Olaf Verschuren AusACPDM 1
|
|
- Colleen Reeves
- 8 years ago
- Views:
Transcription
1 -3-1 Exercise physiology and training in children and adolescents with cerebral palsy Training Training principles Training in children Program Training children with CP Practical considerations 197 Training in children Training Aerobic FITNESS Muscle Strength Physical training: The process whereby repeated systematic exercise leads to functional and morphological adaptations in the body. Anaerobic Training principles The PRINCIPLES of TRAINING are the rules to follow when using physical activity programs: Specificity Reversibility Adaptation/Supercompensation Specificity In order for a training program to be beneficial, it must improve the specific physiological capabilities required to perform a given sport or activity. Specificity Example, a goalkeeper needs to focus on reaction work in their training, in comparison to a midfielder who should focus on agility, stamina, speed etc. A runner who wants to improve his leg strength, should train differently to a cyclist. Both would need muscular endurance but the training method should be different!! Olaf Verschuren AusACPDM 1
2 -3-1 Reversibility Use it or lose it. When you stop training, the training effects can be reversed so don t quit! The training history will be an important factor. The longer you have trained the longer the effects will be present. Adaptation/Supercompensation In order to improve through training we need to apply greater demands on our body. This is the principle of OVERLOAD. The body will adapt to the new norm. Is it possible to train children? after training Typically developing children children adults Payne VG, Morrow JRJ (1993) Exercise and VO2max in children: a metaanalysis. Res Q Exerc Sport 6: Training in typically developing children Little progression after training compared to adults (5-% vs. 1-15%) Program: carefully adapted to each individual s potential Baquet G, van Praagh E, Berthoin S. Endurance training and aerobic fitness in young people. Sports Med. 23;33(15):17-3. The three most important aspects of training 1. FUN 2. FUN 3. FUN Fitnesslevels in CP Low fitness High fitness How to develop a fitness training? lopers rolstoelrijders Olaf Verschuren AusACPDM 2
3 no CP level I level II Height no CP level I level II Height -3-1 Fitnesslevels in children with CP Muscle strength (HHD) Low compared to typically developing peers Muscle strength (HHD) Fitnesslevels in children with CP Aerobic Lundberg A 19 Strength ILOP control hemiplegic diplegic RECT GLUT Damiano et al, 199 non dominant side ABD ADD HAMS QU 9 QU 3 muscle groups PF (E) PF (F) DF (E) DF (F) Strength ILOP control hemiplegic diplegie RECT dominant side Testuitslagen GLUT ABD ADD HAMS QU 9 QU 3 muscle groups PF (E) PF (F) DF (E) DF (F) Percentage of predicted values Muscle strength right side (n=7) Fitnesslevels in children with CP Aerobic Verschuren et al. 2 (submitted) Fitnesslevels in children with CP Anaerobic Bar-Or et al 1996; Parker et al 1992 Fitnesslevels in children with CP Anaerobic Verschuren et al. 213 Female Male Typically developing Cerebral palsy (GMFCS I or II) Typically developing Cerebral palsy (GMFCS I or II) Mean Power Mean Power Fitnesslevels in CP Low fitness High fitness lopers rolstoelrijders % of the observation children's play anaëroob Walking stairs, playing hide and seek, etc. aëroob Amusement Park, Sports, Cycling, etc duration of the activities (in sec.) Muscle Strength Aerobic Fitnesstraining FITNESS Anaerobic Muscle Strength Olaf Verschuren AusACPDM 3
4 -3-1 Training is?? Fitnesstraining Aerobic Muscle Strength Training is?? Cerebral Palsy Effect of aerobic training 3 RCTs: van den Berg-Emons et al. 1995, Unnithan et al. 27, Verschuren et al. 27 Trainingsprogram 2- à aerobic fitness of 1 22% Trainingsprogram -9 à aerobic fitness of 26-1% Cerebral Palsy Content aerobic training Duration of the training: 1-5 minutes 2 to times a week 3-9 Trainingsintensity between 6- % of HRmax. FITNESS Anaerobic Training is?? Typically developing Trainingsprogram weeks tot 1 à aerobic fitness of 5-1% Typically developing ACSM guidelines: Duration of the training: 2-6 minutes 3 times a week - Trainingsintensity between 55-9% of HRmax. Cerebral Palsy Effect of anaerobic training 1 RCT: Verschuren et al. 27 Trainingsprogram of 5 à anaerobic fitness of approx. 25% Cerebral Palsy Content anaerobic training Trainingsintensity maximal during exercises of 2-3 seconds Strength training in children with Cerebral Palsy Typically developing No clear evidence in current literature. Training seems beneficial Typically developing Guideline short-term and intermediate term anaerobic Trainingsintensity maximal during exercises of 1-3 seconds Different training modalities - Progressive Resistance Exercise - Electro stimulation Effect of resistance training on MUSCLE STRENGTH Lower extremity Upper extremity Electro stimulation Effect of resistance training on GMFM Lower extremity Electro stimulation What works? N= 119 Muscle strengthening is not effective in children and adolescents with cerebral palsy: A systematic review. Scianni A, Butler JM et al. Aust J Physiother 29; p1-7 N= 99 Muscle strengthening is not effective in children and adolescents with cerebral palsy: A systematic review. Scianni A, Butler JM et al. Aust J Physiother 29; p1-7 Olaf Verschuren AusACPDM
5 -3-1 Effect training on WALKING SPEED Lower extremity Electro stimulation Discussion Different methods in 1 review / metaanalysis If there is no effect on muscle strength or activity level à is training still worthwhile? Progressive resistance exercise is most oen used. N= 63 Muscle strengthening is not effective in children and adolescents with cerebral palsy: A systematic review. Scianni A, Butler JM et al. Aust J Physiother 29; p1-7 Is this method effec7ve? Effect of resistance training for the lower extremity in children and adolscents CP Dodd et al. 23 Liao et al. 27 Lee et al. 2 Scholtes et al. 21 Total NSCA guidelines Important ingredients according to the NSCA guidelines Warming- up (5-1 minutes) Type of exercise Intensity Frequency (2-3 7mes a week) DuraPon of the programme Progression during the programme Age of children N= 15 Verschuren et al. PT journal 211 Type of exercises Type of exercises: mostly functional based Result on muscle group level. Type RCTs in children with CP NSCA guidelines Dodd: multi-joint exercises (heel raises, half squats and stepups) multi-joint exercises Single-joint and Liao: multi-joint exercises (sit-to-stand) loaded (using weight vest) Lee: multi-joint exercises (squat to stand, lateral step up, stair up and down) loaded (using weight cuffs), Scholtes: multi-joint exercises (leg press) and loaded (using a weight vest) What is the trainingseffect on the muscle groups that were targeted? Muscle groups targeted in RCT s: Knee-extensors Hip-extensors Plantar flexors Study Dodd et al. Lee et al. Liao et al. Ankle plantar flexors Knee extensors Knee flexors Hip extensors Hip flexors Hip abductors Hip adductors Scholtes et al Be aware of compensapon during exercises! Olaf Verschuren AusACPDM 5
6 -3-1 Intensity of the programme RCTs in children with CP Intensity Dodd: 3 sets of - repetitions to fatigue Liao: 1 set of 1 repetitions at 2% 1RM 1 set of repetitions until fatigue at 5% 1RM 1 set of 1 repetitions at 2% 1RM Lee: 2 sets of 1 repetitions (low load and no progression) Scholtes: 3 sets of RM Only 2 of the studies are in line with the NSCA guidelines NSCA guidelines 1-3 sets of 6-15 repetitions of 5-5% RM Duration of the programme RCTs in children with CP NSCA guidelines -2 weeks Duration Dodd: 6 weeks Liao: 6 weeks Lee: 5 weeks Scholtes: 6 weeks ( week program) No study is in line with the NSCA guidelines Effect of resistance training of the lower extremity in typically developing children Significant relapon between durapon and trainingseffect: Behringer et al. Pediatrics Oct 25, 21 N= 172 Age of training Content of resistance training Recommendations RCTs in children with CP Age Dodd: mean 13.1, SD 3.1, range -1 years of age Liao: mean 7., SD 1.6, range 5- years of age Lee: mean 6.3, SD 2.5, range - years of age Scholtes: mean 1.5, SD 1.1, range 6-13 years of age NSCA guidelines Age 7 and onwards Variabels RCTs in children with CP NSCA guidelines Type Dodd: multi-joint exercises (heel raises, half squats and step-ups) Single-joint and multi-joint Liao: multi-joint exercises (sit-to-stand) loaded (using weight vest) exercises utilizing Lee: multi-joint exercises (squat to stand, lateral step up, stair up and down) concentric and eccentric loaded (using weight cuffs), single joint exercises contractions Scholtes: multi-joint exercises (leg press) and loaded (using a weight vest) Longer interventions with sufficient intensity, for example, weeks, may be needed to see significant or meaningful improvements in strength. In 3 out of the studies included children younger than the recommended 7 years of age. Intensity/ Dodd: 3 sets of - repetitions to fatigue volume Liao: 1 set of 1 repetitions at 2% 1RM 1 set of repetitions until fatigue at 5% 1RM 1 set of 1 repetitions at 2% 1RM Lee: 2 sets of 1 repetitions Scholtes: 3 sets of RM Duration Dodd: 6 weeks Liao: 6 weeks Lee: 5 weeks Scholtes: 6 weeks ( week program) Age Dodd: mean 13.1, SD 3.1, range -1 years of age Liao: mean 7., SD 1.6, range 5- years of age Lee: mean 6.3, SD 2.5, range - years of age Scholtes: mean 1.5, SD 1.1, range 6-13 years of age 1-3 sets of 6-15 repetitions of 5-5% RM -2 weeks Age 7 and onwards Verschuren et al. PTjournal 211 Recommendations Single-joint resistance training may be more effective for very weak muscles or for children or adolescents who tend to compensate when performing multi-joint exercises, or at the beginning of the training. Recommendations Depending on the complexity of the exercise and the level of motor impairment, children and adolescents with CP may need more than 1 minute of rest between bouts (perhaps up to 3 minutes). Recommendations Since strength training, as it is traditionally done, requires maximal effort and can include somewhat complicated activities, older children and adolescents, over 7 years old, are perhaps better suited to this intervention that younger children. Olaf Verschuren AusACPDM 6
7 -3-1 Recommendations Children or adolescents with more impairment might also benefit from strength training, but if it is difficult for them to contract voluntarily, methods such as electrical stimulation, mental imagery and biofeedback could be helpful. Training is effective Aerobic Fitnesstraining CP FITNESS Muscle strength Training can be more effective EXAMPLE STUDY Training is effective Anaerobic Aerobic FUNCTIONAL FITNESS Muscle strength Randomized Clinical Trial Goes Zwolle Breda Utrecht N=6 N=65 Randomized GMFCS level (I or II) Fitnessprogram 2 times a week for 5 minutes 2 physical therapists 2 groups year year Anaerobic Experimental group N = 32 Control group N = 33 Trainingsscheme HRmax in children with CP Ingredients for training In the training we used standardized TASK- SPECIFIC aerobic and anaerobic exercises, which were based on walking activities, such as Running / Walking fast Step up and down Stepping over Bending Turning Getting up from the floor Olaf Verschuren AusACPDM 7
8 -3-1 Aerobic exercises The exercises Fitnesstraining guidelines Frequency: 2 days per week standardized exercises Intensity: Anaerobic exercises Aerobic 6 - % max. HR Duration: 5 minutes Activity:Rest: standardized exercises 1:1 Fitnesstraining guidelines Training Anaerobic Frequency: Intensity: Duration: 2 days per week maximal 3-5 minutes Activity:Rest: 1:3 1:5 1. Introduction Explain purpose of training and give children heart rate monitor 2. Warming-up 3. Training focus In circuit format (with 2 children in each group) for aerobic part (month 1-3) In group format for anaerobic part (month -). Closure of the training The effects of a functional fitness program in children and adolescents with Cerebral Palsy: a randomized trial Olaf Verschuren, Marjolijn Ketelaar, Jan Willem Gorter, Paul Helders, Tim Takken Aerobic FUNCTIONAL Muscle strength Experimental group (n=32) GMFCS I n=23 GMFCS II n=9 Randomization Control group (n=33) GMFCS I n=22 GMFCS II n=11 Objectives Primary objective; Study the effects on: aerobic (1-m Shuttle Run Test) anaerobic (Muscle Power Sprint Test) Secondary objective; Study the effects on: Functional muscle strength Agility Participation HRQoL FITNESS 11.6 (2.5) years Boys/girls 1/1.7 (2.7) years Boys/girls 23/1 Controlgroup: Baseline Follow-up: REGULAR PHYSIOTHERAPY Anaerobic Traininggroup: TRAINING + REGULAR THERAPY REGULAR THERAPY Olaf Verschuren AusACPDM
9 -3-1 Results Aerobic and anaerobic 1-m Shuttle Run Test Mean Muscle Power (MPST) Experimental group Control group Experimental group Control group P<.1 P=. P-values: group(2) x time(3) interaction of repeated-measures analysis of variance For info 1-m SRT: Olaf Verschuren et al. Physical Therapy 26;6(6): For info MPST: Olaf Verschuren et al. Ped Phys Ther 27;19:1-115 Body Function and Structure Functional muscle strength Agility & improvement 3-sec Repetition Maximum Experimental group Control group x5 meter sprint test Experimental group Control group P<.1 P<.1 P-values: group(2) x time(3) interaction of repeated-measures analysis of variance Participation Children s Assessment of Participation and Enjoyment (CAPE) 1,6 Intensity 1,5 1, 1,3 1,2 control group 1,1 1 exp group,9,,7,6 + + Participation (intensity) Children s Assessment of Participation and Enjoyment (CAPE). Significant (p<.5) Skill-based activities (+2%) Physical activities (+2%) Overall activities (+27%) Not significant Recreational activities (+1%) Social activities (+%) Self-improvement activities (+6%) For info 1x5 meter:olaf Verschuren et al. Ped Phys Ther 27;19:1-115 P-values: group(2) x time(3) interaction of repeated-measures analysis of variance Health-related Quality of Life TACQOL-PF Conclusion Follow-up Aerobic and anaerobic 1 meter shuttle run test Experimental group Control group Significant (p<.5) Not significant Basic motor functioning (+1%) Autonomy (+%) Cognitive functioning (+%) Pain and symptoms (+1%) Social functioning (+2%) Global positive emotions (+2%) Global negative emotions (+2%) Functionally based Easy to implement Effective and Fun Mean Power (Watts) MPST Experimental group Control group -5 P-values: group(2) x time(3) interaction of repeated-measures analysis of variance Olaf Verschuren AusACPDM 9
10 -3-1 Follow-up Muscle strength and agility Functionele spierkracht (3-sec HM) Follow-up Participation Results of more studies Experimental group Control group 1x5 meter sprint test Experimental group Control group Intensity 1,6 1,5 1, 1,3 1,2 1,1 1,9,,7,6 + + follow-up control group exp group Exercise programs: What s the GOAL? Based on rationale for RCT s in published papers. Muscle Strength HEALTH related factors Dodd et al. Liao et al. Lee et al. Scholtes et al. End of training FOLLOW-UP CEREBRAL PALSY Berg-Emons et al. 199: after 3 17% Verschuren et al. 27: after 9 % Aerobic Muscle strength Body Mass Index Anaerobic Motor skill Agility / Speed HEALTH related problems and/or PERFORMANCE related problems GOAL Aerobic N= 15 Verschuren et al. PTjournal 211 Trainingsprogram 2- à aerobic fitness 1 22% Trainingsprogram - 9 à aerobic fitness 26-1% PERFORMANCE related factors PERFORMANCE related factors End of training FOLLOW-UP GMFM Anaerobic Trainingsprogram à anaerobic fitness 1% Trainingsprogram à anaerobic fitness 25% Verschuren et al. 27: aer Anaerobic 9 % Agility 5% Walking Speed Agility Trainingsprogram à agility % Trainingsprogram à agility 1% Olaf Verschuren AusACPDM 1
11 -3-1 Exercise programs: What s the effect? Only during the intervenpon What have we done?? follow- up too short HEALTH related problems and/or PERFORMANCE related problems No effect (at follow- up) Difficult to be acpve in daily life. Recent study LEARN 2 MOVE 7- Program designed to improve physical activity LEARN 2 MOVE 7- Group fitness training 3 x hh + LEARN 2 MOVE 7- Lifestyle intervention Motivational Interviewing A directive, client-centered counseling style to elicit behavior change by helping clients explore and resolve ambivalence. (Rollnick & Miller 1995) Training 16 weeks 1-2 times a week for an hour 2-5 children per group 15-2 seconds maximal! Motivational interviewing Olaf Verschuren AusACPDM 11
12 -3-1 Results Learn to Move The combination of counselling, homebased physiotherapy and fitness training was not effective in improving fitness, social participation in recreation and leisure, self-perception or quality of life. What have we done? Part 2. Are we satisfied when we become succesful in increasing PHYSICAL ACTIVITY? 3-6 min PHYSICAL ACTIVITY exercise continuum Regardless of Physical Activity Sitting and mortality Fitness level and mortality Van der Ploeg H et al. Arch Intern Med 2:172(6):9-5 Sedentary physiology in children with CP Uptime (Pirpiris and Graham 2) Sedentary pursuits (Maher et al. 27) Typically developing hemiplegia diplegia Mean hours per week Cerebral palsy CP Definitions of Sedentary Behavior Evolution of definitions of sedentary behavior: 21. Sedentary behavior should be defined as the muscular activity rather than the absence of exercise The origins of the word sedentary hint at a simpler, more workable definition. The word sedentary derives from the Latin verb sedere to sit. When sitting or lying, the majority of the body s largest muscle groups are under relaxation; in contrast, when standing, even if still, a large proportion of the body s musculature are under tension. Therefore any non-exercise activity that involves sitting or lying can be considered sedentary. 2. Sedentary behaviour is any waking behaviour characterized by an energy expenditure 1 5 METs while in a sitting or reclining posture. Important factors of Sedentary Behaviour Posture (sitting or reclining) Energy expenditure ( 1.5 METs) Muscular inactivity Low sedentary CP = Coach Potato High sedentary Olaf Verschuren AusACPDM
13 -3-1 What do we know about sedentary behavior in children with CP? EMG acpvity? Energy expenditure? Lying and sitting Standing? EMG acpvity? Energy expenditure?? EMG acpvity Energy expenditure Sitting Standing Energy expenditure (METS) GMFCS Rest Sit with support Sit without Standing level (lying) support (n=) ± ± ±.1 I (n=) ± ± ±. II (n=3) ± ± ±.19 III (n=6) ± ± ±.25 IV(n=2) ±.13 not possible 1.7 ±.6 V (n=1) not possible 1. Muscle activity GMFCS Rest Sit with support Sit without Standing level (lying) support (n=) ± ± ±.67 I (n=) ±.5.91 ± ±1. II (n=3) ± ± ±1.6 III (n=6) ± ± ± 3. IV(n=2) ±.6 Not possible. ± 2.6 V (n=2) ±.57 Not possible 1.7 ± 1. Summary Children with CP have low fitness levels. Children with CP are able to increase their fitness levels. It is difficult to become and stay physically active. Even if we (or they) succeed, we are not doing enough. We need to get them less sedentary. Stand up for your health and ask a question? Take home message! Sleep Sedentary behavior* Light physical activity Moderate physical activity Intense activity cut down, replace by HEALTH ENHANCING PHYSICAL ACTIVITIES Wake up x Trip to and passive transportation* - walk or bike to school -brisk walk or bike fast to school from school sitting/reclining* - break up sitting every hour -PA lesson with Heart Rate > 6% HRmax School - active play (recess) sitting/reclining* - break up sitting every hour -moderate to vigorous activities After school screen time* - active play (out- or indoors) -play (competitive) sports Bed time x hours 15 hours 3-6 minutes 1 Olaf Verschuren AusACPDM 13
14 Beperkt uithoudingsvermogen Beperkte kracht/ verwacht krachtsverlies*** Beperkt krachtuithoudingsvermogen GMFCS I + II GMFCS III GMFCS I + II GMFCS III GMFCS I + II GMFCS III CP trainingsgroep Principes CP trainingsgroep individueel CP trainingsgroep Voor en/of na interventie**** POPEYE CP trainingsgroep POPEYE + Principes CP trainingsgroep individueel -3-1 Kind met een hulpvraag* Onderzoek** (oa. CP onderzoek, GMFM, krachttesten, GMFCS) * Kinderen met CP met een hulpvraag die gericht is op kracht en/of uithoudingsvermogen ** Meetinstrumenten volgens POPEYE- protocol *** Treedt vaak op pre- of postoperatief, na inactieve periode of tijdens Botox **** met interventie wordt hier bedoeld: Botox, SDR, of multilevel chirurgie Olaf Verschuren AusACPDM 1
IMGPT: Exercise After a Heart Attack 610 944 8140 805 N. RICHMOND ST (Located next to Fleetwood HS) Why is exercise important following a heart
Why is exercise important following a heart attack? Slow progression back into daily activity is important to strengthen the heart muscle and return blood flow to normal. By adding aerobic exercises, your
More informationExercise Prescription Case Studies
14 Exercise Prescription Case Studies 14 14 Exercise Prescription Case Studies Case 1 Risk Stratification CY CHAN is a 43-year-old man with known history of hypertension on medication under good control.
More informationMoeheid, fysieke activiteiten en fitheid bij volwassenen met spastische bilaterale cerebrale parese
Moeheid, fysieke activiteiten en fitheid bij volwassenen met spastische bilaterale cerebrale parese Wilma M.A. van der Slot, revalidatiearts 1,2 Channah Nieuwenhuijsen 2, Rita van den Berg-Emons 2, Marij
More informationFUNCTIONALLY BASED EXERCISE PROGRAM
FUNCTIONALLY BASED EXERCISE PROGRAM for children and adolescents with Cerebral Palsy GMFCS level I and II The fitnessprogram described in this book is developed for children and adolessoncents with Cerebral
More informationClinical Care Program
Clinical Care Program Therapy for the Cardiac Patient What s CHF? Not a kind of heart disease o Heart disease is called cardiomyopathy o Heart failure occurs when the heart can t pump enough blood to meet
More informationRelation between physical fitness and gross motor capacity in children and adolescents with cerebral palsy
DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY ORIGINAL ARTICLE Relation between physical fitness and gross motor capacity in children and adolescents with cerebral palsy OLAF VERSCHUREN PCS PHD PT 1,2,3 MARJOLIJN
More informationFitness Training A Sensible Guide to Preparing for Selection in the Gurkhas
Fitness Training A Sensible Guide to Preparing for Selection in the Gurkhas Background Physical fitness has a number of components: aerobic endurance (stamina), strength, speed, flexibility, muscle endurance,
More information5TH GRADE FITNESS STUDY GUIDE
PHYSICAL EDUCATION 5 TH GRADE FITNESS STUDY GUIDE PART I. Revised 5-13 DIRECTIONS: Review the following terms and concepts. Do not try to memorize the definitions, rather think about and understand: 1)
More informationCerebral palsy (CP) describes a group of disorders of the development of
Authors: Olaf Verschuren, BSc, PT Marjolijn Ketelaar, PhD Tim Takken, MSc, PhD Paul J.M. Helders, MSc, PhD, PCS Jan Willem Gorter, MD, PhD Affiliations: From the Center of Excellence, Rehabilitation Center
More informationIn structured sports programs, participation and enjoyment should be emphasized rather than competition and winning.
Preschool Children The California Department of Health Services Physical Activity for Children, Youth, and Adults All preschool children should participate every in a form of physical activity appropriate
More informationTHE BADMINTON ASSOCIATION OF ENGLAND MISSION STATEMENT
THE BADMINTON ASSOCIATION OF ENGLAND MISSION STATEMENT Badminton is an Olympic Sport It is played by groups, families and individuals of all ages and it provides a healthy, lifelong sport activity that
More informationArchery: Coaching Young Athletes. Developing Fundamental Movement Skills
Archery: Coaching Young Athletes Developing Fundamental Movement Skills Make a long term commitment Long Term Athlete Development Long Term Athlete Development (LTAD) is a strategy for helping youngsters
More informationACL Reconstruction Rehabilitation Program
ACL Reconstruction Rehabilitation Program 1. Introduction to Rehabilitation 2. The Keys to Successful Rehabilitation 3. Stage 1 (to the end of week 1) 4. Stage 2 (to the end of week 2) 5. Stage 3 (to the
More informationPhysical Therapy & Exercise
Physical Therapy & Exercise n n Purpose of Physical Therapy: To guide you. do,) to maximize your independence and quality of life at all stages of Parkinson s Purpose of exercise: To maintain as much normal
More informationPreparing for the Washington State Criminal Justice Training Commission Physical Ability Test
Preparing for the Washington State Criminal Justice Training Commission Physical Ability Test Whereas many training routines can be used to improve performance in the Physical Ability Test (PAT), participants
More information?Clinical question: What are the effects, if any, of lowerextremity
?Clinical question: What are the effects, if any, of lowerextremity strength training on gait in children with cerebral palsy? The purpose of Evidence in Practice is to illustrate the literature search
More informationFitness Fundamentals
Fitness Fundamentals Participate 2-3/week Duration 30-60 minutes Intensity moderate to vigorous Exercises should be developmentally appropriate, enjoyable and varied. Benefits can include increased Careful
More informationPhysical Therapy and Occupational Therapy Services of Young Children with Cerebral Palsy
Physical Therapy and Occupational Therapy Services of Young Children with Cerebral Palsy Denise Begnoche, PT, DPT, Lisa Chiarello, PT, PhD, PCS, Doreen Bartlett, PT, PhD, Robert Palisano, PT, ScD Hui-Ju
More informationBasic Principles of Strength Training and Conditioning
Basic Principles of Strength Training and Conditioning John M. Cissik, MS, CSCS Whether you are a recreational weight trainer, a weekend athlete, or a strength coach working with elite athletes, it is
More informationPost Surgery Rehabilitation Program for Knee Arthroscopy
Post Surgery Rehabilitation Program for Knee Arthroscopy This protocol is designed to assist you with your rehabilitation after surgery and should be followed under the direction of a physiotherapist May
More informationExercise therapy and multiple sclerosis a powerful non-pharmacological intervention
Malmö, November 2014 Exercise therapy and multiple sclerosis a powerful non-pharmacological intervention Ulrik Dalgas, PhD Department of Public Health Section of Sport Science Aarhus University Denmark
More informationStrength Training for the Runner
Strength Training for the Runner Strength Training for the Runner What? The goal of resistance training for runners is not necessarily adding muscle mass but 1. improving muscular strength, 2. improving
More informationRehabilitation Protocol: Total Hip Arthroplasty (THA)
Rehabilitation Protocol: Total Hip Arthroplasty (THA) Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington 781-744-8650 Lahey Outpatient Center, Lexington 781-372-7020 Lahey Medical
More informationWHAT IS THE CORE RECOMMENDATION OF THE ACSM/AHA PHYSICAL ACTIVITY GUIDELINES?
PHYSICAL ACTIVITY AND PUBLIC HEALTH GUIDELINES FREQUENTLY ASKED QUESTIONS AND FACT SHEET PHYSICAL ACTIVITY FOR THE HEALTHY ADULT WHAT IS THE CORE RECOMMENDATION OF THE ACSM/AHA PHYSICAL ACTIVITY GUIDELINES?
More informationConcussion Management Protocol for G-Force Program
Concussion Management Protocol for G-Force Program Baseline ImPACT testing Recommended but not mandatory - Can be done anytime but ideally recommended before season begins - Ideally this should be done
More informationhe American Physical Therapy Association would like to share a secret with you. It can help you do more with less effort breathe easier feel great.
The Secret... T he American Physical Therapy Association would like to share a secret with you. It can help you do more with less effort breathe easier feel great. The secret is about good posture, which
More informationStrength Training for the Knee
Strength Training for the Knee This handout is to help you rebuild the strength of the muscles surrounding the knee after injury. It is intended as a guideline to help you organize a structured approach
More informationUSCGA Health and Physical Education Fitness Preparation Guidelines
USCGA Health and Physical Education Fitness Preparation Guidelines MUSCULAR STRENGTH Muscular strength and endurance can be improved by systematically increasing the load (resistance) that you are using.
More informationLumbar Disc Herniation/Bulge Protocol
Lumbar Disc Herniation/Bulge Protocol Anatomy and Biomechanics The lumbar spine is made up of 5 load transferring bones called vertebrae. They are stacked in a column with an intervertebral disc sandwiched
More informationAssessment of Fitness in Cerebral Palsy
Assessment of Fitness in Cerebral Palsy Edward A. Hurvitz, M.D. Dept. of PMR The Cerebral Palsy Program The Human Performance Laboratory The University of Michigan, Ann Arbor Physical Fitness A set of
More informationABOUT US. Why train using the ACTIV8 Program? - Restoration of movement. Performance Enhancement & Injury Prevention
ABOUT US Mission Statement - ACTIV8 Strength and Conditioning Program is committed to providing training experience for each participant. Our focus is on building a strong and functionally fit human being
More information12. Physical Therapy (PT)
1 2. P H Y S I C A L T H E R A P Y ( P T ) 12. Physical Therapy (PT) Clinical presentation Interventions Precautions Activity guidelines Swimming Generally, physical therapy (PT) promotes health with a
More informationGCE PHYSICAL EDUCATION PE2 UNIT GUIDE. Content Title: Methods of training. Practical Application/Explanation. Fartlek training. Continuous training
Content Title: Methods of training Key points GCE PHYSICAL EDUCATION Different methods of training How to design specific training sessions How to design a training programme PE2 UNIT GUIDE Practical Application/Explanation
More informationCurrent Concepts of Low Back Pain. Terry L. Grindstaff, PhD, PT, ATC, SCS, CSCS
Current Concepts of Low Back Pain Terry L. Grindstaff, PhD, PT, ATC, SCS, CSCS 28% population reports LBP in past 3 months (CDC 2010) 60% recurrence rate (Turner et al, 1992) Low Back Pain Low Back Pain
More informationStrength & Conditioning Fundamentals to Improve Performance
trength & Conditioning Fundamentals to Improve Performance Long Term Development of Junior Athlete Through to enior Ranks What Can A strength Program Achieve? 1. Improve speedenhanced stretch shortening
More informationTests For Predicting VO2max
Tests For Predicting VO2max Maximal Tests 1.5 Mile Run. Test Population. This test was developed on college age males and females. It has not been validated on other age groups. Test Procedures. A 1.5
More informationMuscle strengthening is not effective in children and adolescents with cerebral palsy: a systematic review
Muscle strengthening is not effective in children and adolescents with cerebral palsy: a systematic review Aline Scianni 1, Jane M Butler 1, Louise Ada 1 and Luci F Teixeira-Salmela 2 1 The University
More informationDr. O Meara s. Anterior Knee Pain (PatelloFemoral Syndrome) Rehabilitation Protocol www.palomarortho.com
Dr. O Meara s Anterior Knee Pain (PatelloFemoral Syndrome) Rehabilitation Protocol www.palomarortho.com Anterior Knee Pain (PatelloFemoral Syndrome) Rehabilitation Protocol Hamstring Stretching & Strengthening
More informationAn Effective Exercise Prescription for Ataxia. Polly Swingle, PT The Recovery Project, LLC www.therecoveryproject.net 734-953-1745
An Effective Exercise Prescription for Ataxia Polly Swingle, PT The Recovery Project, LLC www.therecoveryproject.net 734-953-1745 1 Are you Functional? Sit to stand from a chair without the use of your
More informationThe type of cancer Your specific treatment Your pre training levels before diagnose (your current strength and fitness levels)
Exercise and Breast Cancer: Things you can do! Cancer within the fire service is one of the most dangerous threats to our firefighter s health & wellness. According to the latest studies firefighters are
More informationIntroduction. Is youth strength training safe?
STRENGTH TRAINING FOR YOUNG ATHLETES Scott Riewald, PhD, CSCS, NSCA-CPT and Keith Cinea, MS, CSCS, NSCA-CPT National Strength and Conditioning Association Education Department Introduction More and more,
More informationBiomechanics of cycling - Improving performance and reducing injury through biomechanics
Biomechanics of cycling - Improving performance and reducing injury through biomechanics Biomechanics is the science concerned with the forces that act on the human body and the effects these forces produce.
More informationPHOEBE RUNCIMAN DR. YUMNA ALBERTUS-KAJEE PROF. WAYNE DERMAN DR. SUZANNE FERREIRA
NOVEL USES OF ELECTROMYOGRAPHY IN EVALUATION OF SKELETAL MUSCLE RECRUITMENT DURING EXERCISE IN ATHLETES WITH DISABILITIES: A KEY TO INJURY PREVENTION AND FUTURE CLASSIFICATION? PHOEBE RUNCIMAN DR. YUMNA
More informationTherapeutic Recreation: Effects of a Riding Protocol on a Child with Cerebral Palsy
May 2009 Rose Flammang, SPT Katrina Francis, SPT Therapeutic Recreation: Effects of a Riding Protocol on a Child with Cerebral Palsy The purpose of our research project was to Evaluate the effect of a
More informationBy Agnes Tan (PT) I-Sports Rehab Centre Island Hospital
By Agnes Tan (PT) I-Sports Rehab Centre Island Hospital Physiotherapy Provides aids to people Deals with abrasion and dysfunction (muscles, joints, bones) To control and repair maximum movement potentials
More informationPhysical Activity in the School Environment and the Community
Chapter 5 Physical Activity in the School Environment and the Community Chapter objectives: To briefly describe how our changing society is influencing the effect of schools on the behaviour of modern
More informationtotal hip replacement
total hip replacement EXCERCISE BOOKLET patient s name: date of surgery: physical therapist: www.jointpain.md Get Up and Go Joint Program Philosophy: With the development of newer and more sophisticated
More informationSome cross-training workouts to improve your energy system fitness
Some cross-training workouts to improve your energy system fitness In the previous post (http://www.danbakerstrength.com/free-articles/recent-trends-inhigh-intensity-aerobic-training/), I detailed how
More informationAlways warm up before commencing any exercise. Wear the correct clothing and footwear; do not train if you are unwell or injured.
SUGGESTED FITNESS PROGRAMME General Exercise Guidance Good exercise training advice is highly specific to the individual. It should be understood, therefore, that the advice provided here can only be general.
More informationRehabilitation Protocol: Total Knee Arthroplasty (TKA)
Rehabilitation Protocol: Total Knee Arthroplasty (TKA) Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington 781-744-8650 Lahey Outpatient Center, Lexington 781-372-7020 Lahey Medical
More informationTension Type Headaches
Tension Type Headaches Research Review by : Dr. Ian MacIntyre Physiotherapy for tension-type Headache: A Controlled Study P. Torelli, R. Jenson, J. Olsen: Cephalalgia, 2004, 24, 29-36 Tension-type headache
More informationExercise Principles and Guidelines for Persons with Cerebral Palsy and Neuromuscular Disorders
Exercise Principles and Guidelines for Persons with Cerebral Palsy and Neuromuscular Disorders INTRODUCTION: Health and well being are the result of many factors: Physical activity is one of these factors.
More informationTHE BIG SIX. Six Best Volleyball Strength Training Exercises. By Dennis Jackson, CSCS www.strength-and
THE BIG SIX Six Best Volleyball Strength Training Exercises By Dennis Jackson, CSCS www.strength-and and-power power-for for-volleyball.com THE SQUAT What it is The two most common squatting exercises
More informationSue Schuerman, PT, GCS, PhD UNLVPT
Sue Schuerman, PT, GCS, PhD UNLVPT Exercise & Physical Activity (Your Everyday Guide from the National Institute on Aging) Go4Life Retain our physical and mental health Continue to do the things we enjoy
More informationStrength and Conditioning Program
Strength and Conditioning Program Guidelines All speed work must be performed when the body is fully rested. Proper sprinting techniques must be taught and mastered by the player. Adequate rest must follow
More informationPlyometric Training. Plyometric Training. chapter
chapter 16 Plyometric Training Plyometric Training David H. Potach, PT; MS; CSCS,*D; NSCA-CPT,*D Donald A. Chu, PhD; PT; ATC; CSCS,*D; NSCA-CPT,*D; FNSCA Chapter Objectives Explain the physiology of plyometric
More informationBenefit of exercise for Parkinson s disease. Dr Florence Chang Movement disorder fellow
Benefit of exercise for Parkinson s disease Dr Florence Chang Movement disorder fellow Objectives Review evidence of exercise in animal models of PD Review evidence of exercise benefitting patients with
More informationWellness for People with MS: What do we know about Diet, Exercise and Mood And what do we still need to learn? March 2015
Wellness for People with MS: What do we know about Diet, Exercise and Mood And what do we still need to learn? March 2015 Introduction Wellness and the strategies needed to achieve it is a high priority
More informationMIAMI POLICE DEPARTMENT
MIAMI POLICE DEPARTMENT POLICE OFFICER PHYSICAL AGILITY TEST TRAINING MANUAL 400 NW 2 nd Avenue, Miami, FL 3328 REVISED 0/2 TABLE OF CONTENTS OVERVIEW... 2 LIST OF EVENTS... 3 EQUIPMENT REQUIRED... 4 PREPARING
More informationPhysical & Occupational Therapy
In this section you will find our recommendations for exercises and everyday activities around your home. We hope that by following our guidelines your healing process will go faster and there will be
More informationChapter 9: Strength Training Program Design. ACE Personal Trainer Manual Third Edition
Chapter 9: Strength Training Program Design ACE Personal Trainer Manual Third Edition Introduction There are six (6) types of resistance training: 1. Isometric force development 2. Concentric force development
More information12 week Century Ride Training Program
12 week Century Ride Training Program by Daniel M. Healey Graham Watson 2014 If you are contemplating doing your first Century Ride, a guaranteed route to success is to simply spend more time riding your
More informationRehabilitation. Rehabilitation. Walkers, Crutches, Canes
Walkers, Crutches, Canes These devices provide support through your arms to limit the amount of weight on your operated hip. Initially, after a total hip replacement you will use a walker to get around.
More informationHip Conditioning Program. Purpose of Program
Prepared for: Prepared by: OrthoInfo Purpose of Program After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle.
More information1.1.1 To include: Body language - facial expressions, gestures, eye contact and posture
Unit 415 Delivering Personal Training Sessions Recommended Guided Learning Hours: 58 Credit value 9 QCF Unit Number J/600/9053 1. Understand how to instruct exercise during personal training sessions 1.1
More informationFlexibility, Static and Dynamic Stretching, and Warm-Up
Readings: Flexibility, Static and Dynamic Stretching, and Warm-Up NSCA text: Chapter 12 pp 251 260, 266-274 Course web site: Supplemental optional reading articles on course web site discussed and cited
More informationThe Effects of Moderate Aerobic Exercise on Memory Retention and Recall
The Effects of Moderate Aerobic Exercise on Memory Retention and Recall Lab 603 Group 1 Kailey Fritz, Emily Drakas, Naureen Rashid, Terry Schmitt, Graham King Medical Sciences Center University of Wisconsin-Madison
More informationTymikia S. Glenn, BS ACSM CPT Fitness and Membership Director Milan Family YMCA
Tymikia S. Glenn, BS ACSM CPT Fitness and Membership Director Milan Family YMCA Benefits of Starting an Exercise Program 1. Helps build and maintain healthy bones, muscles and joints 2. Reduces feelings
More informationThe Royal Military College - Duntroon Army Officer Selection Board Bridging Period Conditioning Program
The Royal Military College - Duntroon Army Officer Selection Board Bridging Period Conditioning Program CONTENTS Page Contents i INTRODUCTION 1 FAQS 2 CYCLE 1: NEUROMUSCULAR CONDITIONING FOCUS (WEEKS 1
More informationTraining our energy systems
Training our energy systems By: Kelly Mackenzie, MSC, BPE, AFLCA trainer Regardless of what mode of exercise we are using, we can train all three of our energy systems. There are physiological adaptations
More informationStrength Training. Designed Specifically for Novice/Junior/Senior Skaters and Coaches
Strength Training Designed Specifically for Novice/Junior/Senior Skaters and Coaches Strength Training Instructor Guidelines Instructor Qualifications A. Degree in exercise, physical education or sports
More informationUNIVERSAL FITNESS NETWORK, Inc. 2315 West Monica Dunlap, IL 61525 (309)-360-5615 bahenso@comcast.net FACTS ABOUT THE PHYSICAL FITNESS ASSESSMENT TESTS
UNIVERSAL FITNESS NETWORK, Inc. 2315 West Monica Dunlap, IL 61525 (309)-360-5615 bahenso@comcast.net FACTS ABOUT THE PHYSICAL FITNESS ASSESSMENT TESTS Universal Fitness Network, Inc. specializes in physical
More informationCervical Fusion Protocol
REHABILITATION DEPARTMENT Cervical Fusion Protocol The following protocol for physical therapy rehabilitation was designed based on the typical patient seen at the Texas Back Institute for the procedure
More informationKnee Conditioning Program. Purpose of Program
Prepared for: Prepared by: OrthoInfo Purpose of Program After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle.
More informationKnee Pain/OA Physical Therapy Approaches
Knee Pain/OA Physical Therapy Approaches G. Kelley Fitzgerald, PT, PhD, FAPTA Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences Director, Physical Therapy Clinical
More informationNeuro-rehabilitation in Stroke. Amit Kumar Neuro-Occupational Therapist
Neuro-rehabilitation in Stroke Amit Kumar Neuro-Occupational Therapist Neuro-rehabilitation A process whereby patients who suffer from impairment following neurologic diseases regain their former abilities
More information12 Week Do-it-Yourself Fitness Program
12 Week Do-it-Yourself Fitness Program Created by Brad Awalt, MS, ACSM Assistant Manager, Health Plus brad.awalt@vanderbilt.edu January 2011 Do you have a goal to begin an exercise routine, but not sure
More informationEligibility The NCSF online quizzes are open to any currently certified fitness professional, 18 years or older.
Eligibility The NCSF online quizzes are open to any currently certified fitness professional, 18 years or older. Deadlines Course completion deadlines correspond with the NCSF Certified Professionals certification
More informationPEER REVIEW HISTORY ARTICLE DETAILS VERSION 1 - REVIEW
PEER REVIEW HISTORY BMJ Open publishes all reviews undertaken for accepted manuscripts. Reviewers are asked to complete a checklist review form (http://bmjopen.bmj.com/site/about/resources/checklist.pdf)
More informationPost-Operative ACL Reconstruction Functional Rehabilitation Protocol
Post-Operative ACL Reconstruction Functional Rehabilitation Protocol Patient Guidelines Following Surgery The post-op brace is locked in extension initially for the first week with the exception that it
More informationRehabilitation of Sports Hernia
Rehabilitation of Sports Hernia (Involving Adductor Tenotomy, Ilioinguinal Neurectomy and Osteitis Pubis) An appendix follows this protocol for examples of exercises in each phase of rehabilitation. There
More informationPHYSIOTHERAPY OF HIP AND KNEE AFTER SURGERY AND INJURY BY RACHEL GEVELL PHYSIOTHERAPIST
PHYSIOTHERAPY OF HIP AND KNEE AFTER SURGERY AND INJURY BY RACHEL GEVELL PHYSIOTHERAPIST AIMS AND OBJECTIVES To demonstrate the use of physiotherapy assessment and treatment following: Hip Arthroplasty
More informationTone Management in Cerebral Palsy. Jenny Wilson, MD wilsjen@ohsu.edu OHSU and Shriners Hospital for Children October, 2015
Tone Management in Cerebral Palsy Jenny Wilson, MD wilsjen@ohsu.edu OHSU and Shriners Hospital for Children October, 2015 Disclosures I am involved in a Dysport sponsored research study Goals Describe
More information9 TH GRADE KINETIC WELLNESS
Teacher: Mr. Hartung 9 TH GRADE KINETIC WELLNESS Introduction to 9 th Grade Physical Education Introduction/Overview Chapter 1 10 reasons to get and stay in shape - Key terms you should be able to define
More informationExercise Intensity in Cardiac Rehabilitation: The Clinical Side of the Coin
Exercise Intensity in Cardiac Rehabilitation: The Clinical Side of the Coin Bonnie Sanderson,PhD, RN, FAACVPR AACVPR President 2010-2011 Associate Professor Auburn University School of Nursing Overview
More informationEdited by P Larking ACC Date report completed 18 January 2010
Brief report Hart Walker Reviewer Adrian Purins AHTA Edited by P Larking ACC Date report completed 18 January 2010 1. Background Cerebral Palsy (CP) is a group of disorders that arise from brain damage
More informationEFFECT OF VIBRATORY PLATFORM THERAPY ON POSTURE IN CHILDREN WITH CEREBRAL PALSY: A PILOT STUDY
EFFECT OF VIBRATORY PLATFORM THERAPY ON URE IN CHILDREN WITH CEREBRAL PALSY: A PILOT STUDY Pierina MAGNA a, Natalia JERIA a, Carlos ALVAREZ a,b, Chiara RIGOLDI c & Manuela GALLI c a Departamento de Kinesiología
More informationPatellofemoral/Chondromalacia Protocol
Patellofemoral/Chondromalacia Protocol Anatomy and Biomechanics The knee is composed of two joints, the tibiofemoral and the patellofemoral. The patellofemoral joint is made up of the patella (knee cap)
More informationHip Bursitis/Tendinitis
Hip Bursitis/Tendinitis Anatomy and Biomechanics The hip is a ball and socket joint that occurs between the head of the femur (ball) and the acetabulum of the pelvis (socket). It is protected by several
More informationFoot and Ankle Conditioning Program. Purpose of Program
Prepared for: Prepared by: OrthoInfo Purpose of Program After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle.
More informationContact us for more info: 020 7736 8191 /
Winter Sports Advanced Ski Exercises - Introduction The following exercises are for individuals who already have a significant level of fitness. If you are unsure as to whether they are appropriate for
More informationFact sheet Exercises for older adults undergoing rehabilitation
Fact sheet Exercises for older adults undergoing rehabilitation Flexibility refers to the amount of movement possible around a joint and is necessary for normal activities of daily living such as stretching,
More informationA randomized controlled trial comparing two rehabilitation interventions for young children with cerebral palsy
A randomized controlled trial comparing two rehabilitation interventions for young children with cerebral palsy CO-PRINCIPAL INVESTIGATORS Mary Law and Johanna Darrah RESEARCH TEAM Brenda Wilson Nancy
More informationThis very important area is often the least understood or completely ignored by some coaches when designing a fitness program for their athletes.
This very important area is often the least understood or completely ignored by some coaches when designing a fitness program for their athletes. An understanding of the various energy systems of our body
More informationACL Reconstruction Post Operative Rehabilitation Protocol
ACL Reconstruction Post Operative Rehabilitation Protocol The following is a generalized outline for rehabilitation following ACL reconstruction. The protocol may be modified if additional procedures,
More informationCARDIAC REHABILITATION HOME EXERCISE ADVICE
CARDIAC REHABILITATION HOME EXERCISE ADVICE Introduction Exercise is a very important as part of your rehabilitation and your future health. You will need to exercise at least three times per week, minimum,
More informationStrength Training HEALTHY BONES, HEALTHY HEART
Strength Training HEALTHY BONES, HEALTHY HEART No matter what your age, strength training can improve your bone health and your balance. As we age, our bones lose both tissue and strength. This condition
More informationOUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES
OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES General Therapy Guidelines 1. Therapy evaluations must be provided by licensed physical and/or occupational therapists. Therapy evaluations
More informationTORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013)
Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals: Timely access to geographically located acute stroke unit care with a dedicated interprofessional team
More informationSYDNEY 22-24 August 2014
SYDNEY 22-24 August 2014 Overview Most common injuries Injury prevention strategies - massage - posture advice - walking poles - stretching - strengthening - taping / bracing Hills Training Cross Training
More information