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STARTING AN EXERCISE PROGRAM Mary Ann Burke, P.T., M.S., G.C.S.

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Presentation on theme: "STARTING AN EXERCISE PROGRAM Mary Ann Burke, P.T., M.S., G.C.S."— Presentation transcript:

1 STARTING AN EXERCISE PROGRAM Mary Ann Burke, P.T., M.S., G.C.S.

2 BENEFITS OF EXERCISE Weight Control Weight Control Combat Health Conditions & Disease Combat Health Conditions & Disease Improve Psychological Well-Being Improve Psychological Well-Being Boost Energy Boost Energy Improve Sleep Improve Sleep

3 WEIGHT CONTROL Non-Dieting/Overweight Non-Dieting/Overweight Controls gained weight Controls gained weight Low-amount exercise groups lost weight/fat Low-amount exercise groups lost weight/fat High-amount exercise group lost more of each in a dose-response manner High-amount exercise group lost more of each in a dose-response manner Slentz CA, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE-a randomized controlled study. Arch Intern Med 2004 Jan;164(1):31-9

4 BLOOD PRESSURE A single episode of exercise reduces BP in hypertensive subjects A single episode of exercise reduces BP in hypertensive subjects Regular aerobic exercise reduces BP in hypertensive subjects. Regular aerobic exercise reduces BP in hypertensive subjects. No proof of resistance training reducing BP No proof of resistance training reducing BP Cardoso, CG, et al. Acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure in normotensive and hypertensive subjects. Clinics 2010 Mar;65(3):317-25

5 TYPE 2 DIABETES Structured interventions combining exercise and weight loss have been shown to lower type 2 diabetes by up to 58% in high risk populations. Structured interventions combining exercise and weight loss have been shown to lower type 2 diabetes by up to 58% in high risk populations. Most benefits of physical activity on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. Most benefits of physical activity on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. Colberg SR, et al. Exercise and type 2 diabetes. Diabetes Care 2010 Dec;33(12):e147-67

6 CANCER 66% of cancer mortality in the USA can be linked to tobacco use, poor diet and lack of exercise. 66% of cancer mortality in the USA can be linked to tobacco use, poor diet and lack of exercise. Moreover, only 5-10% of most types of cancer are caused by defects in single genes that run through families, and only a similar small percentage are because of occupational and environmental factors. Moreover, only 5-10% of most types of cancer are caused by defects in single genes that run through families, and only a similar small percentage are because of occupational and environmental factors. Havard Report on Cancer Prevention. Vol. 1: Causes of Human Cancer. Cancer Causes Control 1996

7 CANCER Mounting evidence indicates that exercise may significantly reduce the risk of some cancers. Mounting evidence indicates that exercise may significantly reduce the risk of some cancers. The strongest evidence comes from research on colon cancer, where physical activity has been shown to reduce the risk by up to 50%. The strongest evidence comes from research on colon cancer, where physical activity has been shown to reduce the risk by up to 50%. Shepard RJ & Shek PN. Associations between physical activity and susceptibility to cancer. Sports Med 1998;26:

8 OSTEOPOROSIS A number of studies with postmenopausal women have shown that exercise can increase bone density or prevent further bone loss when compared to non-exercise controls. A number of studies with postmenopausal women have shown that exercise can increase bone density or prevent further bone loss when compared to non-exercise controls. Dalsky GP, Stocke KS, & Ehsani AA, et al. Weight bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med 1988;108:

9 IMPROVE PSYCHOLOGCAL WELL-BEING Exercise is a lifestyle that leads to improved physical and mental health throughout life. Exercise is a lifestyle that leads to improved physical and mental health throughout life. Hillman CH, et al. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci 2008 Jan;9(1):58-65

10 DEPRESSION Although antidepressant medication may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment, exercise was equally effective in reducing depression among patients with major depressive disorder. Although antidepressant medication may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment, exercise was equally effective in reducing depression among patients with major depressive disorder. Blumenthal JA, et al. Effects of exercise training on older patients with major depression. Arch Intern Med Oct 25;159(19):

11 MEMORY Study on 120 older adults, half of whom started a program of moderate aerobic exercise. Study on 120 older adults, half of whom started a program of moderate aerobic exercise. After 1 year, MRI scans showed that the brains of subjects who exercised increased their volume, while non-exercising subjects brains lost up to 1.5% of their volume. After 1 year, MRI scans showed that the brains of subjects who exercised increased their volume, while non-exercising subjects brains lost up to 1.5% of their volume. Further testing showed that increased brain volume translated into better memory. Further testing showed that increased brain volume translated into better memory. NPR Report of a study by researcher Art Kramer.

12 BOOST ENERGY Sedentary people who completed a regular exercise program reported improved energy levels compared to groups that did not exercise. Sedentary people who completed a regular exercise program reported improved energy levels compared to groups that did not exercise. Puetz T. News release of a study review from the University of Georgia, 2006.

13 IMPROVE SLEEP Exercise is a healthy, safe, inexpensive, and simple means of improving sleep. Exercise is a healthy, safe, inexpensive, and simple means of improving sleep. Youngstedt SD. Effect of exercise on sleep. Clin Sports Med 2005 Apr;24(2):355-6

14 DEFINITIONS Aerobic/Cardiovascular Activity Aerobic/Cardiovascular Activity Exercises that speed up breathing and heart rate Exercises that speed up breathing and heart rate Running, Cycling, Walking, Swimming, Dancing Running, Cycling, Walking, Swimming, Dancing Typically performed for long durations Typically performed for long durations

15 Definitions Heart Rate (HR) Heart Rate (HR) Measured in beats per minute (BPM) Measured in beats per minute (BPM) Rate of Perceived Exertion (RPE) Rate of Perceived Exertion (RPE) A measure of how hard youre working A measure of how hard youre working Rated on a Borg Scale Rated on a Borg Scale

16 Borg Scale 6 – 20% effort 6 – 20% effort 7 – 30% effort – Very, very light (Rest) 7 – 30% effort – Very, very light (Rest) 8 – 40% effort 8 – 40% effort 9 – 50% effort – Very light (Gentle walking) 9 – 50% effort – Very light (Gentle walking) 10 – 55% effort 10 – 55% effort 11 – 60% effort 11 – 60% effort 12 – 65% effort 12 – 65% effort 13 – 70% effort – Somewhat hard – steady pace 13 – 70% effort – Somewhat hard – steady pace 14 – 75% effort 14 – 75% effort 15 – 80% effort – Hard 15 – 80% effort – Hard 16 – 85% effort 16 – 85% effort 17 – 90% effort – Very Hard 17 – 90% effort – Very Hard 18 – 95% effort 18 – 95% effort 19 – 100% effort – Very, very hard 19 – 100% effort – Very, very hard 20 - Exhaustion 20 - Exhaustion

17 Definitions Flexibility Training/Stretching Flexibility Training/Stretching Enhances range of motion of joints Enhances range of motion of joints

18 DEFINITIONS Strength/Resistance Training Strength/Resistance Training Improve strength and function of muscles Improve strength and function of muscles Weight lifting, Resistance bands Weight lifting, Resistance bands Body weight (push-ups, squats) Body weight (push-ups, squats) Set Set Repeating the same exercise a certain # of times Repeating the same exercise a certain # of times Repetition Repetition Number of times an exercise is performed during a set Number of times an exercise is performed during a set

19 DEFINITIONS Warm Up Warm Up Preparing for the stress of exercise Preparing for the stress of exercise Light intensity aerobic activity Light intensity aerobic activity Increase blood flow and heat up muscles Increase blood flow and heat up muscles Cool Down Cool Down Less strenuous exercise after more intense workout Less strenuous exercise after more intense workout Slow down breathing and heart rate Slow down breathing and heart rate Stretching Stretching

20 BASIC TRAINING GUIDELINES (ACSM/Centers for Disease Control and Prevention) Warm Up Warm Up Reduce the risk of injury Reduce the risk of injury minutes minutes All major joints and muscles should be engaged All major joints and muscles should be engaged Walking, stretching, calisthenics Walking, stretching, calisthenics

21 BASIC TRAINING GUIDELINES (ACSM/Centers for Disease Control and Prevention) Aerobic Training Aerobic Training Frequency: 4-7 days/week Frequency: 4-7 days/week Intensity: RPE Intensity: RPE Duration: minutes Duration: minutes Mode: Aerobic activities Mode: Aerobic activities Progression: Progression: Phase 1: 6 weeks, low intensity Phase 1: 6 weeks, low intensity Phase 2: 6 months, gradual increase Phase 2: 6 months, gradual increase Phase 3: Maintenance Phase 3: Maintenance

22 BASIC TRAINING GUIDELINES (ACSM/Centers for Disease Control and Prevention) Strength Training Strength Training Frequency: 2-3 days/week Frequency: 2-3 days/week 48 hrs of rest between 48 hrs of rest between Intensity: RPE of Intensity: RPE of Repetitions: 15 Repetitions: 15 Sets: 1-3 Sets: 1-3 Rest: seconds between sets Rest: seconds between sets Progression: RPE of Progression: RPE of reassessed every 2-4 weeks reassessed every 2-4 weeks

23 BASIC TRAINING GUIDELINES (ACSM/Centers for Disease Control and Prevention) Flexibility Training Flexibility Training Frequency: 2-7 days/week Frequency: 2-7 days/week Intensity: Range gently increased in each position Intensity: Range gently increased in each position Mild muscular tension, not pain Mild muscular tension, not pain Duration: Position held for 5-40 sec Duration: Position held for 5-40 sec Repetitions: 1-5 per stretch Repetitions: 1-5 per stretch Progression: Develop fuller ranges naturally with time and practice Progression: Develop fuller ranges naturally with time and practice

24 BASIC TRAINING GUIDELINES (ACSM/Centers for Disease Control and Prevention) Cool Down Cool Down Reduce the risk of injury Reduce the risk of injury minutes minutes Slowed down movements Slowed down movements Continue until heart rate is < 100 bpm Continue until heart rate is < 100 bpm

25 LAND BASED EXERCISE PROGRAMS Gym Programs Gym Programs Aerobic and strengthening equipment Aerobic and strengthening equipment Exercise classes Exercise classes Areas for stretching Areas for stretching Trainers Trainers

26 LAND BASED EXERCISE PROGRAMS Home Home Exercise Equipment Exercise Equipment Treadmill Treadmill Stationary Bike Stationary Bike Weights Weights Exercise Ball Exercise Ball DVDs DVDs Walking Walking Biking Biking Hiking Hiking

27 POOL EXERCISE PROGRAMS Aqua-kinetics/Aqua-aerobics Aqua-kinetics/Aqua-aerobics Group exercise Group exercise Swimming Swimming

28 FIVE TIPS TO HELP YOU GET STARTED

29 1. Assess Your Fitness Level Consult with your physician Consult with your physician Record Baselines Record Baselines Heart rate before and after walking 1 mile Heart rate before and after walking 1 mile Time to walk 1 mile Time to walk 1 mile # of push-ups # of push-ups Forward reach Forward reach Waist circumference Waist circumference Body Mass Index (BMI) Body Mass Index (BMI)

30 2. Design Your Fitness Program Set goals Set goals Balanced routine Balanced routine Aerobic activity Aerobic activity 150 minutes of moderate intensity or 75 minutes of vigorous activity per week 150 minutes of moderate intensity or 75 minutes of vigorous activity per week Strength training Strength training 2 or more days/week 2 or more days/week Go at your own pace Go at your own pace Schedule time Schedule time

31 2. Design Your Fitness Program Include different activities Include different activities Keep boredom at bay Keep boredom at bay Decrease risk of injury Decrease risk of injury Emphasize different body parts Emphasize different body parts Allow time for recovery Allow time for recovery Put it on paper Put it on paper

32 3. Assemble Your Equipment Athletic shoes Athletic shoes Pick shoes designed for the activity in mind Pick shoes designed for the activity in mind Pick shoes that are right for your foot Pick shoes that are right for your foot Choosing Equipment Choosing Equipment Practical Practical Enjoyable Enjoyable Easy to Use Easy to Use

33 4. Get Started Start slowly, build gradually Start slowly, build gradually Warm up and cool down Warm up and cool down Speed up to a pace you can continue for 10 min Speed up to a pace you can continue for 10 min Gradually increase amount of time Gradually increase amount of time Work up to min of exercise Work up to min of exercise Break things up Break things up Shorter but more frequent exercise has aerobic benefits too Shorter but more frequent exercise has aerobic benefits too

34 4. Get Started Be Creative Be Creative Include various activities (walking, cycling, rowing) Include various activities (walking, cycling, rowing) Take a weekend hike Take a weekend hike Evening dancing Evening dancing Listen to your body Listen to your body If you feel pain, shortness of breath, dizziness, nausea, take a break If you feel pain, shortness of breath, dizziness, nausea, take a break Be flexible Be flexible Give yourself permission to take a day off Give yourself permission to take a day off

35 5. Monitor Your Progress Reassess Reassess 6 weeks after you start 6 weeks after you start Every 3-6 months Every 3-6 months You may need to increase exercise time to keep making fitness gains You may need to increase exercise time to keep making fitness gains

36 SAFETY!!! Dont over exert yourself Dont over exert yourself 4-6 weeks of light intensity, then increase 4-6 weeks of light intensity, then increase Develop the habit Develop the habit Develop a schedule and stick to it Develop a schedule and stick to it Make adjustments Make adjustments Listen to your body Listen to your body If you feel pain, shortness of breath, dizziness, STOP. If you feel pain, shortness of breath, dizziness, STOP. Moderately challenging but tolerable Moderately challenging but tolerable

37 Common Exercise Injuries Shoulder Pain/Rotator Cuff Tendonitis Shoulder Pain/Rotator Cuff Tendonitis Discrepancy between overworking the power muscles of the shoulder at the expense of the smaller rotator cuff muscles Discrepancy between overworking the power muscles of the shoulder at the expense of the smaller rotator cuff muscles Chest and incline press Chest and incline press Overhead press Overhead press Lateral raises Lateral raises

38 Common Exercise Injuries Back and Neck Pain Back and Neck Pain Improper weight lifting technique Improper weight lifting technique Overloaded compressive forces Overloaded compressive forces Weak musculature Weak musculature Poor posture Poor posture Jarring activities Jarring activities Exercises that compress the spine Exercises that compress the spine Flexion/extension machines Flexion/extension machines

39 Common Exercise Injuries Elbow Pain/Golfers Elbow/Tennis Elbow Elbow Pain/Golfers Elbow/Tennis Elbow Gripping & pulling a load that is too heavy Gripping & pulling a load that is too heavy Improper lifting technique (wrist motion) Improper lifting technique (wrist motion) Cable pull downs Cable pull downs Rows Rows Biceps curls Biceps curls Triceps extension Triceps extension

40 Common Exercise Injuries Plantar Fasciitis/Achilles' Tendinitis Plantar Fasciitis/Achilles' Tendinitis Improper foot wear Improper foot wear Weak hip musculature Weak hip musculature Over training Over training Running Running Inclined Walking/Hiking Inclined Walking/Hiking Jumping Jumping

41 Common Exercise Injuries Knee Pain Knee Pain Anterior knee pain Anterior knee pain Tendinitis Tendinitis Meniscus tear Meniscus tear Arthritis Arthritis Deep squats Deep squats Knee extension Knee extension Bias toward quadriceps strengthening Bias toward quadriceps strengthening Neglecting hamstrings and hip abductors Neglecting hamstrings and hip abductors

42 Treatment Strategies for Minor Injuries Decrease exercise intensity Decrease exercise intensity Make sure all 3 components are present Make sure all 3 components are present Cardiopulmonary Cardiopulmonary Strengthening Strengthening Flexibility Flexibility

43 Treatment Strategies for Minor Injuries Ice affected area min/2-3 x day Ice affected area min/2-3 x day If swelling is involved…RICE If swelling is involved…RICE Rest Rest Ice Ice Compression Compression Elevation Elevation

44 Treatment Strategies for More Severe Injuries Physician Physician Physical Therapist Physical Therapist Orthopedic Specialist Orthopedic Specialist

45 HAVE FUN!


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