Introduction[edit | edit source] Show
For most adults, an exercise program including aerobic, resistance, flexibility, and neuromotor exercise training is indispensable to improve and maintain physical fitness and health. An exercise training program ideally is designed to meet individual health and physical fitness goals within the context of individual health status, function, and the respective physical and social environment[1]. Physical activity and fitness are associated with a lower prevalence of chronic diseases, such as heart disease, cancer, high blood pressure, and diabetes.[2] Therapeutic exercise is one of the core skills upon which the profession of physiotherapy is based. By considering definitions of therapeutic exercise, physical activity, and exercise, it is possible to see that, although therapeutic exercise contains the components of both physical activity and exercise, it also provides a systematic exercise programme for remediation of impairments and improvement of function[3]. What is the difference between physical activity and exercise? Physical activity refers to the contraction of skeletal muscle that produces bodily movement and requires energy. Exercise is a physical activity that is planned and is performed with the goal of attaining or maintaining physical fitness. Physical fitness is a set of traits that allows an individual to perform physical activity[4]. Designing a therapeutic exercise programme[edit | edit source]A programme may include a range of different types of exercise such as those for improving or preventing deterioration in aerobic capacity, muscle strength, power and endurance, flexibility or range of movement, balance, coordination, and agility.
In general, all exercise training and sport sessions should
Between the training sessions, there must be enough time to recover. Common training principles[edit | edit source]Overload A system must be exercised at a level beyond which it is presently accustomed for a training effect to occur. The system being exercised will gradually adapt to the overload or training stimulus being applied, and this will go on happening as long as the training stimulus continues to be increased until the tissue can no longer adapt. The training stimulus applied consists of different variables such as intensity, duration, and frequency of exercise. It is important to give the system being exercised enough time to recover and only apply a training stimulus again when the system is no longer fatigued[5]. Specificity Any exercise will train a system for the particular task being carried out as the training stimulus. Examples below:
Reversibility The beneficial effects of training begin to be lost as soon as training stops. This happens in a similar time frame as it takes to train the system[5]. Individuality Variation in response to a training programme will occur in a population as people respond differently to the same training programme. This response can be explained by: the initial fitness level of the individual; their health status; and their genetic makeup. Training programmes should be designed to take this into account.
Motor learning Motor learning is concerned with the acquisition of motor skills and how the individual interacts with the task to be learned and the environment. This uses perception or sensing, cognition, and motor processes. Learning a skill is a relatively permanent change in an individual and there are several stages that the person will go through before the skill is retained.
When teaching a patient an exercise
Safety Whenever an individual exercise, there is a risk that they may injure themselves. Safety factors are considered here in relation to the physiotherapist. the environment and the patient or person carrying alit the exercise[5]. Basic Exercise Principles[edit | edit source]Practicing the basic exercise principles is crucial for developing an effective fitness training program. The principles of exercise apply to everyone at all levels of physical training, from the Olympic champion to the weekend golfer. You can easily remember the basic principles of exercise if you use the so-called FITT factors, where FITT stands
The video below summerizes FITT Principle (ACSM recommends to use the FITT method[7]) [8] Frequency (how often): Exercise should be carried out 3-5 days a week. Training three times a week produces significant training effects; however, training 5 days a week at a lower-intensity exercise may be more manageable for some people. Little additional benefit is seen with more than five training sessions a week, and the risk of injury is increased. Training twice a week does not produce increases in VO2max; however, it may produce some functional changes and it is probably better than no exercise at all[5]. Moderate-intensity aerobic exercise done at least 5 d ∙ wk or vigorous-intensity aerobic exercise done at least 3 d ∙ wk or a weekly combination of 3–5 d ∙ wk of moderate and vigorous-intensity exercise is recommended for most adults to achieve and maintain health/fitness benefits[7]. Intensity (how hard) Intensity can vary between light, moderate and vigorous intensity activities. For example, walking slowly is a low intensity activity, walking briskly or shooting around a basketball is a moderate intensity activity and running (>5mph) is a vigorous intensity activity. A good rule of thumb is that a person doing moderate-intensity aerobic activity can talk, but not sing. A person doing vigorous-intensity activity cannot say more than a few words without pausing for a breath[9]. Intensity can be monitored by heart rate in most patients, although some patients may have pathology or be on drug treatment that affects their HR response to exercise (in which case HR cannot be used to monitor exercise intensity). The short video below shows hart rate calculation [10] Measures of perceived effort and affective valence (i.e.the pleasantness of exercise) can be used to modulate or refine the prescribed exercise intensity. eg Borg Rating of Perceived Exertion (RPE) Scales, Talk Test[7]. Time (duration or how long) A total of 20-60 minutes of continuous or intermittent aerobic activity a day should be performed. The activity can be divided into a minimum of lO-minute bouts throughout the day. The duration of training is dependent on intensity. Individuals starting at the lower end of the training band need to sustain exercise longer (30-60 minutes) to achieve training effects[5]. Type Refers to the sort of activity to complete eg Aerobic activities like walking, jogging, biking, swimming or dancing or strengthening activities such as exercises using exercise bands, weight machines or hand-held weights. Putting it together[edit | edit source]150 minutes of moderate to vigorous physical activity is recommended each week. For some, a serious behavior change is needed and for others, a modification to current behaviors is more appropriate. When adopting or modifying a physical activity routine, it is important to set realistic goals. Too often, individuals expect to lose unrealistic amounts of weight, run faster and longer and start seeing drastic body composition changes instantly. Instead, use the acronym S.M.A.R.T.
Putting the FITT principle together, one can effectively plan an exercise routine and set a S.M.A.R.T. goal. See Also[edit | edit source]Anaerobic Exercise : Anaerobic high intensity interval training (HIIT) is a highly desirable workout, because it engaging all muscle fibers, the fast twitch as well as the slow twitch. This makes anaerobic (HIIT) good for a complete training effect. The benefits from anaerobic (HIT) exercise depend on the effort put in. Maximum “effort” by a large muscle mass, such as the legs, produces optimum benefits for the whole body. Aerobic Exercise: Aerobic exercises mainly shows an effect in health-related components of fitness especially cardiovascular endurance and body composition. Strength Training : Strength training (also known as resistance exercise) increases muscle strength by making muscles work against a weight or force. Resistance exercise is an anaerobic exercise. Endurance Exercise References[edit | edit source]
Why it is important to follow the principles of exercise training?Understanding exercise principles allows trainers to monitor the stress (exercise load) placed upon their client in order to make the training safe and effective, helping the client to achieve their goals.
Why is it important to follow the principle of progression?ACE explains the principle of progression: “as the body adapts to the exercise program you must gradually increase the overload to continue to adapt. It is critical that all progressions are gradual and small in nature to prevent over loading the body's ability to recover.”
Why we need to know and understand the overload principle the progression principle and the specificity principle?These principles of training are Overload, Progression, and Specificity. These principles are key to seeing continuous improvement throughout the course of training. Without utilizing them, plateaus are inevitable, and improvement will be minimal.
What are some benefits of using the overload principle for training?Progressive overload benefits your training because you'll avoid a plateau. By changing or progressing in your workouts, you'll keep your muscles challenged and you'll get stronger. For example, in the first month of strength training, you might perform 10 repetitions at one weight.
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