Fitness

1
Fitness

• Implications for
• Adapted Physical Education

2
Definitions and Issues

• ACSM Four Component Definition
• Cardiovascular endurance
• Body composition
• Muscular strength and endurance
• Flexibility
• Fifth Component ?
• Beliefs, Attitudes, and Intentions that lead to
  fitness

3
Ecological Approach

• Stresses lifestyle and involving parents,
  siblings, and other supports
• Fitness Goal for Adapted PE
• persuade persons with low fitness that regular
  exercise can ameliorate problems and increase
  quality of life

4
Concerns for the Adapted Educator

• poor body alignment/inefficient movement patterns
  fatigue and reduction in job efficiency
• mechanical inefficiencies negatively affect
  energy level
• reduced sensory input
• spasticity
• use of crutches or prostheses
• loss of functional mass

5
Concerns for the Adapted Educator

• Architectural and Attitudinal Barriers
• Low self-worth
• Poor body image and self concept due to poor
  balance-coordination-timing
• Can find success in walking, jogging, cycling,
  swimming, and weight lifting

6
Fitness

• 1950s Kraus-Weber
• American children less fit than Europeans
• 6 items
• straight/bent-knee sit-ups
• double-leg lift - supine/prone
• trunk lift prone
• toe touch from stand

7
AAHPERD Tests

• Many revisions since 1950s
• 1988 Revision Four Components
• one mile walk/run (10-14min)
• body comp (sum or tri calf) 25mm-36mm
• muscular strength/endurance
• bent knee sit-ups (60sec)
• pull-ups (1-5)
• lower-back/hamstring flexibility
• sit and reach 25cm

8
Other Tests

• Presidents Council on Physical Fitness and
  Sports (Five Components)
• 1mi walk/run
• curl ups
• V-sit reach
• shuttle run
• pull-ups
• Rewards for 85th percentile
• Use of NORMS?
• YMCA

9
Testing for Adapted PE

• AAHPERD tests for individuals with mental
  retardation and other impairments
• What do you think about norms?
• Yes, separate tests are no longer valid
• AAHPERD philosophy - Minimal standards for
  health-related fitness tests are applicable to
  everyone

10
Raricks Findings

• Individuals with MR performed 2 to 4 years behind
  peers
• Suggested same items but different set of norms
• 1990s Holistic Approach - Wellness
• 1990s Issues
• self-esteem, self-motivation
• beliefs, attitudes
• Best Practice -
  A lifespan, ecological approach

11
Exercise Prescription

• F.I.T. principle
• F.I.T.-M.R. Guideline for individuals with
  disabilities
• Frequency - Daily
• Time - at least 30 minutes
• Intensity and Modality- Four components

12
I - Intensity

• Muscle strength/endurance - number of pounds
  (weight / resistance) lifted, pushed, pulled or
  propelled
• Flexibility - distance a muscle is stretched
  beyond normal length
• Body composition - caloric expenditure in
  relation to caloric intake
• Cardiorespiratory fitness - distance and speed

13
M - Modality

• Muscle strength/endurance - isotonic, isometric,
  or isokenetic
• Flexibility - static stretch, independent
  (active) or assisted (passive), PNF
• Body composition - diet, aerobic exercise, and
  counseling
• Cardiorespiratory fitness - type of rhythmic,
  large muscle activity, continuous or
  discontinuous (intermittent)

14
R - Rate of Progression

• Three stages of progression
• 1) initial conditioning (4 to 6 weeks)
• 2) improvement conditioning (5 to 6 months)
• 3) maintenance

15
Cardiovascular/Aerobic Endurance

• Considerations
• Modality (high impact or low?)
• VO2max or METs?
• Metabolic Equivalents are easier to understand
  and comprehend
• 1 MET equals 3.5 mlkgmin, the amount of energy
  expended at rest
• METs can be used for assessment and prescription

16
METs, RHRs, MHRs, THRs

• Good fitness performing at an 11 MET level or
  appx 40 mlkgmin VO2max
• RHR - resting heart rates
• newborn 110-200
• 1 to 24 months 100-200
• 2 to 12 years 80-150
• 13 years/older 60-100
• RHR can be used for assessment or evaluation

17
METs, RHRs, MHRs, THRs

• MHRs - maximum heart rate
• Calculated by 220-age in years
• Use MHR to determine target heart rate or THR
• THR 60-90 of max
• For persons with low fitness, 55-70 THR is
  recommended
• Approximately a THR of 110 (55 of 200) is
  appropriate for initial conditioning stage

18
Factors that can cause higher HR

• Heat
• Humidity
• Stress
• Medications
• Overweight
• Heart Conditions
• Infections with fever

19
Factors that can cause lower HR

• Paralysis
• amputations
• Heart conditions
• ANS damage
• Medications

20
Aerobic Exercise Plan THRs and use of RPEs

• Key Points
• Low-impact
• Continuous
• For Addressing HR factors
• Use of RPE scale can be very beneficial
• 6-20 corresponds to HR (11-16 training range)
• Increase intensity gradually so that discomfort
  is minimal

21
Body Composition

• Genetics?
• Exercise and nutrition play critical roles
• Better indication of wellness than overall weight
• Key factor for individuals with disabilities

22
Body Composition

• Determined by
• skin fold calipers
• hydrostatic weighing
• bioimpedence
• MRI
• Average percentages
• 18-30 for women
• 10-25 for men

23
Body Composition

• Body Mass Index (BMI) - alternative measure
• ratio of body weight to the square of body height
• BMI Body weight
• Height(2)
• Reduction of Fat loss - 2 factors
• aerobic conditioning (FITMR)
• nutrition (P,F,C)

24
Muscular Strength/Endurance

• Assessment
• principle of specificity
• Choices must be made about most important muscle
  groups to test
• abdominal (bent-knee sit-ups)
• upper arm/shoulder (pull-ups/push-ups)
• hip/thigh (jump or sprint)

25
Muscular Strength/Endurance

• Exercises
• At least 2 days a week
• Games and activities can facilitate
• Principle of overload
• Strength/endurance can be developed by
• isotonic (eccentric / concentric)
• isometric (no movement, but contraction)
• isokinetic (constant resistance machines)
• Most common - use of weights

26
Muscular Strength/Endurance

• Use of machines, various objects, and
  activities---- CREATIVITY!
• Contraindications
• Valsalva Effect
• increase in pressure (intraabdominal and
  intrathoracic)
• slower HR, decrease blood to heart, increase
  blood pressure
• Breath holding can lead to ruptured tissues,
  (abdominal region) hernias, eyes

27
Flexibility

• ROM is measured with a goniometer
• CP, MD, arthritis, paralysis- ROM needed almost
  everyday
• Proprioceptive Neuromuscular Facilitation (PNF)
• Sit-and-reach test used for assessment

28
Flexibility

• Considerations
• Purpose
• maintain elasticity
• warm-up and cool-down
• correct pathological tightness
• Static versus Ballistic
• Seconds to hold stretch?
• Key areas
• lower back, hamstrings, and ?

29
Specific Considerations

• Severe Developmental Disabilities
• Instructional Strategies/Considerations
• Typically, rely on caregivers
• Full physical assistance
• Goals
• ROM to prevent contractures and stimulate CNS
  integration
• functional ability to perform movement patterns
• exercise capacity tolerance

30
Specific Considerations

• Spinal Paralysis
• Instructional Strategies/Considerations
• Postural fitness imbalances is strength and
  flexibility cause postural deviations, mechanical
  inefficiencies, coordination, control, and
  balance problems
• Weight control and aerobic endurance
• Strength

31
Spinal Paralysis

• Associated with ROM
• 5 normal, full ROM full resistance
• 4 good, full ROM moderate resistance
• 3 fair, full ROM only
• 2 poor, full ROM with positional mod.
• 1 trace, contraction can be seen, no movement
  gravity eliminated
• 0, zero, complete paralysis
• Used in sport classification for SCI

32
Specific Considerations

• Other Health Impairments
• Instructional Strategies/Considerations
• Low MET classification by ACSM
• Usually are not aware of low level of fitness
  until brought to attention
• Weight control and aerobic endurance

33
Specific Considerations

• Limited Mental Function
• Instructional Strategies/Considerations
• weight control and cardiorespiratory endurance
• partner or role model to set pace
• play and game behaviors related to fitness for
  ecological validity