Chapter 16 Flashcards
Physiologic & Training Considerations for Youth
- Peak oxygen uptake
- Submaximal oxygen demand is higher compared with adults for walking & running
- Glycolytic enzymes are lower than adult
- Sweating rate
Basic Guidelines for Youth Training
Mode - walking, jogging, running, games, activities, sports, water activity, resistance training
Frequency - 5 to 7 days of the week
Intensity - Moderate to vigorous cardiorespiratory exercise training
Duration - 60 minutes per day (but not if outside!)
Movement assessment - Overhead squats; 10 push up (or as many as can be tolerated); Single leg stance (if tolerated, 3-5 per leg)
Flexibility - Follow the flexibility continuum for each phase of training
Resistance training - 1 to 2 sets of 8 to 12 reps at 40 to 70% on 2 to 3 days per week; Phase 1 of OPT model should be mastered before moving on ; Phases 2-5 should be reserved for mature adolescents on the basis of dynamic postural control and licensed physicians recommendation
Special considerations - Progression for the youth should be based on postural control and not on the amount of weight that can be used; make it fun
Arteriosclerosis
A general term that refers to hardening (and loss of elasticity) of arteries
Atherosclerosis
Buildup of fatty plaques in arteries that leads to narrowing and reduced blood flow
Peripheral vascular disease
A group of diseased in which blood vessels become restricted or blocked, typically as a result of atherosclerosis
Normal physiologic & functional changes associated with aging
- Reductions in maximal attainable heart rate
- Reductions in cardiac output
- Reductions in muscle mass
- Reductions in balance
- Reductions in coordination (neuromuscular efficiency)
- Reductions in connective tissue elasticity
- Reductions in bone mineral density
Physiologic & Training Considerations for Seniors
- Max oxygen uptake, max heart rate and measures of pulmonary function decrease with age
- % of body fat will increase & bone mass & lean body mass will decrease with age
- Balance, gait, and neuromuscular coordination may be impaired
- Higher rate of both diagnosed & undetected heart disease
- Pulse irregularity is more frequent
Basic Guidelines for Seniors
Mode - stationary or recumbent cycling, aquatic exercise, or treadmill with handrail support
Frequency - 3 to 5 days for moderate-intensity; 3 days for vigorous intensity
Intensity - 40% to 80% of VO2peak
Duration - 30 to 60 min per day or 8 t 10 minute bouts
Movement assessment - Push, pull, OH squat or sitting and standing into a chair; single leg balance
Flexibility - Self myofascial elease and static stretching
Resistance training - 1 to 3 sets of 8 to 20 reps at 40 to 80% on 3 to 5 days per week; Phase 1 of OPT model should be mastered before moving on ; Phases 2-5 should be based on dynamic postural control and licensed physicians recommendation
Special considerations - Progression should be slow, well monitored & based on postural control; Exercises should be progressed if possible toward free sitting (no support) or standing; Making sure client is breathing in normal manner & avoid holding breath as in a Valsalva maneuver; If client cannot tolerate SMR or static stretches because of other conditions, perform slow rythmic or dynamic stretches
Obesity
The condition of subcutaneous fat exceeding the amount of lean body mass
Physiologic & Training Considerations for Overweight or Obese individuals
- May have other comorbidities (diagnosed or undiagnosed) including hypertension, cardiovascular disease, or diabetes
- Maximal oxygen uptake and ventilatory (anaerobic) threshold is typically reduced
- Coexisting diets may hamper exercise ability and result in significant loss of lean body mass
- Measures of body composition (hydrostatic weighing, skin-fold calipers) may not accurately reflect degree of overweight or obesity.
Basic Guidelines for Obesity
Mode - Low impact or step aerobics (such as treadmill walking, rowing, stationary cycling, and water activity)
Frequency - At least 5 days per week
Intensity - 60% to 80% of max heart rate. Use the “talk test” to determine exertion; Stage 1 cardiorespiratory training progressing to stage 2 (intensities may be altered to 40%-70% of max heart rate if needed).
Duration - 40 to 60 min per day or 20-30 minute sessions twice per day
Movement assessment - Push, pull, single leg balance (if tolerated)
Flexibility - SMR (only if client is comfortable); Flexibility continuum
Resistance training - 1 to 3 sets of 10 to 15 reps on 2 to 3 days per week; Phase 1 will be appropriate performed in a circuit-training manner (higher reps such as 20 may be used)
Special considerations - Make sure client is comfortable; exercises should be performed in a standing or seated position; May have other chronic diseases
Diabetes
Chronic metabolic disorder, caused by insulin deficiency, which impairs carbohydrate usage and enhances usage of fat and protein
Type 1 Diabetes
Typically diagnosed in children, teens, or young adults; specialized cells in the pancreas called beta cells stop producing insulin, causing blood sugar levels to rise, resulting in hyperglycemia - to control this the individual must inject insulin to compensate for what the pancreas cannot produce
Type 2 Diabetes
Associated with obesity, particularly abdominal obesity; produce adequate amounts of insulin, but their cells are resistant to the insulin (the insulin present cannot transfer adequate mounts of blood sugar to the cell).
Physiologic & Training Considerations for Individuals with Diabetes
- Frequently associated with comorbidities (including cardiovascular disease, obesity, and hypertension)
- Exercise exerts an effect similar to that of insulin
- Hypoglycemia may occur several hours after exercise, as well as during exercise
- Clients taking Beta blocking medications may be unable to recognize signs and symptoms of hypoglycemia
- Exercise in excessive heat may mask signs of hypoglycemia
- Increased risk for retinopathy
- Peripheral neuropathy may increase risk for gait abnormalities and infection from foot blisters that may go unnoticed
Basic Guidelines for Diabetes
Mode - Low impact activities (such as cycling, treadmill walking, low-impact or step aerobics)
Frequency - 4 to 7 days per week
Intensity - 50% to 90% of max heart rate. Use the “talk test” to determine exertion; Stage 1 cardiorespiratory training (may be adjusted to 40%-70% of max heart rate if needed) progressing to stage 2 and 3 based on a physician’s approval
Duration - 20 to 60 minutes
Movement assessment - Push, pull, OH squat, single leg balance or single leg squat
Flexibility - Flexibility continuum
Resistance training - 1 to 3 sets of 10 to 15 reps on 2 to 3 days per week; Phase 1 and 2 of the OPT model (higher reps such as 20 may be used)
Special considerations - Make sure client has appropriate footwear and have client or physician check feet for blisters or abnormal wear patterns; Advise client or class participant to keep a snack (quick source of carbohydrate) available during exercise, to avoid sudden hypoglycemia; Use SMR with special care and licensed physician’s advise; Avoid excessive plyometric training, and higher-intensity training is not recommended for typical client
Hypertension
Consistently elevated arterial blood pressure, which, if sustained at a high enough level, is likely to induce cardiovascular or end-organ damage
Normal blood pressure - <120/80 mm HG.
Hypertension blood pressure - >140/90 mm HG
Prehypertensive blood pressure - 120/80 to 135/85
Valsalva maneuver
A maneuver in which a person tries to exhale forcibly with a closed glottis (wind pipe) so that no air exits through the mouth or nose as, for example, in lifting a heavy weight. The Valsalva maneuver impedes the return of venous blood to the heart.
Physiologic & Training Considerations for Individuals with Hypertension
- Blood pressure response to exercise may be variable and exaggerated, depending on the mode and level of intensity
- Despite medication, clients may arrive with preexercise hypertension
- Hypertension frequently is associated with other comorbidities, including obesity, cardiovascular disease, and diabetes
- Some medications, such as beta blockers, for hypertension will attenuate the heart rate at rest and its response to exercise
Basic Guidelines for Hypertension
Mode - Stationary cycling, treadmill walking, rowers
Frequency - 3 to 7 days per week
Intensity - 50% to 85% of max heart rate. Stage 1 cardiorespiratory training progressing to stage 2 (intensities may be altered to 40%-70% of max heart rate if needed)
Duration - 30 to 60 minutes
Movement assessment - Push, pull, OH squat, single leg balance (squat if tolerated)
Flexibility - Static and active in a standing or seated position
Resistance training - 1 to 3 sets of 10 to 20 reps on 2 to 3 days per week; Phase 1 and 2 of the OPT model; Tempo should not exceed 1 second for isometric and concentric portions (e.g. 4/1/1 instead of 4/2/1); Use circuit or PHA weight training as an option, with appropriate rest intervals
Special considerations - Avoid heavy lifting and Valsalva maneuvers - make sure client breathes normally; Do not let client overgrip weights or clench fists when training; Modify tempo to avoid isometric & concentric muscle action; Perform exercises in a standing or seated position; Allow client to stand up slowly to avoid possible dizziness; Progress client slowly
Physiologic & Training Considerations for Individuals with Coronary Heart Disease (CHD)
- The nature of heart disease may result in a specific level of exercise, above which it is dangerous to perform
- Clients with heart disease may not have angina (chest pain equivalent) or other warning signs
- Between the underlying disease & medication use, the heart rate response to exercise will nearly always vary considerably from age-predicted formulas, and will almost always be lower
- Clients may have other comorbidities (such as diabetes, hypertension, peripheral vascular disease, or obesity)
- Peak oxygen uptake (as well as ventilatory threshold) is often reduced because of the compromised cardiac pump and peripheral muscle deconditioning
Basic Guidelines for CHD
Mode - Large muscle group activities, such as stationary cycling, treadmill walking or rowing
Frequency - 3 to 5 days per week
Intensity - 40% to 85% of max heart rate reserve. Talk test. Stage 1 cardiorespiratory training.
Duration - 5 to 10 minutes warm-up, 20 to 40 minutes of exercise, followed by a 5 to 10 minute cool down
Movement assessment - Push, pull, OH squat, single leg balance (squat if tolerated)
Flexibility - Static and active in a standing or seated position
Resistance training - 1 to 3 sets of 10 to 20 reps on 2 to 3 days per week; Phase 1 and 2 of the OPT model; Tempo should not exceed 1 second for isometric and concentric portions (e.g. 4/1/1 instead of 4/2/1); Use circuit or PHA weight training as an option, with appropriate rest intervals
Special considerations - Be aware that the clients may have other diseases to consider as well; Modify tempo to avoid isometric & concentric muscle action; Avoid heavy lifting and Valsalva maneuvers - make sure client breaths normally; Do not let client overgrip weights or clench fist; Perform exercises standing or sitting; Progress exercise slowly
Osteopenia
A decrease in the calcification or density of bone as well as reduced bone mass
Osteoporosis
Condition in which there is a decrease in bone mass and density as well as an increase in the space between bones, resulting in porosity and fragility
Type 1 (primary) - associated with normal aging and is attributable to a lower production of estrogen & progesterone, both of which are involved with regulating the rate at which bone is lost
Type 2 (secondary) - caused by certain medical conditions or medications that can disrupt normal bone reformation, including alcohol abuse, smoking, certain diseases or certain medications
