309 Exam 2

Functional Movement

Ability to move the body with proper muscle and joint function for effortless, pain-free movement

what are some examples of functional movement

breathing, transitioning from lying down to standing up, squat, reach overhead, walk or run

Proprioception

brain's ability to sense the relative positions and movements of the different body parts

what are some examples of proprioception

- signals from the brain to larger leg/trunk muscles keep us steady whole standing on a moving bus/ rocking boat/ or play equipment
- eyes closed and touch your nose
- balancing on one leg
- throwing a ball without looking at throwing arm

why is proprioception important

- improving reaction time and speed
- preventing injuries and improving balance
- reducing stress

proprioception with muscle spindles

detect quick change of length which reflexively causes the muscle to contract

proprioception with golgi tendons organs

golgi tendon organs (GTOs)- detect tension in the tendons, causing the muscle to relax
- example carrying a box or lifting a weight that is too heavy: muscles will drop it

Neutral posture

the posture of the spine in which the overall internal stresses in the spinal column and muscular effort to hold the posture are minimal

what does natural posture look like

body is in a straight line

how to assess neutral spine

wall test, dowel test

what are the benefits of neutral position

- minimizes compressive and shear forces imposed on the joint
- optimizes the timing and speed of contraction of stabilizing muscles
- optimizes ideal muscle length-tension and force-coupling relationship (muscles or muscle groups moving together, in synergistic manner, producing movement around a joint)

stability definition

function of being stable while under a dynamic/static load

Mobility definition

increase range of motion, stabilization or control of the muscles that surround each joint

what are six alignment faults discussed in lecture/PPT

- loss of cervical neutral
- loss of thoracic extension
- internal rotation of the shoulders
- posterior pelvic tilt
- anterior pelvic tilt
- knee valgus

internal rotation of the shoulders
verbal cues

verbal cues: create as much width between your shoulders

loss of cervical neutral
verbal cues

head positioned in front of the body or tilting up or down
- verbal cues: tuck the chin

Loss of thoracic extension
verbal cues

rounding of the thoracic spine
- verbal cues: while tucking your chin, stand or sit as tall as possible

posterior pelvic tilt
verbal cues

loss of neutral lordosis in the lumbar spine or flattening of lumbar spine
- verbal cues: align your rib cage over your pelvis

anterior pelvic tilt
verbal cues:

excessive arching of low back
- verbal cues: gently contract your glute muscles, lock your ribcage on top of your pelvis

knee valgus

knees collapsing inward

corrective exercises for loss of cervical neutral

- chin tucks
- isometric cervical exercises (using hands on forehead resisting neck flexion efforts)

corrective exercises for loss of thoracic extension

scapular retraction with no weight;progressing to seated rows

corrective exercises for internal rotation of the shoulders

band or dumbbell shoulder external rotations

corrective exercises for posterior pelvic tilt

glute bridges;quadruped or bird dog

corrective exercises for anterior pelvic tilt

curl-up;side plank/bridge

corrective exercises for knee valgus

lateral band walks: clam shells; glute bridges; bird dog

what are the diaphragmatic breathing steps

1. sit, lie flat or stand in a comfortable position
2. one hand on stomach just below ribs- other hand on chest
3. take a deep breath in through nose, and let stomach push your hand out. Chest should not move
4. breathe out through pursed lips like whistling. Feel hand on stomach go in, use it to push air out
5. do this breathing 3 to 10 times. Take your time with each breath

what are four advantages of diaphragmatic breathing

- diaphragm- prime muscles of respiration BUT also vital to core stabilization
- *increase work capacity*(proper conditioning of diaphragm)
- *reduce risk of hyperventilation*
- focused, deep breathing *stimulates the vagus nerve*, (extends from brain to belly)
- *activates the "rest and digest" response* (parasympathetic response)
- slows down heart rate and decrease blood pressure-stress reduction

first stage of instability training

maintain optimal alignment without significant swaying for 30 seconds
A1: wide staggered stance eyes open
A2: wide staggered stance eyes closed
A3: wide staggered stance eyes closed with weight shift

second stage of instability training

maintain optimal alignment without significant swaying for 30 seconds

B1: narrow staggered stance eyes open

B2: narrow staggered stance eyes closed

B3:narrow staggered stance eyes closed with weight shift

third stage of instability training

maintain optimal alignment without significant swaying for 30 seconds
C1: single leg stance
C2: single leg stance eyes closed
C3: single leg stance with reach to specific target

What is self-myofascial release

how to manage soft tissue restriction

what are some theories as to why self-myofascial release works

- most likely does not break up scar tissue
- neutral mechanisms are responsible for temporary increases in ROM
- SMR relaxes hypertonic (tense) areas within soft tissue
- increases blood flow
- compressive force imposed on myofascial stimulate mechanoreceptors (GTOs) that reduce muscle-firing rates

Why might foam rolling be a better option before a high-intensity workout instead of static stretching? think about explosiveness following foam rolling vs static stretching

Static stretching reduces explosiveness. Foam rolling has been found not to reduce explosiveness. It also breaks down adhesion and scar tissue. Creates external tension which helps muscle to relax (golgi tendon)

what was the take home message from the video about myofascial lines (first slide in flexibility PPT)

Everything is connected in a line. - Treat above and below the area with issue. Strengthening all the muscles along that entire line for movement. Helping with the coordination of movement down that line.

what are two keys that you learned from the connective tissue video (in canvas under lecture module)

1. Connective tissue connects everything. it forms a network through your entire body. Is a part of the structure of a muscle. Part of immune system\= The immune system patrols then reports back to lympathic system. All this traveling around happens within connective tissue. Is the terrain of a lot of the immune system.
2.Musculoskeletal Pain-
They found that. The thicker the fasica was the more back pain the individual had. Especially in the fasica that connected to the muscle. Fascia has multiple layers that all should move. Fascia stretches and glides in a person with no back pain. Those with low back pain the fascia doesn't glide as well.

static flexibility

full range of motion of a given joint due to external forces (gravity, partner, exercise equipment)

dynamic flexibility

full range of motion of a given joint by voluntary use of skeletal muscles in combination with external forces

what are six assessments that can be used to measure flexibility

1. goniometers
2. sit and reach tests (no longer recommend this test)
3. active straight leg raises
4. back to wall shoulder flexion
5. overhead lunge
6. ankle mobility assessment
7. squat and overhead squat assessment

explain what is meant by hypermobility in clients and specific tests to measure hypermobility

hypermobile\= some or all persons joints have unusually large joint ROM
training specifics- may not need more flexibility training. dont stretch through laxity. work on stabilization
testing\= Beighton score. 9 points\=hypermobile
one point if....
-while standing and bending forward the individual can place their palms on ground with legs straight
-for each elbow that extends more than 10 degrees
-for each knee that extends more than 5 degrees
-for each thumb that with the wrist flexed can be manipulated to the forearm
-one point for each fifth finger that extends beyond 90 degrees

what are the four different types of stretching

1. static
2. ballistic
3. dynamic
4. proprioceptive neuromuscular facilitation

static stretching

holding stretch for 15-30 seconds

ballistic stretching

bouncing- not recommended

dynamic stretching

- balance/coordination
- slow/controlled, sport specific movement

Proprioceptive Neuromuscular Facilitation (PNF)

hold relax method
- partner required
- stretch 10 seconds
- resist 6 seconds
- stretch 20-30 seconds

explain the concept of contraindicated stretches and give examples

the risk of injury may outweigh the benefits of performing a particular stretch
- forward fold

explain activation of muscle spindles and Golgi tendon organs related to flexibility

m.s- proprioceptor in muscle. detect quick change of length which reflexively cause the muscle to contract
g.t- proprioceptor is tendon. detect tension in the the tendon causing muscle to relax.

static stretching- five areas to consider

1. don't stretch through extreme laxity (the hypermobile client)
- work on stabilization instead
2. Don't stretch shoulder capsule to stretch chest (pectoralis major)
3. make sure to create stiffness at adjacent joints when stretching
4. monitor neutral spine during stretching
5. tighten the glutes during hip flexor stretches

what does the ACSM FITT-VPP stand for (flexibility)

frequency, intensity, time, type, volume, pattern, progression

frequency for flexibility

at least 2-3 days/wk with daily being most effective

Intensity for flexibility

stretch to tightness or slight discomfort
- proper technique is key

time for flexibility

- at least 10 minutes (major muscle groups)
- 10-30 sec for static: 4 or more reps/muscle groups
- PNF 10 sec stretch, 6 sec resist/contraction, 20-30 second stretch

Type for flexibility

static or PNF stretching techniques \= all major muscle-tendon units
- also dynamic and PNF can be effective (be careful with ballistic)

volume for flexibility

60 seconds of total stretching time for each flexibility exercise

pattern for flexibility

each flexibility exercise 2-4 times - warm up first

Progression for Flexibility

"methods of optimal progression are unknown'

cardiorespiratory fitness (CRF)

- ability of the circulatory and respiratory system to supply oxygen to the muscles to perform dynamic PA
- dose/response concept: increased physical activity\= lower death rate
- the primary role of a professional is to provide safe, evidence-based information

VO2max

concept of maximal oxygen uptake
- accepted measure of CRF

what are the three energy systems

creatin phosphate (CP) (phosphagen system), anaerobic glycolysis (glycolytic system), oxidative system

creatine phosphate (CP) (phosphagen system)

immediate source of ATP and lasts about 10 seconds

anaerobic glycolysis (glycolytic system)

- fast source of ATP and lasts about 90 seconds
- breaks down glucose or glycogen into pyruvate

Oxidative System

- slower source of ATP and lasts indefinitely
- requires presence of oxygen to produce ATP, which occurs in the mitochondria of the cell

what are some examples of field tests

cooper 12-minute run, 1.5-mile run/walk, Rockport 1-mile walk test, 6-minute walk test (older adults/some clinical populations), YMCA 3-minute step test

advantages of field tests

- easy to administer to large numbers of individuals
- little equipment
- low skill needed to complete test

disadvantages of field test

- tests can become a near-max or maximal test for some clients
- unmonitored BP, HR

"Good" VO2max for people in age group of 20-29

women: 40.6-44.7
males: 50.2-55.2

"Good" VO2max values for people in age group 30-39

women: 32.2-36.1
males: 45.2-49.2

what are the components of a CRF training session

warm-up, conditioning, cool-down, stretching/foam rolling

Warm-up guidelines

- transition from rest to exercise
- reduce risk of musculoskeletal injuries
(improving joint ROM and function, increasing connective tissue extensibility)
- increase body temperature
- gradually increase HR and systolic BP
- enhances psychological readiness for activity
- may reduce risk of injury
- good warm-up should be a chance to *drive quality movement*

cool down guidelines

- gradual recovery of heart rate (HR) and blood pressure (BP)
- enhance venous return (reduce risk of venous pooling, reduce risk of hypotension and dizziness)
- promotes heat dissipation

What are the FITT-VP guidelines

- frequency
- intensity
- time
- type (mode)
- volume
- progression

Frequency Considerations

- for most adults, 3-5 day/week (5 x 30 minutes/ 3 x 50 minutes)
- 7 days/week increases risk of orthopedic injury

Time considerations

- performance continuously or intermittently ( 1 session or bout of 10 minutes or more per day)
most adults
- 30-60 minutes/day of moderate intensity exercise
- 20-60 minutes/day of vigorous intensity exercise
- combination of both
- 10 minutes or less are still associated with favorable health outcomes

Type (mode) Considerations

aerobic types exercise that
- employ large muscle groups
- continuous (or intermittent (H.I.I.T.) and rhythmic
- repetitive activities
consideration for modality to promote adherence
- personal choice/enjoyable
- access to activities
- heath constraints
- skill and experience

exercise volume (quantity)

- product of frequency, intensity and duration
- moderate: 150min/wk
- vigorous: 75min/wk
- increased health benefits: aerobic exercise to 300min/wk of mod or 150 of vigorous
- expend at least 1000kcal/wk of moderate intensity exercise
- minimum of 100-200 steps/day\= 3000 steps (brisk pace)

intensity (exercise prescription)

- 3-5.9 mets\= moderate
-6 or greater\= vigorous
- RPE (rating of perceived exertion)
- caloric expenditure
-heart rate reserve method (HRR)
- VO2 reserve (VO2R)

progression of exercise (guidelines)

- gradual progression is key
- ACSM: an increase in exercise time per session if 5-10minutes every 1-2wk over the first 4-6 wk of an exercise training program is reasonable for the average adult
- increase either duration or intensity
- avoid large increase- gradual progression is key

what intensity range is considered moderate and vigorous related to HRR/VO2R

- light intensity\= 30-39%
- moderate intensity\= 40-59%
- vigorous intensity\= 60-89%

what is more accurate - HHR or VO2R? why?

VO2R beucase its tied closely to energy expenditure. the higher the intensity, the more oxygen clients consume and the more calories they burn

HITT training (high-intensity interval training)

- shorter workouts
- shorter time,
- (vigorous) high- intensity exercise
- use all your energy

what did the HITT study at McMaster University find related to older adults (in CRF basics 1b PPT)

results: older adults HIIT group had greater improved memory performance compared to mod-intensity group or stretching group

stage one of aerobic progression

- initial conditioning
- typically last 4 weeks and serves to familiarize client with exercise training

stage two of aerobic progression

- improvement stage
- typically last 4 to 5 months and rate of progression is more rapid

stage three of aerobic progression

- maintenance stage
- after 6 months, this stage is designed to maintain the level of fitness achieved by the client

progression of exercise
why increase duration before intensity

- avoid large increases which decrease in muscle soreness, injury, undue fatigue, long term risk of overtraining

energy expenditure
(absolute recommendation and differences)

- absolute: initial exercise program to first achieve the 100 kcal per wk threshold then progress gradually toward the higher recommended rage of (2500-3000 kcal per wk)
- differences will be in body mass, age and gender

exergy expenditure
relative recommendations

relative is 14-23 kcal/kg/wk

energy expenditure
pros and cons of absolute and relative recommendations

relative is not accurate with the VO2max while absolute is

energy expenditure
- STRRIDE study- what was purpose of this study (read the STRRIDE study article)- what is the importance of 14kcal/kg/wk and 23 kcal/kg/wk

- studies of a targeted risk reduction intervention through defined exercise

HR reserve

- HRmax - HR rest (the difference between a person's resting heart rate and maximum heart rate)

calculate HHR

max heartrate\= (207- (0.7* age in years))
\[(HRmax - HR rest)(%intensity)] + HR rest
- units: B/min

VO2 reserve method

- VO2max- 3.5 (the difference between a person's resting oxygen consumption (VO2R) and maximal oxygen consumption (VO2max)

Calculate VO2 max reserve

\[(VO2max- 3.5)(% intensity)] + 3.5
- units: ml/kg*min

how to calculate METs in metabolic calculations

target VO2 / 3.5 ml/kg*min

using ACSM chart to recommend mph and % grade for a client

higher mi/hr and lower % grade

calculating caloric expenditure (kcal/min)

(target VO2 * weight in kg)/ 1000ml/L and * everything by 5kcals/L

calculating min/week and kcal/week -with absolute and relative recommendations

* absolute: (1000 kcal/wk)
(1000 kcal/wk) / (kcal/min)
* relative: (wight in kg) \* (14kcal/kg/wk) (kcal/wk)/(Kcal/min)

five exercises to add into daily routine

thoracic extension- mobility of thoracic spine: more flexed when sitting

true hip flexor stretch- mobility of pelvis: prevent hip from getting too tight. put spine in better position

chin nods- great for neck muscle and forward head posture

shoulders W’s- combines chin nod posture with retraction of your shoulders, rotator cuff and scapular muscles

glute bridge- extend hips and take pressure off core: posture/core control

if not getting enough sleep… what needs to be scaled back in training

volume

intensity

frequency

what percent of Americans get less than 7 hours

40%