Week 6 Cv And Flexabilty Training

Question 1

Cardiorespiratory ‘aerobic’ training

Answer 1

Assess cardiorespiratory fitness status
– Single-stageTreadmillJoggingTest
– Astrand-Rhyming Cycle Ergometer Test

Devise an aerobic exercise programme that..

– Meets the individuals needs and interests
– Takes into account their age, gender, fitness level & exercise habits

Does your client have a health or fitness goal?
– The quantity of exercise needed to promote health is less than that needed to develop and maintain higher levels of fitness
– Adjust exercise prescription according to your clients primary goal

Your estimated VO2max can be expressed in two ways:
1. Absolute VO2max
(L/min)
2. Relative VO2max
(ml/kg/min)

Question 2

Goals of CV exercise training

Answer 2

Improve health & ↓ disease risk
– Can be achieved with moderate intensity activity done 30 min.d, 5 d.wk-1

Improve fitness
– Can only be achieved with vigorous intensity activity
• CV demands must reach an intensity sufficient to ↑ (overload) stroke volume and cardiac output
• CV overload must activate specific muscle groups to enhance local circulation and the muscle’s metabolic machinery

Question 3

Elements of CV exercise session

Answer 3

Warm – Up (5 – 10 min)
– ↑ blood flow to working cardiac and skeletal muscles, ↑ body temp, ↓ the risk of muscle & joint injury, and abnormal cardiac rhythms. Performed at low intensity.

Endurance conditioning (20 – 60 min)
– Follow the FITT principle

Cool-down (5 – 10 min)
– ↓ the risk of CV complications caused by stopping exercise suddenly. Performing low intensity exercise allows HR and BP to return to baseline. Muscle pump prevents venous pooling and ↓ risk of dizziness and fainting

Question 4

Why cool down ?

Answer 4

Performing active cool-downs
i) promote faster
recovery of the cardiovascular and respiratory systems
ii) accelerate recovery of blood
lactate
iii) may partially
prevent immune system depression

Question 5

HR and VO2 response to aerobic exercise

Answer 5

Hr and exercise Intensity are both linear

VO2 and exercise intensity are both linear

Range of training intently 70-80% of Hr max

Question 6

Blood flow response to exercise

Answer 6

Blood flow is redirected, away from areas it is not needed via smooth muscle vasoconstriction (SNS mediated), and increased to exercising muscle via local vasodilation (metabolic and endothelial mediated) mechanisms

Sympathetic nervous system,
Vasoconstriction

Question 7

Acute BP response to aerobic exercise

Answer 7

A linear ↑ in systolic blood pressure (SBP) with increasing levels of exertion, while diastolic blood pressure (DBP) may decrease due to vasodilation

Question 8

CV & pulmonary adaptations

Answer 8

Increased
+ Blood volume & total hemoglobin
+ Heart size and volume (cardiac hypertrophy)
+ Stroke Volume (at rest & during exercise)
+ Cardiac output (maximum)
+ Blood vessel size & improved endothelial function
+ Lung volume
+ Oxygen extraction from blood (↑ aVO2 diff)
+ VO2max

Decreased:
- Resting & submaximal HR
- Blood pressure

Question 9

Musculoskeletal adaptations

Answer 9

Increased
+ Capillarisation
+ Mitochondrial content & function
+ Aerobic enzyme (such as citrate synthase) activity
+ Myoglobin stores
+ Glycogen & triglyceride storage
= ↑ capacity to generate ATP aerobically
+ Bone density & mass
+ Strength of connective tissue

Question 10

Blood lactate concentration

Question 11

Additional adaptations

Answer 11

Increased
+ Fat oxidation
+ Heat acclimation
+ High-density lipoprotein cholesterol
+ Glucose tolerance
+ Mood

Decreased
- Body mass & body fat
- Total cholesterol
- Low-density lipoprotein cholesterol
- Risk of developing atherosclerosis
- Insulin resistance
- Depression

Question 12

Factors that affect aerobic training responses

Answer 12

Five important factors influence the aerobic training response:
1. Initial level of aerobic fitness
2. Trainingintensity
3. Trainingfrequency
4. Trainingduration
5. Genetics

Question 13

Take home points so far….

Answer 13

1. When we exercise aerobically, oxygen consumption increases linearly with changes in cardiac output (which is redistributed to the active skeletal muscle) and SBP increases with exercise intensity
2. Endurance exercise stimulates cardiorespiratory, musculoskeletal and metabolic adaptations which improve health and aerobic fitness

Question 14

Intensity of Exercise

Answer 14

Exercise intensity is a key factor in determining physiological adaptations to the exercise stimulus
Consider
– Client’s aerobic fitness status – Goals for the programme
– Exercise preferences
– Injury risks
Intensity and Duration are indirectly related

Question 15

Exercise Intensity Domains

Question 16

Prescribing exercise intensity

Answer 16

Aerobic exercise intensity can be expressed in a number of ways

1. Energy expended per unit of time (e.g. 9 kcal.min-1)
2. Absolute exercise level or PO (e.g. cycle at 150 W)
3. Relative metabolic level %VO2max, or %VO2R (e.g. 85% VO2max or 75% VO2R)
4. Exercise HR, %HRmax or %HHR (e.g. 180 b.min-1 , 80% HRmax or 75% HHR)
5. Multiples of resting metabolic rate (e.g. 6 METs)
6. Rating of perceived exertion (e.g. 14) RPE =
   7.talk test (eg inability to have a conversation, intensity > anaerobic threshold)

Note: Heart rate reserve (HHR) = HRmax – Hrrest VO2 reserve (VO2R) = VO2max – VO2rest

Question 17

Estimating intensity of aerobic exercise

Question 18

Interaction of fitness and training intensity

Question 19

What intensity is recommended?

Answer 19

Aerobic training has been demonstrated to be beneficial when performed at an intensity of 60 – 90% of maximum heart rate (HRmax) or 40 - 85% of HR reserve (HRR)
…But it does vary depending on clients’ initial fitness classification

Question 20

Fat burning zone

Question 21

Duration of exercise

Answer 21

30 – 60 min per day (≥ 150 min/wk) of moderate intensity exercise
• 20 – 60 min per day (≥ 75 min/wk) or vigorous intensity exercise
• Or a combination of moderate and vigorous intensity per day to attain the volumes of exercise recommended
• <20 min per day can be beneficial in sedentary individuals
• ≥60 – 90 min per day needed for weight management

Question 22

Frequency of exercise

Answer 22

The frequency of exercise sessions depends on your clients caloric goals, health & fitness level, preference and time constraints
For health benefits individuals should exercise at moderate intensity for at least 5 days per week
– 5 times per week at light to moderate intensities for individuals with poor aerobic fitness levels
– 3 times per week at a moderate to vigorous intensity for individuals with good aerobic fitness
Exercising on alternate days can aid recovery and ↓ the risk of injury

Question 23

Volume of exercise

Answer 23

Product of Frequency, Intensity and Time
• For health: A target volume of ≥ 500 – 1000 MET-min.wk-1 = approximately 1,000 kcal.wk-1 of moderate intensity (3-6 METs) exercise (for about 150 min.wk-1)
• For weight loss: Each activity session should last at least 60 min at sufficient intensity to expend 300 kcal or more
• Determine weekly caloric expenditure goal / target caloric threshold

Question 24

Types (Modes) of Aerobic Exercise

Answer 24

Gym based
• Treadmills
• Upright, recumbent and spinning bikes
• Rowers
• Steppers and vertical climbers
• Elliptical trainers
Consider
– Exercise intensity / Level of fitness required – Level of skill required
– Rate of energy expenditure required
– Ease of grading & adjusting intensity

Question 25

Progression considerations

Answer 25

Initial conditioning stage : Beginners
– Moderate intensity (3-6 METs) aerobic activity
– Starting at 20 min & progressing to 30 min, 3 days/wk
– Progress to ‘Improvement stage’ when aerobic activity can be sustained at 55% - 60% HHR for 30 min
Improvement stage : Intermediate exercisers
– Intensity increased towards 80-85% of HHR and ↑ duration ≤ 10 min per session, every ~2 weeks until your client is able to exercise continually at moderate-to-vigorous intensity for 20 – 30 min
– ↑ frequency from 3 to 5 days/wk
– ↑ intensity gradually to reduce the risk of injury, soreness & overtraining
Maintenance stage : Advanced exercisers
– Frequency ~3 days/wk at the intensity and duration reached at the end of the improvement stage. Vary activities to reduce training monotony

Question 26

Take home points

Answer 26

FITT principles should be manipulated, and exercise volume and progression considered, in accordance with you client’s current fitness status and training goals. Intensity is the key!

Question 27

Exercise Training Intensity Domains

Question 28

Identifying training zones

Question 29

Types of endurance training

Answer 29

Continuous
1. Recovery / Long slow distance training below aerobic threshold (light)
2. Steady / tempo training between the aerobic & anaerobic threshold (moderate)

Interval
3. Fartlek/mixed pace work around anaerobic threshold (vigorous)
4. Interval training
• High Intensity Interval Training (HIIT) work around VO2max pace (severe)
• Sprint Interval Training (SIT) work at intensities greater than the pace that would elicit VO2max (supramaximal)

Question 30

Recovery & Long Slow Distance training

Answer 30

Performed at intensities below aerobic threshold (50 – 63% HRmax / 30 – 40% HRR) good for W/Up, C/D, recovery (20-40 min) or prolonged sessions
Limited adaptations:
– ↑Bloodvolume(plasma&totalHb)
– ↑ Mitochondria size and density (content) – ↑Fatmetabolism
– Developmentofneuromuscularpatterns
• Appropriate intensity for deconditioned clients or special population groups
• Used during ‘recovery’ sessions or for ‘recovery’ during intervals sessions.

Question 31

Steady/Tempo training

Answer 31

Performed at intensities between the aerobic and anaerobic threshold (64 - 75% HRmax / 40 - 60% HRR) for moderate to long durations (20 – 120 min)
Adaptations:
– Promotes greater peripheral skeletal muscle adaptations = improves muscle O2 utilisation
• Increased capillary density
• Increasedmyoglobincontent
• Increased size and number of mitochondria
• Increasedenergystores(glycogen&FFAs)
• Increased oxidative capacity of all fibre types

Question 32

Threshold Training

Answer 32

Performed at or ‘close to’ anaerobic threshold (75 - 95% HRmax / 60 - 85% HRR) for 20 – 40 minutes
Adaptations:
• Maximises the aerobic
benefits previously
discussed
• Develops lactate
tolerance and improves ability to remove the by products of anaerobic metabolism
= lactate accumulation curve shifts to the right. Aerobic (LT1) and anaerobic (LT2) thresholds occur at higher intensities, indicating improved aerobic performance

Question 33

Fartlek training

Answer 33

Intermittent exercise
• Fartlek training or ‘speed play’
training
• Unstructured form of interval training, where the duration and intensity of each effort is varied in a sporadic manner
• Around 30 – 40 minutes
• Fun way of performing interval training

Question 34

Interval training

Answer 34

• Structured intermittent exercise
• Increased total volume of high intensity work
compared to continuous training
• Long intervals: 60s – 4 min at intensities between anaerobic threshold and VO2 max (85 - 100% HRmax / 75 - 100% HRR)
• Short intervals: <60s at intensity >VO2 max
• Interspersed by brief periods of light-intensity work or inactivity that allow a partial but often not a full recovery

Question 35

Interval training stimulus

Answer 35

Greater demand on cardiac output = ↑ SV = ↑ VO2max

Question 36

Enhancing VO2max

Question 37

Interval training considerations

Answer 37

9 variables that could be manipulated

Training emphasis (energy system)
Aerobic= work rest ration > 1
Example work rest ratio 3;2 minutes

Lactate = w:r ratio 1:2

ATP/PCr = w:r 1:6

For an aerobic focus session volume should enable athletes to
spend between ~5 (team and racket sports) and ~10 (endurance sports) min at ~VO2max

Question 38

HIIT design for optimising time @ VO2max

Question 39

Body Weight Interval Training

Answer 39

18 sessions over 6 weeks
• 11-minute session involved five exercises
1. Burpees
2. High knee running on the spot
3. Split squat jumps
4. High knee running on the spot
5. Squat jumps
• Each performed for 60-seconds at a self- selected “challenging” pace (82 ± 5% HRmax, 14 ± 3 out of 20 RPE), interspersed with active recovery periods (walking)

Resulted in a 7% improvement in VO2max

Question 40

Monitoring and Reviewing

Answer 40

Training logs (record training sessions, monitor FITT principles, chart progress over time)
• Monitor absolute (e.g. km/h or W) and relative training intensity (HR & RPE response to exercise)
• Review performance (e.g. time-trial, lactate threshold, VO2max)
Compare to client goals, how well is the programme meeting the clients needs?

Question 41

Contraindications for aerobic training

Answer 41

Pregnancy
– Light-to-moderate intensity for a maximum of 30 min.d-1, 4 d.wk-1
– Avoid contact sports & exercise in supine position
– No exercise for at least 6 – 8 weeks (or 12 weeks after caesarean) after
giving birth
• Children & Adolescents
– Inferior cooling mechanism = ↑ risk of dehydration
• Older people
– LongerdurationW/UpandC/Drequired(10–15min)
– Exercise intensity should be challenging but health-related, monitor & prescribe intensity based on RPE
– Mode of exercise should not impose excessive orthopedic stress

Question 42

Take home points

Answer 42

Continuous (steady/tempo and threshold) and intermittent (fartlek & interval) training methods can be used to improve aerobic fitness
2. Training should be monitored and performance (absolute & relative) routinely reviewed
3. Consideration for the needs of certain populations (pregnancy, children & adolescent and older people) is required when designing aerobic training

Question 43

Flexibility Testing

Answer 43

Assess Flexibility
1. Shoulder internal/external
rotation
2. Thomas Test (flexibility of hip flexors)
3. Active Knee Extension (hamstring flexibility)
4. Hip internal/external rotation
5. Knee to wall test (ankle flexibility)
Flexibility programmes should be individualised to address the needs, abilities and interests of the client
Identify the joints and muscle groups needing improvement

Question 44

Why stretch?

Answer 44

Increase ROM around the joint
• Primarily attributed to decreased muscle–tendon unit (MTU) stiffness and increased tolerance to stretch
Reduced injury risk?
• Some evidence suggests there is an association between flexibility and injury risk (local and global)
Decreased muscle soreness?
• Reduced muscle strain for the same ROM = reduced susceptibility to muscle damage
Improved performance
• Due to enhanced ability to stretch or reach during a sport as well as the decrease resistance of a more compliant (less stiff) muscle to the intended movement

Question 45

Types of Flexibility exercises

Answer 45

Static stretching
– Involves slowly stretching a muscle/tendon group and holding the position for a period of time (i.e. 10 – 30s) x 2-4 reps (60s in total)
– Activestaticstretchinginvolvesholdingthe stretched position using the strength of the agonist muscle. This ‘active tension’ is required to stimulate ↑ muscle length
– Passivestaticstretchinginvolvesassuming a position while holding a limb or other part of the body with or without the assistance of a partner or device.

Question 46

Types of Flexibility exercises

Answer 46

Ballistic stretching or “bouncing” stretch
– Use the momentum of the moving body segment to produce the stretch
– Notadvocated
Dynamic or slow movement stretching
– Involves a gradual transition from one body position to another, and progressive ↑ in reach and ROM as the movement is repeated several times (e.g. 8 - 10 reps)

Question 47

Types of Flexibility exercises

Answer 47

Proprioceptive neuromuscular facilitation (PNF)
– Reach end of ROM & perform isometric contraction of the muscle groups (3 – 6s) followed by a static stretching of the target muscle (10 – 30s) (i.e. contract-relax)
– The muscle group is then allowed 30s to recover and the process repeated 2-4 times

Question 48

PNF – How does it work?

Answer 48

Autogenic inhibition
• Static contraction of the lengthened target muscle (TM) stretched causes ↑ firing of tension-sensing mechanoreceptors ‘Golgi tendon organs [GTOs]’ and ↓ efferent (motor) drive to the TM thereby facilitating additional stretch

Reciprocal inhibition
• Contraction of the opposing muscle (OM) causes activation of the muscle spindle (detects change in muscle length) and ↓ efferent (motor) drive to the TM thereby facilitating additional stretch

Question 49

Compassion of stretching techniques

Question 50

When to stretch?

Answer 50

Stretching should form an integral part of W/Up and C/D Dynamic stretching
– Should be performed after pulse/ temp raising W/Up, using exercises that will mimic the general movement of the following session
– Benefits strength, speed & power-dominant activity
• Increases HR, muscle & core temperature
• Decreases MTU stiffness and increases ROM
• Allows rehearsal of specific movement pattern = increased coordination
• Primes the neuromuscular system
Static stretching / PNF stretching
– Static stretching can result in immediate, short-term decreases in muscle strength, speed and power
– Should be performed as part of a C/D, targeting the muscles worked during the main session

Question 51

Other Consideration?

Answer 51

Strength Training
– Strength exercises involve a movement against an opposing force
– Active tension in the most lengthened position (eccentric load) is found to increase flexibility
• IncreasesRangeofMotionandFasciclelength • Primes the neuromuscular system
Example Exercises
– RomanianDeadlift
– Single leg calf raise (From an incline)
– Bulgarian Split squat

Question 52

Contraindications for flexibility training

Answer 52

During pregnancy
– Developmental, excessive, uncontrolled or ballistic stretching should be avoided due to the ligament softening effects of the hormone relaxin
Children & Adolescents
– Increased injury risk during growth spurts (B: 14 – 16 yrs, G: 11 – 13 yrs) because the soft tissue around the joint is already stretched. Stretching should only be encouraged to mild tension
Older people
– Require a longer W/Up (15 min) prior to stretching routine, with progression from moderate to full ROM.
Post-fracture
– Avoid stretching a fracture site for 8 – 12 weeks post-fracture
Stop if any sharp pain or uncontrolled cramping occurs during a stretch