HANDOUT FINALS

Topic 1: Mobility training and assessment of movement competency

Movement allows us to interact with our environment in different ways. It provides the foundation for our
ability to perform fitness activities, work and athletic tasks as well as the basic abilities for daily living. We
develop our movement repertoire starting with the general and fundamental movement patterns, and
then progress to (context-) specific, complex, and mature motor patterns. The variety of our physical
activities, therefore necessarily requires a composite of movement abilities. It is also important to
recognize that these movements occur on different planes and involve handling our own body weight
most (if not all) of the time. Hence, we train functionally (i.e., by movement pattern) for the purpose of
improving performance and reducing the incidence of injury.

Exercise routines that prepare the body for vigorous participation in physical activities (i.e., warm-up) as
well as gradually returning to the resting state (i.e., cooldown) after participation will also complement
the training. Finally, recommendations on the quantity and quality of exercise for developing
cardiorespiratory and musculoskeletal fitness will provide guidance to the exercise program design.

Importance of Warm-up and Cooldown

• Warmups and cool-downs generally involve doing your activity at a slower pace and reduced
intensity.
• Warming up helps prepare your body for aerobic activity. A warmup gradually revs up your
cardiovascular system by raising your body temperature and increasing blood flow to your
muscles. Warming up may also help reduce muscle soreness and lessen your risk of injury.
• Cooling down after your workout allows for a gradual recovery of pre-exercise heart rate and blood
pressure. Cooling down may be most important for competitive endurance athletes, such as
marathoners, because it helps regulate blood flow. Cooling down doesn't appear to help reduce
muscle stiffness and soreness after exercise, but more research is needed.
• Although there's controversy about whether warming up and cooling down can prevent injuries,
proper warmups and cool-downs pose little risk. Plus, they seem to give your heart and blood
vessels a chance to ease into — and out of — an exercise session. So, if you have the time,
consider including a warmup and cool-down in your workout routine.

How to warm up

Warm up right before you plan to start your workout. In general, warm up by focusing first on large muscle
groups, such as your hamstrings. Then you can do exercises more specific to your sport or activity, if
necessary.

Begin by doing the activity and movement patterns of your chosen exercise, but at a low, slow pace that
gradually increases in speed and intensity. This is called a dynamic warmup. A warmup may produce
mild sweating, but generally won't leave you fatigued.

Here are some examples of warm-up activities:

 • To warm up for a brisk walk, walk slowly for five to 10 minutes.

• To warm up for a run, walk briskly for five to 10 minutes.

• To warm up for swimming, swim slowly at first and then pick up the tempo as you're able.

How to cool down

Cooling down is similar to warming up. You generally continue your workout session for five minutes or
so, but at a slower pace and reduced intensity.

Here are some examples of cool-down activities:

• To cool down after a brisk walk, walk slowly for five to 10 minutes.

• To cool down after a run, walk briskly for five to 10 minutes.

• To cool down after swimming, swim laps leisurely for five to 10 minutes.

A word about stretching

If stretching exercises are part of your workout routine, it's best to do them after the warm-up or cool-
down phase, when your muscles are already warm.

Stretching can improve flexibility and range of motion about a joint. Stretching may also help improve
your performance in some activities by allowing your joints to move through their full range of motion.
However, studies haven't consistently shown that stretching helps prevent muscle soreness or injury.

Be kind to your body

Finding time for regular aerobic workouts — plus warming up and cooling down — can be challenging.
But with a little creativity, you can probably fit it in. For example, walking to and from the gym can be your
warmup and cool-down.

Topic 2: Mobility

Each joint has a specific function that can be generally classified either as providing stability or mobility.
Thus, the following joints should be mobile: ankle (sagittal plane) hip (different planes), thoracic spine,
and the shoulder. In contrast the knee, lumbar spine, and scapulae should be stable. Starting with the
ankle and moving up the body, the joints alternate between mobility and stability.

The inability of a joint to move well through its specific range of motion shows lack of mobility. Should you
be able to execute movement but lack enough control of it, then the body will decrease the joints ROM in
an effort to control it. This is the essence of how stability affects mobility. Hence, it would be necessary to
recognize the importance of training by movement pattern addressing joint function (or dysfunction) at
the same time.

When intended mobile joint is immobile, the stable joint is forced to compensate by becoming less
stable. For example, if the hip lacks mobility because of weak or poorly activated iliopsoas muscles, the
lumbar spine is intended to be stable will move instead. In other words, it will compensate for the
inaction of the hip. In the same manner, the lumbar spine will extend as a compensatory action when the
glutes are weak, under-used or poorly activated (because of too much sitting). The glutes are responsible
for hip extension and trunk stability.

As the lumbar spine compensates for the hip’s lack of or poor mobility. The hips’ function (e.g. flexion,
extension, abduction, adduction) further deteriorates. This subsequently manifests as low back pain.

Weak or poor activation of the hip adductors, hamstrings, and quadriceps muscles, as well as the
gastrocnemius causes the femur to adduct and internally rotate which in turn leads to the knee
collapsing medially or inward

Function of joints

JOINT FUNCTION

Ankle Mobility (Sagittal)

Knee Stability

Hip Mobility

Lumbar spine Stability

Thoracic Spine Mobility

Scapula Stability

Shoulder Mobility

FITT Principles

The FITT principle is a framework for developing an exercise plan that can help improve health and
manage lifestyle diseases. It's an acronym that stands for:

• Frequency: How often you'll exercise

• Intensity: How hard you'll work during your exercise

• Time: How long you'll exercise during each session

• Type: What types of workouts will be a part of your workout program

The FITT principle can be used by anyone, from beginners to elite athletes, and for any type of activity. It
can also be used by therapists for individuals recovering from a condition.

Here are some tips for using the FITT principle:

 • Frequency

Ideally, you should exercise 3–6 times per week, but you can start as low as once a week.

• Intensity

You can determine the intensity of your exercise by your heart rate or the amount of weight you're using.

• Time

Workouts should last at least 30 minutes.

• Type

You can include a variety of exercises in your workout program, such as cardio like running, biking, or
dancing, or strength training like lifting weights

Topic 3

ENERGY BALANCE

This is the relationship between the calories you consume (intake) and the calories you expend (output)
over time.

Basically, the amount of energy IN and OUT remain the same over time, weight stays the same

• IN is greater that OUT over time is weight gain

• OUT is greater than IN over time is weight loss

When managing your weight, balance the calories you get from food and beverages (IN) with the calories
you use to keep your body going and being physically active (OUT) over time. This means that energy in
and out do not have to balance exactly every day.

ENERGY INTAKE

This is defined as the total energy content of foods consumed, as provided by the major sources of
dietary energy: carbohydrate (4 kcal/g), protein (4 kcal/g), fat (9 kcal/g), and alcohol (7 kcal/g) (Mela,
2005).

Exactly how many calories an individual needs depends on various factors such as gender, current body
size, activity level, and body weight goals (i.e., to maintain, lose, or gain weight).

ENERGY OUTPUT

Many people mistakenly believe that they only “burn calories” when they exercise. In fact, your body is
burning calories all the time, even while asleep.

Three Parts of Total Daily Expenditure:

 1. Basal Metabolic Rate (BMR)

• This is the energy expended just to keep your basic body functions going (breathing, heart
beating, liver and kidneys functioning, among others).

• This accounts for the greatest amount (about 60%) of total daily expenditure.

• Men have the tendency to have more muscle mass compared to women.

• Since our muscles are calorie-hungry tissues, an increase in muscle mass will elevate the
BMR.

2. Thermic Effect of Food (TEF)

• This is the energy expended to digest and metabolize the foods you eat.

• It generally accounts for 6 to 10% of your total daily energy expenditure.

3. Thermic Effect of Activity (TEA)

• This is the energy expended when doing any form of physical activity, programmed exercise as
well as house work, gardening, among others.

• It generally accounts for 30% of total daily energy expenditure.

Metabolic Equivalent (MET)

• the unit of human energy expenditure while the body is at rest or in its basal state but not asleep

NUTRIENTS

1. CARBOHYDRATES

• These are the major provider of energy that fuels the brain and muscles in the form of glucose.

• The healthiest sources of carbohydrates are unprocessed or minimally processed whole grains,
vegetables, fruits, and beans.

Types:

• Simple carbohydrates

o contains energy but few nutrients

• Complex or dietary starch

o contains important nutrients and fiber

o cereals, oats, whole grain bread, brown rice, quinoa, beans and other legumes

2. PROTEINS

• These are essential for building our body tissues, cells, and muscles, as well as for making
hormones and antibodies.
 o They transport nutrients to the right places and help control fluid balance between the
blood and surrounding tissues.

o Sources: plants and animals such as eggs, milk, fish and seafood, nuts and seeds,
chicken, turkey, beans, and soya

3. FATS

• Functions:

o provide our body with insulation from the cold

o protect our organs against concussive forces such as a fall or hit

o enhance the taste of our food

o provide feelings of satiety

• Types:

o Saturated

▪ solid at room temperature

▪ animal-based which are commonly found in cookies and desserts, pizza, and
cheese

▪ recommended that they be replaced with unsaturated fats

o Unsaturated

▪ liquid at room temperature

▪ beneficial in terms of improving our blood cholesterol levels

▪ commonly plant-based

4. VITAMINS

• These are organic substances that are needed in small amounts to help promote and regulate
chemical reactions and processes in the body.

5. MINERALS

• These are inorganic substances that are involved in water balance, nerve impulse stimulation,
acid-base balance, and energy reactions.

6. WATER

• This is an essential nutrient at every age.

GLYCEMIC INDEX

• This shows how various consumed carbohydrates affect one’s blood sugar level.

• By sticking to foods with a lower glycemic index, one can help maintain blood sugar and avoid
excessive insulin response, thereby lessening fat production and generally making one feel better.

• However, this is not absolute; one should still consider how one’s body respond to food.

FOOD PYRAMID AND SERVING SIZES

• Balanced diet

o one’s proportioal intake of foods belonging to different food groups

• Variety

o consuming assorted foods from different food groups every day

• Moderation

o eating foods in the right proportions

OTHER NUTRIENTS – VITAMINS AND MINERALS

VITAMINS

These are organic substances needed in small amounts to help promote and regulate chemical reactions
and processes in the body.

Water-Soluble Vitamins

• These are usually found in carbohydrate foods – fruits, vegetables, breads, and cereals.

• Vitamins B and C

• The human body have limited storage capacity for these vitamins.

• Foods that are high in carbohydrates are almost always rich in B vitamins as well.

Fat-Soluble Vitamins

• These are delivered with fats and oils.

• Vegetable and cereal oils are excellent sources of Vitamin E, an important antioxidant that can
help protect cells from becoming damaged through oxidation.

• This is important because physical activity increases the amount of oxygen pulled into cells,
thereby increasing the risk for oxidative damage.

As a general rule, it is better to derive vitamins through consumption of a wide variety of foods rather than
supplements, as supplementation may more easily result in toxicity and may also give individuals the
wrong impression that a good quality diet is unnecessary because supplements are consumed.
MINERALS

• These are inorganic substances that are involved in water balance, nerve impulse stimulation,
acid-base balance, and energy reactions.

Iron and zinc are critically important for energy metabolism but are also among the nutrients which
people may not be consuming enough, especially vegetarians because the best source of minerals is red
meat.

Topic 6:

PHYSICAL ACTIVITY

Definition of Terms

• Physical Activity

o any bodily movement carried out by the skeletal muscles which require energy

o light intensity activities are quick and easy movements, such as standing or walking down a
hallway which require little energy or effort

o moderate intensity activities require more effort which cause your breathing and heart rate
to accelerate but still allow for comfortable conversations

o vigorous intensity activities are more intense, sustained activities such as cycling or
running which require considerably more energy or effort that cause rapid breathing and a
substantial increase in heart rate

• Exercise

o a subset of physical activity – planned, structured, repetitive movements of the body

designed specifically to improve or maintain physical fitness

• Physical Fitness

o a set of physical attributes that allow you to perform moderate to vigorous levels of
physical activities

o associated with the ability to delay onset of fatigue; engage in and enjoy active pursuits
during leisure time, as well as reduced risk for noncommunicable diseases such as
hypertension, heart disease, chronic low back pain, obesity, among others.

As an individual engages in more intense physical activities, there are concomitant gains in health and
fitness.

1. An individual does daily tasks effectively and efficiently. It provides reserve strength for
emergencies and helps you look and feel good.

2. Being physically fit confers protection against chronic diseases. Physically active individuals are
less likely to develop or die from heart disease, respiratory disease, high blood pressure, cancer,
diabetes, and osteoporosis.
FAD DIETS

These are popular yet unhealthy diet plans that promise quick results in terms of weight loss, which is
greater than the healthy weight loss of one to two pounds per week.

General Characteristics of Fad Diets:

1. These diets are not nutritionally balanced, do not offer a variety of foods, and are inadequate in
energy and nutrients to support one’s daily needs.

2. They involve a restrictive amount and/or kinds of foods.

3. Often, they are unsustainable as the tendency of people undergoing such diets is to get fed up
with the diet and start overeating, often choosing unhealthy foods.

Recognizing Fad Diets:

1. Relies primarily on a single food (e.g., grapefruit) based on testimonials

2. Claims to have been developed according to “confidential research”; based on a “scientific

breakthrough”

3. Promotes rapid and “painless” weight loss

4. Promises miraculous results

5. Restricts food selection

6. Requires the use of selected products

7. Uses liquid formulas instead of foods

8. Does not involve physical activity

9. Does not encourage healthy behavioral changes

10. Fails to provide information on risks associated with weight loss and of the diet use

11. Fails to provide information on weight maintenance upon completion of the diet phase

Body Mass Index (BMI)

WHO criteria Asian criteria

Nutritional Status
BMI cut-off BMI cut-off
Underweight < 18.5 < 18.5
Normal 18.5 – 24.9 18.5 – 22.9
Overweight 25 – 29.9 23 – 24.9
Pre-Obese - 25 – 29.9
Obese ≥ 30 ≥ 30
Obese Type 1 (obese) 30 – 40 30 – 40
Obese Type 2 (morbid obese) 40.1 – 50 40.1 – 50