Advanced Exercise Prescription Study Guide PDF

Topic 1. Physiological Basis of Muscular Strength & Endurance A. Neuromuscular System: ​ Central Nervous System (CNS): Brain and spinal cord. ​ Peripheral Nervous System (PNS): Motor neurons connecting CNS to muscles. ​ Motor Unit: An α-motor neuron + all muscle fibers it innervates. B. Mus...

Topic 1. Physiological Basis of Muscular Strength & Endurance A. Neuromuscular System: ​ Central Nervous System (CNS): Brain and spinal cord. ​ Peripheral Nervous System (PNS): Motor neurons connecting CNS to muscles. ​ Motor Unit: An α-motor neuron + all muscle fibers it innervates. B. Muscle Contraction Process: 1.​ Action Potential (AP): Generated in motor cortex → travels via motor neurons to neuromuscular junction (NMJ). 2.​ Neuromuscular Junction: ​ Acetylcholine (ACh) released → binds to receptors → triggers AP in muscle. 3.​ Excitation-Contraction Coupling: ​ AP travels along sarcolemma → T-tubules → Ca²⁺ released from sarcoplasmic reticulum (SR). ​ Ca²⁺ binds troponin → tropomyosin shifts → myosin binds actin → contraction. 4.​ Relaxation: Ca²⁺ pumped back into SR → tropomyosin blocks actin binding sites. C. Force Production Mechanisms: ​ Motor Unit Recruitment: ​ Order: Slow (Type S) → Fast Fatigue-Resistant (Type FR) → Fast Fatigable (Type FF). ​ More motor units = greater force. ​ Rate Coding: Frequency of APs → higher frequency = greater force (e.g., tetanus). 2. Adaptations to Strength Training A. Neural Adaptations: ​ Increased motor unit recruitment and rate coding (Del Vecchio et al., 2019). ​ Enhanced synchronization of motor units. B. Structural Adaptations: ​ Hypertrophy: ↑ Cross-sectional area (CSA) of muscle fibers (Trezise & Blazevich, 2019). ​ Fiber Type Shift: MHCIIx → MHCIIa (more oxidative fibers) (Liu et al., 2003). C. Functional Outcomes: ​ Strength: ↑ 1RM (e.g., leg press from 134.7 kg to 275.0 kg post-training). ​ Endurance: ↑ Repetitions at submaximal loads (Campos et al., 2002). 3. Adaptations to Muscular Endurance Training A. Key Changes: ​ ↑ Capillarization (Holloway et al., 2018). ​ Fiber type shift: MHCIIx → MHCIIa (more fatigue-resistant fibers). ​ Enhanced mitochondrial density and oxidative enzymes. B. Example: ​ High-rep training (20–25 reps) → ↑ squat repetitions (Campos et al., 2002). 4. Training Methods A. Advanced Techniques: ​ Forced Reps: Partner-assisted reps post-exhaustion. ​ Rest-Pause: Short breaks between single reps. ​ Drop Sets: Reduce weight after failure → continue reps. ​ Circuit Training: Minimal rest between exercises (15–30 s). B. Program Design Variables: 5. Program Design Principles A. Exercise Order: ​ Prioritize multi-joint, power, and structural exercises first. ​ Example: Clean and Jerk → Bench Press → Deadlift → Assistance exercises. B. Progression: ​ 2-for-2 Rule: Increase load if 2 extra reps achieved in 2 consecutive sessions. ​ Load Increase: ​ Upper body: 1–2 kg (beginners) to 2–4+ kg (advanced). ​ Lower body: 2–4 kg (beginners) to 4–7+ kg (advanced). C. Training Frequency: ​ Beginners: 2–3 full-body sessions/week. ​ Advanced: 4–7 split sessions/week (e.g., push/pull/legs). D. Rest Periods: ​ Longer rests (2–5 min) → optimal for strength. ​ Shorter rests (95% even during maximal exercise in healthy individuals. ​ Transit Time: Reduced time for RBCs to pass through pulmonary capillaries during exercise, but gas exchange remains efficient. 3. Training Methods A. Long Slow Distance (LSD) ​ Intensity: 50–70% VO₂max. ​ Volume: >250 min/week (e.g., 3–5 sessions of 50–90 min). ​ Adaptations: ​ ↑ Fat oxidation, mitochondrial biogenesis, and capillary density. ​ Example Plan: 3×90-min sessions weekly (Mon, Wed, Fri). B. Threshold Training ​ Intensity: 75–85% VO₂max (near lactate threshold). ​ Volume: 100–150 min/week (e.g., 3–4 sessions of 25–45 min). ​ Adaptations: ​ ↑ Lactate clearance, mitochondrial enzyme activity, and Type I fiber recruitment. ​ Example Plan: 3×35-min sessions with 5x5-min intervals (Tues, Thurs, Sat). C. High-Intensity Interval Training (HIIT) ​ Intensity: 85–100% VO₂max. ​ Work:Rest Ratio: 1:0.5–1:1 (e.g., 5x5-min intervals with 2.5–5 min rest).  ​ Adaptations: ​ ↑ VO₂max, cardiac output, and anaerobic capacity. ​ Example Plan: 3×5x5-min sessions weekly (Mon, Wed, Fri). 4. Program Design Variables Key Considerations: ​ Exercise Order: Warm-up (5–10 min) → Conditioning → Cool-down (5–10 min) + Stretching. ​ Training Frequency: More sessions/week → greater adaptations (e.g., ↑30% VO₂max with 5x/week vs. 3x/week). 5. Practical Implications ​ HIIT: Most effective for rapid VO₂max gains (↑30% with near-maximal intensity). ​ Threshold Training: Best for improving lactate threshold and race pace. ​ LSD: Enhances endurance and fat metabolism but has minimal impact on VO₂max. ​ Hybrid Programs: Combine methods (e.g., HIIT + LSD) for balanced adaptations. 6. Key Studies & Figures ​ Murias et al. (2010): VO₂max ↑ from 2.29 to 2.95 L/min in older adults post-training. ​ Montero et al. (2017): RBC volume ↑ from 1800 ml to 2000 ml after 8 weeks. ​ Hoppeler et al. (1985): Mitochondrial density correlates with VO₂max. ​ Gormley et al. (2008): Vigorous intensity training ↑ VO₂max by 25% vs. 15% with moderate. 7. Progression & Individualization ​ Factors Influencing Progression: Age, health status, training history. ​ Example Progression: ​ LSD: Start with 3x30-min sessions, progress to 5x60-min over 12 weeks. ​ HIIT: Begin with 4x4-min intervals, advance to 6x5-min with shorter rest. Topic 3. Anaerobic performance 1. Physiological Basis of Anaerobic Performance ​ Anaerobic Exercise: ​ Defined as intense physical activity of very short duration.  ​ Fueled by energy sources within the muscles, independent of oxygen use (ACSM, 2014). ​ Examples: Sprinting, weightlifting, and other high-intensity, short-duration activities. 2. Determinants of Anaerobic Performance Anaerobic performance is influenced by several physiological factors: 1.​ Neuromuscular Factors: ​ Brain-Muscle Connection: ​ The brain generates signals that are delivered to muscles via motor neurons. ​ Upper motor neurons (from the brain to the spinal cord) and lower motor neurons (from the spinal cord to the muscles) are involved. ​ Muscle contraction occurs in response to these signals. ​ Force-Frequency Relationship: ​ The force produced by a muscle increases with the frequency of neural stimulation (Hirschfield et al., 2000). ​ Training adaptations can attenuate the decline in action potential (AP) frequency, leading to increased maximal force and rate of force development (RFD) (Van Custem et al., 1998). 2.​ Muscle Size: ​ Role in Performance: ​ There is a linear association between lean muscle mass and peak power output. ​ Studies show a strong correlation between lower extremity lean mass and mean power output (r = 0.73 for males, r = 0.77 for females, P < 0.01). ​ Training Adaptations: ​ Muscle volume increases with training, particularly in the quadriceps, hamstrings, and adductors (Nuell et al., 2020). 3.​ Muscle Fiber Type: ​ Fast-Twitch (FT) Fibers: ​ The greater the number and size of FT fibers, the greater the ability to perform anaerobic work. ​ FT fibers are more suited for explosive, high-intensity activities like sprinting. ​ Training Adaptations: ​ Sprint training can lead to a bidirectional shift in muscle fiber types, with an increase in Type IIA fibers and a decrease in Type IIB fibers (Esbjornsson et al., 1993). 4.​ Enzymatic Activity: ​ Anaerobic Enzymes:  ​ Enzymes like creatine kinase (CPK), phosphofructokinase (PFK), and lactate dehydrogenase (LDH) speed up anaerobic metabolism. ​ These enzymes facilitate the breakdown of glucose and creatine phosphate to produce ATP. ​ Training Adaptations: ​ Glycolytic enzyme activity increases after training, enhancing the muscle's ability to produce energy anaerobically (MacDougall et al., 1994). 5.​ Buffering Capacity: ​ Role in Performance: ​ Buffering capacity refers to the muscle's ability to neutralize acid (e.g., lactic acid) that accumulates during intense exercise. ​ Low pH (acidosis) can contribute to muscle fatigue by impairing cross-bridge formation and enzyme activity. ​ Training Adaptations: ​ Training increases buffering capacity, allowing muscles to tolerate higher levels of lactate accumulation without a significant drop in pH (Sharp et al., 1986). 3. Training Adaptations Summary Anaerobic training leads to both neural and peripheral adaptations: ​ Neural Adaptations: ​ Increased action potential frequency (↑ AP Freq). ​ Peripheral Adaptations: ​ Increased muscle mass (↑ Muscle Mass). ​ Shift in muscle fiber types (↑ I → IIa < Type IIx). ​ Increased enzyme activity (↑ Enzyme Activity). ​ Increased buffering capacity (↑ Buffering Capacity). 4. Training Methods Several training methods are used to improve anaerobic performance: 1.​ High-Intensity Interval Training (HIIT): ​ Consists of repeated short bouts of high-intensity exercise (e.g., 130% VO2max) alternated with low-intensity recovery or rest. ​ Example: 30 seconds of sprinting followed by 1 minute of walking. 2.​ Repeated Sprint Exercise: ​ Involves repeated short sprints ( D > E > Control (Foster-Schubert et al., 2012). ​ Structured exercise alone has minimal impact without caloric deficit. 5. Skeletal System and Bone Health ​ Bone Types: ​ Cortical (Compact): Dense outer layer. ​ Trabecular (Spongy): Inner porous layer. ​ Bone Remodeling: ​ Osteoclasts resorb bone; osteoblasts form new bone. ​ Mechanical loading stimulates bone formation (e.g., weight-bearing exercise). ​ Osteoporosis: ​ Reduced bone density due to aging, menopause, or inactivity. ​ Prevention: Weight-bearing exercises (e.g., jumping, resistance training). 6. Muscle Anatomy and Hypertrophy ​ Muscle Structure: ​ Hierarchy: Muscle → Fascicles → Muscle Fibers → Myofibrils → Sarcomeres (actin/myosin). ​ Hypertrophy vs. Atrophy: ​ Hypertrophy: Increased muscle mass (exercise-induced). ​ Atrophy: Decreased mass (inactivity, malnutrition). ​ Mechanisms: ​ Fiber Hypertrophy: Enlargement of existing fibers (primary mechanism). ​ Fiber Hyperplasia: Increase in fiber number (controversial in humans). 7. Resistance Training Guidelines ​ Repetition Continuum:  ​ Strength: 1-5RM (≥85% 1RM). ​ Hypertrophy: 6-12RM (67-85% 1RM). ​ Endurance: 15+RM (≤50% 1RM). ​ Key Findings: ​ Hypertrophy can occur across a wide load range (30-85% 1RM) if sets are taken to failure. ​ No significant difference in hypertrophy between heavy, moderate, or light loads (Schoenfeld et al., 2014; Mitchell et al., 2012). 8. Practical Recommendations ​ Hypertrophy Tips: ​ Moderate loads are time-efficient. ​ Light loads require more reps (metabolic stress). ​ Heavy loads increase joint stress. 9. Key Takeaways 1.​ Fat Loss: Requires caloric deficit; most effective with diet + exercise. 2.​ Bone Health: Weight-bearing and resistance exercises maintain BMD. 3.​ Muscle Growth: Achievable across various loads; consistency and volume matter most.