PHYSICAL ACTIVITY FOR HEALTH AND FITNESS

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PHYSICAL ACTIVITY FOR HEALTH AND FITNESS

• A) Cardiovascular Disease And Physical Activity
• Cardiovascular disease (CVD) account for MOST
  CAUSES OF DEATH.

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Forms of CVD

• 1) Coronary artery disease (CAD)
• Progressive narrowing of coronary arteries by
  atherosclerosis - ischemia - myocardial
  infarction - tissue necrosis, atherosclerosis
  begin in young children
• 2) Hypertension
• High blood pressure elevation above levels
  desirable for age and size,
  about 25 - 50? of adult people suffer from
  hypertension
• 3) Stroke
• Cerebral infarction caused by thrombosis,
  embolism or atherosclerosis -
  blood supply to part of brain diminished another
  cause - cerebral hemorrhage

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• 4) Congestive Heart Failure
• Heart muscle damaged, decrease in CO. Caused by
  hypertension, infarction, cardiomyopathy
• 5) Other Cardiovascular Diseases
• Peripheral vascular disease, valvular heart
  disease, rheumatic and congenital heart diseases

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Risk Factors for CAD

• Elevated blood lipids
  (? LDL-C, ? HDL-C, INDEX
  ? 3)
• Hypertension
• Cigarette smoking
• Diabetes
• Obesity
• Physical inactivity
• Stress

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Risk Factors for Hypertension

• CONTROLABLE
  - obesity, diet (? salt
  intake), oral
  contraceptives, physical inactivity, insulin
  resistance
• UNCONTROLABLE
  - heredity, advancing age

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Prevention Through Physical Activity

• Epidemiological studies - physical inactivity
  doubles the risk of CAD.
• EVEN LOW INTENSITY ACTIVITY SUFFICIENT TO REDUCE
  THE RISK OF CVD

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• Exercise Improves heart contracility, coronary
  circulation, decrease LDL, increase HDL-C,
  control of hypertension, obesity, alleviate
  stress, decrease of peripheral resistance reduces
  body fat, blood glucose which reduce insulin
  resistance!
• Death during Exercise
• Rare
• In people over 30 - arrhythmias from
  atherosclerosis
• Under age of 30 - cardiomyopathy, aortic
  aneurysm, myocarditis

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• Exercise Rehabilitation in Patients with Heart
  Disease
• Substantially reduces the risk of death from a
  subsequent heart attack, relatively little effect
  on reducing risk for the recurrence of nonfatal
  heart attack.

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B) Obesity, Diabetes and Physical Activity

• Obesity
• Condition in which a person has an excessive
  amount of body fat. Men with more than 25 ?,
  women more than 35? BODY FAT
• BODY MASS INDEX (BMI)
• 20 - 25 normal
• 25 - 30 overweight
• 30 - 35 light obesity
• 35 - 40 - heavy obesity
• ? 40 monstrose obesity.

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• PREVALENCE - over 25 ? of adult population is
  overweight or obese
• DAILY ENERGY EXPENDITURE
• sum of resting metabolic rate (RMR), thermic
  effect of meal (TEM), thermic effect of activity
  (TEA).

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• Body adapts to changes in energy intake by
  ADJUSTING ANY OR ALL OF THESE COMPONENTS.
• Adaptations - under control of SYMPATHETIC
  NERVOUS SYSTEM GENETIC COMPONENT in etiology of
  obesity important.
• ENVIRONMENTAL FACTORS (cultural habits,
  inadequate physical activity, improper diet),
  hormonal imbalance, emotional trauma -
  contribution to obesity.

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Health problems associated with obesity

• increased overall rate of death (heart disease,
  hypertension, diabetes, gallbladder disease)
• changes in normal body function (respiratory
  problems, polycythemia, lower exercise tolerance)
• orthopaedic problems (gon-,cox-arthrosis)
• upper body obesity (high levels of visceral fat)
  significantly greater risk
• psychological problems - social stigma
  (psychiatric counselling in effort to lose weight)

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• Treatment of Obesity
• Special diets, appetite suppressors, surgical
  methods, behavior modification
• The Role of Physical Activity in Obesity
• Exercise Training - changes in weight and body
  composition total weight decreases, fat mass
  decreases, fat-free mass increases.

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• Combination
  - dietary restriction moderate
  exercise (300 - 500 kcals per day) - much more
  successful (minimizing loss of fat-free mass and
  maximize loss of fat mass)

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Diabetes Mellitus

• RISK of coronary artery disease, cerebrovascular
  disease, hypertension, peripheral vascular
  disease
• The Role of Physical Activity in Diabetes
• Type I - in some patients exercise improve
  glycemic control (individual variations),
  reduction the risk of CVD and
  cerebrovascular disease
• Type II - exercise decreases insulin resistance
  and increases insulin sinsitivity
  (muscle contraction - insulin - like effect -
  increase in membrane permeability to glucose -
  increase in number of glucose
  transporters associated with the plasma membrane).

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PRESCRIPTION OF EXERCISE FOR HEALTH AND FITNESS

• Exercise prescription - complete medical
  examination in following persons
• men ? 40 years
• women ? 50 years people
  considered
• at high risk.

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• Medical Evaluation - history, physical
  evaluation, exercise electrocardiogram - graded
  exercise test (rate of work gradually increased
  every 1 - 3 min until maximal rate of work)
• ECG MONITORED for arrhythmias
  and ST changes.

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THE EXERCISE PRESCRIPTION involves 4 basic factors

• 1) mode or type of exercise
• 2) frequency of participation
• 3) duration of each exercise bout
• 4) intensity of exercise bout

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• AD 1) Most frequently - walking, jogging,
  running, cycling, rowing, swimming, hiking,
  various sports (tennis, football)
• AD 2) Starting with 3 exercises per week, optimal
  frequency 3 - 5 per week
• AD 3) Short - duration high intensity (10 min)
  3 times or low - intensity long
  duration endurance training (30 - 60 min)
• AD 4) For most people, intensity of 60 of VO2
  max is optimal, health benefits occur even at
  intensities lower than 60

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Monitoring Exercise Intensity

• 1) TRAINING HEART RATE - linear relationship
  between HR and VO2 with increasing rates of
  work)

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• 2) METABOLIC EQUIVALENT SYSTEM (MET) VO2 at rest
  - 3,5 ml.kg.min. ? 1 MET. Intensity - according
  to oxygen requirments of different activities
  (level walking - 2.5 MET, football - 9.0 MET)
• 3) RATING OF PERCEIVED EXERTION
• Use of numerical scales - subjective rating of
  difficulty of work

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The Exercise Program

• Individual exercise capacity - widely varies even
  between people of similar ages and physical build
  - program INDIVIDUALIZED (on results of
  physiological, medical tests, individual needs
  and interests).
• Physical activity considered A LIFE TIME PURSUIT!
  
• (benefit rapidly lost when discontinuation).

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Exercise Program Consists of
Following Activities

• 1) Warm-up and stretching activities
• 2) Endurance training
• 3) Cool-down and stretching activities
• 4) Flexibility training
• 5) Resistance training
• 6) Recreational activities

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• AD 1) Purpose - increase in HR, breathing,
  reduction of muscle and joint soreness and
  injury. Starting 5 - 10 min stretching, 5 - 10
  min low-intensity activity
• AD 2) Purpose - improve CV, respiratory,
  metabolic system, body weight reduction
• AD 3) Reduction of intensity (running - walking),
  for several minutes - prevents blood pooling in
  extremities (prevention of fainting)

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• AD 4) Purpose - for people with poor flexibility
  or muscle joint problems (low back
  pain) - performed slowly (prevention of muscle
  pulls or spasms).
• AD 5) Purpose - reduction of blood pressure,
  increase in CV and respiratory fitness, reduction
  of obezity, prevention of osteoporosis.
• Begin with a weight of one half of 1 - RM -
  proper weight when can be lifted 10 times.

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• AD 6) Purpose - for enjoyment and relaxation
• Exercise training extremely important part of
  REHABILITATION PROGRAMS for a number of diseases
  - improvement of patients prognosis.