (vs 14% MCT)
- O2 cost by 15% (vs 5% MCT)
- HR by 8 bpm (vs 0,7 MCT)
Both improved Q of L
Type of interval conditioning (IC) (3)
What they form ?
What they utilize ?
- Spontaneous Conditioning: Getting skilled up, feeling fitter
- Fitness Conditioning: Getting trained up
- Performance Conditioning: Getting even fitter
Form a logical progression continuum for training Both aerobic (1,2,3) and anaerobic (2,3) energy systems
Type of interval conditioning Fitness level RPE Work/rest ratio Duration Type Approach
Fitness level
- deconditionned
- Mod to high
- high
RPE
- 9-11
- 11-13 progress to 13-15 with recovery 9-11
- 13-15 progress to 15-17 with recovery 9-11
Work/rest ratio
- Instructor programmed, participants controlled aerobic effort recovery
- Set by instructor aerobic effort 1 vs recovery 1 & anaerobic effort 1 vs recovery 3
- Set by instructor aerobic effort 1 vs recovery 1 & anaerobic effort 1 vs recovery 3
Duration
- Instructor programmed, participants controlled Effort interval: 10 sec to 5 min
- Set by instructor, aerobic: 3-5min & anaerobic: 80-90 and progress to 90-270 secs, Recovery 3-5min
- Set by instructor, aerobic: 3-5min & anaerobic: 80-90 and progress to 90-270 secs, Recovery 3-5min
Type
- Walking, stationary bike, stair climbing and descending
- Walking jogging, cycling, rowing, swimming, exercise to music, circuit training
- Timed or race walks, runs, swims, triathlon, mini marathons
Approach
- Not breathless
- work a little harder than you usually do
- Highly structured
Guidelines for applying the overload principle to AET in OA (5)
- Increase only one variable at a time
- Increase duration before intensity
- Increase duration in 1 min increments as tolerated
- Increase intensity by activating arms (arms above waist) & increasing resistance before increase speed
- Allow minimum of 2 weeks for adaptation prior to increasing further overload variables
Should we apply the principal of overload in OA ? (3)
Yes but with more caution than YA
- recovery takes longer
- safety margins are narrower
- Consequences of overtraining can be greater
T or F Manipulating intensity (speed and load) is more stressful for OA than manipulating training volume (reps, time , frequency)
TRUE
3- Functional relevance, as instructor.. ?
- Find aerobic exercise that have functional relevance such as stepping, stair climbing and picking up something
4- Challenge (3)
- Focus on increasing demands on multiple body systems (ex sensorymotor ability training)
- This is different than manipulating the exercise variables seen in overload
- increase complexity of the task (Walking to music time, Adding second task)
5- Accomodation
What can influence the ability of OA to perform AET ? (2)
The ability to monitor and adapt to the needs of participants at each session exercise
- Medications; pain due to arthritic
- Muscle soreness from previous exercise session
Frequency and duration for AET
30 min of mod exercise on most days of the week. Can be done in several session (3x10min) = similar cardio gains
Intensity, participants should be encouraged to: ? (2)
- Perform exercises to the best of their abilities but to never push themselves to a point of overexertion, pain, or beyond a level they consider to be safe
- To become skilled at listening to their bodies and understanding signs and symptoms of overexertion
Which of the 3 method is better to measure workload in OA ? A) HR B) RPE C) METs
All 3 !!
Heart rate + disadvantages (5)
Most common method of monitoring exercise intensity
dis
- Values estimated ( estimated max HR)
- Less reliable in OA vs YA (use of meds)
- Participants must slow-down to take heart rate without monitor
- Self palpation is often inaccurate
- % of HR reserve may represent a higher than expected % of VO2max
RPE (5)
- Self perceived scale effort
- Take into account;
- Central –> HR and breathing
- Local –> muscle fatigue
- Can allow participants to continue exercising while still self monitoring
- OA tend to lower their value
5 Important to follow RPE scale instruction
METS
First 8-10 weeks of training, AET should be ?
- Some activities have a wide range values
1. Ballroom dance = 4-6 MET
2. Aerobic dance = 6-9 MET
3. Skipping = 8-12 MET - Some have a little variance
1. Cycling 16 km/h = 5-6 MET
A type that can be maintained at a constant intensity
FITT principle
F = Exercise most days of the week
I = at the beginning of the program, for Healthy OA should be RPE 11-13 AND Frail or sedentary OA RPE 9-11
T = 30 min most days
T = 1. Activities that use large muscle group
2. Can be maintained for a prolonged period of time
3. Rhythmical & continuous
