Approaches to Prevention Test 1 Population aka public health or community based approach o Bike trails o Inexpensive and non invasive Personal aka clinical or one on one approach o High risk o Expensive invasive inconvenient Combination tends to work best Levels of Prevention 1 Intervene before physical education Ex shots Prevention of disease by altering susceptibility or reducing exposure for susceptible individuals 2 Screening looking for disease has the risk factors Detection and treatment 3 Rehabilitation after the fact Physical Activity bodily movement produced by the contraction of skeletal muscle that substantially increases energy expenditure above basal level Leisure Activity physical activity that a person or group chooses to do during discretionary time Household Activity Occupational Activity Transportation Activity usually across a reasonable distance Lifestyle Activity Leisure time Household Transportation ADLs Activities for Daily Living Exercise Exercise Testing leisure time physical activity conducted with the intention of developing physical fitness Physical Fitness a set of attributes or characteristics that people have or achieve that relates to the ability to perform physical activity Physiological Health Related Skill Related Metabolic Cardiovascular fitness Agility Morphological Body composition Coordination Bone integrity Muscular strength Muscular endurance Flexibility Balance Power Reaction time Speed Health Related Physical Fitness ability to perform ADLs with vigor and demonstration of traits and capacities that are associated with low risk of premature development of the hypokinetic diseases Cardiovascular Fitness aerobic power ability of the circulatory and respiratory systems to supply oxygen during sustained PA Measured in METs Cardiovascular Endurance the ability to perform large muscle dynamic moderate to high intensity exercise for prolonged periods Body Composition the relative amounts of muscle fat bone and other vital parts of the body Muscular Fitness a term developed by and used by ACSM that comprises both muscle strength and muscle endurance Muscle Strength the ability of the muscle to exert force Static isometric strength dynamometer Dynamic isotonic strength 1 RM Isokinetic all joint angles with constant speed accommodating resistance Isotonic concentric Eccentric lengthening Muscle Endurance muscles ability to continue to perform without fatigue The ability of a muscle group to execute repeated contractions over a period of time sufficient to cause muscular fatigue or to maintain a specific percentage of the maximum voluntary contraction for a prolonged period of time Joint Flexibility range of motion available at a joint The ability to move a joint through its full range of motion Physiological Physical Fitness non performance component of physical fitness that relates to biological systems that are influenced by one s level of habitual physical activity Ex Blood Pressure Blood Lipids Metabolic Fitness the state of metabolic systems and variables predictive of the risk for Diabetes and CV disease which can be favorably altered by increased physical activity or regular endurance exercise without the requirement of a training related increase in VO2 max Morphologic Fitness a non performance component of fitness related to body composition factors such as body circumference body fat and regional body fat distribution Bone Integrity a non performance component of fitness related to bone mineral density Physiological Fitness Examples stress tolerance Blood pressure glucose tolerance insulin sensitivity blood lipids Skill Motor Related Physical Fitness those components of physical fitness that have a relationship with enhanced performance in sports and motor skills Balance Static ability to maintain total body equilibrium while standing in one spot Dynamic ability to maintain equilibrium while moving from one point to another Physical activity something you do Physical fitness something you acquire METs metabolic equivalent Used to describe exercise intensity 1 MET resting energy expenditure per minute x MET x times resting energy cost 1 MET 3 5 ml kg min Moderate Intensity PA 40 59 HRR or VO2R 64 76 HR max 5 6 out of a 10 RPE scale Relative 3 5 9 6 METs for 10 MET capacity The effort of a healthy individual might expend while walking briskly Absolute mowing dancing cycling swimming Hard Vigorous Intensity PA 60 84 HRR or VO2R 77 93 HR max 7 8 out of a 10 RPE scale Light Intensity PA 40 HRR or VO2R 63 HR max 5 out of 10 RPE 6 METs for 10 MET capacity May be intense enough to represent a substantial challenge to an Absolute individual and results in a significant increase in heart and breathing rate Relative Relative Absolute 3 METs for 10 MET capacity Walking slowly at home store or office Sitting using a computer at a desk London Bus Study Origins of the relationship of physical activity and health The conductors had less coronary heart disease than the drivers and the disease seemed to be appearing in them at a later age The physical effort in the conductor s work may be a protective factor Harvard Alumni Studies Physical activity as an index of heart attack risk in college alumni How many stairs climbed city blocks walked hours of sports participation Total activity converted to kcal week Blocks and sports and stairs divided into 2000 kcal and 2000 kcal Relative risk RR of 1 64 1 0 is no difference so 64 increase risk in MI death from 2000 to 2000 kcal Below 1 0 is reduced risk so 0 75 is a 25 reduction in risk Students Alumni 5 5 5 5 PA Habits less active more active low risk 5 5 5 5 stayed sedentary stayed active low risk Also got a look at intensity of activity That is lower risk in strenuous sports vs other activities kcal wk Minimal 1000 kcal lost wk Optimal 2000 kcal lost wk Activity of longer duration and higher intensity shows better results Greater health benefits can be obtained by engaging in PA of more Its never too late too old to start vigorous intensity Harvard study shows more PA has greater benefits Cooper study shows fitness quintile defined by amount of oxygen body can utilize VO2 shows greater ability to consume then the lower your risk is PA and fitness are both important Fit and Fat Sedentary overweight worst sedentary lean active overweight active lean best 20 reduction from sedentary to active overweight Fitness level is more important than lean vs fat Relationship btwn strength and functional limitation High