Fitness and Healthy Lifestyle

1
Fitness and Healthy Lifestyle

• Chapter 13

2
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

3
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

4
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

5
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

6
Definitions of Fitness, Activity, and Related
Terms

• Physical fitness
• Physical activity
• Exercise
• Function or capacity
• Health
• Wellness

7
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

8
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

9
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

10
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

11
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

12
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

13
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

14
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

15
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

16
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

17
Other Fitness Tests

• Each country has its own test, norms, and minimal
  standards
• Presidents Council on Physical Fitness and Sport
  - uses norms and award structure
• YMCA test is used worldwide
• Various single fitness component tests

18
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

19
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

20
The 1950s Early Beginnings

• Kraus-Weber research findings
• American College of Sports Medicine
• Presidents Council on Youth and Fitness
• First AAHPER Youth Physical Fitness Test
• Contributions of Rarick

21
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

22
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

23
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

24
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

25
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

26
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

27
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

28
Personalizing Goals for Various Conditions

• Severe developmental disabilities
• Spinal paralysis and injury rehabilitation
• Other health impairments
• Limited mental function
• Limited sensory function

29
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

30
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

31
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

32
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

33
Limited Sensory Function

• Same fitness needs as general population
• Senior citizens - assistance with
  cardiorespiratory fitness

34
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

35
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

36
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

37
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

38
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 persons schedule
• Intensity can be prescribed by several methods -
  VO2 max, METS, or calories, maximal heart rate,
  rating of perceived effort, pain, and
  breathlessness

39
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

40
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

41
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

42
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)

43
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

44
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

45
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

46
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

47
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

48
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

49
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

50
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

51
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

52
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

53
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

54
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

55
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

56
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

57
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

58
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

59
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

60
Underlying Theories

• Reasoned action attitude theory
• Self-efficacy or social cognitive theory
• Perceived competence theory

61
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

62
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

63
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

64
Organization of the Lesson Five Parts

• Warm-up
• Aerobic conditioning
• Flexibility exercises for each major muscle group
• Muscle strength/endurance exercises
• Cool-down

65
Teaching for Fitness A Review of Principles

• Individual differences
• Overload/intensity
• Frequency
• Specificity/transfer
• Active/voluntary movement
• Correct breathing
• Recovery/cool-down
• Warm-up

66
Teaching for Fitness A Review of Principles

• Static stretch
• Contraindication
• Adaptation
• Motivation
• Maintenance
• Nutrition
• Environmental factors
• Ecological or social validity

67
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

68
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

69
Interval or Intermittent Training

• Associated terms
• Set
• Work interval
• Rest interval
• Repetitions
• Target time
• Level of aspiration

70
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

71
Continuous Conditioning

• Exercises that impose consistent submaximal
  energy requirements throughout the training
  session
• Aerobics, including dance and hydroaerobics
• Rope jumping, continuous

72
Combination Conditioning

• Use both continuous and intermittent activity
• Other examples include
• Astronaut or football drills
• Jogging, hiking, and cycling
• Obstacle or challenge courses