exercise science and prescription unit 1

what do humans use for fuel/energy and cellular function

ATP

how is ATP synthesized

from the breakdown of macronutrients in the diet

how many calories are in 1 gram of carbs, protein, and fat

4 cal/g of carbs

4 cal/g of protein

9 cal/g of fat

how are carbs absorbed

as glucose primarily but fructose and galactose also contribute

how are fats absorbed as

fatty acids

triglycerides

cholesterol

what are proteins broken down into in the body

amino acids and small peptides for absorption

are carbs used to create energy anaerobically or aerobically

both

what is the anaerobic metabolism process of carbohydrates

glucose undergoes glycolysis to produce 2 ATP and two pyruvic acid

what occurs in glycolysis if the initial fuel is glycogen

3 ATP is yielded

what is the aerobic metabolism of carbohydrates

the pyruvic acid produced from glycolysis enters the krebs cycle to yield 2 ATP and hydrogen ions

what happens to the hydrogen ions produced from Krebs cycle

they are transported to the electron transport chain where they produce 30-32 ATP molecules

triglycerides

the storage form of fat

what does hydrolysis do to triglycerides

releases fatty acids and glycerol

where does the glycerol from hydrolysis of triglycerides go

it can enter the metabolic pathway for glucose and yield 19 ATP

how are fatty acids broken down

through beta oxidation to form acetyl CoA which then enters the Krebs cycle

what happens to acetyl CoA in Krebs cycle

it combines with oxaloacetic acid from carb metabolism to form citric acid and continue through the cycle to produce ATP

how much ATP can complete oxidation of fatty acids yield

441 ATP

what does protein metabolism use fuel for

endurance activities lasting longer than 90 minutes

what is deamination

a process that occurs to proteins where the amine group is removed

what is transamination

removal of nitrogen that leaves behind a carbon skeleton

what occurs to the carbon skeleton left behind from deamination and transamination

they can be converted into glucose through gluconeogenesis to provide ATP

what is glycolysis

the anaerobic breakdown of glucose into pyruvate, ATP, and NADH

what is the Krebs cycle (citric acid cycle)

processes acetyl CoA to produce ATP, ADH, and FADH2

what is oxidative phosphoralization

uses energy from NADH and FADH2 to generate ATP in the presence of oxygen

what does the phosphagen system provide

immediate energy for short bursts through creatine phosphate breakdown

what does the aerobic system provide

sustains lower intensity activities over longer periods using oxygen to metabolize macronutrients to ATP

what are the three main metabolic pathways for energy

phosphagen (ATP phosphocreatine)

anaerobic glycolysis

aerobic metabolism (oxidative phosphorylation)

what does the phosphocreatine system provide

rapid but unlimited supply of ATP that peaks in the initial seconds of high intensity exercise

how long does the phosphocreatine system work

during the first 30 seconds of intense exercise

does the phosphocreatine system still function after the initial start of high intensity exercise

yes it still produces ATP but at a lesser extent

what does anaerobic glycolysis provide

provides energy starting almost immediately and ramping up ATP production as phosphocreatine stores decline

how long does the anaerobic glycolytic system work

30 seconds-2 min

what does oxidative phosphorylation provide

efficient but slow energy that increases as activity continues especially during lower energy exercise

how long does the aerobic system provide energy

predominately after 2 minutes of exercise

what is the difference in ATP output in anaerobic and aerobic metabolism

anaerobic metabolism is faster but only yields 2 ATP per glucose molecule

aerobic metabolism is slower but yields 30-32 ATP per glucose molecule

what does accumulation of metabolic byproducts in anaerobic metabolism do

it can hinder muscle performance

what determines the amount of ATP produced from fatty acids

the length of the fatty acid

what occurs to pyruvate when oxygen is present

it is converted to lactate to allow for continued ATP production

where is energy derived from at lower levels of exercise (less than 70% oxygen consumption)

60% from fats

40% from glucose

where is energy derived from in higher intensity exercise (greater than 70% oxygen consumption)

primarily carbohydrates

what occurs to insulin secretion during exercise

it is suppressed so muscle use GLUT4 transporters for glucose uptake bypassing the need for insulin

maximum oxygen uptake (VO2 max)

the maximum volume of oxygen that can be takin in, transported, and utilized by the body during intense exercise

oxygen consumption

the rate at which the body uses oxygen

what is the body's oxygen consumption at rest

3.5 mm per kg per minute (1 MET)

what occurs to oxygen consumption as we exercise

it proportionally rises with intensity of activity reaching a peak at max oxygen consumption

what does the peak oxygen consumption represent (VO2 max)

the efficiency of the heart, lungs, and muscles in delivering and utilizing oxygen

what occurs to oxygen consumption after exercise

it gradually decreases but remains elevated for a period to restore homeostasis, replenish energy stores, and remove metabolic byproducts

what does a high VO2 max indicate

a greater ability to perform endurance exercise

what is Ficks principle

VO2max= max CO x arteriovenous oxygen difference

what does 2 METs mean

a person is consuming oxygen at twice the resting rate

how is VO2 max tested

an individual wears a mouthpiece or mask connected to a spirometer that measures the volume and composition of expired air

what are tests that can be used to estimate VO2 max

cooper walk/run test

1.5 mile run test

step test

Rockport walk test

cooper walk/run test

run or walk as far as possible in 12 minutes

1.5 mile run test

run 1.5 miles as quickly as possible

step test

step up and down on a platform for 3 minutes

Rockport walk test

walk one mile as quickly as possible

balance

ability to maintain or move the body within its BOS without falling

cardiopulmonary endurance

the ability to sustain moderate intensity activities over time

coordination

the precise timing and sequencing of muscle activation for smooth movement

flexibility and mobility

the ability to move freely and achieve the necessary ROM for activities

muscle performance

the muscles capacity to produce tension, encompassing strength, power, and endurance

neuromuscular control

the effect of interaction between sensory and motor systems for coordinated movement

stability

ability to hold or control body segments during movement

what is therapeutic exercise

the systematic performance of planned physical movements of activities intended to enable the patient or client to:

-prevent or remediate impairments of body structure and function

- enhance activities or participation

- prevent or reduce health related risk factors

- optimize overall health status, fitness, or sense of well being

how does the ICF model contribute to therapeutic exercise prescription

provides a comprehensive view of the patients overall health and function

what do the patients goals directly relate to in the ICF model

participation restrictions

when prescribing exercise what part of the ICF model is targeted to write SMARTF goals for the plan of care to adress

impairments/functional limitations

what is the purpose of performing regular exercise

to achieve a positive adaptation in physical function

what are the goals of treatment for the acute/protective phase

POLICE

patient education

posture

rest/relative rest

gentle mobility

submaximal isometrics

what is the goal of treatment during subacute/controlled motion phase

regain ROM/flexibility

gradually load tissues, introduce resistive stress

neuro reeducation/activation patterns

what is the goal of treatment in the settled/return to function or sport phase

progressive loading to heavier loads

functional specific strengthening and loading

plyometrics

mimic functional/sport demands

what is the overload principle

to improve any aspect of physical fitness the body must be challenged with a workload greater than it is accustomed to

what s the SAID principle

states that exercise training programs should be built on specificity

the adaptive effects of training are specific to the type of exercise preformed

what is the reversibility principle

adaptive changes from resistance exercises are temporary, unless maintained through regular functional activities or a consistent maintenance program

when does reduces muscle performance (detraining) occur

within 1-2 weeks after stopping resistance exercises

when does a loss of training effects occur

within 2-4 weeks of stopping resistance exercise

what can help to engage patients in a lifelong maintenance program of exercise

integrate strength and endurance gains into daily activities and rehabilitation

what two factors can influence how a patient responds to exercise

environmental and personal factors

what is FITTVP

frequency

intensity

time

type

volume

progression

exercise intensity

how hard a person is working during exercise

how can exercise intensity be measured

HR

RPE

Counting Talk Test

METs

% of 1 rep max

what is submaximal loading

involved using a lighter load or lower intensity often used to build endurance

what is maximal loading

higher load or intensity used to increase maximal speed or force output

how is exercise intensity determined for patients

desired outcomes

individuals fitness level

goals

what is time in relation to exercise

how long the individual is working during a bout of exercise or the total exposure to exercise stimulus during a workout

what are some ways time can be recorded during exercise

it can be a set time or exercise

sets and reps also measure time

also includes the rest interval between sets or between exercises

what is a repetition

the number of times a particular movement is repeated or the number of muscle contractions to perform to move the limb through a motion against a specific load

what is a set

a predetermined number of repetitions grouped together

what is volume in terms of exercise

a measure of the overall stress of the exercise prescription

how is exercise volume calculated

the product of frequency, sets, repetitions, and intensity

what should be considered about volume when prescribing exercise

consider the prescribed exercise as well as other physical activities and non exercise related physical stress

what is a progression in exercise

increasing the dosage of exercise over time as the individual adapts

how can exercises be progressed

by increasing any component of FITTVP

what should be focused on when progressing exercise

focus on performance improvements rather than adding stress

what components of exercise should be progressed first

time or duration before intensity or frequency

what are behavioral/psychological/lifestyle factors that can impact exercise

sedentary lifestyle

poor nutrition

use of tobacco, alcohol, drugs

low motivation

inadequate coping skills

difficulty wit change

what are examples of physical environment characteristics that can impact exercise

architecture barriers

ergonomic characteristics

what are examples of socioeconomic factors that can impact exercise

economic status

education level

healthcare access

family or social support

what are the 5 key domains of the social determinants of health

economic stability

education access and quality

healthcare access and quality

neighborhood and build environment

social and community context

what are the two key steps to a structured approach to exercise prescription and progression

continuous assessment and adaptation

thoughtful manipulation of exercise variables