Exercise safety & clearance
What are some risk factors?
cardiovascular disease :
Low Risk: An individual without
symptoms of CVD with less than two risk
factors.
Moderate Risk: An individual without
symptoms CVD with two or more risk
factors.
High Risk: An individual with symptoms
of CVD, or with documented
cardiovascular, pulmonary, or metabolic
disease.
factors : age, family history, cigarette smoking, sedentary lifestyle, obesity, hypertension, dyslipidemia, pre diabetes, HDL)
If painful- soothe
If weak - strengthen
If tight- loosen
If loose- tighten *yet do not just consider the impairment for that client but also consider the underlying reason for that impairment and think about whether or not it is safe and appropriate to prescribe certain exercise*
What does S stand for in SMART Goals?
Specific
What do I want to achieve?
What, when, where, how
What is the Principle of Specificity of Training?
• training responses/adaptations are tightly coupled to the mode, frequency + duration of exercise performed
• majority of training-induced adaptations occur only in those muscle fibres that have been recruited during the exercise regimen, with little or no adaptive changes occurring in untrained musculature.
• predicts that the closer the training routine is to the requirements of the desired outcome, the better the outcome.
Specificity of strength and power training
- Adaptations should be relevant to the particular sport or functional goals
- Should target : specific muscle groups, velocity, range of movement, joint angle, and type of contraction (concentric, eccentric, isometric)
What does the F in FITT stand for?
Frequency --> number of times per day or week that an exercise should be performed, expressed in sessions, episodes or bouts.
• depends on intensity & duration of the exercise (long/intense exercise sessions cannot be completed as frequently as shorter/less demanding sessions)
• varies based on patient abilities, preferences & goals.
• Patients with low level of fitness - benefit from multiple, short daily exercise sessions / patients of moderate to higher levels of fitness – benefit from longer, more intense sessions.
• Resistance training is recommended at least twice weekly, with at least 48 hours separating the exercise training sessions for the same muscle group
What is the Borg Rate Of Perceived Exertion?
• Scale of 0-10 • Outcome measure scale for exercise intensity
prescription
• Suitable for wide range of patient populations
• Has been used to theoretical estimates of %1RM
• Research suggests that rating of >6 after 2
repetitions, weight is likely too heavy to complete 12-15 reps
Describe is the 1st risk profile?
1) Low-risk individuals & vigorous
exercise --> medical clearance/consultation not necessary, --> Submaximal or maximal testing;
no physician present, emergency procedures in place
What does M stand for in SMART goals?
Measurable
How will I know when I achieve them?
What is the Overload Principle?
=> involves increasing the load placed on muscle during training to achieve neuromuscular adaptations
Example:
- Increase resistance
- Increase reps (i.e. from 8 to 12 per set) or sets
- Increase duration of training session
- Reducing rest periods
--> done gradually to minimise risk of injury/excessive fatigue, don't change too many variations at once.
What does the I in FITT stand for?
Intensity --> the rate at which the activity is being performed or the magnitude of the effort required to perform it
• light > moderate > vigorous
• Intensity can be measured subjectively or objectively thru RPE, HR or VO2
What are the decision-making elements to consider when developing an exercise program?
Follow current evidence-based protocols
Consider the patient’s current abilities and limitations and related contextual factors
Consider biomechanical principles when prescribing each exercise
Consider appropriate dosage parameters
Educate the patient about their condition, safety, how to independently do the exercises, progress and correct performance; and provide feedback, handouts and demonstrations
Strength and conditioning rules are based on assumption that your client is fit and healthy with no injuries
• Often need to start with specific isolated exercises and progress
• focus on specific muscle groups before bringing in the larger muscle groups; complete large multi-joint exercises with more complex stability requirements at the end.
Describe the 2nd risk profile
Moderate-risk individuals &
moderate exercise --> Medical clearance/consultation not necessary --> Submaximal or maximal testing;
no physician present, emergency procedures in place
What does A stand for in SMART goals?
Achievable/Attainable
Can I realistically achieve this goal?
What does the second T in FITT stand for?
Time (recommended)
• WHO recommendations : --> at least 22 minutes of moderate-intensity physical activity --> or 11 minutes of vigorous physical activity --> or a combination of moderate & vigorous physical activity every day (performing more than the minimum requirements achieves further health benefits).
• Aerobic activity : bouts of at least 10 minutes duration (total time can be broken up).
• Resistance training : no specific amount of time, 'repetitions’ and ‘sets’ are standard ways to describe dosage.
Describe the 3rd risk profile
Moderate-risk individuals &
vigorous exercise --> medical clearance/consultation recommended --> Physician supervision recommended for maximal exercise testing
What does R stand for in SMART goals?
Relevant
Is it worthwhile? Does and the objective make sense and fit with the purpose?
What does the second T FITT stand for?
Type
• aerobic : walking, running, hiking, cycling, swimming, dancing
• resistance : climbing stairs, carrying objects, weight training with bodyweight/free weights/weight machines/resistance bands
• flexibility : stretching, Pilates, yoga, tai chi
• balance : yoga, tai chi, specific balance exercises.
Describe the 4th risk profile
High-risk individuals & moderate to vigorous exercise --> medical clearance/consultation recommended --> Physician supervision recommended for submaximal
or maximal exercise testing
What does T stand for in SMART goals?
Time based/Timely
When can I achieve this goal?