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Principles of Exercise Prescription

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1 Principles of Exercise Prescription
Mr. Cheng Yuk Chuen, Joshua Director of Training Program, Hong Kong Physical Fitness Association

2 Principles of training
Overload-stimulus greater than normal Adaptation-level of training Specificity-specific to system and muscle Progression-increase intensity and design the training sequence

3 An Exercise Session Warm-up Period (5’-10’)
Conditioning Period(20’-60’) Aerobic Exercise (Optional recreational game) Muscular Strength & Endurance Stretching Exercise Cool-down Period(5’-10’)

4 Purpose of Warm-up Prepare body for more strenuous exercise
Facilitates the transition from rest to exercise Improve blood circulation Increase the metabolic rate Increase body temperature Dissociates more oxygen Stretch postural muscles Reduce risk of musculo-skeletal injury

5 Purpose of Conditioning
Develop cardiorespiratory fitness Improve heart health and weight control Maintain and improve muscle tone, strength and muscle mass Maintain and improve muscle elasticity and joint mobility. Prevention of musculo-skeletal disorder such as low back pain and shoulder osteo-arthritis

6 Purpose of Cool-down Gradual recovery from the endurance phase:
Adjust the circulatory response (e.g. HR and BP) Improve venous return risk of post-exercise hypotension and dizziness Reduce risk of cardiovascular complications(e.g. sudden cardiac death)

7 Components of Exercise Prescription
Exercise Mode (Type of exercise) Exercise Intensity Exercise Duration Exercise Frequency Progression of Exercise Programme

8 Aerobic Exercise Prescription

9 Typical Aerobic Exercise session
ACSM (2006) p.137

10 Exercise Mode Any form of physical activity which uses large muscle groups. Examples: walking, jogging, running, biking, stepping, rowing, etc.

11 Exercise Intensity Low to Moderate RPE 2-5 (weak to strong)
HR Formula 1 THR = HRmax X (35% - 69%) where HRmax = 220 – Age HR Formula 2 THR = HRR X (20% - 59%) + Resting HR where HRR = HRmax – Resting HR

12 Rating of Perceived Exertion (RPE)
Rating Perception Level of Intensity Nothing at all No intensity Very weak Weak Light Moderate Somewhat strong Strong Heavy 6 Very Strong Extremely Strong Strongest Intensity

13 Exercise Duration 20-60 minutes/sesssion Continuous or intermittent
(10 min. each bout)

14 Exercise Frequency For moderate intensity, at least 3 days/week
For lower intensity, more than 3 days/week is required

15 Progression Initial Improvement Maintenance Goal
Minimal muscle soreness, discomfort and injury Gradual increase stimulus, increase in CR fitness Long term CR fitness developed Intensity 40-60% HRR 50-85% HRR 70-85% HRR Duration 15-30 min 25-40 min 20-60 min Week 1-4 weeks 5-24 weeks 24 weeks onward Frequency 3-4 session/week 3-5 session/week Rate of Progress slow More rapid

16 Guidelines for aerobic exercise
Goal: reach 50th percentile in fitness parameters Minimal threshold (20% HRR or 50% HRmax) may sufficient for low areobic fitness adult (VO2max<30 mL/kg/min) 60-80% HRR or 77-90% HRmax are sufficient for improvements in most adults’ CR fitness HRR method is more accurately for prescribing intensity kcal exercise energy expenditure per day

17 Muscular Exercise Prescription

18 Muscular training principle
Strength Training Exercise or Resistance Exercise Rhythm breathing Full range of motion Speed of lifting Balance of training Resistance mode: machine weights, free weight, rubber band or body weight

19 Exercise Intensity Weights that are heavy enough to be lifted for 8 – 12 repetitions (reps.)

20 Exercise Duration 8-10 exercise for body major muscle groups
Each exercise lifts 8-12 reps.(1 Set) 10-20 minutes per session

21 Exercise Frequency At least 2 training sessions per week

22 Progression Start with low intensity with 1 set per session
Gradually build up every weeks

23 Flexibilty Exercise Prescription

24 Exercise Mode Static muscle stretching exercise
5’-10’ low-intensity large muscle activity (eg. Brisk walking, jog slowly) Can be a specific flexibility training session Can be combined into the warm up and cool down phase Dynamic or Proprioceptive Neuromuscular Facilitation as progressive mode

25 Exercise Intensity Stretch the muscle to feel mild discomfort or feel tight but no pain

26 PNF Corbin and Lindsey (1997) p.83

27 Exercise Duration Hold each muscle stretch for 10-30 seconds
Do it for all major muscle groups

28 Exercise Frequency At least 3 times per week
Stretch before and after exercise

29 Progression Not required!

30 Art of Exercise Prescription
Exercise prescriptions require individual modification, Individual difference: physiologic and perceptual responses vary among individual Exercise intensity, duration and training progression should be adjusted with monitoring BP, HR and RPE. Individual interests, abilities and limitations should be addressed on preparing desired program outcomes.

31 Practicum Pair work Fill up the first page of the information and questionnaire provided for your partner Base on the information provided by your partner, try to write the exercise prescription (page 2) to him/her Follow the exercise prescription from your partner and fill up the exercise record (page 3&4) for 1 month Write the overall comment for your partner

32 Exercise Prescription Training Course Practicum Consultant’s Name: __________________________ Patient’s Name: Age: Date : Gender: Weight: kg Height: cm PAR-Q: 是 否 問 題 1.  醫生曾否說過你的心臟有問題,以及只可進行醫生建議的體能活動? 2.  你進行體能活動時,是否感到胸口痛? 3.  過去一個月,你曾否在沒有進行體能活動時也感到胸口痛? 4.  你曾否因感到暈眩而失去平衡,或曾否失去知覺? 5.  你的骨骼或關節是否有毛病?且會因改變體能活動而惡化? 6.  醫生現時是否有給你一些有關血壓或心臟藥物(例如去水丸)給你服用? 7.  是否有其他理由令你不應進行體能活動? Risk Factors Identification: 是 否 Risk Factors 1.  Family History 2.  Smoking 3.  Hypertension 4.  Hypercholestrolemia 5.  Obesity 6.  Inactivity 7.  High blood glucose 8.  High HDL (negative risk factor) Total Score of Risk: ____________ Risk Classification: __________________ Other History and Consideration:



35 整體評語:

36 END Thank You

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