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Transcript of Fitness and Healthy Lifestyle Chapter 13. Introduction Major goal in adapted physical activity...
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Fitness and Healthy Lifestyle
Chapter 13
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Introduction
• Major goal in adapted physical activity– Detriments to achievement
• Lack of knowledge
• Lack of self-determination
• Lack of self-confidence
• Lack of self-esteem
• Role models
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Recent Changes in the Knowledge Base
• NCPAD• WHO• Biocultural approach to physical activity• Healthy People 2010• American Association on Mental
Retardation• Exercise and physical activity adherence
focus
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Recent Changes in the Knowledge Base
• Increased use of FITNESSGRAM, the ACTIVITYGRAM, and the new Presidential Active Lifestyle Award - PALA
• ACSM updated guidelines and resources
• Minimal physical activity standard for health benefits
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Recent Changes in the Knowledge Base
• Minimal physical activity standard pertaining to calories expended during activity
• Easy-to-understand information about conditioning, training, and testing people with disabilities
• NCPERID standards
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Definitions of Fitness, Activity, and Related Terms
• Physical fitness
• Physical activity
• Exercise
• Function or capacity
• Health
• Wellness
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Rehabilitation Versus Fitness Programming
• Rehabilitation - restoration and/or maintenance of physical function which allows an individual to perform activities of daily living without incurring high levels of stress or fatigue
• Services provided in hospitals or centers that provide services for persons temporarily or permanently disabled
• Medical model• Reimbursed by insurance
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Rehabilitation Versus Fitness Programming
• Fitness testing and training - conducted in many settings and follows many models
• Associated with goals beyond activities of daily living
• Prevention of hypokinetic conditions like obesity, heart disease, high blood pressure
• Hypokinetic - insufficient movement or exercise• Hypokinetic disease begins in childhood
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Lifestyle Problems of Americans
• Everything that interferes with wellness and negatively affects lifespan
• Various factors such as diet, stress, smoking, drug abuse, and physical inactivity are risk factors
• SHPPS report on physical activity in schools• Healthy People 2010 - increase daily physical
education• Exercise adherence
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Lifestyle Concerns Pertaining to Disability
• Poor body alignment and inefficient movement patterns increase energy expenditure
• Various factors negatively affect mechanical efficiency and energy level
• Coping with barriers requires extra energy• Employment requires high levels of fitness• Obtain social acceptance and overcome
discrimination
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Lifestyle Concerns Pertaining to Disability
• Relief of chronic depression and other mental health problems
• Sedentary lifestyles are associated with lack of socialization into sport or physically active lifestyles
• Success in programs can increase body image and self-concept
• Activity deficit hypothesis• Obesity associated with movement problems in
children
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Components of Health-Related Fitness
• Cardiorespiratory or aerobic endurance• Body composition• Muscular strength and endurance• Flexibility• Also beliefs, attitudes, and intentions that
give persons the self-determination, self-confidence, and self-esteem to achieve and maintain fitness goals
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The FITNESSGRAM
• School-age individuals with functional capacity to perform the test items
• Criterion referenced• Includes alternatives items for individuals
who cannot perform the prescribed six tests• Unique aspects include the PACER,
cadence tapes for curl-ups and push-ups, and alternative tests for upper body strength
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Assessment of Physical Activity
• ACTIVITYGRAM – Recall of physical activity over previous 24
hours in 30-minute blocks– Six categories examined as well as the intensity
levels in each 30-minute block
• Data is also gathered through the use of heart rate monitors, activity monitors, direct observation, and self-report
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Brockport Physical Fitness Test
• Parallels the FITNESSGRAM and is a health-related, criterion-referenced test
• Presents standards for youth in the general population as well as five subgroups with various disabilities
• Recommended adaptations and alternatives for testing students with various disabilities
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Brockport Physical Fitness Test
• Target Aerobic Movement Test• Seated Push-Up• Reverse Curl• Wheelchair Ramp Test• Modified Apley Test• Modified Thomas Test• Dumbbell Press• Target Stretch Test
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Other Fitness Tests
• Each country has its own test, norms, and minimal standards
• President’s Council on Physical Fitness and Sport - uses norms and award structure
• YMCA test is used worldwide
• Various single fitness component tests
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School Fitness Testing: History, Issues, Trends
• Which tests to use
• How high to set fitness standards
• How much time to spend training and testing
• Fitness over sports and motor skills training
• Trend toward performance within healthy fitness zones
• Personalization of fitness goals and tests
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Types of Fitness: Physical and Motor
• Physical fitness - health-related– Cardiorespiratory endurance, body
composition, muscular strength and endurance, and flexibility
• Motor fitness - skill-related– Agility, balance, coordination, speed, power,
and reaction time– Included as part of definition of physical
education in IDEA
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The 1950s: Early Beginnings
• Kraus-Weber research findings
• American College of Sports Medicine
• President’s Council on Youth and Fitness
• First AAHPER Youth Physical Fitness Test
• Contributions of Rarick
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The 1960s to the 1980s
• 1960-1970s focus on both physical and motor fitness
• 1980s AAHPERD tests changed focus exclusively to health-related fitness
• Fitness tests for persons with mental retardation• Fitness norms developed for youth who were blind
or visually impaired - later adjusted to match general population except running items
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The 1980s Onward: Health-Related Fitness
• Late 1980s AAHPERD moved to criterion-referenced
• Physical Best replaced by FITNESSGRAM
• Major research for fitness of various populations funded by U.S. government including four specifically targeted at various disability groups
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Fitness Classifications Requiring Special Help
• Various methods of classifying fitness and identification of individuals who require special help
• Adapted physical activity generally focuses on those who are classified as having symptomatic clinical status
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VO2max
• Maximum amount of oxygen consumed by cells in the final seconds of exercise prior to total exhaustion
• Age and gender both affect VO2max
• Active muscle mass, understanding test instructions, and poor motivation affect results
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METS
• Metabolic equivalents
• Alternative way of indicating aerobic capacity
• Ranges from 1 to 16– Those who function in the 1 to 6 range have
severe fitness problems that interfere with daily living activities
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Exercise Prescription: Five Components
• Frequency - 3 to 5 times a week
• Intensity - 60 to 90% of maximum heart rate
• Time - 20 to 60 minutes
• Modality - rhythmic, large muscle activity
• Rate of progression - gradual increase in frequency, intensity, and time
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Exercise Prescription: Five Components
• Assessment
• Goal setting
• Decision making about training
• Establishment of dates and program duration
• Evaluation to determine if goals are being achieved
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Personalizing Goals for Various Conditions
• Severe developmental disabilities
• Spinal paralysis and injury rehabilitation
• Other health impairments
• Limited mental function
• Limited sensory function
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Severe Developmental Disabilities
• Postural reflex mechanism and muscle tone• Population includes those with limited
mental and/or physical capacities• Major goals include ROM, functional
ability to perform movement patterns used in fitness, and exercise capacity tolerance
• For those with good intelligence, ROM is the primary fitness goal
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Spinal Paralysis and Injury Rehabilitation
• Strength is a major goal - often with ROM
• Residual strength grading system– Also used in disability sport classification
• Postural fitness is associated with imbalances in strength and flexibility
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Other Health Impairments
• Weight loss and aerobic endurance are generally the major goals
• Sedentary lifestyles
• Concurrent conditions
• Distorted perceptions about ‘feeling good’
• Realization of fitness level
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Limited Mental Function
• Same fitness needs as general population• Weight loss and cardiorespiratory endurance are
generally most important goals• Understanding of speed and distance• Congenital heart disease• Autonomic nervous system regulation• Severe retardation - importance of fitness training
over other goals
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Limited Sensory Function
• Same fitness needs as general population
• Senior citizens - assistance with cardiorespiratory fitness
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Aerobic Capacity or Cardiorespiratory Endurance
• Most important component of health-related fitness
• Improvement - performance of vigorous activities that elevate heart rate for a minimum of three minutes
• Begin with interval conditioning – Bouts of 1 min of exercise interspersed with 1
or 2 min of rest
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Assessment of Aerobic Capacity
• Field tests - step tests, distance runs, and walking tests
• Field tests provide estimates of ability• Laboratory tests are done on treadmills,
bicycle and wheelchair ergometers, and arm-cranking devices
• Awareness of cardiac resting and exercise recovery rates
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Assessment of Aerobic Capacity
• Resting heart rate is a good indicator of fitness
• Recovery time helps determine whether exercise demands are appropriate or excessive
• Recovery of breathing rate to normal should require less than 10 min
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Prescribing Aerobic Exercise
• Continuous (more than 3 min) low-impact exercise recommended
• Four principles for low-fit people– Use low-impact activities– Match frequency, intensity, and time to ability– Pay attention to self-concept and motivation– Teach acceptance that rate of progression will
be slower than for average people
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Matching Frequency Intensity and Time to Ability
• Frequency - daily when working with low-fit people
• Time - as many minutes as can be tolerated and/or woven into a person’s schedule
• Intensity can be prescribed by several methods - VO2 max, METS, or calories, maximal heart rate, rating of perceived effort, pain, and breathlessness
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Intensity Prescribed by VO2max, METS, or Calories
• 40 to 70% VO2max• Moderate intensity is defined as 3 to 6
METS• 300 calories per exercise session
• Maintain heart rate in the target zone during exercise
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Intensity Prescribed by Maximal Heart Rate
• Fastest speed a heart can attain during exhaustive exercise without compromising or endangering life
• Age-adjusted MHR formula• Exercise within a range of 60 to 90% of MHR• When active mass is limited MHR is not
applicable• Some OHI conditions, environmental factors,
stress, and medications can affect MHR
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Perceived Exertion, Pain, and Dyspnea
• Children from age 7 onward give RPEs that correlate highly with heart rate
• Overweight persons tend to overestimate• Use for people whose hearts do not respond
properly to exercise• Goal of exercise tolerance for individuals
unable to maintain target heart rate
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Perceived Exertion, Pain, and Dyspnea
• Real pain versus discomfort• Increase intensity gradually• Coping with or ignoring discomfort may need
to be taught• Use numerical scales to objectify ratings of
pain and dyspnea (breathing discomfort)
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Body Composition
• Individual components that constitute the total body mass
• Females have more fat, and males have more muscle tissue
• Children have less body fat than adults• Largely genetically determined• Some disabilities affect body composition• Body fat percentage is a major fitness concern
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Assessment of Body Fat
• Measured using laboratory protocols and formulae
• Estimated using skinfold caliper measures
• Triceps is recommended if using one site
• Best combination of skinfold measures is controversial
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Body Mass Index: Substitute Measure
• Substitute for body fat measures when skinfold calipers are not available
• Ratio of body weight to the square of body height:
€
BMI =Bodyweight(kg)
Height 2(meters)
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Body Mass Index: Substitute Measure
• Interpret physical and motor fitness scores in relation to height, weight, and skinfolds
• Height-weight tables heighten motivation for lifestyle changes but weight and percent body fat are not highly correlated
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Prescribing Exercise for Fat Loss
• Large muscle activity needs to use more calories then are consumed daily
• ACSM recommends no more than 2.2 lb should be lost per week
• Obesity is a medical problem• Long-duration activity at low intensity is as
effective as short duration/high-intensity activity• Counseling and support groups are essential
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Muscle Strength/Endurance
• Strength developed when muscle exertion is near maximum
• Endurance developed when a muscular activity continues for several seconds
• Age and gender differences in strength parallel changes in muscle mass
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Assessment of Muscle Strength/Endurance
• Principle of specificity - benefits of exercises done in one position will not transfer when the muscle is used in other positions
• Four general muscle groups tested
• Focus is on the number of times an exercise is done in the prescribed posture or position
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Prescribing Exercise for Muscle Strength/Endurance
• Sedentary persons should take all muscle groups through strength and endurance exercises at least 2 days a week
• Variety of different activities
• Principle of overload - progressively increasing the demands made on a muscle group - increase reps then resistance
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Prescribing Exercise for Muscle Strength/Endurance
• Isotonic exercises - dynamic or moving– Endurance exercises - use lighter weights and
more repetitions– Strength exercises - use heavier weights and
fewer repetitions– Progressive resistance exercise– Strength should be coordinated with a good
flexibility routine
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Prescribing Exercise for Muscle Strength/Endurance
• Isometric exercises - static– Maximum or near-maximum muscle
contraction that is held for 6 sec and repeated several times
– Highly specific, strengthening muscles only for work at the same angle as the training
– Not based on the overload principle– Not recommended for individuals with heart
disease and high blood pressure
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Prescribing Exercise for Muscle Strength/Endurance
• Isokinetic exercises - machine-generated– Constant resistance machines– Keep velocity of movement constant and match
the resistance to the effort of the exerciser– Maximal tension exerted throughout the range
of motion
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Valsalva Effect and Contraindications
• Increase in intraabdominal and intrathoracic pressure that results when breath is held
• Causes– Heart rate to slow down– Return of blood to the heart to decrease– Blood pressure to elevate
• Contraindicated for persons with high blood pressure conditions or glaucoma
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Range of Motion and Flexibility
• Ability to move body segments through the actions and planes designated normal for each joint
• Range of motion (ROM) - when the movement capacity at a joint is measured in degrees
• Flexibility - functional stretching ability• Gender, age, and musculoskeletal differences
affect flexibility as well as some disabilities
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Assessment of ROM/Flexibility
• Flexibility is specific to each muscle group
• Sit-and-reach measures hamstring, hip, and spine flexibility
• Measurements begin from anatomical position and are either an average of two or three measurements or the maximum
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Prescribing Stretching Exercises
• Purposes are generally to maintain elasticity, to warm up and cool down, or to correct pathological tightness
• Stretches should be slow and static not ballistic• Modalities can be active, passive, and/or
combinations• Incorrectly done stretches can worsen disabilty or
cause injury
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Using Proprioceptive Neuromuscular Facilitation
• A system of stretching that requires the help of an assistant that stimulates the proprioceptors to enhance functional flexibility
• Based on the principle of reciprocal innervation• Recommended for individuals with cerebral palsy
and arthritis• Two types of PNF
– Contract-relax– Hold-relax - recommended if pain is an issue
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Beliefs, Attitudes, and Practices
• Application of theories can be used to help persons develop fitness and make changes in lifestyle
• Belief, attitudes, and practices should be included when developing goals and objectives
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Underlying Theories
• Reasoned action attitude theory
• Self-efficacy or social cognitive theory
• Perceived competence theory
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Self-Reports
• Assessment includes self-reports of motivation, food intake, physical activity, and attitudes about the body and exercise
• Self-motivation information helps in counseling and individualized teaching
• Diaries or logs of food intake and physical activity help structure goal setting
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Weather and Temperature Concerns
• Important in all aspects of fitness• Susceptibility to heat and cold extremes• ANS damage compromises temperature
regulation - dehydration a major concern• Poikilothermy• Humidity and wind-chill factor• Body temperature responses - hypothermia,
hyperthermia, and heat stroke
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Space and Equipment
• Variety of physical activity spaces
• Select equipment based on weakest muscle groups
• Equipment for aerobic endurance
• Instruction and experience in use of community health and exercise centers
• Adaptable equipment for variety of levels
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Organization of the Lesson: Five Parts
• Warm-up
• Aerobic conditioning
• Flexibility exercises for each major muscle group
• Muscle strength/endurance exercises
• Cool-down
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Teaching for Fitness: A Review of Principles
• Individual differences• Overload/intensity• Frequency• Specificity/transfer• Active/voluntary movement• Correct breathing• Recovery/cool-down• Warm-up
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Teaching for Fitness: A Review of Principles
• Static stretch• Contraindication• Adaptation• Motivation• Maintenance• Nutrition• Environmental factors• Ecological or social validity
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Exercise Conditioning Methods
• Methods of teaching various exercise components– Interval or intermittent– Circuits– Continuous– Combinations
• Built around one modality or incorporated in various games and movement activities
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Interval or Intermittent Training
• Especially beneficial for persons with asthma, MD, and MS
• Exercise for short periods with rest intervals between
• Generally planned for individuals or small groups
• Sessions become more demanding each week
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Interval or Intermittent Training
• Associated terms:– Set– Work interval– Rest interval– Repetitions– Target time– Level of aspiration
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Circuit Training
• Moving from station to station
• Each station focuses on different muscles
• Fewer stations for younger students
• Amount of time at each station varies and transition time is kept short
• Intensity increases gradually over time
• Leaders at stations can be used if needed
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Continuous Conditioning
• Exercises that impose consistent submaximal energy requirements throughout the training session– Aerobics, including dance and hydroaerobics– Rope jumping, continuous
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Combination Conditioning
• Use both continuous and intermittent activity
• Other examples include– Astronaut or football drills– Jogging, hiking, and cycling– Obstacle or challenge courses