Principles of Exercise Prescription

1. Principles of Exercise Prescription Mr. Cheng Yuk Chuen, Joshua Director of Training Program, Hong Kong Physical Fitness Association

2. Principles of training • Overload-stimulus greater than normal • Adaptation-level of training • Specificity-specific to system and muscle • Progression-increase intensity and design the training sequence

3. An Exercise Session • Warm-up Period (5’-10’) • Conditioning Period(20’-60’) • Aerobic Exercise (Optional recreational game) • Muscular Strength & Endurance • Stretching Exercise • Cool-down Period(5’-10’)

4. Purpose of Warm-up • Prepare body for more strenuous exercise • Facilitates the transition from rest to exercise • Improve blood circulation • Increase the metabolic rate • Increase body temperature • Dissociates more oxygen • Stretch postural muscles • Reduce risk of musculo-skeletal injury

5. Purpose of Conditioning • Develop cardiorespiratory fitness • Improve heart health and weight control • Maintain and improve muscle tone, strength and muscle mass • Maintain and improve muscle elasticity and joint mobility. • Prevention of musculo-skeletal disorder such as low back pain and shoulder osteo-arthritis

6. Purpose of Cool-down • Gradual recovery from the endurance phase: • Adjust the circulatory response (e.g. HR and BP) • Improve venous return risk of post-exercise hypotension and dizziness • Reduce risk of cardiovascular complications(e.g. sudden cardiac death)

7. Components of Exercise Prescription • Exercise Mode (Type of exercise) • Exercise Intensity • Exercise Duration • Exercise Frequency • Progression of Exercise Programme

8. Aerobic Exercise Prescription

9. Typical Aerobic Exercise session ACSM (2006) p.137

10. Exercise Mode • Any form of physical activity which uses large muscle groups. • Examples: walking, jogging, running, biking, stepping, rowing, etc.

11. Exercise Intensity • Low to Moderate • RPE 2-5 (weak to strong) • HR Formula 1 • THR = HRmax X (35% - 69%) where HRmax = 220 – Age • HR Formula 2 • THR = HRR X (20% - 59%) + Resting HR where HRR = HRmax – Resting HR

12. Rating of Perceived Exertion (RPE) Rating Perception Level of Intensity 0 Nothing at all No intensity 1 Very weak 2 Weak Light 3 Moderate 4 Somewhat strong 5 Strong Heavy 6 7 Very Strong 10 Extremely Strong Strongest Intensity

13. Exercise Duration • 20-60 minutes/sesssion • Continuous or intermittent (10 min. each bout)

14. Exercise Frequency • For moderate intensity, at least 3 days/week • For lower intensity, more than 3 days/week is required

15. Progression

16. Guidelines for aerobic exercise • Goal: reach 50th percentile in fitness parameters • Minimal threshold (20% HRR or 50% HRmax) may sufficient for low areobic fitness adult (VO2max<30 mL/kg/min) • 60-80% HRR or 77-90% HRmax are sufficient for improvements in most adults’ CR fitness • HRR method is more accurately for prescribing intensity • 150-400kcal exercise energy expenditure per day

17. Muscular Exercise Prescription

18. Muscular training principle • Strength Training Exercise or Resistance Exercise • Rhythm breathing • Full range of motion • Speed of lifting • Balance of training • Resistance mode: machine weights, free weight, rubber band or body weight

19. Exercise Intensity • Weights that are heavy enough to be lifted for 8 – 12 repetitions (reps.)

20. Exercise Duration • 8-10 exercise for body major muscle groups • Each exercise lifts 8-12 reps.(1 Set) • 10-20 minutes per session

21. Exercise Frequency • At least 2 training sessions per week

22. Progression • Start with low intensity with 1 set per session • Gradually build up every 10-12 weeks

23. Flexibilty Exercise Prescription

24. Exercise Mode • Static muscle stretching exercise • 5’-10’ low-intensity large muscle activity (eg. Brisk walking, jog slowly) • Can be a specific flexibility training session • Can be combined into the warm up and cool down phase • Dynamic or Proprioceptive Neuromuscular Facilitation as progressive mode

25. Exercise Intensity • Stretch the muscle to feel mild discomfort or feel tight but no pain

26. PNF Corbin and Lindsey (1997) p.83

27. Exercise Duration • Hold each muscle stretch for 10-30 seconds • Do it for all major muscle groups

28. Exercise Frequency • At least 3 times per week • Stretch before and after exercise

29. Progression Not required!

30. Art of Exercise Prescription • Exercise prescriptions require individual modification, Individual difference: physiologic and perceptual responses vary among individual • Exercise intensity, duration and training progression should be adjusted with monitoring BP, HR and RPE. • Individual interests, abilities and limitations should be addressed on preparing desired program outcomes.

31. Practicum • Pair work • Fill up the first page of the information and questionnaire provided for your partner • Base on the information provided by your partner, try to write the exercise prescription (page 2) to him/her • Follow the exercise prescription from your partner and fill up the exercise record (page 3&4) for 1 month • Write the overall comment for your partner

32. Exercise Prescription Training Course PracticumConsultant’s Name: __________________________Patient’s Name: Age: Date : Gender: Weight: kg Height: cm PAR-Q: 是 否 問 題 1. 醫生曾否說過你的心臟有問題，以及只可進行醫生建議的體能活動? 2. 你進行體能活動時，是否感到胸口痛? 3. 過去一個月，你曾否在沒有進行體能活動時也感到胸口痛? 4. 你曾否因感到暈眩而失去平衡，或曾否失去知覺? 5. 你的骨骼或關節是否有毛病?且會因改變體能活動而惡化? 6. 醫生現時是否有給你一些有關血壓或心臟藥物(例如去水丸)給你服用? 7. 是否有其他理由令你不應進行體能活動? Risk Factors Identification: 是 否 Risk Factors 1. Family History 2. Smoking 3. Hypertension 4. Hypercholestrolemia 5. Obesity 6. Inactivity 7. High blood glucose 8. High HDL (negative risk factor)Total Score of Risk: ____________ Risk Classification: __________________ Other History and Consideration:

35. 整體評語：

36. END Thank You