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PHTA 2473 Therapeutic Exercise II AHS 2213 Athletic Training Practicum III

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zalika
20 diapositives · 333 Views · Oct 12, 2014

This guide delves into the importance of endurance and aerobic fitness, highlighting the physiological benefits of long-duration, low-intensity exercises. It covers aerobic capacity, the role of mitochondria in energy production, and the effects of continuous versus discontinuous aerobic training. The recommendations from ACSM on frequency, intensity, and modes of exercise are also discussed, alongside methods to measure and prescribe aerobic exercise effectively. Additionally, it addresses orthopedic considerations and the significance of circuit training for combined strength and aerobic improvement.

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  1. PHTA 2473 Therapeutic Exercise IIAHS 2213Athletic Training Practicum III Chapter 6 Endurance

  2. Aerobic Fitness • Ability to do work • Expressed as… • Aerobic capacity –or- • CV endurance –or- • CV fitness –or- • Cardio respiratory fitness • Long duration, low-intensity exercise enhance aerobic fitness

  3. Endurance Activities • Activities that affect CV system • Activities that affect muscular system • Examples?

  4. VO2 Max (maximal oxygen uptake) • Maximum volume of oxygen consumed during exercise • Measure of efficiency of the aerobic system

  5. Aerobic Activity • Uses metabolic pathways that use oxygen to provide energy for muscle contraction • Aerobic metabolism takes place in the Mitochondria • Oxidative capacity • Forms ATP (adenosine triphosphate) • “oxidative phosphorylation” • 19x more ATP produced this way than by anaerobic adenosine triphosphate-phosphocreatine (ATP-PC) system.

  6. Long term aerobic training can improve aerobic fitness approx. 10%-20% • See Box 6-1 p. 100 Shankman

  7. Adaptive Physiologic Changes With Aerobic Exercise • Notable changes in oxygen transport system • Increased size and # of mitochondria • Increased myoglobin content • Improved mobilization/use of fat and carbs. • Selective hypertrophy of Type I slow-twitch fibers • Decreased resting HR and submax HR • Increased blood volume and hemoglobin • Reduced BP • Improved oxygen extraction rates from blood

  8. Measuring and Prescribing Aerobic Exercise • Age-adjusted maximum heart rate (AAMHR) • ACSM minimal training intensity for improved VO2 max 60% MHR • 220-age=MHR • (220-age)(60% to 90%)=THR • Karvonen formula • 50%-85% VO2 max • Maximum heart rate reserve (MHR reserve) • Difference between MHR and RHR • MHR-RHR=MHR reserve • How to figure: • MHR = 220-age • Take RHR • Choose intensity level between 50%-85% of VO2 max • (MHR reserve)(intensity level) • RHR + Intensity level= Maximum training heart rate • Or

  9. Karvonen Formula

  10. Subjective estimate of exercise Patient reported Relative exertion scale Patients perception of exercise Example: 1st person: Walking up hill-13 2nd person: Running up hill-13 Borg Scale of Relative Perceived Exertion

  11. Borg Scale • Borg Scale • 6 • 7 very, very light • 8 • 9 very light • 10 • 11 • 12 • 13 somewhat hard • 14 • 15 hard • 16 • 17 very hard • 18 • 19 very, very hard Endurance Training Zone Strength Training Zone http://www.medicinenet.com/

  12. Frequency, Intensity, Duration • ACSM recommendations: • Frequency • 3-5 days/week • Intensity • 60-90% age adjusted MHR –or- • 50-85% MHR reserve • Duration • 20-60 minutes continuous aerobic activity

  13. Mode of Activity • ACSM recommendations • Activity that uses: • Large muscle groups • Can be maintained continuously • Rhythmic • Aerobic • Examples • Walking • Biking • Jogging • Stair climbing • Rowing • Swimming

  14. Mode of Activity • Initiation/Intensification of aerobic conditioning program • Higher CV risk • Increased rate of orthopedic injury • Decreased compliance with program

  15. Methods of Aerobic Training(2 types) • Continuous Aerobic Activities • No rest interval • Little variation in HR • Examples • Jogging • Walking • Running • Cycling • Stair climbing • What to use in clinic? • Which would burn more calories and use more oxygen: Treadmill or Stationary Bike? • Why?

  16. Methods of Aerobic Training(2 types)-cont. • Discontinuous Aerobic Activities • AKA Interval training • Can involve same activities as continuous • Rest intervals interspersed with bouts of exercise • Advantages • Large amounts of high-intensity work in short amount of time • Tends to develop strength and power vs. endurance • Ratio of work to rest • 1:1 or 1:1.5 • Rest can be passive or active • Which would stress aerobic pathways? • Which would minimize capacity to develop strength and power?

  17. Orthopedic Considerations for Aerobic Conditioning • Can be challenging • Choose appropriate activity for each condition: • Post surgical R/C • HNP • Grade III ankle sprain • ORIF hip fracture • Post op ACL repair

  18. Muscle Fatigue(2 hypotheses) • Attempt to clarify peripheral neuromuscular fatigue as a result of prolonged or strenuous muscle activity • 1st • Decreasing amounts of energy supplies • ATP • Glycogen • Phosphocreatine • 2nd • Noxious metabolites accumulate • Hydrogen ions • Ammonia • Probably combination of both

  19. Circuit Training • Combination of resistance (strength) and aerobic exercise • Goals • Improve local muscular endurance • Improve cardio respiratory fitness • Improve muscular strength • Can customize for desired outcomes • 12-15 exercise stations • Various levels of resistance • 40-50% of predetermined 1 RM • 2 types • Fixed loaded • Load or resistance remains constant • Improvement occurs when circuit is completed in less time • Target • Time required to complete remains the same • Complete as many reps as possible in prescribed time • 2 ways to perform • 15-20 second bouts-no rest • 30 second bouts-15 second rest in between

  20. Combining Endurance and Strength • Goal • Improve strength • Strength training combined with moderate, long duration endurance program • Goal • Improve endurance • Strength and high intensity interval training • SAID principle