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EXERCISE AND FITNESS

Dr. Editha C. Dizon

PHYSICAL FITNESS
A set of attributes that people have or achieve that relates
to the ability to perform physical activity.

FITNESS

The ability to perform moderate to vigorous levels of

physical activity without undue fatigue and the capability
of maintaining this capacity throughout life.

Ex. Bathing

TRAINING PRINCIPLES

The Principle of Overload/stress

The Principle of Specificity of Training

The Training Principle of Progression

The Principle of Regularity of Sports Participation

The Principle of Recovery/Rest

The Principle of Diminished Returns

The Principle of Seasons

The Training Principle of Individuality

REVERSIBILITY

Physical benefits are lost through disuse or inactivity

HEALTH RELATED FITNESS

A state characterized by an ability to perform daily

activities with vigor

The demonstration of traits and capacities that are

associated with low risk of premature development of
hypokinetic diseases

Sedentary life style risk factor for hypokinetic diseases

FITNESS TESTING
1. Cardiovascular-respiratory function

Level of endurance of the heart and lung

2. Body composition

Ratio of fat and lean muscle

3. Muscular strength and endurance

How much power can you endure?

How long?
4. Flexibility

SPECIFICITY

Refers to the bodys adaptation to a particular type and

amount of stress placed upon it

TEST RESULTS CAN BE UTILIZED FOR

Strength and weakness identification

Achievement of individual goals

Educational purposes

Motivation

Program evaluation
BENEFITS OF EXERCISE
Improve cardiovascular and respiratory functions
Decrease coronary risk factor
Increase HDL
Decrease body fat/ weight loss
Lower blood pressure in HPN
Decrease glucose concentration
Increase insulin sensitivity
Promotes well-being
Reduce tension/depression
Improve body image
Increase social activity
Improve balance and coordination
Increase bone density

DIMINISHING RETURNS

As you gain benefits as the results of physical activity

additional benefits will be more difficult to achieve.
A bigger person losses weight more than a smaller
person.

Remember:

Keepers of patients well being

Patients active involvement in his own care through

exercise

Advising exercise without instruction is liken to over the

counter medications without prescription

Exercise results in relatively predictable specific

responses in the body

Produces dose-response curve

REHABILITATION MEDICINE: EXERCISE AND FITNESS DRA. DIZON (2016)

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INDIVIDUALITY

No two bodies are alike

There are individual limits on each persons adaptability

and potential for improvement
OVERLOAD

Provide a greater stress or demand on the body that is it

normally accustomed to handling.

CARDIOVASCULAR ENDURANCE

Improve physical working capacity

Reduce fatigue

Reduce risk of coronary heart disease

CARDIOPULMONARY FITNESS

Progressive overloading
FIT
o Frequency
o Intensity
o Time

PAR-Q

Has your doctor ever said that you have a heart condition
and that you should only do physical activity
recommended by a doctor?

Do you feel pain in your chest when you do physical

activity?

In the past month, have you had chest pain when you
were not doing any physical activity

Do you have a bone or joint problem that could be made

worse b a change in you physical activity

Is your doctor currently prescribing drugs for you blood

pressure or heart condition?

Do you know any other reason why you should not do

physical activity? (exercise induced asthma, pressure
urticaria,)

DRUG Rx
Name of Drug
Strength of Drug
Dose
Frequency

EXERCISE Rx
Type of Exercise
Intensity
Duration
Frequence

TYPE OF EXERCISE
Isotonic, rhythmic aerobic
Use large Muscle groups
No large Isometric component
Continuous

AEROBICS
Swimming
Jogging cyclin
Cross country skiing
Aerobic dancing
Brisk walking

METHODS
OF
EVALUATION

CARDIVASCULAR

Submaximal Tests
o Bicycle ergometer
o Treadmill
o Bench Step Test

VO2 MAX
o Open circuit spirometry

FITNESS

FIVE COMPONENTS OF FITNESS

1.

CARDIOVASCULAR FITNESS

Ability of the heart and lung to sustain moderate to

intense activity 60-90% of maximum heart rate =THR
Low resting heart rate without underlying cardiac
problem or medication

REHABILITATION MEDICINE: EXERCISE AND FITNESS DRA. DIZON (2016)

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o

Heart rate reserve method

The volume of oxygen a body is using while exercising at

maximum capacity
VO2 Max = SVmax X HRmax X (CaO2 CV)2) max

o
o

Field stress test

o 1.5 mile run (time)
o 12 min run (distance)
o

Intensity
o 55/65% to 90% of HRmax
o 40/50% to 85% of VO2R of HRmax

HEART RATE MONITOR

ECG - more accurate
Telemetric Monitors (e.g. Ciclomaster, Nissei,
Polar, Seiko)
Palpation

BORGS SELF PERCEIVED EXERTION SCALE

o patient selects a number that reflects his
feeling of exertion
o RATING DESCRIPTION OF EFFORT

11 to 20

11 no fatigue

20 VERY HARD

Normal 13-14 somewhat hard

Somewhat Hard = 60% of HR

range (12-13)

Hard = 85% of HR range (16)

TALK TEST
o Pace is suitable if you can talk easily to a
partner while exercising.
o To determine the intensity of the exercise

MHR = (220 - AGE) + 10 bpm

HRmax

= 220 age
(Lower Extremities)
= 220 - age 11 (Upper Extremities)

HRTZ

= HRmax x 0.55
= HR max X 0.99

THR

= (HRmax-HRR) X (%) + HRR

EXERCISE PRESCRIPTION

F- Frequency (3-5 days/week)

I - Intensity (60%-90% MHR)

o (50%-85% VO Max)

T - Time/duration (<10am, >4pm)/(20/60 min)

T- Type/Mode
o
Aerobic (uses large muscle groups,
continuous, rhythmical, aerobic)
o
Resistance training (moderate intensity)

CARDIOPULMONARY FITNESS

Duration
o 20-60 minutes

Continuous

Intermittent

Frequency
o At least 3-5x a week
o Novice 3x week
o Mainstay: 3-5/week
o Elite:
1-2/day
3-5 week

Intensity
o Target heart rate
o Direct method
o Percent of heart rate maximum

REHABILITATION MEDICINE: EXERCISE AND FITNESS DRA. DIZON (2016)

TIME
o
o

preferably before 10am. or after 4pm. - outdoor

no restriction indoor

DURATION
o 5-10 minutes warm up
o 15-30 exercise
o 5-10 minutes cooldown
o

WARMP-UP

Stretching / Flexibility exercise

Calisthenics

Slow jog - cardio

Gradual increase in speed of activity

Increase neuromuscular transmission

Reduce Injury Rate

increase neuromuscular
transmission
better reaction time
cardiovascular
preparedness
increased flexibility

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BODY COMPOSITION

BMI (QUETELET INDEX)

Dynamic Exercise

Sustained activity at level of THR

achieve exercise effect

COOLDOWN PERIOD

Prevents pooling of blood in

extremities gradual return to resting
heart rate

Calisthenics/stretching

CARDIORESPIRATORY FITNESS

Dose response to exercise

Lower doses of exercise may improve fitness but at a

slower rate

Higher intensity

Greater cardiovascular risk

Greater orthopedic injury

Lower adherence to exercise

2.

3.

WAIST CIRCUMFERENCE

WAIST TO HIP RATIO

DESIRED BODY WEIGHT
MALE 15-20% TOTAL BODY FAT IDEAL
FEMALE 20-25 % TOTAL BODY FAT IDEAL
18.5 22.5 normal BMI
WAIST smallest circumference in the trunk
HIP
WAIST-TO-HIP RAITO
o Average value for age 17-39

Male 0.80-0.90

Female 0.90-0.98

MUSCULAR STRENGTH

Ability of the muscle to generate maximum force or

tension

BODY COMPOSITION

Total body content of water, protein, fat and minerals

Lean body weight VS fat weight

Overweight vs overfat vs obesity

Reduce risk of hypertension

Reduce risk of coronary heart disease

BODY FAT COMPOSITION EVALUATION
o Underwater weighing
o Caliper
o Ultrasound bioelectrical impedence, Near
Infrared Interactance (NII) measurements

REHABILITATION MEDICINE: EXERCISE AND FITNESS DRA. DIZON (2016)

MUSCLE STRENGTH AND ENDURANCE

Improve functional capacity for lifting and carrying
Reduced risk of back pain
Optimal posture

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TESTS

Isometric: dynamometry
o Equal muscle length and same joint angle
o Zero motion speed with varying resistance

COMPARISON OF DIFFERENT TYPES

CONTRACTION
Tension
Length
Isotonic
varying
Varying
Isometric
Varying
equal
Isokinetic
Accommodating Varying
Resistance
(varying
4.

Isokinetic: machines
o Iso=equal; kinetos=move
o Definition: one kind of muscle contraction that
occurs when the rate of movement is constant
o Not occur in the living body without using
special machine (isokinetic dynamometer)
o First introduced by Hislop and Perrine in 1967
o Equal motion speed with accommodating
resistance

Isotonic: calisthenics/weight lifting 1RM weightlifting test

o Maximum weight lift once
o Iso = equal; tonus = tension
o Muscle physiologists defined a kind of muscle
contraction that develops constant tension
throughout the whole muscle excursion as
isotonic contraction; however, it is seldom seen
in the living body
o Clinicians use isotonic contraction commonly
and refer to a muscle contraction that causes a
joint to move through some range of motion.
o Even though the resistance remains the same,
the tension generated by the muscle is not
equal tension because
the moment arm to the joint axis
is changing throughout the motion
the resistance with respect to the
gravity is changing throughout the
motion

REHABILITATION MEDICINE: EXERCISE AND FITNESS DRA. DIZON (2016)

MUSCLE

Speed
Varying
zero
Constant

MUSCLE ENDURANCE

OF

Ability of the muscle to sustain a contraction of a period

of time
Evaluation
o Number of repetitions of a given exercise
o isokinetic machine to evaluate percent decline
in torque

Muscle Strength & Endurance

TYPE OF EXERCISE
o Resistance training

INTENSITY
o 1 set 8 -12 RM
o 1 set of 10-15

FREQUENCY
o 2-3x a week

5.

FLEXIBILITY

Range of motion of a joint or series of joint that are

influenced by muscles, tendons, ligaments, bones and
bony structures
Suppleness of the muscles
Enhance functional capacity for bending and twisting
Reduce risk of low back pain
Sit and Reach

PAUZKI

sweating occurs earlier

faster return to resting heart rate
lower resting heart rate

Everything in Moderation:

Type and intensity

o Static: 10-30 sec
o PNF: 6 sec contraction then 10-30 sec assisted
stretch
o Ballistic
Duration at least 4 reps per muscle group
Frequency 2-3 days a week
Evaluation
o Goniometry
o Flexometry
o Electrogoniometry

WEIGHT LOSS EXERCISE

Continuous brisk walking for 30 minutes

10,000 steps normal healthy walking

Regular exercise 3x/week is necessary to maintain

fitness

10 weeks of regular exercise is required to achieve

fitness
PROPER CLOTHING

Warm weather
o Light clothing
o Lycra/spandex

Cold Weather
o Thicker clothing

15 minutes:
o stair walking
o running 2.4 km
o jumping rope
o bicycling 6.4 km
20 minutes:
o basketball
o swimming laps
30 minutes:
o water aerobics
o walking 3.2 km
o raking leaves
o fast dancing
30 minutes:
o bicycling 8 km
o shooting baskets
30-45 min:
o wheeling self in wheelchair
o gardening
o touch football
45-60 min:
o volleyball
o washing windows
o washing floors
o washing & waxing a car

PRECAUTIONS

2 hours after light meal

4 after heavy meal

Light activity after illness or injury

Longer warm up after a lay off

Drink water before and after exercise

Proper Shoes

1 size bigger

arch support

good cushion

double socks / terry socks

ADAPTATION

occurs within 6-8 weeks of regular exercise

lower heart rate at same exercise level

increase muscle strength / endurance

REHABILITATION MEDICINE: EXERCISE AND FITNESS DRA. DIZON (2016)

Problems are to the mind

what exercise is to the muscles,
they toughen and make strong.
PAUZKI