1
Q
Arrange
A
- Thank the client for taking the time to do the assessment and planning work
- Discuss the clients requirements for subsequent sessions
- Send the client away with words of encouragement and instructions on how to contact the exercise professional if they have any questions
2
Q
How to keep clients accountable to themselves
A
- encourage to keep PA log
- Use weekly planner
- Helps them monitor their own progress
- may provide insight for next trainer-client meeting
3
Q
Relapse planner
A
- Preemptive measure
- Facilitate discussion of what things might derail the client’s efforts and what strategies might help to keep them of track
4
Q
Establishing a follow-up schedule
A
- Facilitates adherence and helpful adjustment to the action plan and physical activity prescription
- may be especially important for clients who have been inactive and strive to make significant change in their behavioral patterns
5
Q
Creating a network of online and community based resources
A
- Provide advice to clients based on sound, current and evidence-based information, using ethical and professional conduct
- Identify community resources, websites etc. that can help the client
6
Q
Who is an older adult?
A
- 65+, 70+ by CSEP definition
7
Q
How is age demographics changing in our population
A
- Fastest growing population age group is 85+ and 100+
- By 2031, 1 in 4 Canadians will be 65+
8
Q
Expected physiological changes with age to cardiovascular system
A
- Increase left ventricle wall thickness
- decrease myocardial contractility
- decrease max HR
-Increased intimal thickness and vascular stiffness - 25% decrease in CO during exercise
9
Q
Changes in VO2 with age
A
- Decrease CO and decreased muscle oxidative capacity
- decreased VO2max
10
Q
Physiological changes with age respiratory system
A
- Increase chest wall stiffness
- Decreased respiratory muscle strength
- Decreased sensitivity of respiratory receptors
- Decreased alveolar surface area
- increased bronchi diameter
- decreased bronchiole diameter
- decreased elastic recoil
11
Q
Results of physiological changes to respiratory system with age
A
- Decreased maximal voluntary ventilation
- Increased residual lung volume
12
Q
Physiological changes with age to MSK system
A
Sarcopenia
- Reduction in # of muscle fibers and fiber size
- greatest decline in type II fibers
- increase in intramuscular fat
By age 70
- 40 % decrease in muscle mass
- 30% decrease in strength
- 3.5% decrease in power per year
13
Q
Result of MSK system changes with age
A
decreased strength and power
14
Q
Physiological changes with age to neuromuscular system
A
- decrease coordination of the muscles with the nervous system
- decreased nerve muscle conduction velocity
- decreased muscle coordination
- ability to respond to an unexpected stimulus
- reaction time and time to execute movements
15
Q
Physiological changes with age to skeletal system
A
- connective tissue loses elasticity, muscle fibers shorten, decrease production of synovial fluid
- Thinning + calcification of vertebrae, reduction in height, poor posture, increased rigidity
- Arthritis
16
Q
Physiological changes with age to sensory system
A
- Layout, position of limbs, navigation, anticipation/ avoidance
- hearing, maintaining balance, vestibular system
- spatial position and movement of body relative to support surface
- decreased proprioceptor sensitivity, particularly at the foot and ankle
17
Q
Physiological changes with age to cognitive system
A
- reductions in brain volume - executive function
- neurons and synapses
- mild decline in short-term memory
- increased forgetfulness
- increase in time to learn new information
- slowing in speed of response and problem-solving
Some changes can start as early as 40s
18
Q
Changes with age to mental health
A
- Most common: depression, delirium
Physiological changes require readjustment and psychological coping: - Social isolation
- Functional decline
- Substance abuse
- Elder abuse
- changing life situation
- Financial insecurity
19
Q
Benefits of physical activity to our health as we age
A
- Improved cardiorespiratory function
- Maintain bone health
- Improved cognition
- Improves emotional well-being
- increased life expectancy
- Slow premature aging
- maintain functionality and independance
20
Q
Old Canadian PA guidelines for 65 and older
A
- 150 minutes of moderate to vigorous in bouts of 10 minutes or more
- strengthening activities 2 days per week
- those with poor mobility should perform PA to enhance balance and prevent falls
- 30-70% reduced risk
- only 25% of Canadian older adults reach the recommended guidelines
21
Q
New PA guidelines
A
- 150 minutes moderate to vigorous
- physical activities that challenge balance
- strengthening twice per week
- several hours of light physical activity
- 7-8 hours of good quality sleep
- limited sedentary time to 8 hours or less
- no more than 3 hours recreational screen time
- 30-70% reduced risk
- about 50% of Canadian older adults reach the recommended guidelines
22
Q
Medical history in older adults
A
65-79
- 12% no disease
- 23% one disease
80+
- 8% no disease
- 14% one disease
Most common is high blood pressure followed by arteritis and then heart disease
23
Q
What is risk of adverse effects correlated with
A
- physical condition/functional capacity
- Presence of disease/disability
- Inherent danger of the physical activity
24
Q
Training principles
A
- Overload: ability to get uncomfortable
- Progression: ability to build on and improve ( 20% improvement in VO2max, 30% in strength/power)
- Specificity: making sure exercise is practical
- Reversibility: more pronounced with age (10 days VO2 decrease by 10%)
- Individuality: everyone is unique
25
Aerobic FIIT for older adults
F: 4-5 days moderate, 3 days vigorous
I: moderate to vigorous, 60% HRmax, 12-14/20 RPE (HRmax=208 - (0.7x age)
T: 30 min per day for mod, 20 for vigorous, 60-90 min to max health and fitness benefits, 10 min bouts
T: Rhythmical movement of large muscles
26
Muscle strength FITT
F: 1-3 days per week
I: Moderate 50% 1rm, heavy 80% 1rm
T: varies 8-10 repetitions for strength, 10-15 for endurance
T: progressive weight training program
27
Muscle power FITT
F: 1-3 times per week
I: low <50, moderate, high >70%
T: 1-3 sets for 6-10 reps
T: high velocity or intent to move at a high velocity - increase function/mobility (task specific movement)
28
Flexibility FITT
F: 2-4 sets, 2-3 times per week
I: Static or dynamic
T: Static 10-30, 60 seconds per muscle
T: Static or Dynamic
29
Warm up for older adults
- Longer warm-up needed 10 min minimum
- dynamic movement of large muscle groups
- Progress to target intensity by end of warm up
30
Cool down in older adults
- Longer cool-down needed (5-10 min)
- Goal is to reduce body temperature, HR and respiration to baseline
- Want to avoid hypotensive response risk
- visual checks of HR and BP may be warranted
31
Internal factors to keep older adults active
Motivation
- Greater concern for health and mobility outcomes
- Annual fitness assessments as a motivator
Long-term adherence
- Self-efficacy
- Task-specific self efficacy
- Plans for lapses (coping planning)
32
External factors keeping older adults active
Environment
- Accessibility
- Fall risk
Planning/timing session
- Morning vs night (vision)
- Winter vs summer
33
Differences in child cardiovascular fitness
- Higher resting HR at rest and during exercise
- Faster heart rate recovery (greater parasympathetic input)
- Lower stroke volume - lower Q
- Lower absolute VO2, higher VO2 (small body mass)
- Higher respiratory rate
- ventilation threshold decreases with age
34
Metabolic differences with children
- Lower blood lactate production during exercise
35
Neruomuscular differences with children
- Lower economy of locomotion (stride length, motor skills)
- Resistance training - muscle strength increase but not size
- Fiber type proportion is differentiated in early childhood
- Faster anaerobic exercise recovery
36
Perceptual differences in children
- Lower RPE during short-duration exercise and higher REP in longer exercise
37
24 hour movement guidelines for children (5-17)
- Sweat: 60 min Moderate to vigorous
- Step: several hours of structured and unstructured activities
- Sleep: 5-13: 9-11 hours, 14-17: 8-10 hours
- Sit: No more than 2 hours recreational screen time
38
24 hour movement guidelines for 0-4
MOVE
- Infants: several times a day through interactive floor play and tummy time
- Toddlers (1-2) and preschoolers (3-4): >180 minutes of PA at any intensity spread throughout the day (60 min vigorous to moderate)
SLEEP
- Infants: 0-3 14-17 hours, 4-11 12-16
- Toddlers: 11-14
- Preschoolers: 10-13
SIT
- not restrained for >1 hours at a time
- no screen time <2 years old
- < 1 hour for 2-4
39
PA levels in children CAN and screen time
- 1/3 of children and youth meet guidelines
- 60% of preschoolers meet guideline
- boys engage in more MVPA than girls
- 50% of children and youth exceed the screen time recommendation
- 24% of preschoolers exceed the screen time recommendation
40
Health benefits of PA for children
- Better motor development
- Improved cognitive development
- Better psychosocial health
- Better cardiometabolic health
- Aerobic fitness
- Better bone health
- Favorable body composition and weight status
In older children
- muscular stregth
- heart health
- higher academic achievement
- better mental health
41
Facilitators of PA participation for children
- Fun and friendship
- being outdoors
- access to facilities
- school PA policies
- high perceived motor competence
- sport participation
- opportunities for unstructured free play
- parental physical activity and parental support for physical activity
42
BMI index on growth charts
- 85th percentile cut-off for over weight
- 95th percentile for obesity
43
Aerobic fitness assessments in children
- children often fail to demonstrate plateau 0 use VO2 peak
- Use treadmill vs bike
- need size adjusted equipment
- workloads adjusted to child's age and size
44
PACER 20m shuttle run
Beep test
- Field-based test
- Starts at 8.5 km/h increases 0.5 every min
- 21 levels
- correlated with measured VO2 peak
- 8+
45
Guidelines for treadmill testing protocol
- 2 hours after solid food consumption
- no vigorous activity that day
- habituated to lab environment and equipment
- contraindications to exercise ruled out
- low intensity warm up
- age maturity and attention span considered (8 to 12 minutes)
- ancillary measure taken by discontinuous tests
- speed change should not be excessive
- end-points decided prior to test
- cool down after
46
FITT for PA in children
F: Daily, with a mix of structured and unstructured activities in a variety of environments
I: Moderate (5-6/10 RPE) heavy breath and vigorous (7-8/10) out of breath
T: anything fun and enjoying
T: At least 60 minutes of MVPA throughout the day + several hours of light physical activity
47
Guiding principle for long-term development in spor
1. Quality is key
2. Optimal programming is critical
3. Inclusion is non-negotiable
4. Collaboration makes the system better
48
Goals of log-term development in sport and PA
1. Support development of physical literacy
2. Strive for excellence
3. Empower people to be active for life
49
Domains of physical literacy
- Affective: Motivation and confidence
- Physical: physical competence
- Cognitive: knowledge and understanding
- Behavioral: engagement in physical activities for life
50
Physical literacy 5 core prinicples
- Is an inclusive concept accessible to all
- Represents a unique journey for each individual
- Can be cultivated and enjoyed through a range of experiences in different environments and contexts
- Needs to be values and nurtured throughout life
- Contributes to the development of the whole person
51
Physical-literacy based programming
- Activities scaled to participants ability
- structured and unstructured movement opportunities
- opportunities for participants to personalize activities
- instructors provide mastery experiences
- Aerobic physical activity = high participation
- Age and size-appropriate equipment
52
Physical literacy 5+5
1. Always moving
2. Fun and social
3. Challenging
4. with purpose
5. everyone included
+
1. Appropriate (space and equipment)
2. Symmetry
3. Mimicry
4. Cueing and feedback
5. Teaching games for understanding
53
Resistance training in children and youth considerations
- Training plan should consider age, sex, training status, health status and fitness
- Ensure the exercise environment is safe and free of hazards; use appropriately sized equipment
- begin with 5-10 minutes of dynamic warm-up
- Low to moderate intensity 2-3 times/ week, with 1 to 2 sets (progress to 3-5) 8-12 exercises
- Proper form and technique is prioritized over progression in intensity
- Include exercises that challenge balance and coordination
- vary the program to optimize gains, have fun and avoid boredom
54
benefits of RT in children
- increase strength, bone density, coordination, balance, sport performance and self-esteem
- Decrease cardiovascular risk
55
