Fitness and Healthy Lifestyle
Chapter 13
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
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
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
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
Definitions of Fitness, Activity, and Related Terms
• Physical fitness
• Physical activity
• Exercise
• Function or capacity
• Health
• Wellness
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
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
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
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
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
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
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
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
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
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
Other Fitness Tests
• Each country has its own test, norms, and minimal standards
• President’s Council on Physical Fitness and Sport - uses norms and award structure
• YMCA test is used worldwide
• Various single fitness component tests
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
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
The 1950s: Early Beginnings
• Kraus-Weber research findings
• American College of Sports Medicine
• President’s Council on Youth and Fitness
• First AAHPER Youth Physical Fitness Test
• Contributions of Rarick
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
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
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
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
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
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
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
Personalizing Goals for Various Conditions
• Severe developmental disabilities
• Spinal paralysis and injury rehabilitation
• Other health impairments
• Limited mental function
• Limited sensory function
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
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
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
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
Limited Sensory Function
• Same fitness needs as general population
• Senior citizens - assistance with cardiorespiratory fitness
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
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
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
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
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 person’s schedule
• Intensity can be prescribed by several methods - VO2 max, METS, or calories, maximal heart rate, rating of perceived effort, pain, and breathlessness
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
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
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
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)
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
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
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:
€
BMI =Bodyweight(kg)
Height 2(meters)
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Underlying Theories
• Reasoned action attitude theory
• Self-efficacy or social cognitive theory
• Perceived competence theory
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
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
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
Organization of the Lesson: Five Parts
• Warm-up
• Aerobic conditioning
• Flexibility exercises for each major muscle group
• Muscle strength/endurance exercises
• Cool-down
Teaching for Fitness: A Review of Principles
• Individual differences• Overload/intensity• Frequency• Specificity/transfer• Active/voluntary movement• Correct breathing• Recovery/cool-down• Warm-up
Teaching for Fitness: A Review of Principles
• Static stretch• Contraindication• Adaptation• Motivation• Maintenance• Nutrition• Environmental factors• Ecological or social validity
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
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
Interval or Intermittent Training
• Associated terms:– Set– Work interval– Rest interval– Repetitions– Target time– Level of aspiration
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
Continuous Conditioning
• Exercises that impose consistent submaximal energy requirements throughout the training session– Aerobics, including dance and hydroaerobics– Rope jumping, continuous
Combination Conditioning
• Use both continuous and intermittent activity
• Other examples include– Astronaut or football drills– Jogging, hiking, and cycling– Obstacle or challenge courses