Physical Activity and Exercise Fundamentals

Physical Activity and Exercise Recommendations

• Physical activity is any bodily movement produced by the contraction of skeletal muscles resulting in an increase in caloric expenditure over resting energy expenditure.
• Exercise is planned, structured, and repetitive bodily movement done to improve or maintain components of physical fitness.
• Physical fitness is a set of attributes or characteristics that relate to an individual's ability to perform physical activity.

Key Terms: Skill-Related Physical Fitness Components

• Agility: Ability to change the body's position in space with speed and accuracy.
• Coordination: Ability to use senses (sight, hearing) and body parts together for smooth and accurate task performance.
• Balance: Maintaining equilibrium while stationary or moving.
• Power: Ability/rate to perform work.
• Reaction time: Time elapsed between stimulation and the reaction to it.
• Speed: Ability to perform a movement in a short period.

Key Terms: Health-Related Physical Fitness Components

• Cardiorespiratory endurance: Ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity.
• Body composition: Relative amounts of muscle, fat, bone, and other vital body parts.
• Muscular strength: Muscle's ability to exert force.
• Muscular endurance: Muscle's ability to perform without fatigue.
• Flexibility: Range of motion at a joint.

Exercise is Medicine (ACSM Textbook)

• EIM targets healthy adults, not those with chronic disease.
• MVPA is estimated based on daily frequency and duration of moderate-to-vigorous physical activity.

Physical Activity Guidelines (Early Years, Children, Youth)

• Infants (under 1 year) are encouraged to be physically active through interactive floor play.
• Toddlers (1-2 years) and preschoolers (3-4 years) should accumulate at least 180 minutes of physical activity daily, including activities that develop movement skills and progression toward 60+ minutes of energetic play by age 5.
• Children (5-11 years) should accumulate at least 60 minutes of moderate-to-vigorous intensity physical activity daily. Daily activity should include vigorous activities at least 3 days/week, and activities that strengthen muscle/bone at least 3 days/week.
• Youth (12-17 years) should accumulate at least 60 minutes of moderate-to-vigorous intensity physical activity daily. Daily activity should include vigorous activities at least 3 days/week, and activities that strengthen muscle/bone at least 3 days/week.

Current Physical Activity Levels in Children

• Research by Colley, Garriguet, Janssen, Craig, Clarke, and Tremblay (2007-2009) investigated physical activity levels of Canadian children (6-19 years).
• Study analyzed data from the Canadian Health Measures Survey.

Disease Risk Factors

• Family history
• Hypercholesterolemia
• Hypertension
• Cigarette smoking
• Impaired fasting glucose
• Obesity
• Physical inactivity

What Do These Trends Suggest?

• A majority of "healthy" Canadian children and adults do not meet recommended MVPA guidelines.
• Direct implications for health are evident.
• Targeted interventions to promote MVPA are required.

ACSM: Chronic Care Model and Population Health

• Recommendations for patients with chronic conditions are similar to guidelines for healthy individuals.
• Barriers to exercise must be considered for chronic conditions patients.

Exercise Testing

• Assess the need for exercise testing before management programs.
• Consider client prudence, and select appropriate tests.
• The Short Physical Performance Battery may be a useful alternative.

Essential Steps for Exercise Programming

• Step 1: Assessment - Check health history, symptoms, cardiovascular restrictions, and relevant treatments.
• Step 2: Assessment - Determine clients current level of physical activity.
• Step 3: Assessment - Identify exertional symptoms (and their impact on physical activity.
• Step 4: Assessment - Evaluate physical function and performance (e.g. mildly impaired, moderately impaired)
• Step 5: Assessment - Select recommended physical performance tests (e.g. ADL questionnaires, six-minute walk test)
• Step 6: Testing - Consider protocol for formal exercise tolerance testing.
• Step 7: Referral - Assess for program referral based on limitations in physical function, clinical condition, safety, and client/patient preferences.
• Step 8: Monitoring - Develop strategy for monitoring progress (participation, clinical responses, fitness levels).

ACSM Health and Disease in Relation to Physical Activity

• Physical activity can influence a downward spiral of chronic diseases.
• Increasing MVPA can reduce the cascade of adverse effects.

Two Styles of Exercise Prescription

• FITT Style – Focuses on frequency, intensity, time, and type of activity.
• Pharmacy Style – Examines the indication, specific exercises, dose (duration/repetition), progression & cautions relating to chronic conditions and exercise (with specific risks considered).