Strength and Power

what percent of body mass is muscle at birth

~25%

muscle fiber size, mass, strength, and endurance (INCREASE/DECREASE) linearly with age

increase

% difference in muscle fiber size, mass, strength, and endurance between men and women

~10%

training gains occur (EQUALLY/DIFFERNTLY) between males and females during childhood

equally

rapid acceleration of muscle fiber size and muscle mass increases at what age

puberty

acceleration of muscle fiber size and muscle mass is greater in (MALES/FEMALES)

males

hypertrophy is more prevalent in (MALES/FEMALES)

males

at what age does muscle mass peak in females

16-20 years old

at what age does muscle mass peak in males

18-25 years old

what percent of body mass is muscle in young/middle adulthood

~40%

muscle strength and endurance typically peak in what decade of life

3rd decade (20-29 year old)

muscle strength declines by 15-20% during what decades of life

6-7th decades

muscle fiber size, muscle fiber number, and contraction speed (INCREASES/DECREASES) in late adulthood

decreases

endurance and oxygen uptake (INCREASES/DECREASES) in late adulthood

decreases

significant improvements in strength and power are possible with what type of training

resistance training

training guidelines in childhood (pre-puberty)

- must be supervised

- avoid overly intense or maximal load

- variety in movements and equipment

- 8-15 reps/sets with good form throughout

- encourage participation and proper technique instead of maximal load

contraindications to resistance training

- pain with unresisted movement

- inflammatory neuromuscular disease (i.e. Guillain-Barre)

- muscular dystrophy

- severe cardiopulmonary disease

activity is limited with (LOWER/HIGHER) levels of pain

higher

how should exercise be modified if patient experiences sharper pain with a more acute onset

reduce load or stop activity all together

pain only with passive stretch is likely due to what type of tissue

non-contractile

nerve pain presentation

- "shooting", "electric"

- reduce intensity or stop activity if it occurs

bone pain presentation

- "deep ache"

- can continue exercising if not changing

muscle/tendon pain presentation

- "ache", "sharp", "stab"

- can try to exercise with ache, but need to reduce intensity or stop activity with sharp/stab

how to modify exercise with worsening pain

decrease intensity or change exercise type

how to modify exercise with steady pain

progress exercise with patient tolerance

how to modify exercise with improving pain

progress exercise

how to modify exercise if there is soreness day after (not muscle soreness)

1 day off, stay at same intensity

how to modify exercise if there is soreness during warm up that goes away

stay at same intensity level

how to modify exercise if there is soreness during warm up that goes away and comes back during session

2 days off and reduce intensity

how to modify exercise if there is soreness through warmup that perissts

2 days off and reduce intensity

"2 point bump" concept

- have patients remain within 2 points of where they start on a 0-10 pain rating scale

- if pain increases beyond 2 points, modify exercise

benefits of a warmup

- increase blood flow to targeted muscle groups

- increase viscosity of synovial fluid

- improves extensibility and elasticity of muscles, tendons, and ligaments

overview of acute muscle soreness

- related to muscle fatigue

- lack of adequate blood flow

- temporary build up of metabolites

- resolves after exercise stops and blood flow returns

- cool down can help

overview of delayed onset muscle soreness (DOMS)

- typically after a bout of vigorous/unaccustomed exercise

- most noticeable in muscle belly or muscle tendonous junction

- begins 12-24 hours after exercise and peaks 48-72 hours after exercise

- tenderness to palpation

- increased pain with stretching or contraction

- local edema and warmth

- reduced strength for up to 2 weeks

overview of osteoporosis

- reduced bone mineral density

- increased risk for fracture

- resistance training can help improve bone mineral density

- slower progression of activities

- don't do 1 rep max testing

ACSM guidelines for resistance training for patients with osteoporosis

frequency: 1-2 nonconsecutive days/week (may progress to 2-3 days/week)

intensity: adjust resistance so last 2 reps are hard

time: 1 set of 8-12 reps and progress to 2 sets after ~2 weeks (no more than 8-10 exercises/session)

type: standard equipment

overview of osteoarthritis

- inflammation of cartilage and bone

- loss of space within joint

- progressing factors (modifiable) -- physical activity, strength, mobility, diet, body weight

osteoarthritis resistance training guidelines

2-3 days/week close to fatigue (2-3 reps in reserve)

osteoarthritis general exercise guidelines

- 150 min/week of moderate intensity exercise

- 90 min/week of vigorous intensity exercise

overview of rheumatoid arthritis

- autoimmune disease

- inflammation of joints, tendon sheaths, synovial membrane, articular cartilage, and subchondral marrow

- can have adhesions that limit mobility

- symptoms have exacerbating periods

- typically have hand joint involvement

RA exercise selection considerations

- need to follow symptoms state response to treatment

- potential difficulty holding on to weights due to hand symptoms

- perform activities in pain free ranges

- protect joints when in period of flare up

cerebrovascular attack (CVA) exercise considerations

- many individuals with CVA have other comorbidities

- age predicted HR max likely not applicable

- early onset fatigue likely

- need to ensure ability to move through ROM before adding load

ACSM recommendations for resistance training with CVA

frequency: at least 2 days/week on nonconsecutive days

intensity: 50-70% 1 RM

time: 1-3 sets of 8-15 reps

type: standard equipment, ensure safety

MS exercise considerations

- intensity of activities will vary based on symptom state (reduce intensity during exacerbation)

- RPE can allow for adjustable intensity based on symptoms

- increased rest time between sets to allow full recovery and prevent excessive fatigue

- large movements allow for multiple muscle groups to be targeted within 1 exercise

ACSM recommendations for resistance training with MS

frequency: 2 days/week

intensity: 60-80% 1 RM

time: begin 1 set and gradually work up to 2 sets of 10-15 reps

type: multi joint and single joint exercises

Parkinson's disease exercise considerations

- many patients are fall risks

- as disease progresses, free weights become less safe due to freezing and movement coordination decline

- cognitive decline can be present with disease

- exercise prescription will change as disease progresses

ACSM recommendations for resistance training with Parkinson's disease

frequency: 2-3 days/week

intensity: 30-60% 1 RM for novice; 60-80% 1 RM for advanced

time: 1-3 sets of 8-12 reps (begin with 1 set and progress to 3 sets)

type: as disease advances, use machines to allow for increased safety

cancer exercise considerations

- many types of cancer with different specific precautions

- need to consider treatment stage

- active treatment reduces overall energy and capacity, increases infection risk, and can reduce bone mineral density

exercise selection for cancer patients

- account for cancer related fatigue (increase rest breaks, decrease load)

- promote activity within capacity

- consider any surgical procedures

COPD exercise considerations

- lower ability to inspire lead to less oxygen intake and less oxygen circulating to muscles and less ability for muscles to use oxygen to replenish energy

- loss of global energy more likely due to oxygen replenishment issues

- allow for adequate rest breaks

ACSM recommendations for resistance training with COPD

frequency: at least 2 nonconsecutive days/week

intensity: 60-70% of 1 RM for strength; <50% 1 RM for endurance

time: 2-4 sets of 8-12 reps for strength; 1-2 sets of 15-20 reps for endurance

type: machine, free weights, body weight