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134 Cards in this Set
- Front
- Back
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Muscular strength testing |
1 rep max testing (1RM) can measure absolute strength or relative strength (abs/body weight). should only be done in clients in phase 3-4 of IFT model. bench press, leg press, squat. contraindications - done with free weights, so must have proper form and control, not for beginners, proper breathing patterns, not for people with hypertension or vascular disease. warm up at 50% anticipated 1RM first do 3-5 reps at about 70% anticipated max rest 1 min do 2-3 reps at 85-90% anticipated max rest 2 minutes do at anticipated max. adjust up or down as necessary, wait 2-4 minutes in between each trial. client should achieve 1RM in 3-5 testing sets to estimate 1RM, weight at which you can do 6-8 reps = 80-85% 1RM. averages (men, women) ranges with age, relative strength: bench press: 0.72-1.19; 0.47-0.65 leg press: 1.49-2.04; 1.04-1.59 squat: |
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Estimating 1RM through submax testing |
for individuals with health considerations. can use weight at which a given # of reps completed to estimate 1RM. |
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What tests are done for muscle strength at sub maximal levels |
look at strength ratios between left and right and between agonist and antagonist. |
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What are appropriate strength ratios at the shoulder joint? |
flexion:extension = 2:3 (anterior vs. posterior delts) internal rotation:external rotation = 3:2 |
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What is the appropriate strength ratio at the elbow |
flexion:extension = 1:1 (biceps:triceps) |
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What is the appropriate strength ratio at the hip joint? |
flexion:extension = 1:1 (quads, iliopsoas, TFL : erector spinae, glutes, hamstrings) |
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What is appropriate strength ratio in the lumbar spine? |
flexion : extension = 1:1 (iliopsoas/abs: erector spinae) |
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What is the appropriate strength ratio at the knee? |
flexion:extension = 2:3 (hamstrings : quads) |
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What is the appropriate strength ratio at the ankle? |
plantarflexion : dorsiflexion = 3:1 (gastrocnemius : tibialis anterior) inversion : eversion = 1:1 (tibialis anterior : peroneals) |
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What are some different sports skills assessments that can be performed? |
basically only for clients at phase 4 of IFT training model, athletes Power testing: power = force x velocity or work/time -standing long jump test -vertical jump test speed, agility and quickness tests -pro agility test (5-10-5 shuttle run) -40 yard dash |
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what is the movement efficiency model? |
movement efficiency involves synergistic approach between stability and mobility. - "proximal stability promotes distal mobility" active muscle systems, passive systems (i.e. joint capsule, ligaments), neural systems (proprioceptors, motor units), and arthtokinematics (joint mechanics) all feed into sensory input and motor output --> joint mobility and stability --> movement efficiency |
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Movement of foot and ankle in gait cycle |
level of stability varies. as foot transitions from heel strike to accepting body weight on one leg the ankle moves into pronation (with accompanying calcaneal eversion) and the foot forfeits some stability in exchange for increased mobility to help absorb impact forces. as the foot prepares to push off, the ankle moves back into supination (with calcaneal inversion) becoming more rigid and stable again to increase force transfer into motion |
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Mobility and stability throughout the kinetic chain - what joints need to be stable vs. mobile; example of exercise for each joint |
glenohumeral - mobility, cable crossover scapulothoracic - stability, pull up, hang and hold thoracic spine = mobility, woodchopper, lunge + twist lumbar spine - stability, supermans hip - mobility, hip swing, abduction, adduction knee - stability, strengthen hip, quad, glute, hamstring ankle - mobility, boss foot - stability, balance activities |
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What happens when the joint lacks the requisite amount of stability or mobility? What can cause these imbalances |
if joint doesn't have enough mobility, it will seek ROM in other planes; adjacent more stable joints may need to compensate. muscle imbalances can be caused by repetitive motion, awkward postures, work environment, side-dominance, poor exercise technique, imbalanced weight lifting, congenital conditions, pathologies, structural deviations, trauma. imbalances alter muscle physiological and neurological properties which compromises mobility-stability relationship. the body subsides to the law of facilitation - achieves desired movement following path of least resistance. all of this leads to dysfunctional movement which will inevitably lead to some breakdowns. as one muscle lengthens, other shortens. leads to tightness and weaknesses |
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What is the relationship between sarcomere length and muscle tension |
length-tension relationship is the relationship between contractile proteins of the sarcomere and their force generating capacity. slight stretching of sarcomere increases spatial distance between proteins and increases force generating capacity. similarly, if sarcomere is over-shortened, muscle is weaker. problem if sarcomere is overstretched - because then sarcomeres don't adequately overlap and force generation decreases length-tension relationship can be shifted if muscles are chronically shortened (trauma, aging, immobilization; loss of sarcomeres in myofibril) or lengthened (antagonist to shortened muscle); shortened muscles generate more force at shortened sarcomere length; and lengthened muscles generate more force at longer lengths |
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Explain reciprocal inhibition at a joint |
hypertonic muscles (shortened) decrease neural drive to opposing muscle via reciprocal inhibition. both muscles on either side of the joint demonstrate weakness because of altered length-tension relationship, the reciprocal inhibition of the opposing muscles contributes to further weakening of the antagonist thereby reducing its ability to generate adequate levels of force at the joint. when this occurs, the body has to call on other muscles at the joint that will assume responsibility of becoming the prime mover (synergistic dominance). can cause overload on synergist muscles at the joint that weren't meant for the movement in question |
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What is the first phase of functional movement and resistance training |
stability and mobility training; reestablish appropriate levels of stability and mobility within kinetic chain |
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What are programming components of the stability and mobility training phase? What is proper progression? |
-proximal stability (lumbar spine) - core function, work on isolated activation of core musculature with emphasis on lumbar spine -proximal mobility (pelvis and thoracic spine) - mobilize pelvic and thoracic spine in all three planes without loss of lumbar stabilization -proximal stability of scapulothoracic joint / proximal mobility of glenohumeral joint -distal mobility and stability of distal extremities -static balance - promote core muscle function with seated and standing stabilization over a fixed base of support. |
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What stretching techniques should be performed at each stage of a workout? |
stretching important for flexibility. pre-exercise -myofascial release, warm up static stretched in reconditioned clients with poor flexibility and imbalances -myofascial release and dynamic stretching in clients with good balance and flexibility -dynamic stretches and ballistic stretches in performance athletes during exercise - dynamic stretches post-exerise - myofascial release, PNF, static stretches static stretches - min 4 reps holding each 15-60 sec; PNF - min 6 sec hold followed by 10-30 sec passive stretch; myofascial release - cover area 2-6 inches for 30-60 sec |
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What is autogenic inhibition |
activation of a GTO inhibits muscle spindle response. when static stretch is performed, small change in muscle length stimulates low grade muscle spindle activity and a temporary increase in muscle tension muscle response progressively decreases (desensitization). after 10 sec or so, GTO gets activated by stretch. under GTO activation muscle spindle activity and any tension in the muscle is temporarily inhibited allowing further muscle stretching. myofascial release might stimulate autogenic inhibition |
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In beginning stages of proximal stability training, what is the most important exercise to focus on |
activating the core; in individuals with good posture, the TVA works respectively with the neural system to produce hoop tension effect - draws ab wall in and upward. increases intraabdominal pressure. reduces joint compression in lumbar discs. delayed activation of the TVA inadequately stabilizes spine and can increase injury risk. activation of TVA - drawing-in, hollowing, bracing. need to reestablish reflexive function. first focus on core activation in isolation, no loading. then do stabilization exercises over fixed base of support, then over dynamic base of support. |
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Specific programming for proximal stability (core function) |
supine "drawing-in" - start by performing Kegels; 1-2 sets of 10 reps with 15 sec rest intervals. 2 sec tempo -TVA contractions - 1-2 sets of 10 reps, 15 sec rest intervals, 2 second tempo -combination of both contractions -contractions with normal breathing - 1-2 sets of 5-6 reps with slow 10 sec counts, progress to 3-4 sets of 10-12 reps quadraped drawing in with extremity movement = elevate one arm and/or leg about 1 inch off ground without losing control of lumbar spine. progression -raise one arm 1 inch off floor and perform the following shoulder movements: 6-12 inch sagittal, frontal and transverse. 1-2 sets of 10 reps, 2 second tempo, 15 sec rest intervals. -raise one knee and do the same movements but at hip - 1-2 sets of 10 reps each, 2 sec tempo - raise contralateral limbs and perform following sequence of movements: repeat above movements in matching planes or alternating planes. 1-2 sets of 10 reps, 2 sec tempo |
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What are some exercises and stretches appropriate for developing proximal stability at the hip and thoracic spine? |
cat-camel pelvic tilts supine bent knee marches modified dead bug with reverse bent knee marches lying hip flexor stretch hip fexor - half kneeling triplanar stretch lying hamstring stretch glute bridge supine 90-90 hip rotator stretch spinal extensions and spinal twists rocking quadrapeds |
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Cat-camel |
objective is to improve extensibility within the lumbar extensor muscles. 2-4 reps is appropriate |
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Pelvic tilt - progression |
objective - improve hip mobility in the sagittal plane. 1) lie supine with knees bent and feet on floor, arms in T with palms facing up. contract abs to tilt pelvis posteriorly, hold, relax; then contract erector spine to tilt pelvis anteriorly. 1-2 sets of 5-10 reps holding each position for 2 sec. 30 sec rest between sets 2) supine bent knee march - slowly raise one leg, drive knee toward chest; hold; alternate. 1-2 sets of 5-10 reps per leg, holding each 2 sec with 30 sec rest between sets 3)modified dead bug with reverse bent knee marches - start with legs at 90 degree angle; lower one leg toward floor maintaining bent knee. alternate. 1-2 sets of 5-10 reps per leg, hold end range motion 2 sec; 30 sec rest interval 4) add simultaneous arm movement - start with arms straight above chest. lower leg and same side arm. 5) additional progressions - contraleteral or bilateral movements of arms and legs |
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Hip flexor mobility - exercises and progression |
objective - improve hip flexor mobility in sagittal plane without compromising lumbar stability 1) start with lying hip flexor stretch. lie supine, grab leg behind knee and pull to chest with knee bent. extend opposite leg until its fully extended (or until lumbar stability is compromised) 2-4 reps per side, each for 15 sec minimum 2) half kneeling triplanar stretch - helps with mobility in all planes. start in half kneeling position. lunge forward to stretch hip flexor, 2-4 reps per side, hold 15 sec minimum 3) sagittal plane - extend arm opposite forward leg overhead. reach arm behind head while lunging forward. 2-4 reps per side, 15 sec hold 4) frontal plan - extend arm opposite front leg overhead and laterally flex torso while lunging forward 5) transcverse plane - place arm opposite leading leg behind head and rotate torso over the leading leg 6) spiral pattern. assume half kneeling position with front leg elevated (on step). lunge forward while simultaneously reaching both arms upward toward side of trailing leg and return to upright position as arms swing down (woodchoppers). 1-2 sets of 5-10 reps per side holding end range motion for 1-2 sec. 30 second rest between sets. |
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Exercises for hamstring mobility and progressions |
objective - improve mobility of hamstrings in sagittal plane without compromising lumbar stability. 1) lie supine, keep one knee bent. other leg rest it on wall with slight knee flexion and pointed toes. slowly extend the raised leg stretching hamstrings. 2-4 reps per side, hold each min of 15 sec. 2) perform series of pelvic tilts, holding anterior pelvic tilt to increase stretch 3) extend lowered leg so its laying flat on ground during stretch |
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Exercises for hip mobilization and progressions |
glute bridge - 1) 1-2 sets of 5-10 reps per side. hold end range motion 1-2 seconds; 30 sec rest interval b/w sets 2) from starting position, pull one knee toward chest, tilt pelvis posteriorly, and old knee to chest during bridge 3) place riser or pad under thoracic spine. supine 90-90 hip rotator stretch - lie supine with both feet on wall at 90 degree angle at knee and 60-80 deg bend at hips. cross one leg over opposite knee. push crossed knee away from body while lifting opposite foot off wall increasing degree of hip flexion; 2-4 reps per side, 15 sec hold |
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Exercises for thoracic spine mobilization and progressions |
spinal extensions - lie supine, knees bent, arms at sides with elbows extends. flex shoulder, raise both arms overhead and try to touch floor. return to starting position. 1-3 sets of 5-10 reps, holding end range 1-2 sec, 30 sec rest between sets. repeat but with abducting arms 135 degrees - Y formation; T formation; wiper formation spinal twists - lie on one side, both knees bent, resting on riser/block. swing arm over on side as well. 1)try to move spine so that it touches floor. 2-4 reps per side, hold each 15-30 sec. 2) place squeezable ball b/w knees 3)extend lower legend rest inside upper knee on squeezable object 3) repeat stretch but change upper arm from rib grab position to abducting arm 90 degrees with extended elbow and attempt to bring the upper arm to touch the floor. 4) push-pull - |
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Exercises for posterior mobilization |
rocking quadrapeds - objective is to promote hip and thoracic mobility while maintaining lumbar stability. assume quadruped position, rock backward and forward. |
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Stretches for shoulder capsule |
stretch inferior capsule using overhead triceps stretch stretch posterior capsule by bringing arm across body stretch or do wall stretch stretch anterior capsule using pec stretch (on wall) stretch superior capsule by placing rolled up towel above elbow against trunk grasping base of elbow and pulling it inward and downward. |
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Internal and external humeral rotation exercise and progressions |
objective - improve rotator cuff function. lie supine, knees bent. abduct arms to 90 degrees resting backs of upper arms on the mat and bend elbows 90 degrees 1)external rotation - rotate arms backward to touch floor. hold 15-60 sec. repeat 2-4 times. internal rotation - rotate arms forward, should be able to reach 20-30 degrees above floor. hold 15-60 sec, 2-4 reps. 2)once end ranges can be reached, add resistance. add no more than 5 pounds and build up to 3 sets of 12-15 reps with 30 sec rest interval b/w sets |
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Diagonals to improve rotator cuff function |
lie supine on mat with knees bent diagonal 1 - start with arm extended and placed across body, pull arm back across the body, externally rotating and abducting arm to 90 decrees diagonal 2 - start with arm extended and placed at side of body. pull arm across body toward opposite shoulder, externally rotating and adducting arm as it moves toward should with palm toward face. for each, 1-2 sets of 5-10 reps, hold end range 1-2 sec, 30 sec rest between sets. progression - add light cable resistance; lots of type 1 fibers, so volume training is best. add no more than 5 lbs and build volume to 12-15 reps per set. |
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Reverse flys with supine 90-90 |
objective - strengthen posterior muscles of shoulder complex lie supine, legs on chair so knees and hips flexed 90 degrees. abduct arms to 90 degrees, resting back of arms on mat and bending elbows 90 degrees. 1) press back of arms into floor with less than 50% max contraction. 2-4 reps holding contraction 5-10 secs 2) build volume to 3 sets of 12-15 reps, 30 sec rest b/w sets 3) seated with back flat against wall. 2 sets of 12-15 reps, 30 sec rest b/w sets. |
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Prone arm lifts - progressions |
objective - strengthen parascapular muscles lie prone on mat with arms and legs extended, elbows slightly bent. 1) I formation - lift both arms 2-4 in. 2-4 reps, hold 5-10 sec.; Y formation; W formation; O formation. 2) repeat formations with fully extended arms, not bent. 3) build exercise volume toward 3 sets of 12-15 reps with 30 sec rest intervals. 4) incline position on stability ball, standing or in hip-hinge, forward bend position. |
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Closed kinetic chain weight shifts (arms) |
objective - stabilize scapulothoracic joint and lumbar spine in CKC position. lie prone on mat, hands directly under shoulders, extend legs. press body up into plank position. shift body weight 3-6 inches forward, backward, left and right w/o moving hands; 2-4 reps holding each 5-10 sec. progression - offset one hand into staggered position (6-12 inches) and repeat movements on each side of body. |
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Static vs. dynamic balance |
static balance - ability to maintain COM within BOS dynamic balance - ability to move body's COM outside of its BOS while maintaining postural control and establishing a new BOS. |
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Limits of stability |
body is considered stable when line of gravity falls within base of support. limits of stability is the degree of allowable sway away from line of gravity that can be tolerated without a need to change BOS. |
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Exercises and progression to develop static balance |
training conditions to vary - narrow BOS, raise COG (raising arms overhead), shift LOG (raising arms unilaterally, leaning or rotating trunk), sensory alteration, sensory removal (closing eyes) training variables - 2-3 times per week, perform exercises near beginning of workout before fatigue, perform 1 set of 2-4 reps, each for 5-10 sec. progression - start seated, move to standing exercises, add unstable surfaces |
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Stance progression to challenge dynamic balance |
hip width stance, narrow stance. staggered stance, split stance tandem stance single leg stance |
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Single leg stand exercise and progression |
start with feet together, hip hinge 10-15 sec, raise heel 1 inch off floor. hold position. slowly unload entire foot lifting it 1-3 inches off floor. try not to laterally shift hips. extend hip and stand vertically (like swing leg forward). 1-2 sets of 5-10 reps, 30 sec rest b/w sets. repeat with opposite leg. progression 1) leg swing to mimic gait 2) repeat with feet positioned in normal gait-width stance 3) resistance |
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Exercises for introducing dynamic movement patterns over a static base of support |
single leg stance 1) introduce upper extremity movements - move unilaterally, bilaterally, reciprocally. move in different planes. 1-2 sets of 10-20 reps per side. slow tempo, less than 30sec rest b/w sets. 2) introduce lower extremity movements - see above for reps. start by single leg stance, swing leg forward and backward, move leg in different planes. 3) integrate both upper and lower extremity movements - move limbs ipsilaterally or contra laterally. move in sync or out of sync (opposite directions). see above for reps. |
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Describe the movement training phase of functional programming for stability-mobility and movement |
five primary movements - bend and lift, single leg, pushing, pulling, rotational. movement training trains these 5 primary movements to improve ADL |
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Consequences of pronation / supination of the ankle on the lower body kinetic chain |
pronation - causes internal rotation of knee and places stress on medial knee surface which forces knee into abduction (known as valgus stress); more stress on ACL supination - external rotation of knee |
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What are some exercises to train for bend and lift movement |
bend-and-lift: one limiting factor to good technique is ankle mobility - need to evaluate this. exercises are part-to-whole strategy hip hinge: objective is to emphasize glute dominance over quad dominance in first 10-15 degrees of movement. stand straight, push hips back with slight knee bend. goal is to move back while minimizing downward movement. 1-3 sets of 15 reps lower extremity alignment - align hips, knees, and feet. start seated in chair with either squeezable ball between knees (adduction) or band around thighs (abduction). perform 1-2 sets of 5-10 contractions. progression - hold contraction while standing up out of chair and sit back down. 1-2 sets of 5-10 reps. figure 4 position: to promote alignment between trunk and tibia in squat. want thighs parallel to floor. and tibia and trunk parallel. |
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What are some exercises that utilize single leg movement patterns |
progression for all of these exercises involve adding external resistance and increasing balance challenge. 1) half kneeling lunge raise - glute hamstring and adductors will push body up, hamstrings pull down. 1-3 sets of 12-15 reps, 30 sec rest intervals 2) full lunge - 1-3 sets of 12-15 reps, 30 sec rest intervals; emphasize glute push and hamstring pull. progressions = directional changes, different foot positions, additional upper body movements. can even progress to jumps. |
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Exercises and progressions for pushing movement patterns |
bilateral and unilateral presses - open chain pushing movements in unsupported environment. all = 1-2 sets of 12-15 reps with 30 sec rest intervals between sets 1) seated, but no contact with back rest. 2) standing press. split stance, alternate forward leg with each set; cable or TRX 3) single arm press with contralateral stance. 4) single arm press with ipsilateral stance thoracic matrix - to promote multiplanar thoracic mobility. standing up, move arms in all three planes. progress from neutral stance to staggered stance. 1-2 sets of 12-15 reps with 10-15 sec rest between sets overhead press - stability at the shoulder capsule. seated position. press bar overhead. actively engage lats to initiate pulldown sequence. 1-2 sets of 12-15 reps, 30 sec rest intervals b/w sets 1) dowel, weighted bar 2) dumbbells, while introducing changes in planes of movement - i.e. trunk rotation, lateral trunk movements like side lunges, in squat position, do sets of uppercuts with dumbbells. |
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Exercises and progressions to train pulling movement patterns |
bilateral and unilateral rows. open kinetic chain pulling. 1) seated, make contact with chest plate, pull load bilaterally. 1-2 sets of 12-15 reps, 30 sec rest 2) seated row with no chest plate contact 3) standing row, split stance, alt forward leg 4) single arm row with contralateral stance 5) single arm row with ipsilateral stance |
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Exercises and progressions involving rotational movement pattern |
2 key movements - woodchoppers and hay balers (same movement but one starts overhead - choppers and swings down. one starts down and swings up - balers) important to never perform these exercises without thoracic mobility and lumbar stability. all = 1-2 sets of 12-15 reps in ech direction, alternating which knee is in front. 1) half kneeling position, can place unstable surface under back knee to make it harder on core. start up and perform downward swing. imagine holding a short handle i.e. keep hands close to body. 2) long moment arm - extend arms. 3) standing short arm, split stance 4) standing long arm 5)add in a hip hinge/squat while rotating hips outward. 6) squat but with long moment arm 7) full chop - more trunk rotation 8) add external resistance - medicine ball, elastic resistance, cables |
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What are some proven benefits of resistance training |
stimulate muscle development, increased tendon/ligament strength, increased bone density, increased physical capacity, increased RMR, better body composition, improvements in cardiovascular disease risk, high cholesterol/BP/diabetes risk/metabilic syndrome, etc. but not shown to help weight loss. helps maintain muscle mass during weight loss. good in conjunction muscles use energy, so increased RMR. can boost metabolism for up to 72 hours. reduced arthritis pain decrease depression |
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What are some acute physiological adaptations to resistance training? chronic? |
acute - anabolic and catabolic hormone levels increase, metabolism chronic - increased muscular strength and size. increased number of myofibrils, increased sarcoplasm, increased mitochondria |
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What are factors that influence muscular strength and hypertrophy? |
hormone levels - GH and testosterone sex - men have greater muscle mass and thus overall strength, but muscle strength capacity is the same. age - older = less muscle mass. muscle fiber type - muscle length relative to bone length, one of the most important factors - long muscles = greater potential for strength development. limb length - long limbs provide longer resistance force arms and require more muscle force to move a given resistance. tendon insertion point - longer muscle force arm provides a leverage advantage for moving heavier resistance. |
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Relationship between muscular strength, power, and endurance training |
strength = like 1RM, can be absolute or relative. endurance = reps of a given resistance, absolute muscular endurance increases as strength increases; but relative endurance might not change. power = product of muscular strength and movement speed. training with medium resistance and moderate-to-fast movement speeds produces the highest power output and is most effective for increasing power. |
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Resistance training variables to consider |
volume, intensity, tempo, rest intervals and frequency. frequency - inversely related to training volume and intensity. should not train same muscle groups more than every third day. 2-3/wk for beginners, 3-4/wk for intermediate and 4-7 for advanced skill. volume = sets x reps or exercise weight load x reps x sets. reasonable calculation of total energy used. recommended that training volume changes periodically. intensity - can be measured as % of 1RM used in exercise. or effort level achieved in workout (to fatigue). varies inversely with volume. most periodization models for strength training begin with high volume/low intensity , progress to moderate/moderate and conclude with low vol/hgih intensity tempo - no research into most effective. controlled slow movements require even application of muscle force in entire ROM, fast movements require high muscle force to initiate lift and then get by on momentum. most commonly recommended is 6 sec/rep - 1-3 sec concentric action, 2-4 eccentric. rest intervals - |
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Considerations in selecting appropriate exercises and order in resistance training |
group exercises based on body area, function or relevance to a specific activity. primary exercises = multiple muscles from 1 or more of the larger muscle groups., span 2 joints. assisted exercises = smaller muscle groups, more isolated, single-joint. order options: -primary exercises followed by assisted in one targeted area. -alt upper and lower body within or between sessions -grouping pushing/pulling or targeting agonist/antagonist -supersets/compound sets where exercises are done in sequence with little to no rest in between. |
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What are appropriate progressions in resistance training - generally speaking |
begin with uniplanar movement machines --> multi planar machines supported machines --> unsupported machines muscle isolation exercises --> multijoint bilateral, fixed level machines --> unilateral, free moving machines |
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What training volume is recommended for muscular fitness, endurance, hypertrophy, strength or power? |
general fitness - 1-2 sets of 8-15 reps; 30-90 sec rest intervals, various intensity endurance = 2-3 sets of 12+ reps, less than 30 sec rest intervals, 60-70% 1RM hypertrophy - 3-6 sets of 6-12 reps; 30-90 sec rest intervals at 70-80% 1RM strength = 2-6 sets of less than 6 reps; 2-5 min rest b/w sets at 80-90% 1RM power - single effort events = 3-5 sets of 1-2 reps, 2-5 min rest, >90% 1RM; multiple effort events = 3-5 sets of 3-5 reps; 2-5 min rest, >90% 1RM |
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Explain the idea of progression in strength training and how it should be executed |
increase # reps performed, with resistance heavy enough to fatigue target muscles. increase workload. example - range = 10-15 reps. start at weight that person can do 10 reps of. once they can do 15 of same weight, increase resistance by 5%. this should reduce # reps possible. continue to train at this weight until 15 reps reached again then increase by another 5%. this is called a double progressive training model - where first progression is adding reps, 2nd is adding weight. |
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What is the concept of overload? |
need to overload muscles for them to make gains. increase resistance in 5% gradations. |
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What is periodized training? |
training divided into time segments referred to as macrocycle, mesocycle and microcycle. macrocycle is the overall program time frame. long range goals are split ip into shorter term, specific goals (mesocycles), micro cycles are typically 2-4 weeks. usually 1 macrocycle = 6-12 months, split into 2 mesocycles (3 months each) split into 2 microcyles (2-4 weeks) |
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What is the difference between linear periodization models and undulating models? |
linear periodization provides consistent training within each microcycle and changes training variables after each microcycle. i.e. microcycle one, lift x weight, x reps every time. undulating - provides different training protocols during the micro cycles in addition to changing the training variable between micro cycles. i.e. lift x weight, x reps monday; higher weight, lower reps wed; higher weight, lower rep friday. |
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What phases make up the IFT model |
1 = stability and mobility training 2 = movement training 3 = load training 4 = performance training |
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Program design for phase 1 (stability and mobility training) of resistance training |
main goal is to promote proximal stability (core, lower back), then proximal mobility and distal mobility; reestablish proper neuromuscular function and balance. promote tissue extensibility - stretching, PNF, myofascial release improve muscle's ability to maintain good joint position. begins with low grade isometric contractions of targeted muscle (with joint in good posture), followed by dynamic movements that increase muscular volume and load |
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Program design for phase 2 (movement training) of resistance training |
teaching clients to perform 5 basic movements effectively in all three planes (bend and lift, single leg, push, pull, rotation) start with bodyweight. progress to adding external resistance gradually. medicine ball, elastic band, free weights (start with dumbbell then barbell), cables assessments in this phase = movement screens. recommended rate of progression = 5% once end range of reps is reached. progress through reps and sets and then add more resistance or advanced movements time frame = 2 weeks to 2 months |
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FIRST guidelines for movement training (resistance training) |
F = 2-3 days/week. I = low, focus on proper movement patterns R = varies with intensity, but lower intensity allows more reps S = one set is just as effective as multiple in beginners. good to start with single sets. T = based on clients ability and efficiency. |
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FIRST guidelines for improving muscular endurance |
F = 2-3 / week for beginners, as intensity increases, need more time to recover. but endurance emphasizes type 1 fibers which fatigue slower and recover faster, so 3/week is effective. if ability decreases, cut back on sessions I = objective in endurance is to work to fatigue. 75-100 secs which roughly translates to 12-16 controlled reps which corresponds to about 60-70% 1RM R = 12-16 reps, increased by 5% once 16 reps can be done. S = relatively brief rest periods between sets (less than 30 sec, or 30-60 sec in higher intensity); 2-3 sets each. T = total body workout, start with larger muscles of legs, then trunk, upper body and arms. circuit training is more efficient way to train muscular endurance and cardio. pros = more time efficient, get some aerobic; cons = lift less weight due to cumulative fatigue. progression = increase # circuits then weight load. |
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FIRST guidelines for improving muscular strength |
F = high intensity resistance training causes significant micro trauma, so recovery for at least 72 hours is needed. 2 sessions per week, or don't train same body part more than every 3rd day. I = optimal intensity is 80-90% 1RM. near max weight that allow 1-3 reps are highly effective in developing strength. R = fewer reps; about 4 reps at 90% 1RM or 6 reps at 80% 1RM. when 7 reps can be completed, progress weight by 5% S = best to start with one hard set. can progress but general no more than 3-4 sets. 2-5 minute recovery periods between sets of same exercise. single set training can significantly increase strength in shorter time. T = linear exercises that involve multiple muscle groups utilized in basic movements are preferred for increasing total body strength. i.e. squats, deadliest, lunges, pull ups, bench press split training is more efficient. supersets might be good - train another muscle while one is resting to conserve time. also requires higher metabolic response. usually pair opposing muscle groups. double progressive model recommended for progressions - once terminal # reps reached, increase resistance by 5% |
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FIRST guidelines for muscle hypertrophy |
high training volumes, relatively brief rest periods, weights and reps somewhere between those recommended for endurance and strength. F = 6 day split, working 1-2 muscle groups per session. I = 70-80% 1RM R = 6-12 range (reps use anaerobic system id done in 50-70 seconds); successive sets with short rests enhances muscle pump S = 4+ exercises for each major muscle group. 3-6 sets/exercise. means that each muscle group will be trained 12-24 sets of 6-12 reps at 75% max. 30-90 sec rest between sets. T = use isolation exercises to get all small muscles but also use multipoint. perform to failure. ; periodized program; supersets, compound sets (2+ exercises for same muscle in rapid succession) breakdown training - train to failure, then reduce resistance 10-20%, then do to failure (drop sets) assisted training - train to muscle failure and then get manual assistance from trainer on lifting phase for 3-5 post fatigue reps increase resistance one 10-12 rep average is reached for ALL exercises in total body workout. |
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FIRST programming guidelines for performance / power training (phase 4 of resistance training model) |
power training maximizes energy use per unit of training time. targets type 2 fibers. prereqs for performance training = proficient at acceleration and deceleration, stabilization during powerful movements; joint integrity, strength; adequate balance, good core function, anaerobic efficiency, athleticism, no contraindications or medical concerns that affect motor skills medium resistance and fast movement speed produces highest power output. plyometric exercises. minimum between concentric and eccentric actions (amortization phase). movement pattern progression for plyometrics = linear-forward, lateral, backpedal, rotational, crossover/cutting/curving. F = 1-3 plyometric sets/wk. 48-72 hour recovery period recommended. I = multiple considerations (points of contact, speed, vertical height, body weight, exercise complexity). progress from light to hard (start with jumps in place, single linear jumps, multiple linear jumps, multidirectional jumps, hops and bounds, depth jumps) R = lower body reps counted by foot contacts, upper body by hand contacts. beginner level = 80-100 low, 60 moderate, 40 high intermediate = 100-150 low, 80-100 moderate, 60-80 high advanced = 140-200 low, 100-120 mod, 80-100 high type = |
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Program design for improving speed, agility and reactivity |
aim to progressively narrow BOS to improve agility. F = 1-3 nonconsecutive days/wk. I = perform early in session, high intensity. R/S = stationary drills - 1-3 sets for 10-15 sec per rep. progress to 20-30 sec. dynamic drills - start at 1-3 sets for 20-30 yards per rep, progress to 100 yards. 2-3 min rest between reps. |
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Special considerations for resistance training in youth |
increase bone density, psychosocial health, motor skills, sports performance guidelines: qualified instruction, safe exercise environment, pre-training warm up, 1-3 sets of each resistance exercise, 6-15 reps per set. variety of upper and lower body (no specialization at young age), increase resistance by 5-10% increments, 2-3 non-consecutive training days/wk. |
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Special considerations for strength training in older adults |
begin with less weight and more reps. 10-15 reps at 60-70% 1RM. avoid isometric contractions (increases BP), 2 sessions per week. start with single set training. monitor heart rate using RPE. begin with stable/supported surfaces. |
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Equipment options for strength training, pros and cons of each |
selectroized equipment - good for beginners, pre-set motion path cables - works stabilizers, freedom of movement free weights - require equal force application from both arms, works stabilizers, high ROM kettleballs - swinging and lifting; develops strength and power medicine balls - made to be thrown elastic resistance - softer form of resistance, easily adapted. body weight - progression = more reps up to 100 sec; after that point get diminishing returns |
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Protein and amino-acid supplements |
protein supps - sold as hydrolysates - partially digested. - whey powder = 11-15% protein, whey concentrate = 25-89%, isolate = 90+% protein. isolate is lactate free -casein sustained slow release of AAs. -BCAAs may enhance endurance by delaying onset of CNS fatigue -BCAAs, especially leucines increase rate of protein synthesis and catabolism after exercise. |
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Beta-alanine (carnosine) and sodium bicarbonate supplements |
pH buffers in muscle tissue. may delay fatigue onset and enhance muscle force and power output |
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Caffeine effect on exercise |
caffeine resembles adenosine, a molecule that slows down the nervous system, dilates blood vessels, and allows sleep. acts as a mimic antagonist. basically stimulating a stress / fight or flight response. enhances athletic performance, sustains duration, maximizes efforts at 85% VO2 max, quickens speed, decrease perceived exertion but chronic use can contribute to high BP, high blood sugar, decreased bone density, jittery nerves and sleeplessness |
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Effect of creatine on exercise performance |
proven effective in building mass. source of rapid energy. increase muscle stores of creatine --> better performance at high intensity weight lifting (like 1st rep, phosphagen system). can boost muscle strength by 10% |
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Which vitamins / minerals are particularly important for optimal athletic performance? Why? |
iron - for hemoglobin zinc - immune function, protein synthesis, blood formation B12 - metabolism of nerve tissue, protein, fat and carbs Riboflavin - energy production Vit D - calcium absorption, bone growth and mineralization. Calcium - bone health, blood clotting, muscle stimulation |
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Anabolic steroids |
adrostenedione - testosterone precursor DHEA - doesn't affect strength, lean body mass or athletic performance. |
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Physiological adaptations to acute and chronic cardiorespiratory exercise |
muscle: fibers recruited to perform exercise are the only ones stimulated to adapt. low intensity = type 1. adaptations = increased size, # mitochondria, more capillaries, changes in contractile mechanism (filaments) - generate more force, hypertrophy. high intensity = type 2, increases anaerobic capacity by increasing anaerobic enzymes. cardio: expansion of blood vessels, heart muscle hypertrophy, higher CO (mostly because of larger stroke volume), vasodilation with exercise increases --> more effective oxygen delivery to muscles respiratory: no increases in size but strength and fatigue resistance of respiratory muscles improves. increase in tidal volume. cardio adaptations (VO2 max) begin immediately. not noticeable until 2 weeks. reaches peak and plateaus at 6 months. but changes in VT can occur for years. attributed to capillary growth and increased mitochondrial density. capacity of muscle to store glycogen and ability to mobilize fat as fuel also increase. higher intensity training can cause large increases in venous blood return t0 the heart and thus lead to adaptations in SV faster than with steady state cardio |
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Three components of any cardio workout session |
warm up - 5-10 minutes. should be longer for older clients and harder workouts conditioning - higher intensity things should take place early in workout. conclude with more steady state. cardiovascular drift in steady state exercise (gradual increase in HR due to small reductions in blood volume from sweat loss and increasing core temp) cool down - 5-10 minutes.prevents blood pooling. |
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Government guidelines for cardio exercise |
150 minutes per week of moderate intensity aerobic activity or 75 minutes of vigorous activity. additional health benefits from performing more. perform aerobic bouts in periods of at least 10 minutes. participate in muscle strengthening activities at least 2 days/wk. for children: 60+ minutes of moderate to vigorous activity per day; vigorous at least 3 days/wk. 3 days / wk of muscle / bone strengthening exercises |
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Suggested frequency of cardio exercise |
recommended on most days of the week. can see health benefits with 1-2 though. moderate intensity exercise (40-60% VO2 max) min 5 days/wk vigorous (greater than 60% VO2 max) min 3 days/wk combo - 3-5 days / week |
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Methods to monitor cardiovascular exercise intensity |
heart rate (% MHR; % HRR) RPE VO2 or METs caloric expenditure talk test / VT1 blood lactate / VT2 |
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How is maximum heart rate (MHR) determined? What factors affect this? |
usually based on age: 220-age but thats super simplistic. factors affecting it are genetics, exercise modality, medications, body size, altitude and age. huge standard deviation, overestimates in younger adults and underestimates in older adults. corrected formulas: gellish - 206.9 - (0.67 * age) tanaka - 208 - (0.7 * age) |
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Recommended % MHR in exercises for different conditioned adults |
sedentary - 57-67% MHR; 30-45% VO2 max minimal activity - 64-74% MHR; 40-55% VO2 max sporadic physical activity - 74-84% MHR; 55-70% VO2 max habitual physical activity - 80-91% MHR; 65-80% VO2 max high amounts of habitual activity - 84-94% MHR; 70-85% VO2 max |
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Heart rate reserve (HRR) calculation method (Karvonen) |
target heart rate = (HRR * training %) + RHR HRR = MHR - RHR |
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Ratings of perceived exertion |
classical 6-20 scale. hard to use for very sedentary clients because everything seems hard. |
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Measuring exercise in terms of VO2 or METs |
lowest effective training intensity at which adaptations to VI2 max might be provoked is VT1. hard to directly measure VO2 METs = multiples of an assumed average metabolic rate at rest of 3.5 mL/kg/min - walking, leisure activities, work/household activites - less than 3 mets -moderate activity (3-6 mets) = walking fast, heavy cleaning/chores, more aerobic leisure activities vigorous (greater than 6 mets) = jogging, running, sports |
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Estimating caloric expenditure during exercise |
per liter of O2 consumed, 4.69 kcal of fat and 5.05 kcal of glucose is used. average = 5 overall. convert to find relative VO2 caloric expenditure = [VO2 (mL/kg/min) x body weight (kg) / 1000] x 5kcal/L/min |
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Suggested duration of cardio exercise |
can be done in continuous bout or in 10 minute sessions. moderate intensity at least 30 min/session, minimum 5 days / week; total of 150 min/wk vigorous intensity - 20-25 min/session, min 3 days/wk, 75 min/wk total for weight loss, 50-60 min of moderate exercise each day, 5-7 days/wk; total 300 minutes. or 150 min of vigorous exercise. |
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Cardiovascular exercise progression |
need overload and specificity SAID principle - specific adaptations to imposed demands. should only increase in 10% increments good to use different modalities, variations to avoid burnout, injury or overuse. |
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Four cardiorespiratory training phases of the ACE IFT model |
phase 1 = aerobic base training; focus is on generating a positive exercise experience, no fitness assessments, steady state exercise in zone 1. once can sustain for 20-30 min in zone 1, progress to phase 2 phase 2 = aerobic efficiency training; focus is on increasing duration of exercise and introducing intervals. do sub maximal talk test to find HR at VT1. increase work to VT1, then introduce low zone 2 intervals. progress low zone 2 intervals by increasing time of work interval and decreasing recovery. progress to higher zone 2 intervals. most people stay here for years. if they have specific goals, progress to phase 3 phase 3 = anaerobic endurance training; for clients with endurance goals or clients exercising 7+ hours of cardio per week. VT2 test to find HR at VT2. programs will train mostly in zone 1 with intervals into zones 2 and 3. if have further goals for speed for short bursts at near max efforts, athletes progress to phase 4 phase 4 = anaerobic power training; goal is to improve phosphagen system. train in all 3 zones. only work in phase 4 in specific training cycles prior to competition. |
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Three zone training model for aerobic exercise |
zone 1 = below VT1 zone 2 = between VT1 and VT2 zone 3 = above VT2 |
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Different markers of zone 1 cardiovascular exercise |
below VT1, HR < VT1 talk test - can talk comfortably RPE - moderate to somewhat hard, 3-4, 12-13 40-59% VO2R 40-59% HRR 64-76% MHR 3-6 METs considered low to moderate exercise |
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Different markers of zone 2 cardiovascular exercise |
between VT1 and VT2. talk test - not sure if talking comfortably, maybe taking some breaths, but not gasping. RPE = hard, 5-6, 14-16 60-84% VO2R 60-84% HRR 77-93% MHR 6-9 METs moderate to vigorous exercise |
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Different markers of zone 3 cardio exercise |
above VT2, talk test - definitely cannot talk comfortably RPE - very hard - extremely hard, 7-10, 17-20 more than 85% VO2R more than 85% HRR more than 94% MHR more than 9 METs vigorous - very vigorous exercise. |
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Phase 1 of the ACE IFT model for cardiovascular training (aerobic base training) |
generate positive exercise experience. generate adherence. training in zone 1. once adherence is established, exercise duration can be increased until they reach 30-60 min on most days with little fatigue --> then progress to phase 2. establish self efficacy progress as rapidly as tolerated. 10% increase increments PER WEEK. progressions in this phase mostly based on duration |
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Phase 2 of the ACE IFT model for cardiovascular training (aerobic efficiency training) |
principal training focus of increasing duration and introducing intervals. progress through longer work intervals and shorter rest intervals (start at 1:2) focus is on increasing duration of exercise and introducing intervals. do sub maximal talk test to find HR at VT1. increase work to VT1, then introduce low zone 2 intervals. progress low zone 2 intervals by increasing time of work interval and decreasing recovery. progress to higher zone 2 intervals. most people stay here for years. if they have specific goals, progress to phase 3 |
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Phase 3 of ACE IFT model for cardio training (anaerobic endurance training) |
anaerobic endurance training; for clients with endurance goals or clients exercising 7+ hours of cardio per week. VT2 test to find HR at VT2. programs will train mostly in zone 1 with intervals into zones 2 and 3. if have further goals for speed for short bursts at near max efforts, athletes progress to phase 4 70-80% of training performed in zone 1; 5-10% in zone 3. need to alternate hard and easy workouts to avoid injury/allow recovery. this is more effective than training that is the same intensity every day. duration should be increased slowly (less than 10% per week) until total weekly volumes reaches a max of 3 times the anticipated duration of the target event the exerciser is training for. |
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Phase 4 of the ACE IFT model for cardio training (anaerobic power training) |
phase 4 = anaerobic power training; goal is to improve phosphagen system. train in all 3 zones. only work in phase 4 in specific training cycles prior to competition. no more than 4 hard training days per week. and three really intense workouts are better than doing the same workload over 7 days. |
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Special considerations for cardio programming in youth |
before puberty - as little structured activity as possible . preferably more than 1 hour per day. no super heavy lifting. or very heavy training |
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Special consideration for cardio programming in older adults |
avoid cardio risk, avoid orthopedic risks, preserve muscle tissue and take into consideration the rate at which older clients adapt to training. if any cardio risk factors are present, restrict exercise to zone 1 for the first several weeks. less frequent hard training, recovery takes longer. |
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Premise behind mind-body exercise (physiologically) |
HPA (hypothalamic - pituitary - adrenal) axis. meditation reduces activation of the HPA axis at the level of the hypothalamus. this causes decreased adrenal production of catecholamine and cortisol which causes a decrease in arousal and hypervigilance |
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Research supported outcomes of mind body exercise (such as yoga) |
decreased resting BP increased pulmonary function (in asthma too) increased max work capacity and oxygen consumption regression of CAD improved lipid profiles increased muscular strength, flexibility, balance, posture reduced arthritis pain and decreased risk of falls psychological well being increased insulin sensitivity and glucose tolerance |
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What are some common components of mind-body exercise programs |
meditative/contemplative proprioceptive and kinesthetic body awareness breathwork anatomic alignment or proper choreographic form energycentric |
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Different mind-body exercise modalities |
yoga -restorative yoga (stretching) -Iyengar (isometric contractions) -Ashtanga (power yoga) -viniyoga -kripalu (western adaptations) - bikram (set of 26 poses, in particular sequence) - kundalini (yoga of awareness - yogic breathing (pranayama) Qigong exercise Tai chi pilates chiwalking/chirunning alexander technique (postural training) feldenkrais method NIA (neuromuscular integrative action) spiritual dancing |
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SOAP note |
subjective observations objective measurements assessment plan good way to document encounters with clients |
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Programming for individuals with cardiovascular disorders (specifically, CAD) |
cardio disorders are leading cause of death in developed nations risk factors = family history, hypertension, smoking, diabetes, age, dyslipidemia, lifestyle. physical inactivity is a major independent risk factor for CAD. need physician release. should have a physician supervised maximal graded exercise test to determine functional capacity and CV status in order to determine safe exercise level. should ideally work only with low risk patients, meaning they have an uncomplicated clinical course, no evidence of ischemia, functional capacity greater than 7 METs, normal ventricular function with ejection fraction of at least 50%, no arrhythmias. teach proper breathing to avoid Valsalva maneuver. begin with light weights and progress to weight machines. generally, perform one set of 12-15 reps using 8-10 exercises to target the major muscle groups. should not exceed RPE of 11-14. low intensity endurance exercise. avoid isometric exercises. intensity - to begin, RPE of 9-11, 40-50% HRR or 20-30 beats over RHR. if already exercising, can progress to 60-85% HRR, 11-14 RPE. increase duration gradually to 30+ minutes of continuous exercise or interval training. 3-5 days/week of aerobic exercise and 2 days/week of resistance training. be conscious of symptoms - angina, dyspnea (shortness of breath), lightheadedness, dizziness, pallor, rapid HR. |
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Programming for individuals with hypertension |
over 140/90 prehypertensive = 120-139/80-89 be aware of BP meds - messes with HR, use RPE to measure exertion exercise session should be discontinued if SBP or DBP rise to 250 or 115 respectively or SBP fails to increase with increasing workload or drops more than 20 mmHg should participate in 30 min or more of regular exercise at least 5 days/week.avoid isometric exercise and emphasize proper breathing. circuit training with low to moderate resistance and high reps. Type - low impact aerobics, endurance based activities should be primary mode. weight training with low resistance and high reps can be added. mind-body exercise can be good intensity - lower intensity appears to lower BP as much as, if not more than, higher intensity exercise. RPE 9-13 or 40-65% of HRR duration - warm up and cool down longer than 5 min advised, increase gradually to total 40-60 min per session. continuous or intermittent (at least 10 min/bout). frequency - 4-7 days per week. preferably daily to get post exercise hypotensive effects |
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Programming for individuals with history of strokes |
if t-PA given within first 3 hours of stroke, impairments are significantly reduced. notice warning signs - numbness/weakness in arms/legs, confusion, trouble speaking, trouble seeing in one or both eyes, dizziness, loss of balance, severe headache. risk factors = high BP, smoking, heart disease, previous stroke, physical inactivity, and transient ischemic attacks. post stroke, should focus on optimizing ADL skills, regaining balance and coordination, independence. mode = walking, stationary bike, upper body ergometers, water exercise. balance activities, light resistance training light to moderate intensity begin with short bouts of 3-5 minutes and gradually build to 30 minute sessions over time. preferably 5 days / week (begin with 3 and progress) |
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Programming for individuals with peripheral vascular disease (PVD) |
caused by artherosclerotic lesions in peripheral blood vessels. risk factors are same as with CAD. peripheral artery occlusive disease (PAOD) is from blockage in lower extremity vessels; peripheral vascular occlusive disease (PVOD) is characterized by muscle pain caused by ischemia. benefits of exercise - changes in blood viscosity and capillary and mitochondrial density, increased oxidative/glycolytic enzymes improve oxygen utilization. lowers CAD risk. should undergo complete medical eval. walking is exercise of choice - walk to point of intense pain then rest and repeat. repeat for total of 20-30 min; progress to 30-60 min sessions. initial load should induce pain in 3-6 minutes, once can reach 8-12 minutes of continuous work, consider increasing load or time. avoid exercise in cold air or water to reduce risk of vasoconstriction mode = non impact endurance exercise or walking intensity = low to moderate. duration = longer warm up and cool down (10+ min), gradually increase to 30-60 min. frequency = daily exercise is recommended initially. once capacity increases can reduce to 4-5 days/wk |
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Programming for individuals with dyslipidemia |
dyslipidemia definition = total cholesterol greater than 200 mg/dL; greater than 130 LDL, and less than 40 HDL, greater than 150 mg/dL triglycerides = borderline high; high = total 240 mg/dL, greater than 160 LDL, greater than 200 mg/dL triglycerides. exercise is effective in reducing non-HDL levels (6 mg/dL avg). moderate reduction in LDL (3-6 mg/dL avg). no consistent effect on HDL or triglyceride levels; moderate intensity strength training may also reduce LDL (70% 1RM, 3 days/wk, 9 exercises, 3 sets of 11 reps) mode = aerobic to reduce body fat; resistance training 2x/week using light to moderate weight at 10-12 reps. intensity = begin at low to moderate with focus on duration (especially in overweight), progress to short bouts of more intense work. duration = begin at 15 min and build to 30-60 min/day. with goal of 150-200 min each week. frequency = 5 days/wk |
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Types of diabetes and methods of controlling diabetes |
fasting plasma glucose test - fasting blood glucose greater than 126 mg/dL; 100-125 = pre diabetic. type 1 - insulin dependent diabetes, occurs when immune system destroys beta cells in pancreas. requires regular insulin doses. symptoms = thirst, hunger, frequent urination, weight loss, blurred vision and recurrent infections. chronic hyperglycemia because glucose not taken up, pee smells sweet. type 2 - non-insulin dependent; most common form (90-95%); due to insulin resistance in which cells no longer respond to insulin properly. as demand for insulin increases, pancreas loses ability to produce it gradually. leads to chronic hyperglycemia. seen in obese patients; first treatment = weight loss, diet modifications and exercise. gestational diabetes - 7% of pregnant women. increased risk in obese women or with family history. at higher risk for preeclampsia, gestational hypertension and C section delivery and have 7 fold increase in developing diabetes later in life. control - goal is to normalize glucose metabolism and prevent associated complications. |
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Benefits of exercise for diabetic clients |
type 1 - role fo exercise in controlling type 1 diabetes has not been well demonstrated. type 2 - prevention of CAD, stroke, PVD and other diabetes related complications. improve lipid profiles. weight loss. |
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Exercise guidelines, precautions and programming for diabetic clients |
guidelines = gradual warm up/cool down of 5-10 mins; measure blood glucose before and after each exercise session. session should be delayed if pre-exercise glucose is below 100 mg/dL. eat some carbs to try to normalize; also if greater than 300 mg/dL. type 1 - 55-75% HRR, RPE 11-14; avoid high intensity long duration exercise. high intensity can increase hyperglycemia; long duration can induce hypoglycemia. build to 30 min/session. include strength training type 2 - primary goal = weight loss and better glucose regulation. 50-80% HRR, RPE 11-16. 5-6 days/wk. strength training with low to moderate resistance, 8-12 reps or 8-10 exercises twice per week. precautions -avoid exercise if glucose is below 100 or above 300 mg/dL (or 250 mg/dL with ketosis) -be aware of glycemic response during exercise - consume additional carbs before/during exercise - dont inject insulin in primary working muscle group -avoid exercising in peak insulin activity, exercise at same time of day. -proper hydration. - proper foot hygiene -do not ignore pain mode = aerobic exercise such as walking, cycling, swimming, etc. gradual warm up and cool down. resistance training twice a week, 8-10 exercises at 8-12 reps each. intensity = RPE 11-14 for type 1 and 11-16 for type 2 duration = type 1 - work up to 30+ min / session; type 2 - 40-60 min/session frequency = 5-6 days/wk. |
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What is metabolic syndrome? |
characterized by abdominal obesity, atherogenic dyslipidemia, elevated BP, insulin resistance, prothrombotic state, pro inflammatory state. 3 or more of the following -elevated waist circumference (greater than 40 inches in men and 35 inches in women) -elevated triglycerides (above 150 mg/dL) -reduced HDL (below 40 mg/dL in men and 50 mg/dL in women) -elevated BP (greater than 130/85) -elevated fasting blood glucose (greater than 100 mg/dL) treatment objective is to reduce risk of developing cardiovascular disease and type 2 diabetes. lifestyle intervention - weight loss, increased activity, healthy eating, smoking cessation are all treatment strategies. |
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Exercise programming for individuals with metabolic syndrome |
should obtain exercise clearance from physician. recommended that overweight or obese individuals accumulate 200-300 mins of aerobic activity per week. mode = low impact activities to begin with, non-weight bearing for obese clients; 2x/week resistance training using 8-10 exercises at 8-12 reps each. intensity = RPE 11-13 or 30-75% VO2 reserve. begin at low intensity and progress. initially work on progressing duration rather than intensity to optimize caloric expenditure duration = 200-300 min/wk. frequency = 3-5 days/wk; preferably daily. |
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Exercise programming for individuals with asthma |
should receive medical clearance. most can follow exercise guidelines for the general population. exercise can reduce ventilatory requirement for tasks and make ADL easier. exercise induced asthma is brought on by hyperventilation - so should use gradual warm up and cool down. have rescue medication on hand, drink fluids, avoid asthma triggers, exercise indoors, start with low intensity and gradually increase, exercise mid-to-late morning mode = walking, cycling, swimming, jog or run ni more conditioned clients. upper body exercises may not be appropriate because of higher ventilation demands intensity = low to moderate. duration = gradually progress to 30+ minutes. 10+ min warm up/cool down frequency = 3-5/wk. |
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Exercise programming for individuals with cancer |
exercise good prevention. improves immune activity. exercise can improve physical function, mental outlook and quality of life in people undergoing treatment for cancer. physician clearance should be obtained. start slow and build gradually. light to moderate intensity. resistance training with light weights, 10-15 reps, don't expose radiation/surgery wounds to pool water. precautions - anemic, low white blood cell counts (avoid public gyms), dehydration from vomiting, low platelet count. unrelieved pain, nausea, shouldn't exercise within 2 hours of chemo/radiation therapy. mode = weight bearing exercise good to counteract osteoporosis risk (walking is good), non-weightbearing is secondary option. intensity = light to moderate, RPE 9-13. focus more on duration and consistency than intensity duration = can begin with 3-5 min bouts with frequent rests and work up to 10 min bouts, 30-40 min accumulated exercise per session frequency = cardio, flexibility and balance training on a daily basis and strength training 2-3 times per week (at least 24 hour rest between sessions) |
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Exercise programming for individuals with osteoporosis |
physical stress determines strength of bone. weight bearing exercises recommended. higher intensity strength training (8RM) may be most beneficial. mode = weight bearing cardio and resistance training (8RM), balance and coordination exercises intensity = high intensities to promote strain on bone. no jarring, high impact things duration = strain impacts can be low (50-100) and still be beneficial. duration of loading activities can be short - 5-10 min. otherwise, follow age appropriate guidelines. frequency = multiple bouts of load training is better than one longer duration session. but should allow adequate rest between strength training sessions |
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Exercise programming for individuals with arthritis |
obtain physicians release note. low impact aerobic exercise, focus on duration rather than intensity (gradually lengthen to 30 min, 3-5 days/wk), emphasize proper posture, strength training focus on increasing # of reps, put all joints thru full range of motion daily to maintain mobility. mode = non-weightbearing cardio, recreational activities intensity - low intensity dynamic exercises, based no clients comfort level during and after exercise. RPE 9-15 duration = 10+ min warm up and cool down. begin with 10-15 min exercise, progress to 30 min. freq = 3-5x/wk |
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Exercise programming for fibromyalgia |
chronic pain condition most people avoid physical activity because of fear of exacerbating symptoms and level of fatigue. but studies have shown that cardio can help symptoms. mode = low impact activities, stretching, resistance training with light weights, bands. intensity = low to moderate, RPE 9-13 duration - progress to 150+ min / week. freq = regular pattern of exercise 3-5 days/wk |
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Exercise programming for individuals with chronic fatigue syndrome |
exercise can exacerbate symptoms, can induce relapse that lasts days. all exercise should be followed by rest in 1:3 ration. several daily sessions of brief, low impact activity can be added. should symptoms worsen, return to most recent manageable level. start with simple stretching and strengthening - 2-4 reps to start, work up to 8 max. mode = ADL, walking, low impact activities, stretching, light resistance training intensity = low duration = multiple 2-5 min exercise periods followed by 6-15 minute rests. build to 30 min total activity. frequency = 3-5 days/wk |
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Exercise programming for lower back pain |
cardio, resistance training and core exercises should be included. avoid rapid movements, lifting both legs, twisting at waist, unsupported forward flexion. emphasize muscular endurance rather than strength (high reps, low weight). proper form and alignment, avoid head forward positions, bend at knees when lifting, keep objects close to body and do not twist when lifting. low back exercises most beneficial when performed daily. don't exercise in morning. adding in cardio with muscular exercises is more beneficial. cat-camel, birddog, side bridge mode = walking, biking, swimming, core strengthening exercises, light resistance training and stretching intensity = light to moderate. can increase as conditioning improves. duration = 30-60min frequency = 3-5 days/wk with goal of establishing regular pattern |
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Exercise programming for weight management |
BMI 25-29.9 = overweight; greater than 30 = obese strong dose-response relationship between volume (intensity, freq and duration) of endurance ro resistance exercise, the training duration and amount of total and regional fat loss. overweight individuals should accumulate 150+ minutes of moderate intensity exercise per week, ideally 225+/wk. weight maintenance - likely need about 60 min per day of physical activity. reduce energy intake by 500-1000 kcal/day to lose 1-2 lbs / wk. mode = walking, cycling, aerobics, swimming, anything enjoyable and sustainable intensity = low to moderate. duration = 150-200 min/wk frequency = 5-6 days/wk to maximize caloric exxpenditure |
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Exercise programming and consideration for older adults |
max HR declines with age, cardiac output is lower, resting SV declines about 30%, reduction in VO2 max. muscle mass declines (3-5% loss/decade), body fat increases, basal metabolic rate decreases, balance and coordination decrease. exercise can help all of these and also there is some evidence that it can delay cognitive impairment and disability in old age. guidelines: moderate intensity aerobic activity for minimum 30 min, 5 days/wk. or vigorous 20 min, 3 days/wk. muscle strengthening exercises at least twice per week - 8-10 exercises, 10-15 reps each. flexibility exercises at least twice a week. exercises for balance mode = endurance aerobics, high rep, low weight strength training. intensity = low to moderate, RPE 11-13 duration = more gradual warm up and cool down, increase to 30-60 min per session. frequency = 5 days/wk. |
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Exercise programming and consideration for youth |
moderate to vigorous activity 60 min a day with vigorous activity at least 3 days/wk. mode = sustained activities that use major muscle groups, i.e. swimming, running, etc. recreational activities. muscle/bone strengthening exercises at least 3 day/wk intensity = moderate to vigorous. duration = 60+ min daily frequency = daily. |
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Exercise programming for pregnant women |
regular exercise decreases risks of many complications such as gestational diabetes, nausea, back pain, c-section, preeclampsia, etc. more flexible in pregnancy and lower cardiac reserve. should get physical clearance. do note begin a vigorous intensity exercise program. if already active, maintain activity to max 30-40 min, 3-4 days/wk in first trimester. decrease intensity/duration in 2nd and 3rd trimester. if just beginning, start slow. avoid jumping and running, full sit ups, deep knee bends, double leg raises, straight leg tow touches, contact sports, bouncing without stretching, activities where falling is likely. avoid exercise in supine position after first trimester (no longer than 5 min), avoid long periods of standing. keep body temp below 100 F mode = aerobic, strength training intensity = light to moderate, 9-13 RPE duration = begin with 15 min and build to 30 min sessions. frequency = 3/wk generally. may be able to progress to 4-5 times per week |
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Exercise programming post-partum |
in initial 6 weeks after birth, goal is to gradually increase exercise as means of relaxation, personal time and regaining sense of control rather than improving fitness |
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Muscle strains |
injuries in which the muscle works beyond capacity. tears in fibers. pain, weakness, swelling, discoloration and loss of function. frequent in lower extremity and major muscle groups such as groin, hamstrings, calf hamstring strains from severe stretch or rapid movement. risk factors = poor flexibility, poor posture, muscle imbalance, improper warm up and training errors. calf strains common in runners, risk factors = fatigue, fluid and electrolyte depletion, forced knee extension while foot is dorsiflexed. |
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Ligament sprains |
often occur with trauma. common in ankle,e, knee, finger, shoulder. pain, swelling, instability, decreased ROM and loss of function. ACL prevents anterior glide of tibia away from femur. torn often in deceleration of body combined with twisting, pivoting or side-stepping. |
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Overuse injuries |
tendinitis, bursitis, fascitis. often when begin new exercise programs too quickly. |
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Phases of tissue healing |
first = inflammatory phase. lasts up to 6 days. focus is to immobilize area. increased blood flow to area occurs to bring in oxygen and nutrients and rebuild. 2nd = fibroblastic/proliferation, begins at day 3 and lasts until approx day 21. begins with wound filling with collagen. eventually forms scar. 3rd = maturation/remodeling - can last up to 2 years. remodeling of scar, rebuilding bone, restrengthening tissue. |
