copyright © 2013. f.a. davis company part ii: applied science of exercise and techniques chapter...

Copyright © 2013. F.A. Davis Company

Part II: Applied Science of Exercise and Techniques

Chapter 7

Principles of Aerobic Exercise


Key Terms and Concepts

Physical Activity Exercise Physical Fitness Maximum Oxygen

Consumption Endurance

Aerobic Exercise Training (Conditioning)

Adaptation Myocardial Oxygen

Consumption Deconditioning


Energy Systems– Phosphagen, or ATP-PC system– Anaerobic glycolytic system– Aerobic system– Recruitment of motor units– Functional implications

Energy Systems, Energy Expenditure, and Efficiency


Energy Expenditure– Quantification of energy expenditure– Classification of activities

Efficiency

Energy Systems, Energy Expenditure, and Efficiency (cont'd)


Cardiovascular Response to Exercise– Exercise pressor response– Cardiac effects– Peripheral effects• Net reduction in total peripheral resistance• Increased cardiac output• Increase in systolic blood pressure

Physiological Response to Aerobic Exercise


Respiratory Response to Exercise Responses Providing Additional Oxygen to

Muscle– Increased blood flow– Increased oxygen extraction– Oxygen consumption

Physiological Response to Aerobic Exercise (cont'd)


Signs & Symptoms of Excessive Effort Persistent dyspnea Dizziness/confusion Pain Severe leg claudication Excessive fatigue Pallor, cold sweat Ataxia Pulmonary rales

Lack of SBP increase Hypertensive BP >

200/110 Progressive fall in SBP by

10-15mmHg Change in rhythmDelayed Responses:Prolonged fatigueInsomniaSudden weight gain due to

fluid


Fitness Testing of Healthy Subjects Stress Testing for Convalescing Individuals and

Individuals at Risk– Principles of stress testing– Purpose of stress testing– Preparation for stress testing– Termination of stress testing

Multistage Testing

Testing as a Basis for Exercise Programs


Frequency Intensity– Overload principle– Individuals at risk– Variables– Specificity principle

Time (Duration) Type (Mode)– Reversibility principle

Determinants of an Exercise Program


ACSM, AHA, CDC, Surgeon General– Children: Age 6–17– Adults: Age 18–65– Older adults: Age 65 or older– Adults age 50–65 with chronic health conditions

General Recommendations for Aerobic Physical Activity


Warm-Up Period Aerobic Exercise Period– Continuous training– Interval training– Circuit training– Circuit-interval training

Cool-Down Period Application

Exercise Program


Cardiovascular Respiratory Metabolic Other Systems

Physiological Changes That Occur With Training


For the Patient With Coronary Disease– Inpatient phase (Phase I)– Outpatient phase (Phase II)– Outpatient program (Phase III)– Special considerations– Adaptive changes

Application of Principles of an Aerobic Conditioning Program


For the Deconditioned Individual and the Patient With Chronic Illness– Deconditioning– Reversal of deconditioning– Adaptations for participation restrictions

(disabilities), activity restrictions (functional limitations), and deconditioning

– Impairments, goals, and plan of care

Applications of Aerobic Training


Age Differences

Children Young Adults Older Adults

Heart Rate Stroke Volume Cardiac Output Arteriovenous Oxygen

Difference Maximum Oxygen Uptake Blood Pressure Respiration Muscle Mass and Strength Anaerobic Ability


Hypertension

Prehypertensive Stage I

Stage II

Stage II

SBP 120-130; DBP 80-89 SBP 130-140; DBP 90-

100 SBP 140-160; DBP 100-

110 SBP > 160; DBP >110


General Goals of PT intervention– Increase aerobic capacity– Increase ability to perform physical tasks related to self

care, home management, community & work integration & leisure activities

– Improve physiological response to increased O2 demand

– Increased strength, power & endurance– Decreased symptoms associated with increased O2

demand

PT Intervention for Pts with CAD


Increase ability to recognize recurrence & intervention is sought sooner

Reduce risk of recurrence Acquire behaviors that foster healthy habits,

wellness, & prevention Enhance decision making regarding health,

use of health care resources by pt, family, caregivers, etc.

PT Intervention - continued


Unstable Angina Symptomatic heart failure Uncontrolled arrythmias Moderate to severe aortic stenosis Uncontrolled diabetes Acute systemic illness/fever Uncontrolled tachycarida (HR >100 bpm) Resting SBP > 200 mmHG; DBP >110 mmHg Thromophlebitis

Contraindications to Aerobic Exercise


Chest pressure Dyspnea Fatigue Syncope Palpitations Edema – pulmonary/Peripheral – CHF Fluid weight gain – CHF S3 Heart Sound – CHF Renal dysfunction - CHF

Clinical Signs & Symptoms CAD/CHF


Improve physiological reponse to increased O2 demand

Improvement of self management of symptoms Increased ability to perform physical tasks Acquire behaviors that foster healthy habits, wellness

& prevention Reduction of disability associated with acute or chronic

illness Reduction of secondary impairments Improved awareness & use of community resources Increased performance of & independence with ADL’s

PT Intervention for CHF - Goals


Activity Guidelines Self Monitoring – pulse; RPE Symptom recognition & response Nutrition Medications – prescription & OTC Lifestyle issues Psychological/Social Issues Other

Pt Education for Pts with CHD

copyright © 2013. f.a. davis company part ii: applied science of exercise and techniques chapter...

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