Aerobic Exercise Product
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Aerobic overload can be delivered using free aerobics. This method sees the exercise leader perform the exercise with the class following the demonstration and cueing of the exercises. The leader should provide alternatives, giving easy and harder options for each exercise. This style of aerobics within the overload section may not be appropriate early in phase III CR until patients have mastered self-monitoring. In free aerobics (exercise to music), where the leader is introducing different combinations and moves with music, the leader is required to link and combine exercises with an element of choreography. Free aerobics is often the method used in the warm-up section. Free aerobics (FA) has some disadvantages
Aerobic exercise helps increase the ability of the body to process and use oxygen, which is important for you and your baby. Aerobic exercise also has the following benefits An aerobics class provides a consistent time slot when you know you will exercise. If you sign up for a class specifically designed for pregnant women, you will also enjoy the camaraderie of other women. Many community recreation centers offer prenatal exercise classes. If you already attend a regular aerobics class, let your instructor know that you are pregnant. The instructor will suggest ways to modify any movements that may be unsafe or too strenuous. An aerobic exercise video may be helpful if you prefer to exercise at home. Aerobic exercise strengthens the heart and lungs, and helps maintain muscle tone. As long as you choose exercises that are low-impact and keep one foot on the ground at all times to minimize stress on your joints you should be able to continue exercising throughout your pregnancy.
One of the two main training adaptations to regular aerobic exercise an increase in VO2max. The other physiological adaptation, as shown clearly in three studies involving cardiac patients, is that with training, individuals can sustain exercise at a higher proportion (percentage) of their VO2max (Sullivan, et al., 1989 Meyer, et al., 1990 Goodman, et al., 1999). In these three studies, this phenomenon was closely allied to the amount of lactic acid produced at a given VO2, a phenomenon which has been known for many years (Edwards, et al., 1939 Ekblom, et al., 1968). The importance of this is that improvements in aerobic power (VO2max) and endurance capacity (the intensity at the lactate threshold) in cardiac patients, compared to healthy individuals, is mostly due to the adaptations of skeletal muscle and not of the myocardium (Hiatt, 1991). Because the key agent in increasing VO2max in cardiac patients is skeletal muscle, it is important to ensure that this tissue is challenged as...
The rate pressure product turn point identified by Omiya, et al. (2004) is also correlated with both the ventilatory and lactate thresholds (the upper limit recommended for continuous aerobic exercise at which a training benefit is optimised). This finding corresponds with the original concept of the heart rate turn-point reported by Conconi, et al. (1982) (Figure 3.2). However, some debate exists over its merits as a means of estimating the lactate threshold because the relationship may be strongly dependent on the exercise testing protocol used (Bodner and Rhodes, 2000). Nevertheless, from a myocardial perspective, there is no doubt in all these reports that at higher intensities, HR does not continue to rise in a linear fashion, which provides the evidence of a decreased myocardial performance. For the practitioner this means that encouraging patients to work at high HR is not prudent in the early stages of CR. Although Ehsani, et al. (1982) did show that myocardial contractile...
It is often recommended that 20-30 min of moderate intensity exercise three times per week is sufficient exercise to confer some protection against cardiovascular disease if this exercise is in the form of jogging, aerobics, or similar activities, the energy expenditure will be about 4MJ (1000 kcal) per week for the average 70-kg individual, or an average of only about 150 kcal day-1 (Table 1). However, even a small daily contribution from exercise to total daily energy expenditure will have a cumulative effect on a long-term basis. For obese individuals, whose exercise capacity is low, the role of physical activity in raising energy expenditure is necessarily limited, but this effect is offset to some degree by the increased energy cost of weight-bearing activity.
Make sure the patient is not just concentrating on singular sensations, known as differentiated ratings (see Figure 3.7). For aerobic exercise they should pool all sensations to give one rating. If there is an overriding sensation, note the differentiated rating for this. Differentiated ratings can be used during muscular strength activity or where exercise is limited more by breathlessness or leg pain, and not cardiac limitations, as in the case pulmonary or peripheral vascular disease, respectively.
Sleep disturbances, ranging from insomnia to excessive sleep, are common. A structured sleep schedule with consistent sleep and wake times is recommended. Sodium restriction may minimize bloating, fluid retention, and breast swelling and tenderness. Caffeine restriction and aerobic exercise often reduce symptoms.
As a marker of the body's general physiological strain during aerobic exercise, heart rate is usually described as a percentage of maximal heart rate ( oHRmax). The HRmax has for many years provided a practical substitute marker of the percentage of maximal aerobic power ( VO2max). This is based on the assumption that HRmax and VO2max coincide (Astrand and Rhyming, 1954 Astrand and Christensen, 1964). For an individual, heart rate for a given VO2max does not change, regardless of training status, fitness level or age (Skinner, et al., 2003). The use of HRmax allows for the relative comparison of exercise intensity of people of differing ages. Correspondingly, the use of VO2max allows for the relative comparison of individuals of different levels of maximal aerobic power (aerobic fitness). In recognising the heterogeneity of cardiac populations, relative to both age and fitness (Lavie and Milani, 2000), the use of these two relative measures ( HRmax and VO2max) allows for the same...
Thornby, et al. (1995) found that COPD patients exercising with music reported a reduced sense of effort (measured as rate of perceived exertion RPE). Music was found to improve mood during aerobic exercise (Seath and Thow 1995). More recently Murrock (2002) found that playing upbeat music during cardiac rehabilitation exercise sessions did not reduce perceived exertion but significantly enhanced mood (measured on a feelings scale). This chapter has described the practical aspects of design and delivery of group exercise, using both circuits and free aerobics. It is the choice and preference for the exercise leader as to which method they use. Both methods have strengths and weaknesses. The use of music is also at the discretion of the leader, either as background to dictate circuit time, or to use with the free aerobics section.
In this phase attention and distraction strategies can be reinforced and practiced, so they will become a 'habit' before, but also as, shortness of breath increases. Attention strategies might include monitoring of the symptom, advanced planning of activities, energy conservation and appropriate rests, and the use of a fan. Distraction strategies might include music, TV, the Internet, walks, reading, relaxation, guided imagery, self-talk, acupressure, or massage. This phase may require a change or decrease in the exercise regimen, however, optional exercises can replace walking, such as, daily weights, breaking up the exercise to smaller intervals, or chair aerobics. Support groups either organized or within the community can also help patients to learn strategies to cope with increasing dyspnea. Vicarious learning from peers who have developed ways to manage dyspnea is a potent source of self-efficacy or confidence that will help them to control their dyspnea. In the hypoxic COPD...
Check that the venue lighting, floor surface and room space are safe and appropriate, allowing adequate space for a free exercise area, safe placement of equipment and patient traffic around the exercise room (Tharrett and Peterson, 1997 AACVPR, 2004). Specifically, there should be floor space for aerobic exercise per patient of 1.8-2.3 m2, and 0.6 m2 of space per individual using equipment.
AVOIDING DEBILITATION Until the patient returns to normal activity, aerobic (endurance) conditioning exercise such as walking, stationary biking, swimming, and even light jogging may be recommended to help avoid debilitation from inactivity. An incremental, gradually increasing regimen of aerobic exercise (up to 20 to 30 minutes daily) can usually be started within the first 2 weeks of symptoms. Such conditioning activities have been found to stress the back no more than sitting for an equal time period on the side of the bed. Patients should be informed that exercise may increase pain slightly at first. If intolerable, some exercise alteration is usually helpful.15 Conditioning exercises for trunk muscles are more mechanically stressful to the back than aerobic exercise. Such exercises are not recommended during the first few
Especially vitamins, breast feeding women who choose to lose weight can do so by exercising and or reasonable restriction of energy intake. Exercising by jogging, biking, and aerobics for 45 minutes, four or five times per week for 12 weeks did not affect well-nourished mothers' ability to lactate or influence their milk composition. However, it is possible that severe energy deficit in lactation, especially of thinner women, will reduce breast milk volume.
Unlike the dietary approaches mentioned above, increased attention to exercise has been related not only to enhanced short-term weight loss, but also long-term weight loss. In fact, the benefit of exercise has been particularly effective in the long term. Recent research has focused on type of exercise that may produce the best weight losses. In 1995, R.E. Anderson and colleagues found no differences in treatment programs using aerobic exercise, resistance training (weight lifting), or the combination of aerobic exercise and resistance training (although all yielded significant weight losses). In 1985, Leonard Epstein and colleagues reported that lifestyle exercise (e.g., using stairs instead of an elevator), produced somewhat more weight loss in children than did aerobic exercise, although both of these types of exercise promoted far better weight maintenance than did calisthenics. Similarly, in 1995, these researchers found that children who were taught to decrease sedentary...
Major complications, such as hypertension, accelerated atherosclerosis and osteoporosis. The detrimental effects of muscle weakness are responsible for a substantial part of the initial functional disturbance, and rehabilitation programmes should include resistance and weight-bearing activities as well as aerobic exercise. Kobashigawa, et al. (1999) found that when initiated early after cardiac transplantation, exercise training increased capacity for physical work in transplant patients.
As is the case elsewhere, Hungarian women have less leisure time per day than men, an hour less on average (Toth, 1997). Women also have fewer friends than men, are members of fewer organizations that would allow for socializing outside of the home, and sleep less than men (Lobodzinska, 1995). They spend less time on cultural activities and have more home-based leisure activities, such as hobby cooking, gardening, reading, needlecraft, or listening to the radio (Wolf, 2000). However, some younger women in urban areas do participate in aerobics and other fitness classes. The most significant leisure activity for Hungarian women generally, but particularly working women, is watching television (Toth, 1993). Nonetheless, in 1993, men watched more television per day (159 minutes) than women (139 minutes) (Pongracz & Toth, 1999).
Pooled data and meta-analyses of the 'better' studies indicate that the risk of death from CHD increases about twofold in individuals who are physically inactive compared with their more active counterparts. Relationships between aerobic fitness and CHD appear to be at least as strong. For example, in a cohort of middle-aged men followed up for an average of 6.2 years, the risk of dying was approximately double in those whose exercise capacity at baseline was 8 METS. For both physical activity and fitness, adjustment for a wide range of other risk factors only slightly weakens these associations, suggesting independent relationships.
The term 'physical activity' refers to bodily movement produced by skeletal muscle that results in energy expenditure it thus includes activities of daily living, as well as leisure activity from sport and exercise. The term 'exercise' refers to planned or structured bodily movements, usually undertaken in leisure time in order to improve fitness (e.g., aerobics), while 'sport' is physical activity usually in structured competitive situations (e.g., football). Physical activity at recommended levels (moderate intensity for 30 min for 5 days each week) is associated with many health benefits these include lower all-cause mortality rates, fewer cardiovascular events such as myocardial infarction and stroke, and a lower incidence of metabolic disorders including non-insulin-dependent diabetes mellitus and osteoporosis. Levels of activity have been falling in Westernized societies largely because of a decrease in physical activity at work (from increasing mechanization) and increasingly...
In the UK, aerobic circuit interval training for group exercise training is commonly used and is an effective method for delivering aerobic exercise (SIGN, 2002). In addition to the aerobic conditioning phase, resistance training is part of CR exercise. Home-based exercise is also prescribed with self-monitoring skills being used by the patients. Typically an exercise class consists of a warm-up, an aerobic conditioning phase, a cool-down period and a conditioning phase. The exercise programme should be tailored to the needs of the patient.The latter is important to encourage adherence to exercise. Details regarding the exercise component of CR are provided in Chapters 3-5.
There is some dispute as to when coronary heart disease patients should commence an RE programme. There is general consensus that patients should complete a period of aerobic exercise prior to initiating resistance training. The ACSM (2001) and SIGN (2002) recommend a period of four to six weeks' aerobic acclimatisation. This period allows for patients' haemodynamic responses to exercise to be assessed and for any complications to be ruled out before progression to RE. Additionally, the patient can use this time to become familiar with self-monitoring and to establish the correct training intensity.
These long-term changes in diet in registry members are accompanied by long-term changes in physical activity. Women in the registry report 2545 kcal week of physical activity and men report 3293 kcals week. This is equivalent to 1 h per day of brisk activity. Approximately half of registry members engage in walking plus another form of physical activity, including cycling, weight lifting, aerobics, running, or stair climbing. Only 9 of registry members maintain weight loss without physical activity.
Seven studies - four RCTs and three non-randomized studies - have shown that strength training improves skeletal muscle strength and endurance in clinically stable coronary patients.6 In the majority of these studies, weight training was added as a strength training component to the exercise regimens of coronary patients, who had already participated in aerobic exercise training for 3 months or more. Documented benefits occurred with both low and high resistance training. Weight carrying tolerance (time) or
The effects of exercise on blood glucose levels are complex and sometimes unpredictable. Although moderate, extended aerobic exercise generally causes progressive lowering of blood glucose, intense exercise may transiently increase the blood glucose. We generally recommend modification of diet to accommodate exercise, rather than changing the dose of
The aim of this chapter is to outline the evidence for and the practicalities of safely and effectively using heart rate, ratings of perceived exertion (RPE) and metabolic equivalents (METs) to set and monitor exercise. The chapter will also consider observation as a component of monitoring. The main focus of applying the theory will relate to the intensity monitoring of aerobic exercise, exercise using large muscle groups in a sequential or rhythmical manner. The exercise leader will make frequent use of all four methods, relative to the prescription of aerobic exercise. Many of these methods are found in nationally and internationally recognised guidelines, including
Recommended aerobic exercise intensities relative to the percentage of maximal oxygen uptake ( VO2max), maximal heart rate reserve ( HRRmax) and maximal heart rate ( HRmax) Table 3.1. Recommended aerobic exercise intensities relative to the percentage of maximal oxygen uptake ( VO2max), maximal heart rate reserve ( HRRmax) and maximal heart rate ( HRmax)
Age differences in cognition are inferred from observing a motor (vocal or manual) response to the task stimuli, and age-related changes in the motor system must be taken into account. Although age effects on simple reaction time are mild, aging is accompanied by multiple deficits in planning, control, and execution of movements. Only some of these changes can be attributed to age-related changes in the musculoske-letal system. In vivo PET studies of the dopaminergic system of healthy adults suggest that an age-related decline in availability of dopamine receptors in the caudate nucleus and putamen is linked to impaired fine motor performance. In fMRI measures of activation associated with simple motor tasks, older participants show more sluggish hemodynamic response and lower signal-to-noise ratio than their younger counterparts. Notably, some of the age-related motor deficits may be mediated by differences in aerobic fitness and cardiovascular status. Thus, the results of...
Stage one targets adults who are currently inactive or who are not regularly active, and aims to encourage an accumulation of moderate intensity activity on most days of the week. This stage encourages active living, using the stairs instead of the escalator, walking the children to school instead of driving, etc. Despite the intensity being too low to gain significant improvements in aerobic fitness Franklin (1993),ACSM (2001) and Blair and Church (2004) have shown that activity at this lower intensity will offer substantial benefits across a broad range of health outcomes. These benefits include
Besides the thrill of moving through space, dancing is a great way to keep flexible while toning your muscles at the same time. You can get an aerobic workout from jazz or other fast-paced dance, or stretch and maintain muscle tone when you hold positions in ballet. Dance for at least 20 minutes three times a week for maximum benefit, whether it is in your living room or in a class.
In Chapter 5 the different modes of delivery were discussed, with aerobic circuits and free aerobics as key methods in delivery. Often free aerobics will also be used in the warm-up. In free aerobics, where the leader is introducing different combinations and moves with music, the leader is required to link and combine exercises with an element of choreography, i.e. moving in time to the music and facilitating participants to do so. This teaching skill can seem very difficult, as the leader is not only demonstrating and instructing, but also exercising along with the class. As exercise leadership is a motor skill combining many elements, it is advisable to practise moves and combinations of steps prior to taking the class, particularly in the early developmental period of class leadership. Leading free aerobics requires practice and skill. As with any skill, the more leaders can practise the more proficient they will become. A good teacher is not born but develops with practice and...
Fatigue will also occur if VO2 is limited, as discussed previously. Similarly, metabolic substrates can limit exercise and cause fatigue. Phosphocreatine is the most important substrate for intense exercise that lasts only a few seconds. For exercise lasting less than 3 minutes, most energy comes from anaerobic glycolysis, so lactate buffering to control muscle and blood pH is also important. During aerobic exercise lasting more than an hour, glycogen stores in the muscle and liver are important. Thermoregulation and maintaining body fluids are also important for preventing fatigue during long-term exercise.
In glucose-fatty acid cycle, 662-663 growth hormone regulation, 710 hormone effects, 571f, 666f muscle, 666 problems as fuel, 661 sustained aerobic exercise, 672-673 Free nerve endings, in nociceptors, 794 Free water clearance definition, 406 measurement, 412-414 negative example, 416f positive example, 416f
Carbohydrates and aerobic exercise, have been suggested to reduce the risk of cholelithiasis. Holistic health providers have been prescribing herbal medicines, such as turmeric, Oregon grape, bupleurum, and coin grass, with the belief that they may reduce gall bladder inflammation and relieve liver congestion.
Resistance exercise (RE) incorporates all types of strength and weight training and will lead to improvements in both muscle strength and endurance. RE has many proven health benefits, including increases in lean muscular mass, and it has been shown to complement aerobic exercise in the maintenance of basal metabolic rate, important for weight management (Pollock, et al., 2000). In addition, RE can reduce the risk of falling by improving muscular strength and balance (ACSM, 2001). Favourable effects on bone density are associated with resistance exercise (Bjarnason-Wehrens, et al., 2004). Many women in CR, if they are older, will be post-menopausal, and for this group prevention and treatment of osteoporosis are added benefits. Many activities of daily living and occupational tasks require an equal amount, if not more, of upper body strength than aerobic fitness (Lindsay and Gaw, 1997). After a cardiac event people are often afraid to lift or to attempt resistance-based activities....
ST-segment depression occurred less frequently during resistance testing than during aerobic exercise testing to the point of fatigue.7-9 These studies therefore provide indirect evidence of the effectiveness of resistance exercise training in selected patients with coronary disease. The lack of cardiovascular and orthopedic complications in the 3 year follow up of strength training was largely attributed to strict preliminary screening and careful supervi-sion.12 It is unclear if safety can be extrapolated to other populations of coronary or cardiac patients (for example, women, older men and women patients with low aerobic conditioning, patients at moderate to high cardiovascular risk) and this requires study. However, regimens designed to increase skeletal muscle strength can safely be included in exercise programs of clinically stable coronary patients when appropriate instruction and surveillance are provided.
The management of weight loss is a controversial area. At present there is inconclusive evidence regarding the relative effectiveness of physical activity combined with diet, versus diet alone or physical activity alone (Mulvihill and Quigley, 2003). As adipose tissue contains about 7000kcal kg, with physical activity alone it is difficult to lose much weight (BHF, 2004). Therefore, management of obese participants should include advice on diet, physical activity and a behavioural modification component in order to be comprehensive and effective. The most favourable alterations in body composition will occur with low-intensity, long duration aerobic exercise and aerobic exercise combined with high repetition resistance training (Mulvihill and Quigley, 2003).
Few studies have followed the impact of long-term training on the immune systems of elderly people. Given that a number of age-related changes occur in many systems (e.g., neuroendocrine) known to alter immune function both at rest and during exercise, it would be of value to learn the extent to which both acute and chronic exercise influence immune function in the elderly. In older humans, aerobic exercise training lowers the heart rate at rest, reduces levels of the heart rate and plasma catecholamines at the same absolute submaximal workload, and improves left ventricular performance during peak exercise, but it does not reduce, and may even increase, basal sympathetic nerve activity. With age, there is a slow but significant reduction in muscle mass and ability to perform certain physical activities. This may be the result of changes with the age of muscle composition and protein turnover, as well as the decrease of trophic influence in neural control of muscles of the elderly....