Physical Activity
any bodily movement produced by contracting skeletal muscles
resulting in an increase in energy expenditure
Exercise
PA that is planned, structured, repetitive, and purposeful activity to improve or maintain any component of fitness for life or sport
Health
a human condition with physical, social, and psychological dimensions, each characterized on a continuum with positive and negative poles
Positive health- wellness
Negative health- morbidity and mortality
Physical Fitness
“a set of attributes” that people can have or achieve that relates to the ability to perform physical activity
Morbidity
relative incidence of a particular disease in a specific locality.
Ex. diabetes, hypertension, depression, heart disease
Mortality
a measure of the number of deaths (frequency) in a given population
What does MET stand for?
metabolic equivalent of a task
Why are MET’s important?
are used to estimate the energy expenditure for many common physical activities.
MET- Light Exercise
1.6-2.9 METs
standing in line, walking slowly, washing dishes
MET- moderate exercise
3-5.9 METs
golf, tennis, walking quickly 3 mph
MET- vigorous exercise
= to 6 METs
jogging, running, fast walking, soccer, basketball
CMR
Cardiovascular, Metabolic, Renal Disease
S/S of cardiovascular, metabolic or renal disease
pain discomfort in chest, neck, jaw, arms
shortness of breath at rest or mild exertion
dizziness (during exercise)
orthopnea (breathlessness while laying down)
ankle edema (swelling evident at night)
palpitations or tachycardia
intermittent claudication
known heart murmur
unusual fatigue with usual activities
PAR-Q+
the physical activity readiness questionnaire for everyone
When to use PAR-Q+
self-screening for entry into moderate intensity exercise programs
How many questions on PAR-Q+
7 on the first page
ACSM Exercise Guidelines for Healthy Adults 18-65
should accumulate at least 150 min/week of moderate intensity exercise. (30-60 min a day)
OR
at least 75 min of vigorous intensity exercise (20-60 min a day) PLUS resistance train 2 days per week
Why is overall physical activity an important part of exercise prescription?
their are lots of health benefits associated with increasing physical activity.
What part of US has the biggest increase in these trends?
mid south
Louisiana, Oklahoma, mississippi, arkansas, kentucky, alabama
Difference between Type 1 and Type 2 diabetes?
In diabetes type 1, the pancreas does not make insulin, because the body's immune system attacks the islet cells in the pancreas that make insulin. In diabetes type 2, the pancreas makes less insulin than used to, and your body becomes resistant to insulin.
Health-related Components of fitness
ability to perform daily activities with vigor.
cardiovascular fitness
muscular endurance
muscular strength
body composition
flexibility
Skill-related Components of fitness
sport, motor skill performance
power**
speed
agility
balance
reaction time
coordination
Basic Training Principles
principles of
overload
progression
recovery
overuse
specificity
reversibility
individual differences
principle of overload
muscles adapt to a greater resistance
principle of progression
amount and intensity of your exercise should be increased gradually
principle of recovery
components
rest
hydration
nutrition
mobility/flexibility
mental health/stress reduction
high quality sleep
principle of specificity
physiological and metabolic responses and adaptations to exercise training are specific to type of exercise and muscle groups involved
principle of overuse
violating the principle of overload; overdoing it
may result in injuries
principle of reversibility
use or lose it
positive physiological effects and health benefits of regular PA and exercise are reversibile
Individual differences
varying age, fitness levels, and varied responses to a given exercise stimulus.
each person has a different response to exercise
experience
genetics
exercise history
risk factors
Health Concerns with Overweight/Obese Individuals
coronary heart/artery disease
stroke
hypertension
dyslipidemia
osteoarthritis
sleep apnea
type 2 diabetes
some cancers
Society Concerns with Overweight/Obese Individuals
Could not find
Mental benefits of PA and Exercise
increased:
self-esteem
self-confidence
overall cognitive performance
creativity
sleep quality
reduced:
stress
depression
anxiety
cognitive decline
physical benefits of PA and exercise
improved:
ADLs
muscular strength endurance
bone density
mobility
weight management
balance
reduced:
CVD
hypertension
type 2 diabetes
some cancers
chronic health conditions/disabilities
Dose-Response Concept
relationship between the dose of exercise required to elicit the desired response
dose- amount= total weekly energy expenditure
frequency, intensity, or duration
response- relative risk reduction of morality, physical fitness benefits, risk factor reduction
Sudden Cardiac Death
the abrupt loss of heart function, breathing, and consciousness
HCM
hypertrophic cardiomyopathy
heart muscle becomes thickened makes it harder to pump blood.
Common cause of SCD in younger athletes
hypertrophic cardiomyopathy
ACSM Pre-participation Flowchart
CVD Risk Factors
Age
family history
smoking
physical inactivity
body mass/waist circumference
hypertension
dyslipidemia
blood glucose
if one risk factor isn’t known it counts as risk factor
Age
men over 45
women over 55
family history
any heart condition including; myocardial infarction, bypass surgery/angioplasty, sudden death
before the age of 55 in male relatives
before the age of 65 in male relatives
must by 1st degree relative
smoking
current smoker
those that quit within previous 6 months
exposure to environmental tobacco smoke
physical inactivity
not meeting 75-150 min/week of moderate to vigorous physical activity
body mass/waist circumference
BMI greater or equal to 30kgm2
Waist circumference over
102 cm /40 in for men
88 cm/ 35 in for women
hypertension
systolic blood pressure greater than 130mmHg
diastolic blood pressure greater than 80 mmHg
dyslipidemia
LDL above 130
taking lipid lowering medication
total cholesterol over 200
HDL is positive risk factor. it cancels out other risk factors if over…
40 in men and 50 in women
blood glucose
pre-diabetes if over 100
diabetes if over 126
Transtheoretical Model of Change
change as a process involving progress through five stage. describes how people either modify a problem behavior or acquire a positive behavior
stage 1- pre contemplation
-not ready to take action
-no intention to take action in next 6 months
-cons outweigh pros of being active
-misinformed or uninformed
-denial
-unaware
-several failed attempts- demoralized
stage 2-contemplation
intending to be active in the next 6 months
-thinking about taking action
-intend to start in next 6 months
-more aware of pros/cons of engaging in PA
-convinced but not fully committed
-costs may still outweigh the benefits doubt/delay
stage 3- preparation
planning- beginning an activity but may be irregular.
getting ready to take action
intend to be active in next 30 days or immediate future
may have a specific plan to get started or are doing some PA but not meeting ACSM guidelines
smart goals
stage 4-action
behavior change has recently started
actively involved but less than 6 months
“I’m doing it now”
stage 5- maintenance
regular participation for at least 6 months
“i’ve been doing it consistently for at least six months”
making PA a habit
becoming part of their identity
Strategies to help clients move from one stage to next within TMC.
Having clients think of pros/cons
Helping clients make SMART goals
Helping clients to identify specific plans/people/places to support change
Follow-Up with client
support self-efficacy
non judgmental
motivation
discuss relapse
Social Cognitive Theory
key factor is self- efficacy. the more confident one feels in their capabilities and skills to succeed, the more likely they will engage in this behavior
reciprocal determinism
interaction between individuals and their environment. main factors
-environment
-individual personality characteristics/experiences
-behavioral factors
Self-Determination Theory
motivation exists on a continuum.
three psychosocial needs
-self-determination or autonomy
-competence
-relatedness (meaningful social interactions with others)
Intrinsic Motivation
as the doing of an activity for its inherent satisfaction rather than for some separable consequence.
Extrinsic Motivation
a motivation to participate in an activity based on meeting an external goal, garnering praise and approval, winning a competition, or receiving an award or payment.
Why we discourage adding extrinsic motivation if client is already intrinsically motivated?
Extrinsic rewards can undermine intrinsic motivation when used in certain situations or used too often. The rewards may lose their value when you reward behavior that was already intrinsically motivating. Some people also perceive extrinsic reinforcement as coercion or bribery.
Concept of cue/routine/reward when changing habit
the key to change- use the same cue, provide the same reward, change the routine
Barriers related to exercise adherence
lack of time or energy
lack of support, or workout partner, adequate facilities
poor health
self-conscious
Four strategies to help clients adhere to exercise
demonstrate support for client
help with organization and planning
helps client overcome barriers
gives praise and acknowledgement
motivates clients
helps set goals
positive feedback
How does exercise boost memory directly and indirectly?
directly- stimulating physiological changes (lower insulin resistance +inflammation. higher growth factors+ health of brain cells) brain part the controls thinking + memory is bigger
indirectly- improves mood + sleep. decreases stress + anxiety
What exercise is usually studied in exercise/memory research?
walking
What did researchers find in study about tai chi?
had potential to enhance cognitive function in older adults w/ executive function. ( planning, working memory, attention, problem solving)
How long does it take to start seeing cognitive benefits of exercise?
6 months
cholesterol
is a fat like substance. lipoproteins
sources of cholesterol
liver
food intake
3 reasons body needs cholesterol
make hormones
make vitamin D
make bile
two types of proteins that carry cholesterol
low density lipoprotein
high density lipoprotein
role of LDL
travels through bloodstream delivering cholesterol to cells that need it.
if body has too much LDL…
can build up on the walls of arteries
forms plaque
plaque buildup limits blood flow
causes coronary heart disease
^ risk of heart attack/stroke
where is HDL made in body
liver
role of HDL
helps remove excess cholesterol from your cells, tissues, and plaque
returns excess to liver and then removes it
blood pressue
the amount of force caused by blood pressing against the walls of arteries
role of right ventricle
pushes oxygen poor blood to lungs to pick up oxygen
role of left ventricle
pushes oxygen rich blood to your body
four main factors that affect pressure on artery walls.
proportional-
cardiac output
blood volume
blood viscosity
inverse-
resistance
hypertension guidelines
new-
top # 130-139 or +
bottom # 80-89 or +
old-
top # 140 or more
bottom # 90 or more
goal of these guidelines to decrease the risk of these diseases
heart attack, stroke, kidney disease
type 2 diabetes is more common in people with these characteristics
overweight, sedentary, middle age
relationship between glucose and insulin (healthy)
when blood glucose increases, pancreas secretes insulin. when insulin binds to its receptors it causes glucose transporters to come to surface of cell. facilitates entry of glucose into these cells
what goes wrong with type 2 diabetes
production of insulin is low and there can be resistance to insulin. circulating insulin fails to facilitate absorption of glucose into cells, and controls levels of blood sugar
common cause. of SCD in adults 20-30s
hypertrophic obstructive cardiomyopathy
Hypertrophic obstructive cardiomyopathy
genetic abnormality of the proteins used by heart muscle cells. the heart becomes abnormally thick in one area and when heart pumps, it has trouble ejecting blood past the thick part
why does this disease happen with exercise
w/ exertion and dehydration
blood volume decreases
why do runners die even with AED available
they go through ventricular tachycardia which can only be reversed by AED during 1- 2 minutes then it progresses to ventricular fibrillation. O2 is past return point.
prevention methods to detect symptoms of heart issue in younger adults
getting a cardiac echogram, echocardiogram or external exam of heart with ultrasound
self-determination theory
the more self-determined we are that is the more we’re doing what we want to do and aren’t being forced to do- the happier + more successful we tend to be
three basic needs of self-determination theory
autonomy- choice made by you
competence- know what your doing
relatedness- connects you to other people
how did St.Johns football coach incorporate SD theory with his team
ditched the laps, calisthenics.
he let players get water between plays, choose plays to run, implemented autonomy + competence into practice
explain 2004 study related to intrinsic motivation
those who were intrinsic motivation after 6 months outnumbered extrinsically motivated people 3 to 1
5 ideas from positive psychology to keep clients upbeat/motivated
understand that pessimism is not a choice
make workouts fun
devise an engaging workout
frame progress in a positive way
remember that other people matter
two key points
having small successes
making a workout fun
five areas that can motivate people to continue to exercise
demographic + biological factors
psychological, cognitive + emotional factors
behavioral attributes + skills
social + cultural
physical environment. + physical activity characteristics
most likely to dropout of exercise
people who over estimate their expectancies
people who smoke
low self-worth
bad body image
what changed for linda
she joined a “life change” program w/ walking
what error did linda make before?
she skipped the preparation phase