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Exercise Prescription ( I ) 運動處方. 許世全教授 香港中文大學 體育運動科學系 香港體適能總會 副主席. Stanley Sai-chuen HUI Associate Professor, Dept. of SSPE, CUHK Fellow, ACSM Vice-chairman, HKPFA. Changes of Physical Fitness. Changes of Physical Fitness. Effect of 12-week Strength Training. - PowerPoint PPT Presentation
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Exercise Prescription ( I )
運動處方
Stanley Sai-chuen HUIAssociate Professor, Dept. of SSPE, CUHK
Fellow, ACSM
Vice-chairman, HKPFA
許世全教授許世全教授香港中文大學 體育運動科學系香港中文大學 體育運動科學系香港體適能總會 副主席香港體適能總會 副主席
Changes of Physical FitnessChanges of Physical Fitness
Changes of Physical FitnessChanges of Physical Fitness
Effect of 12-week Strength TrainingEffect of 12-week Strength Training
Effect Aerobic Ex on VO2maxEffect Aerobic Ex on VO2max
Foss 1998, Fox Ex Physiology, p. 329
Outlines Course structure & requirement Benefits of regular exercise Pre-exercise screening Risk stratification Guidelines for exercise intensity and
physician supervised exercise test
Course Structure 22 Oct: Introduction
Exercise Prescription I 29 Oct: Exercise Prescription II
Ex. Pres for HTN & DM 5 Nov: Assessment of Fitness (Ex. Attires)
Practicum of Ex Training 26 Nov: Ex Pres for Arthritis & Obesity
Medical Aspect & Community Resources
Course Requirement
Practicum in class – 10% (Ex experience) Practicum outside class – 30% (Ex Presp) Written Test (on-line) – 60%
Attendance : 75%Evaluation : 67%
Component of Evaluation:
A Certificate will be issued to those who passed the assessment, jointly by the HKMA & the HKPFA
Benefits of Regular Exercise
Improvements in Cardiovascular and Respiratory Function Increased maximal oxygen uptake due to both central
and peripheral adaptations
Lower minute ventilation at a given submaximal intensity
Lower myocardial oxygen cost for a given absolute submaximal intensity
Lower heart rate and blood pressure at a given submaximal intensity
Increased capillary density in skeletal muscle
Increased exercise threshold for the accumulation of lactate in the blood
Increased exercise threshold for the onset of disease signs or symptoms (e.g., angina pectoris, ischemic ST-segment depression, claudication)
Improvements in Cardiovascular and Respiratory Function (cont’)
Reduction in Coronary Artery Disease Risk Factors
Reduced resting systolic/diastolic pressures
Increased serum high-density lipoprotein cholesterol and decreased serum triglycerides
Reduced total body fat, reduced intra-abdominal fat
Reduced insulin needs, improved glucose tolerance
Benefits of Regular Exercise
Decreased Mortality and Morbidity
Primary prevention (I.e.,intervention to prevent an acute cardiac event)
1. Higher activity and/or fitness levels are associated with lower death rates from coronary artery disease
2. Higher activity and/or fitness levels are associated with lower incidence rates for combined cardiovascular diseases, coronary artery disease, cancer of the colon, and type 2 diabetes
Secondary prevention (i.e. interventions after a cardiac event [to prevent another])
1. Based on meta-analyses (pooled data across studies), cardiovascular and all-cause mortality are reduced in post-myocardial infarction patients who participate in cardiac rehabilitation exercise training, especially as a component of multifactorial risk factor reduction
2. Randomized controlled trials of cardiac rehabilitation exercise training involving post-myocardial infarction patients do not support a reduction in the rate of nonfatal reinfarction
Results of Studies Investigating the Relationship Between Physical Activity and Incidences of Selected Chronic Diseases
* Few studies, probably less than 5; ** Approximately 5 to 10 studies;*** More than 10 studies.
No apparent difference in disease rates across activity or fitness categories;
Some evidence of reduced disease rates across activity or fitness categories;
Good evidence of reduced disease rates across activity or fitness categories;
Excellent evidence of reduced disease rates across activity or fitness categories, good control of potential confounders, excellent methods, extensive evidence of biological mechanisms, relationship is considered causal.
Disease or Condition
Number of Studies
Trends Across Activity or Fitness Categories and Strength of Evidence
All-cause mortality *** Coronary Artery Disease *** Hypertension ** Obesity *** Stroke *** Peripheral vascular disease
*
Type II diabetes mellitus ** Osteoarthritis * Osteoporosis **
Results of Studies Investigating the Relationship Between Physical Activity and Incidences of Selected Chronic Diseases
Disease orCondition
Number ofStudies
Trends Across Activity orFitness Categories andStrength of Evidence
Cancer Colon *** Rectal *** Stomach * Breast ** Prostate *** Lung * Pancreatic *
Results of Studies Investigating the Relationship Between Physical Activity and Incidences of Selected Chronic Diseases
Other Health Benefits
Decreased anxiety and depression Enhanced feelings of well-being Enhanced performance of work,
recreational, and sport activities Increased ability to perform daily living
tasks Reduced muscle and joint injury risk
Improved work performance Enhanced self-concept and esteem Improved socialization Increased energy Greater resistance to fatigue
Other Health Benefits
Agility 敏捷
Balance 平衡
Coordination 協調
Power 肌爆炸力
Reaction time 反應時間
Speed 速度
Motor skill-relatedCardiovascular endurance
心肺耐力Muscular strength and endurance
肌肉力量與耐力Muscular flexibility肌關節柔軟度Body composition身體脂肪百分比
[Neuromuscular Relaxation肌神經鬆馳程度 ]
Health-related
Physical Fitness
Positive Risk Factors for CHD ACSM (2000) Family History Myocardial infarction, coronary revascularization (bypass
surgery) or sudden death before :• the age of 55 years in father or other male first degree relative
(i.e. brother or son)• the age of 65 years in mother or other female first degree relat
ive (i.e. sister or daughter)
Cigarette smoking Current cigarette smoker or those who have quit in the la
st six months
Hypertension Client on Hypertensive medications Resting SBP > 140 mmHg and/ or DBP > 90 mm Hg
Fasting Glucose Fasting blood glucose of 110mg/dL (6.1mmol/L)
Hypercholesterolemia Total serum cholesterol > 200mg/dL (5.2 mmol/L) or High density lipoprotein (HDL) < 35mg/dL (0.9 mmol/L) Low density lipoprotein (LDL) > 130mg/dL (3.4mmol/L) Client is on lipid lowering medications
Obesity Body Mass Index (BMI) > 25 kg/m2 Waist girth >= 90 cm (M); >= 80 cm (F)
Sedentary Lifestyle Accumulating less than 30 minutes moderate intensity exercis
e 3-5 days weekly
Positive Risk Factors for CHD ACSM (2000)
High level of HDL HDL cholesterol > 1.6 mmol/L (60 mg/dl)
Negative Risk Factors for CHD ACSM (2000)
Initial Risk Stratification
Low risk Younger individuals who are asymptomatic and meet
no more than one risk factor threshold
Moderate risk Older individuals (men 45 years of age; women 55
years of age) or those who meet the threshold for two or more risk factors
High Risk Individuals with one or more signs/symptoms or
known cardiovascular, pulmonary, or metabolic disease
ACSM Recommendations for:(A) Medical Examination and Exercise Testing Prior to Participation, and (B) Physician Supervision of Exercise Tests
Low Risk Moderate Risk High Risk
A.
Moderate exercise NN NN R
Vigorous exercise NN R R
B.
Submaximal test NN NN R
Maximal test NN R R
NN - Not Necessary R - Recommended
1996 U.S. Surgeons’ General Report: 1996 U.S. Surgeons’ General Report: Physical Activity and Health Physical Activity and Health (USDHHS / CDC / ACSM)(USDHHS / CDC / ACSM)
AccumulatingAccumulating at least at least 30 minutes30 minutes of of any any kindkind of of moderate intensity physical moderate intensity physical activityactivity on on most daysmost days of the week of the week
would effectively reduce the risk of would effectively reduce the risk of coronary heart disease, type 2 diabetes, coronary heart disease, type 2 diabetes, hypertension, stroke and some kinds of hypertension, stroke and some kinds of cancercancer
Current Recommendation of PA Current Recommendation of PA for Health Promotionfor Health Promotion
Conclusion
Physical inactivity is one of the most important public health problems and it is important to develop an action plan to address this issue
Policy makers Public health professionals Health service providers Educators Grassroots activists
The Endof
Exercise Prescription ( I )