Unit 4 - Principles of Fitness, Exercise and Health

Question 1

Is “Fitness” described by everyone the same way?

Answer 1

No, as a concept it is difficult to provide a definitive definition, because fitness means different things to different people: A state of well-being, e performs physical activity, adaptation to the stresses of one’s lifestyle, ability to carry out everyday tasks with vigor and without excess stress or fatigue.

Question 2

What are the five main components of total fitness?

Answer 2

• physical fitness (health-related and skill-related) • mental and emotional fitness – harmony with a positive mental state • medical fitness – free from injury, disease and illness • nutritional fitness – good nutritional intake for fuel, growth and repair • social – healthy interaction with others

Question 3

For an instructor, which components of fitness are predominant?

Answer 3

For an instructor the components of physical fitness will be the focus.

Question 4

Which are the five components of health- related fitness?

Answer 4

Cardiovascular fitness Muscular strength Muscular endurance Flexibility Body composition

Question 5

Define cardiovascular fitness.

Answer 5

Cardiovascular fitness is the ability of the heart, lungs and muscles to take in, transport and utilize oxygen during exercise. By doing physical activity the pulse quickens and breathing gets deeper – you are using the cardiovascular system. The cardiovascular system’s efficiency will be improved through regular aerobic training.

Question 6

Define Muscular strength.

Answer 6

Muscular strength can be defined as the maximal amount of force a muscle or group of muscles can generate during one contraction.

Question 7

Why is the development of muscular strength useful?

Answer 7

For 2 key reasons. Firstly, the individual is able to produce a greater maximal force when required to do so. Secondly, with enhanced levels of strength everyday sub-maximal tasks require a lesser percentage of the individual’s maximal effort, thus making the task easier.

Question 8

Give examples for activities requiring maximal strength.

Answer 8

Heavy weight lifting and lifting or moving heavy objects.

Question 9

Define muscular endurance.

Answer 9

Muscular endurance can be defined as the ability of a muscle or group of muscles to contract repeatedly for extended periods of time without fatigue. The vast majority of everyday situations that require an individual to exert force require muscular endurance.

Question 10

Which common activities require muscular endurance?

Answer 10

Carrying shopping, walking up stairs, maintaining a good posture, gardening and exercise sessions involving high repetition resistance training.

Question 11

How can Flexibility be defined?

Answer 11

Flexibility can be defined as the range of movement about a joint or series of joints.

Question 12

Why is it important to the individual to develop and maintain flexibility?

Answer 12

To ensure an appropriate range of motion at all joints and a freedom of movement.

Question 13

Give examples of activities and sports that require flexibility.

Answer 13

gymnastics, dance, yoga and everyday normal function.

Question 14

What does body composition describe in health-related fitness?

Answer 14

It’s used to describe the percentages of fat, bone and muscle in human bodies.

Question 15

Why is the percentage of fat of most interest?

Answer 15

Because it can be very helpful in judging health in addition to body weight.

Question 16

What amount of body fat does the National Institute of Health recommend that an adult’s male body should have?

Answer 16

Between 13 and 17 percent fat.

Question 17

What amount of body fat does the National Institute of Health recommend that an adult’s female body should have?

Answer 17

Between 20 and 25 percent fat.

Question 18

At what body fat percentage do most athletes experience greater performance benefits?

Answer 18

Between 7 and 19 percent for men, and 10 and 25 percent for women, depending on the sport.

Question 19

Which are the 6 skill-related fitness components?

Answer 19

Speed Power Reaction time Co-ordination Balance Agility

Question 20

Explain the skill-related component of Speed.

Answer 20

Speed is about quickness of movement, whether this is the legs of a runner or the arms of the shot putter. Speed is an integral part of every sport and can be expressed as any one of, or combination of, the following: maximum speed, elastic strength (power) and speed endurance.

Question 21

Explain the skill-related component of Power.

Answer 21

Power is the ability to exert maximum muscular contraction instantly in an explosive burst of movements. The two components of power are strength and speed e.g. jumping or a sprint start.

Question 22

Explain the skill-related component of Reaction time.

Answer 22

Reaction time is the ability to respond quickly to a stimulus. Simple reaction time is the time taken between a stimulus and movement e.g. sprint start. Such simple reaction time depends on nerve connections and signal pathways, is ‘hard wired’ in the body and cannot be improved. Another type of reaction time, choice reaction time, is the time taken between stimulus and action which requires a choice. Choice reaction time can be improved by practice and training.

Question 23

Explain the skill-related component of Co-ordination.

Answer 23

The ability to move two or more body parts under control, smoothly and efficiently.

Question 24

Explain the skill-related component of Balance.

Answer 24

The ability to control the body’s position, either stationary e.g. a handstand or while moving e.g. a gymnastics move.

Question 25

Explain the skill-related component of Agility.

Answer 25

The ability to perform a series of explosive power movements in rapid succession in opposing directions e.g. zigzag running or cutting movements.

Question 26

Which factor will affect an individual’s fitness level?

Answer 26

Age

Gender

Physique/body type

Diet

Activity Level

Physical disabilities

Illness and fatigue

Drugs

Stress

Environment

Question 27

How can age affect the fitness level?

Answer 27

Fitness is generally greatest during the 20’s. Although the speed at which the effects of ageing occur can be offset by regular physical activity, it progressively results in weaker muscles, lighter bones, stiffer joints, slower reflexes and an increase in body fat.

Question 28

How can gender affect the fitness level?

Answer 28

Up to puberty males and females tend to be equal in terms of general fitness. However, due to increased levels of testosterone, active males grow stronger due to greater muscle mass. Since males are generally larger than females they have larger lungs and therefore have a greater potential for transporting oxygen thereby increasing CV fitness abilities. With longer bones and larger muscles males have the ability to move faster. Females of all ages tend to be more flexible than males. Females usually have more body fat than males.

Question 29

How does Physique/Body Type affect the fitness level?

Answer 29

An individual’s body type will have a significant impact on their ability to perform various physical tasks successfully e.g. a tall thin person may be more suited to basketball than rugby.

Question 30

What is a simply system for assessing body type?

Answer 30

The visual system of somatotyping. It suggests that there are three distinct body types: ectomorphs, endomorphs and mesomorphs.

Question 31

How are ectomorphs?

Answer 31

Ectomorphs are naturally thin with little body fat or muscle mass. Ectomorphs find it difficult to gain weight (either muscle or fat) and are well suited to weight-bearing aerobic activities such as long distance running.

Question 32

How are Mesomorphs?

Answer 32

Mesomorphs tend to be naturally lean and muscular, with broad shoulders and narrow waist and hips. Mesomorphs are naturally athletic and tend to be suited to a wide variety of sporting activities, especially those requiring a good power to weight ratio.

Question 33

How are Endomorphs?

Answer 33

Endomorphs are naturally predisposed to fat storage. They tend to be apple or pear-shaped and carry large amounts of body fat. Endomorphs also tend to possess a
reasonable degree of muscle mass, although this is often overlooked due to the predisposition for fat storage. Activities such as shot putt and hammer throwing may
be suited to endomorphs.

Question 34

Can any individual clearly be categorized within the three different body types?

Answer 34

No, many individuals are not exclusively one of the body types, but rather a combination of two or more. For example, an individual with a small frame, little muscle mass and a tendency to store body fat could be considered an ectomorph with endomorphic
tendencies.

Question 35

Why is understanding the body type important when discussing and cementing clients objectives?

Answer 35

An endomorph with a goal of becoming a competitive marathon runner may need to re-evaluate their objective as they are not structurally suited to this type of activity. Similarly, ectomorphs are unlikely to succeed in the field of competitive bodybuilding as they have difficulty gaining muscular size. If this is to be discussed, then it will obviously need to be done with sensitivity.

Question 36

How can diet affect the fitness level?

Answer 36

The body needs certain substances for energy, growth and repair which are provided by the food taken in. A healthy diet with quality nutrition will help ensure that the
body will function at its best.

Question 37

How can the activity level affect the fitness level?

Answer 37

Running and training with weights are not the only way to help with your fitness levels. Regular activities such as walking the dog, cycling and gardening, can also
make significant contributions.

Question 38

How can physical disabilities affect the fitness level?

Answer 38

Although a physical impairment may prevent part of the body functioning correctly, targeted exercise can keep the rest of the body very fit. As demonstrated in the
Paralympics, many disabled people are first class athletes.

Question 39

How can illness and fatique affect the fitness level?

Answer 39

When tired or ill the ability to perform diminishes. This could be caused through working too hard with insufficient rest.

Question 40

How can drugs affect the fitness level?

Answer 40

Both medical and recreational drugs (alcohol, cigarettes) will affect an individual’s fitness. When undertaking physical activity, recreational drugs should be avoided
and, if taking drugs for health reasons, medical advice should be sought.

Question 41

How can stress affect the fitness level?

Answer 41

High levels of stress can lead to illness, causing health problems such as high blood pressure and heart disease.

Question 42

How can the environment affect the fitness level?

Answer 42

The quality of the air taken in will determine the amount of oxygen that can be utilised. Aerobic fitness can therefore be significantly influenced by the following
environmental factors:
• fumes from traffic and factories
• weather – hot, cold, humidity
• at high altitude the air is thinner and individuals will need to breathe harder to get enough oxygen in

Question 43

What are the main cause of death in the UK and many
developed nations?

Answer 43

Diseases of inactivity (hypokinetic).

Question 44

What do current guidelines suggests to be active?

Answer 44

• significant health benefits can be gained by including 30 minutes of moderate activity on most, if not all, days of the week (Department of Health, 2004)
• additional health benefits can be gained through regular participation in activity that is of longer duration or of more vigorous intensity (U.S. Department
of Health and Human Services, 1996)

Question 45

What are the benefits of physical activity? What can it help to prevent?

Answer 45

Overall mortality

Cardiovascular diseases

Cancer

Osteoarthritis

Osteoporosis

Falling

Obesity

Type II diabetes

Mental health

Health-related quality of life

Question 46

What does exercise do the body? (Stimulation)

Answer 46

Exercise is a stimulus which primarily affects the cardiovascular and neuromuscular systems and so it is within these that most adaptations are experienced.

Question 47

What are cardiovascular and respiratory adaptations to endurance / aerobic training?

Answer 47

Heart:

• increased size of the heart muscle (ventricular hypertrophy)
• increased strength of contraction
• increased stroke volume
• increased cardiac output
• reduced resting heart rate
• increased blood vessel size
• decreased risk of heart disease

Blood vessels and blood chemistry:

• reduced systolic and diastolic blood pressure (SBP and DBP)
• favourable change in blood lipids
• increased haemoglobin
• increased blood volume

Lungs:

• increased functional capacity during exercise
• increased diffusion of respiratory gases
• increased vital capacity

Metabolic function:

• decreased insulin resistance and improved glucose tolerance - beneficial for treatment and prevention of diabetes
• reduced body fat
• increased maximal O₂ uptake (V0₂ max)

Muscular changes:

• increased capillarisation of muscles
• increased enzymatic function within muscle cells
• increase in size and number of mitochondria
• improved perception of muscle tone

Psychological factors:

• improved self mastery
• increased social interaction
• distraction from the daily routine
• decreased depression and anxiety

Question 48

What short term effects does aerobic exercise have on blood pressure?

Answer 48

There is a linear increase in SBP with increasing levels of exertion.
In contrast, during exertion DBP may decrease slightly, due to vasodilation, or will remain unchanged, except in hypertensives where it may rise as a result of an impaired vasodilatory response.

Question 49

How do heavy weight training and isometric exercise affect blood pressure?

Answer 49

heavy weight training and isometric exercise will significantly increase both systolic and diastolic blood pressure.

Question 50

What long-term effects does aerobic exercise have on blood pressure?

Answer 50

Aerobic exercise using large muscle groups in rhythmical activity is very appropriate for reducing blood pressure over time. With the exception of circuit weight training, chronic strength or resistance training has not consistently been shown to lower resting blood pressure

Question 51

What is Blood pooling?

Answer 51

• During exercise, as the heart rate rises, there is an increased flow of blood to muscles but nevertheless, venous return is maintained mainly due to the increased pumping action of the muscles.
• Should the activity stop suddenly however, the heart will still continue pumping blood around the body at the exercising rate for some time.
• Since the muscles now will have stopped working, extra blood will begin to build up or ‘pool’ in large muscle groups. This effect is called ‘blood pooling.’

Question 52

Which part of the body is mostly affected by blood pooling?

Answer 52

• The legs are most commonly affected due to the extra influence of gravity.
• Common symptoms are nausea, dizziness and fainting.

Question 53

What short-term (while the individual is exercising) effects does exercise have on bones and joints?

Answer 53

Short term responses (to any movements/exercise):

• increase in synovial fluid production

Question 54

What is an increase of synovial fluid production?

Answer 54

In response to increased movement, synovial joints will increase the production of synovial fluid. This fluid acts as a lubricant to protect the joint from excess wear and
tear (much like the oil in a car engine).

Question 55

What are long term adaptations (to weight-bearing exercise)?

Answer 55

• stronger ligaments
• increased bone density
• reduced loss of bone mass associated with age

Question 56

What is delayed onset of muscular soreness (DOMS)?

Answer 56

This is the name given to the pain, soreness or stiffness experienced in muscles typically between 12-72 hours after exercise

Question 57

When is DOMS especially common?

Answer 57

It is particularly common following the beginning of a new exercise programme, especially if it involves increased eccentric loading (e.g. going down stairs, running downhill, downward motion of squats) or an increase in intensity. This seems to be caused by exercise-induced muscle damage followed by an inflammatory response, although the exact mechanisms are still not fully understood.

Question 58

What are the short term effects of exercise on muscles?

Answer 58

• Vasodilation (diversion of blood) to the working muscles, and away from the non-essential organs. This can result in a temporary increase in muscle diameter, sometimes called the ‘pump’
• Possible DOMS

Question 59

What are the long term effects of exercise on muscles?

Answer 59

• repetition of any activity will enhance neuromuscular connections, helping improve motor fitness by enabling greater efficiency of movement and motor unit recruitment
• dependent on the regularity, duration and intensity with which a muscle is used, the properties of a muscle are also changed

Question 60

What effect does aerobic exercise and muscular endurance resistance training have on muscles (fibres)?

Answer 60

Low intensity, long duration exercise can bring about the following changes on Type I fibres:
• an increase in the number and size of mitochondria in the muscle fibres
• an increase in the number of capillaries surrounding these fibres
• an increase in the number of aerobic enzymes stored glycogen and triglycerides in the muscle fibres

Question 61

What effect does Hypertrophy and strength resistance training have on muscles (fibres)?

Answer 61

Short duration, high-intensity exercise affects mainly Type II fibres:
• a decrease in nervous inhibition
• an increase in the diameter of the recruited fibres (hypertrophy) due to an increase in the myofilaments within the fibres
• an increase in the glycolytic activity of the muscle allowing more work to be performed under anaerobic conditions or high-stress conditions

Question 62

What does the modern lifestyle do to our posture?

Answer 62

• Modern lifestyles involve sitting for much longer periods of time e.g. sitting, driving, which encourages a round-shouldered ‘kyphotic’ posture.
• Also, work tends to involve small movements performed under tension (use of a computer keyboard, for example) resulting in shortened muscles and poor flexibility.
• Eventually, these effects will lead to decreased function and increase the risk of injury, pain and discomfort.

Question 63

What should the instructor endeavour to improve good posture?

Answer 63

The instructor should, therefore, endeavour to include resistance exercises, and stretches in their training programmes which help compensate for modern lifestyle factors, such as rounded-shoulders and poor range of movement, etc.

Question 64

What exercises can be included when initiating a posture-improvement process?

Answer 64

• full range
• compound movement patterns
• a free-standing posture
• free weights and cables
• an equal number of push and pull exercises
• dynamic and developmental stretches

Question 65

Name the morphological factors of the benefits of resistance training.

Answer 65

• muscle hypertrophy due to increases in contractile proteins, number and size of myofibrils, connective tissues, and size of type II fibres
• increase in strength and size of ligaments and tendons
• increase in bone density and bone strength
• increase in muscle capillary density

Question 66

Name the Neural factors of the benefits of resistance training.

Answer 66

• increase in motor unit activation and recruitment
• increase in discharge (nerve impulses) frequency of motor neurons (nerve cell)
• decrease in neural inhibition (muscles protective braking mechanisms)

Question 67

Name the biochemical factors of the benefits of resistance training.

Answer 67

• the minor increase in ATP (adenosine triphosphate) and CP (Creatine phosphate) stores
• increase in testosterone and growth hormone during resistance training exercises

Question 68

Name the additional factors of the benefits of resistance training.

Answer 68

• little or no change in body mass
• increase in fat-free mass/muscle mass
• decrease in fat mass and relative body fat percentage
• improved bone health
• increased strength
• increased power
• increased muscular endurance
• improved posture
• improved proprioception
• increased metabolic rate
• increased ROM (range of motion)
• improved immune function

Question 69

Explain the resistance training terminology Repetitions.

Answer 69

• Fleck and Kraemer (1997), define a repetition (rep) as ‘one complete movement of an exercise’.
• It is a cycle of muscular contractions, which for most exercises will be one concentric and one eccentric muscle action.

Question 70

Explain the resistance training terminology Sets.

Answer 70

• A set is a group of repetitions performed continuously without stopping
• The number of repetitions in a set is usually between 1 and 20, depending on the goal of the individual and what they are participating in.

Question 71

Explain the resistance training terminology Repetition maximum (RM).

Answer 71

• This is the maximum number of repetitions at a given resistance that can be performed in a set with good technique
• 1RM means the maximum weight that can be lifted once (effectively maximal muscular strength).
• A 10-15RM target means that momentary voluntary fatigue should sit in between the tenth and fifteenth repetition. RM is usually used as a guide for the load or weight.

Question 72

Explain the resistance training terminology Intensity.

Answer 72

• Intensity refers to how much effort is applied to an exercise, not the amount of fatigue encountered or how hard an exercise feels (relative intensity).
• In the case of resistance training, 1RM would equate to maximum intensity.
• Intensity of an exercise can be estimated as a percentage of the 1RM. Unlike cardiovascular exercise, intensity in resistance training does not correlate with heart rate.

Question 73

Explain the resistance training terminology Intensity.

Answer 73

• Training volume can mean the total number of repetitions performed in a training session or the total amount of weight lifted (load) in a session
• Fleck and Kraemer (1997), also refer to it as the total amount of work performed in a session, a week, a month, or some other time period.
• There is a strong relationship between the volume of training and goals, such as hypertrophy.

Question 74

Explain the resistance training terminology Compound and isolation exercises.

Answer 74

• Compound exercises are defined as multi-joint exercises or those that involve more than one joint.
• Isolation exercises, on the other hand, involve only one joint.
• For example, the squat is a compound exercise that involves the hip, knee and ankle joints;
• the leg extension only involves the knee joint and therefore, is an isolation exercise.

Question 75

What do compound exercises rely on?

Answer 75

• They rely on good neuromuscular co-ordination between agonists, antagonists, synergists and fixators.
• As more muscle groups are utilised during compound work, more weight can be lifted and functional movements can be more efficiently trained.
• This is especially valid for sports specific training and rehabilitation, as long as the correct technique is adhered to.

Question 76

What is Hypertrophy?

Answer 76

Hypertrophy is simply referring to muscular
enlargement and is brought on predominantly by an increase in the cross-sectional area of the muscle fibres

Question 77

What does the process of hypertrophy involve?

Answer 77

The process of hypertrophy, to increase fibre size and therefore, muscle size, involves two main processes:
• increase in the synthesis of the actin and myosin within the myofibril (laid down on the external layers to increase the diameter)
• increase in the number of myofibrils within a muscle fibre

Question 78

What is required in order to achieve hypertrophy?

Answer 78

Moderate loads and high volume training with short to moderate rest periods are required in order to achieve hypertrophy.

Question 79

Name the different types of resistance.

Answer 79

• free weights (e.g. barbells, dumbbells, medicine balls)
• resistance machines (fixed-path machines or cables)
• body weight
• manual resistance (applied by a partner or an opposing limb)
• rubber bands/dynabands
• water

Question 80

What is the Agonists?

Answer 80

The muscle that contracts to produce and control movement

Question 81

What is the Antagonists?

Answer 81

Muscle(s) that relax whilst the agonist is contracting.

Question 82

What is the Synergists?

Answer 82

Muscle(s) that contract to assist the agonist by modifying the desired movement.

Question 83

What are Fixators?

Answer 83

Muscles that fix another part of the body, usually a nearby joint, so that it remains stable.

Question 84

What is the aim of the warm up?

Answer 84

To place the cardiovascular, respiratory and neuromuscular systems in a state of readiness for activity.

Question 85

What are the objectives of the warm up?

Answer 85

• raise the pulse rate
• raise the body temperature
• mobilise the major joints
• stretch muscles in an appropriate way

Question 86

What is the main function of the warm up?

Answer 86

• The main function of the warm-up is to raise the body temperature using all major muscle groups in a controlled rhythmical activity, therefore, increasing blood flow and elasticity of muscle tissue and allowing more oxygen to be carried to the working muscles. The movements chosen should mimic and prepare the body for the activity to follow.

Question 87

What physiological benefits does warm up provide, by raising the body temperature?

Answer 87

• increased core body temperature, which will cause vasodilation, increasing blood supply and providing more oxygen to the tissues and working muscles.
• increased muscle temperature improves the elasticity of intramuscular connective tissue.
• metabolic activity in the muscle tissue is stimulated.
• viscosity within the muscles is reduced, allowing smoother and more efficient contractions with less resistance
• muscles are able to exert greater power under sub-maximal loads due to increased facilitation
• slow, gradual warm-up reduces lactic acid build up in the early part of exercising
• increased speed at which nerve impulses travel. This applies to the motor and sensory nervous pathways, improving general proprioceptive
  activity
• the response of the heart to more strenuous exercise is improved significantly
• connective tissue has an enhanced ability to elongate and synovial fluid is secreted, lubricating joints, which should reduce the risk of injury to soft tissue structures
• mental preparation and a rehearsal effect

Question 88

What types of warm-ups are there?

Answer 88

• passive warm-up
• active general warm-up
• active specific warm-up

Question 89

What is a passive warm-up?

Answer 89

This is simply using some form of external heating, for example taking a warm shower, hot bath, using heat lamps, warm clothing or even pre-exercise massage. Heart rate can increase together with blood pressure and increased circulation around the body, but skeletal muscle will be relatively unaffected. Blood will be diverted towards the skin rather than the muscles.

Question 90

What is active general warm up?

Answer 90

This method increases body temperature as the individual engages in activities that involve large muscle groups (e.g. callisthenics, jogging). This type of
warm-up increases muscle temperature more effectively than the passive method.

Question 91

What is active specific warm up?

Answer 91

Specific warm ups involve the individual going through basic movement patterns and using the same muscle groups as will later be used in the activity, only at a reduced intensity. This is an effective physiological and mental rehearsal of performance skill. The more power necessary for the sport or activity, the more crucial the warm-up phase

Question 92

How can all warm-up methods be combined?

Answer 92

• A larger number of clothes than normal are worn in the form of layers as the performer undergoes a sequence of general joint mobilising activities and jogging (unless it is hot weather), beginning with low-intensity movements.
• As the individual becomes warmer, tracksuits are removed and the activity is progressively intensified until, towards the end of the warm-up sequence, the movements required for the performance skill are practised.

Question 93

How long must a warm-up be?

Answer 93

• No hard and fast rules can be laid down regarding the intensity and duration of a warm-up programme, as this varies with individuals and fitness levels.
• 10-20 minutes is now the suggested ideal time, however, this may seem impractical to most exercisers.
• Warming up should not be too intense as physical performance may be impaired. The onset of sweating is generally indicative of the effectiveness of a warm up sequence.
• The warm-up should be adjusted according to the environment, regarding air temperature, humidity, space, etc.

Question 94

What is the aim of the cooldown?

Answer 94

To return the body and mind to the pre-exercise state.

Question 95

What are the objectives of a cool down?

Answer 95

• decrease the pulse rate
• decrease body temperature
• stretch muscles in an appropriate way

Question 96

Why is cool down important?

Answer 96

Following an intense activity, blood has been diverted to working muscles and there is a tendency for the blood to ‘pool’ in the extremities, especially in the legs.

Light rhythmical activity involving the muscle groups used in the exercise session should be used in this cool down period, decreasing in intensity. This will aid venous return to the heart and help prevent pooling and consequent dizziness and nausea.

These low-intensity exercises disperse the lactic acid present

Question 97

How does stretching during cool down help?

Answer 97

• Stretching activities during the cooldown would also seem to prevent muscle soreness following exercise.
• Gradually bringing the body back to normal also helps psychological wind-down and promotes mental relaxation at the end of the exercise session, allowing time to consider the feeling of satisfaction and benefit that exercise can bring.
• Here the stretches should be static. Some tight muscles will benefit from increased flexibility through developmental stretching.

Question 98

By what is flexibility determined by?

Answer 98

Flexibility is determined by the shape of the bones and cartilage involved in the joint and by the length of the muscles that cross over the joint.

Question 99

What can a significant lack of flexibility affect?

Answer 99

A significant lack of flexibility can dramatically affect posture and force production at a joint. It is normally seen as causing impaired and perhaps painful performance.

Question 100

What can a high degree of flexibility lead to?

Answer 100

A high degree of flexibility or ‘hypermobility’ may also lead to an increased incidence of injury, but is required for success in disciplines such as gymnastics and martial arts.

Question 101

What can cause muscle shortening?

Answer 101

• Jogging, football, boxing and hockey all involve movements where muscles are not worked through their full range. This can lead to muscle tightness and adaptive shortening.
• Muscle shortening can also result from poor posture or when a body part is immobilised in a plaster cast. An improper exercise that overdevelops one muscle group whilst neglecting the opposing group, results in an imbalance that restricts flexibility, e.g. quadriceps/hamstrings.

Question 102

What are the benefits of flexibility training?

Answer 102

• Increased range of motion
• Reduced muscle tension and increased physical and mental relaxation
• Reduced risk of joint sprains or muscle strains
• Reduced risk of back problems
• Decreased muscular soreness (DOMS) associated with other exercise activities
• Decreased muscle viscosity, causing contractions to be easier and smoother
• Improved co-ordination by allowing for greater ease of movement
• Improvement and development of body awareness
• Improved capability for circulation and air exchange
• Improvements in posture

Question 103

What factors affect flexibility?

Answer 103

• Age: Young people are normally more flexible than older people. Babies and infants are very flexible and start to lose this natural flexibility as soon as they start to walk (when the joints become weight-bearing and need more stability).
  As we get older, muscle contractility remains, whilst elasticity is lost, resulting in tighter, stiffer muscles. There is also a reduction in activity levels as we age, which will cause a decrease in flexibility.
• Gender: Studies have shown females to be more flexible than males in most joints and to
  remain so throughout adult life. The reasons for this are uncertain, but may be attributed to structural and anatomical differences or different activities and training experiences earlier in life.
• During pregnancy and in the post-natal period, women produce excess amounts of a hormone called relaxin to assist the birth process. The effects of relaxin are not restricted to solely the pelvic area, but act throughout the body, allowing greater flexibility than normal. Small levels of relaxin are constantly present, and will fluctuate
  slightly throughout a normal menstrual cycle.
• Temperature: An increase in temperature due to either direct heat or the weather can increase the
  elasticity of muscles and tendons and range of motion. Conversely, a decrease in temperature can result in a decrease in flexibility of as much as 20%
• Exercise and resistance training: Active people tend to be more flexible than those with a sedentary lifestyle.
• Heredity: Flexibility can be an inherited characteristic, as well as an acquired one. Some
  people are born with a naturally excessive ROM. This can create a greater potential
  for injury (i.e. joint dislocation) and it may be necessary to concentrate on
  strengthening the muscles acting over the joint in order to increase stability.
• Fashion: Individuals who constantly wear high heels may find that the muscles of the lower limb (gastrocnemius, soleus) adaptively shorten over a period of time, therefore causing reduced ROM at the ankle joint.

Question 104

Name the methods of stretching.

Answer 104

Question 105

Explain active stretching.

Answer 105

• Active stretching is accomplished using antagonist muscles and without assistance from an external force or object.
• It involves actively contracting one muscle or muscle group in order to stretch its opposing muscle group.
• For example, pectorals actively contract to stretch posterior deltoids and tibialis anterior actively contracts to stretch gastrocnemius.

Question 106

Explain Passive stretching.

Answer 106

• This is where another body part or external factor, such as a wall or a partner, is used to facilitate the stretch. For example, a lying hamstrings stretch where the hands are held behind the thigh or on the calf. This method is used to increase joint range and muscle length.
• A training partner can assist by gently pressing parts of the subject’s body through full range. Great care and communication is required between partners

using this method and so it is not recommended for beginners.

Question 107

What Types of stretches are there?

Answer 107

• Ballistic
• Dynamic
• Static maintenance
• Static developmental

Question 108

What is a ballistic stretch?

Answer 108

This form of stretching involves quick, repetitive bouncing or bobbing actions. It is undertaken in order to increase the stretch beyond the muscle’s normal range using momentum and body weight. It is generally considered unacceptable for the average
exerciser, due to the muscular damage that may occur as a result of the stretch reflex. These stretching exercises can produce muscle soreness and even losses in resilience and elasticity. However, they aresometimes necessaryas a more radical method of stretching adhesions and stubborn fibrous tissue inphysiotherapyandrehabilitation.

Question 109

What is a Dynamic Stretch?

Answer 109

This is similar to ballistic stretching, however, the limb movements do not end with bouncing or jerky movements, but instead, are performed under control. These stretches should mimic the movements of the following sport or activity and act as a kind of rehearsal.

• perform 8-10 repetitions of each stretch under control, gradually increasing the ROM

Question 110

Explain Static maintenance stretch.

Answer 110

Static maintenance stretching is where the muscle is taken to the end of its normal range and held without bouncing. These are short stretches, held for 10-15 seconds, and are used to maintain the normal length of the muscle. Following repeated contractions during exercise, the muscle becomes shorter and thicker and
a maintenance stretch is used to return the muscle to its normal length.

• take the stretch to the point of bind, maintaining good alignment and posture
• hold for 10-15 seconds until the tension within the muscle has reduced
• repeat the stretch if desired

Question 111

What is a Static developmental stretch?

Answer 111

These stretches are used to develop the length of the fibres themselves, thereby increasing range of movement at a joint. The following guidelines should be observed:
• take the stretch to the point of bind, maintaining good alignment and posture
• hold for 10-15 seconds, until the tension within the muscle has reduced
• relax and passively increase the ROM of the stretch until tension is felt again
• again hold for 10-15 seconds, until the tension within the muscle has reduced
• again increase the ROM of the stretch until tension is felt again
• hold until the tension reduces, then slowly return the limb to its normal position
• repeat the stretch if desired

Question 112

When should we stretch?

Answer 112

Stretching should form an integral part of the warm up and cool down, although stretching can be performed at any time of the day, appropriate to the individual.
Individuals can be advised to stretch at home, watching TV, or at the office, in order to balance out periods of immobility in positions of poor posture.

Dynamic stretching can be more easily prescribed as part of the warm-up, using exercises that will mimic the general movement of the following session. Dynamic stretches should be performed after some kind of pulse-raising/temperature raising
warm up.

In the cool down part of the session, some kind of static stretching is advised. This may be static maintenance, static developmental, or a form of passive stretch.

Question 113

What Contraindications for flexibility training are there?

Answer 113

• any developmental, excessive, uncontrolled or ballistic stretching should be avoided during pregnancy, due to the softening effects of relaxin
• if the movement is limited by a bony block
• avoid stretching a fracture site for approximately 8-12 weeks post-fracture
• any sharp pain occurring during a stretch
• any uncontrolled muscle cramping occurring during a stretch
• any infected joint or nearby tissue
• any acute inflammation, except for the majority of arthritic clients
• a local haematoma (bruise), resulting from an overstretch injury
• a client suffering from certain vascular or skin diseases

Question 114

What are the six main training principles?

Answer 114

• Specificity
• Progressive overload
• Reversibility
• Adaptability
• Recovery
• Individuality

Question 115

Explain the Training principles Specificity.

Answer 115

Any change or adaptation in the body’s muscles, organs and systems will be very specific to the type of training (stress) undertaken. This is the principle of specificity and means that if a participant wants to improve their running, they should run. Swimming will elicit very generalised improvements in their cardiorespiratory system, which may improve the running fitness. However, for the best results, that person should undertake running training.

Question 116

Explain the Training principles Progressive overload.

Answer 116

• To evoke an adaptation response the stimulus must be large enough to challenge the individual.
• For example, improvements in range of movement can only be achieved by working at or beyond the current limits i.e. it should stretch the muscle and the client should feel this as a mild tension.
• Muscles only get stronger when they are required to work harder than normal.

Question 117

What examples can be used for an adaptive response?

Answer 117

For an adaptive response, the following examples can be used as progressions:
• increase weight used
• increase number of repetitions
• increase number of sets
• decrease rest between sets

Question 118

What is the Training principles Reversibility?

Answer 118

Cessation of the stimulus which caused the adaptation to occur will result in a gradual decline. This principle states, therefore, that any improvements in fitness can only be maintained by regular exercise.

Question 119

What is the Training principles Adaptability?

Answer 119

the body will react in accordance with the type of overload to which it is subjected. For example, high weight low repetition exercise can lead to an increase in strength and intense exercise, lasting less than 10 secs can cause adaptations in the ATP-CP system, making it more efficient. Lower intensity longer duration activities help train the efficiency of the aerobic energy system.

Question 120

What is the Training principles Recovery?

Answer 120

An important concept to grasp is that adaptations occur, not during the activity, but in the time following it. Therefore, scheduled rest periods are a vital part of any
exercise programme. This will include not only rest periods between exercises/sets within individual sessions but between the sessions themselves as well.

Question 121

What is the Training principles Individuality?

Answer 121

• Although many clients may have similar general goals e.g. lose weight, get fitter, each is an individual with different physiological abilities e.g. ROM, current strength, CV level.
• a programme should be designed specific to both a client’s needs and their abilities.
• For example, a client may have a restricted ROM at their hips so the programme may include additional stretching exercises in this region. If a client has a goal of running a marathon, weight-bearing CV exercise could be seen as more appropriate than cycling or rowing.

Question 122

The basic fitness variables can be summarised using…

Answer 122

F.I.T.T.
F - Frequency - how often
I - Intensity - how hard
T - Time - how long
T - Type - the type of training (e.g. strength, endurance)

Question 123

Explain the fitness variable Frequency.

Answer 123

Frequency refers to the number of training sessions per week, month or year.

A typical example for a beginner may be to start with a three times a week schedule with a day’s rest in between.

Competitive athletes may train up to twelve times a week.

The number of exercise sessions per week should reflect current fitness level, time available, any other commitments like family, and goals.

Question 124

Explain the fitness variable Intensity.

Answer 124

This is an important aspect to be considered when designing an exercise programme. It is normally monitored using % of 1RM, RPE or heart rate however there are additional factors that can influence the intensity:

• Lever length: a lever arm (sometimes referred to as a moment arm) is the perpendicular distance between a force’s line of action and an axis of rotation (e.g. a pivot).
• Speed: by increasing the speed of an exercise, intensity is increased e.g. a 100m sprint is a more intense activity than a marathon. Olympic lifts, such as the clean and jerk, where the objective is to lift the weight with maximum effort as quickly as possible is more intense than performing a bench press at a moderate tempo.
• Gravity:It can be increased by adding external weight through the use of free weights, which
  in turn will increase intensity. An increase in body mass will also increase the effects of gravity.
• Range of movement: moving through a full range of movement during exercise is important, although there are potential risks to the connective tissues and joints when approaching end ranges particularly where momentum is involved.

Question 125

Explain the fitness variable Time.

Answer 125

The amount of time dedicated to the session is largely dependent upon the type of exercise, fitness level and the amount of time the client is willing to dedicate to
exercise. When planning for cardiovascular training it is normally measured in minutes, whereas resistance training is usually measured in reps and sets.

Question 126

Explain the fitness variable Type.

Answer 126

The mode or type of training may also be manipulated, as long as the specificity of the adaptation does not move away from the training goal. This can be done by
changing the aerobic exercise from running to cycling, for example, or the resistance exercise from a lateral raise to a shoulder press. Changing the type of exercise or
activity performed can be used to progress a programme and provide variety.

Question 127

Why should the principles of progression and periodisation be applied?

Answer 127

To avoid any plateaus or decreases in performance

Question 128

What does progression (in the principle of a progressive training programme) mean?

Answer 128

Progression means that when an overload is applied it should be gradual and sufficient enough to elicit an adaptation, but it should not be excessive

Question 129

Why is Excessive stimulus counterproductive?

Answer 129

Excessive stimulus is counterproductive since it will lead to overreaching and maybe overtraining.

Question 130

What is a prime example of excessive stimulus?

Answer 130

Excessive post-training muscular soreness, lasting up to 7-11 days after resistance training

Question 131

What is Periodisation (within Principles of a progressive training programme)?

Answer 131

Periodisation is the planned progression and manipulation of the training variables over a prolonged period of time. Varying the intensities and types of training in phases or cycles can cause greater improvements in performance and decrease the risks of overtraining and injury

Question 132

Who tends to make rapid progress initially once exposed to the exercise stimulus?

Answer 132

An untrained individual, as they have a great adaptation potential and are unfamiliar with any exercise stimulus

Question 133

Name signs of Overtraining.

Answer 133

• sudden poor co-ordination
• lack of ability to concentrate
• reduction in performance
• irritability, over sensitivity to criticism
• reported disrupted sleep patterns
• general lethargy
• susceptibility to colds, illness

Question 134

What is the recommended to reduce mortality frequency of training as per ACSM (1998)?

Answer 134

• Frequency 5-7 times a week
• Intensity 50-90% of MHR
• Time 30 minutes in total Type rhythmical use of large muscles

Question 135

What is the recommended To maximise aerobic fitness and reduce mortality frequency of training as per ACSM (1990)?

Answer 135

• Frequency 3-5 times a week
• Intensity 60-90% of MHR
• Time 20-60 minutes
• Type continual, rhythmical use of large muscle groups

Question 136

Define light activity.

Answer 136

Little or no exertion normally does not cause a noticeable change in breathing.

Question 137

Define Moderate activity.

Answer 137

Requires sustained, rhythmic muscular movements at least the equivalent of brisk walking and leaves a person feeling warm and slightly out of breath.

Question 138

Define Vigorous activity.

Answer 138

Requires sustained, large muscle movements at 60 to 70% or more of maximum heart rate, a level that makes a person sweaty and out of breath.

Question 139

Why is monitoring exercise intensity necessary?

Answer 139

Monitoring exercise intensity is necessary to both the safety and effectiveness of the exercise session

Question 140

Which are the methods of monitoring exercise intensity?

Answer 140

• heart rate
• rate of perceived exertion
• talk test

Question 141

How to you estimate maximum heart rate?

Answer 141

220 beats per minute (bpm) – age (ACSM, 2000). With an error range of plus or minus 11 bpm

Question 142

How do you determine Heart rate zones for your clients?

Answer 142

Example: Maximum heart rate = 194 Multiply 194 by 0.6 and 0.9 to get the lower and upper limits of the target heart rate zone:

194 x 0.6 and 194 x 0.9 = a target heart rate zone of 116 to 175 beats per minute (bpm)

Question 143

What is RPE?

Answer 143

Rate of perceived exertion (RPE):
The response of the client should take into account all of the symptoms of exertion such as breathing, muscular fatigue and the subjective feeling of effort. The classic Borg scale given below rates effort between 6 and 20.

Question 144

What is the talk test?

Answer 144

Though probably not as accurate as the previous methods, the Talk Test is nevertheless a simple method of gauging intensity that doesn’t require any equipment or learning.

• light activity Breathing lightly and talking easily, but heart rate has increased
• moderate activity Still talking comfortably, but breathing is deeper and quicker, body warming up
• vigorous activity (heavy increasing to very heavy) Breathing more deeply and harder, talking with a little more difficulty

Question 145

What is the internationally recognised age when there is a significant reduction in the safety margins relating to exercise?

Answer 145

50 is the current internationally recognised age at which there is a significant reduction in the safety margins relating to exercise and when pre-exercise screening is essential to ensure exercise professionals meet their duty of care.

These best practice guidelines are for 50+ individuals who:

• are asymptomatic (i.e. determined by the pre-exercise completion and interpretation of one of the two recommended 50+ pre-exercise screening tools namely: Revised PARQ (PARQ-R) or the AHA/ACSM Health/Fitness Facility Pre-participation Screening Questionnaire)
• have little or no recent and frequent experience of the particular exercise modality

Question 146

What is the approximate age at which the ageing process begins?

Answer 146

40

Question 147

What happens at the age of 50?

Answer 147

50 is the age at which the progressive losses in the musculoskeletal/CV/neuromuscular systems
means that adaptation of exercise needs to be considered.

Question 148

What is the loss in physical capacity with the losses in each of the body systems from the age of 40?

Answer 148

40) result in a corresponding 1-2% loss per year in physical capacity in:
• muscular strength (fewer, smaller and weaker fibres)
• power (fewer fast twitch, smaller, weaker and slower)
• bone density (thinner, more brittle bones and less ability to withstand fracture)
• aerobic endurance (fewer capillaries, less elastic vessels and reduced intake, uptake and utilisation of oxygen)
• balance and co-ordination (less sensory input and less postural stability, less co-coordination and less ability to prevent a trip turning into a fall)
• flexibility, agility and later mobility and transfer skills (stiffer joints, reduced range and ease of movement and less ability to perform activities of daily living (ADLs) e.g. get up and down from floor / chairs safely

In addition, there are:
Sensory declines including:
• reduced motor learning (slower motor learning)
• reduced visual and aural acuity (sight and hearing difficulties)

Cognitive declines including:
• poorer short term memory

Question 149

What guidelines should be followed for adults age 50+ to be safe (i.e. to reduce/minimise the risk of adverse, age-related cardiovascular and articular system events to a minimum)?

Answer 149

• current International guidance (ACSM/AHA) recommends that all people over the age of 50 should complete a recommended pre-exercise health screening questionnaire (PARQ-R or AHA/ACSM) to establish whether they are asymptomatic and ready to participate or whether they should seek further medical assessment prior to participating in an exercise programme
• spend longer warming up and warm up more gradually than younger clients (i.e. to ensure a total of 15 minutes) and begin with moderate shoulder circles before increasing the shoulder ROM and progressing to arm circles. Clients should be advised to do this by taking responsibility for themselves e.g. by walking to the session or by coming early and warming up before the session
• build-in a longer, more gradually tapered cool down after the aerobic training. Clients should be advised to do this by taking responsibility for themselves e.g. by keeping going for a few minutes after the rest of the class have stopped and/or are changing to the next activity (i.e. to prevent/minimise the potential for adverse cardiovascular events)
• keep the intensity of all training components to a challenging but health-related level i.e. without pain or strain and within their individual ‘personal best training zone’ by using the talk-test and educating clients on the use of the RPE scale as a means of monitoring and regulating exercise intensity, as required (N.B. it should be challenging)

Question 150

Further to the guidelines for adults 50+, what should the instructor encourage?

Answer 150

• ensure correct technique as it is even more important for injury prevention with this client group
• take more time during transitions e.g. floor to standing
• simplify exercise. When correct technique cannot be maintained and risk is increased e.g. when any weight-bearing steps involving laterally crossing one leg over the other (e.g. grapevine) are included in a group session, the instructor should use their professional judgement (including the clients current physical activity history) before giving suitable alternatives to the older person e.g. adapt the grapevine by bringing the feet together, and with turns of more than 90 degrees, breaking it down into stages can prevent dizziness until fitness improves
• learn new exercises with the easiest position and/or the lightest resistance and progress slowly initially
• avoid extreme spinal flexion (i.e. full or half curl-ups from supine) and make abdominal training more challenging and safer for the vertebrae by keeping the neck long, and if lifting off the floor, supported by the arm

Question 151

What are the Key safety guidelines when working with pre and post-natal clients?

Answer 151

• Women who have not exercised prior to pregnancy should begin with 15 minutes continuous aerobic activity, increasing gradually to 30 minutes continuous low-moderate intensity aerobic activity.
• Pregnant women should maintain adequate hydration during exercise, avoid exercising in very hot or humid conditions, consume adequate calories, and restrict exercise sessions to no longer than 45 minutes, according to recommended guidelines.
• Heart rate should not be used to monitor exercise intensity during pregnancy. Women should be advised to exercise according to how they are feeling and encouraged to use the talk test to monitor appropriate, individual intensity.

Question 152

What should pregnant woman avoid?

Answer 152

• exercising in the supine position after 16 weeks of pregnancy. The inclined position is unlikely to be a successful alternative to flat supine
• exercising prone
• prolonged, motionless standing
• heavy, uncontrolled, isometric or prolonged resistance work above the head
• leg adduction and abduction against a resistance
• isometric exercises
• loaded forward flexion
• rapid changes of direction or position
• uncontrolled twisting
• exercise with a risk of falling or abdominal trauma
• excessive and uncontrolled de-stabilisation techniques

Question 153

Pregnant women should immediately stop exercising if they experience:

Answer 153

• dizziness, faintness or nausea
• bleeding or leakage of amniotic fluid
• abdominal or contraction type pain
• unexplained pain in the back, pelvis, groin, buttocks or legs
• excessive shortness of breath, chest pain or palpitations

Question 154

Other pre and post-natal exercise considerations

Answer 154

• Hormonal and postural changes make pregnant women vulnerable to injury, joint misalignment, muscle imbalance and motor skills decline, especially if they are genetically hypermobile.
• women in the child-bearing period are habitually forward flexed with shoulder girdle protraction, thoracic kyphosis, long, weak upper back extensors, and short tight pectoral muscles and are prone to neck and shoulder pain.
• instructors should be aware that women in the childbearing period are vulnerable to injury, nausea, dizziness and fainting. Instructors should therefore have up-to-date first aid skills.
• Women should not begin exercising post birth until they have received the permission of their health
  care professional, usually at the post-partum 6 to 8 week check.
• the physiological and postural changes of pregnancy persist post-birth for several months, making women vulnerable to injury and long-term physical health problems such as pelvic floor dysfunction. This has particular significance for exercise involving impact, twisting and rapid, ballistic or aggressive movements, which should be avoided for at least 6 months and introduced progressively.
• high intensity or impact exercise in pregnancy and post-birth carries the risk of long-term pelvic floor muscle (PFM) support and control dysfunction.
• ideally, post-birth, women should be encouraged to re-educate posture, joint alignment, muscle imbalances, stability, motor skills, transversus abdominis (TA) muscle recruitment and pelvic floor muscle function before progressing to more vigorous exercise.
• “sit up”, “crunch” or “oblique cross-over” type exercises are not an appropriate choice for abdominal muscle re-education post birth.*
• *for at least 12 months post-birth the rectus abdominis is mechanically weaker (Coldron, 2007). Excessive oblique’s training may cause downward pressure through the pelvic floor (O’Dwyer, 2008) and anatomically will probably cause a lateral pull on a weaker linea alba. TA and PFMs are unlikely to be recruiting effectively to provide adequate abdominal compression and support.

Question 155

When should a woman be referred to a health professional in regards to post-birth symptoms?

Answer 155

When she is experiencing any of the following symptoms post-birth:

1. stress incontinence or pelvic floor muscle weakness
2. “dragging” pain or a feeling of heaviness in the lower abdominal or pelvic floor area
3. groin, low back pain or difficulty walking, even if mild and intermittent
4. abdominal muscle weakness, excessive abdominal doming, abdominal muscle separation or softness/sinking at the umbilical mid-line, umbilical hernia

Question 156

What does The Disability Discrimination Act (DDA) (1995) say?

Answer 156

It is unlawful to refuse to serve a disabled person, provide a lower standard of service, or offer a less favourable service to a disabled person. Service providers must make “reasonable adjustments” to their facilities and services so that they are accessible to disabled people. Adjustments to buildings and services must be made in expectation of attendance by disabled people; it is not reasonable for disabled people to be asked to wait until adjustments have been made. This may include providing extra help when required, but does not include automatically providing an additional service that is not required.

Question 157

Exemption from the DDA is justified for the following reasons:

Answer 157

• if by meeting the needs of the disabled person the health and safety of any person, including the disabled person, is endangered
• if by serving the disabled person the service provider is unable to serve others (not including a delay or inconvenience to others)
• if the disabled person is unable to enter into a legally enforceable agreement, or give informed consent
• if providing a service to disabled people on the same terms as to other people means that it would not be possible to offer the service at all, or if a higher charge would have to be made to others

Question 158

What to consider when your client has a progressive disability, e.g. multiple sclerosis?

Answer 158

Progressive disorders require careful monitoring to ensure that the exercise programme is not causing the condition to worsen (exacerbation).

Question 159

What to consider when your client has an asymmetrical weakness e.g. stroke, cerebral palsy?

Answer 159

If there is a difference in strength between the left and right side of the body the instructor should aim to improve the affected side as much as possible without neglecting the side which is unaffected. However, if the nerves controlling the affected side have been partially or completely damaged, the ability to improve in the affected muscles is greatly reduced.

Question 160

Explain Spasticity and how to train.

Answer 160

Spastic muscles are very tight or rigid. Since many individuals with physical disabilities will have some degree of spasticity, flexibility training is critical. However, before incorporating any flexibility in a programme the instructor should seek authorisation from a suitably trained medical authority on how to stretch a spastic muscle without causing injury.

Question 161

Explain Neurological conditions, for example muscular dystrophy and how to train.

Answer 161

Muscles can become progressively weaker as a result of the decline in CNS functioning. To help offset this, the programme should try to work on general fitness levels. However, should there be any rapid decline in function the client should immediately be referred to their GP for guidance.

Question 162

Explain Damage to sensory nerves and how to train.

Answer 162

This occurs with many types of physical disabilities. Since this may result in an inability to detect pressure against the skin, left untreated, this can result in a pressure sore. It is generally recognised that the use of a wheelchair increases the risk of developing pressure sores, and so the client will already be aware of the importance
of frequent checks. However, the instructor should also make the client aware that the use of gym equipment may also bring similar associated risks and so extra checks should be made.

Question 163

Explain depression due to disability and what to consider.

Answer 163

Depression is a common secondary condition resulting from an individual’s physical and psychological challenges of living with a disability. Occasionally, depression can cause a person to drop out of the programme. It should be noted that these are only some of the common conditions the fitness professional who works with disabled people will experience and if they in any way doubt their abilities to work safely and effectively with anyone they should refer to a medical authority for guidance.