Accelerated Muscular Development Programs
Resistance training is the mode of exercise performed to stimulate the neuromuscular system. Variations of the number of sets, repetitions, rest period, and weight lifted determines the outcome of the training program. Programs designed to increase strength are typically performed at a high intensity (80 of the one-repetition maximum, 1RM) with long rest periods (two to three minutes) and low to moderate volume (one to three sets of eight to ten repetitions), whereas programs designed to promote muscle hypertrophy are performed at a moderate to high intensity (60-80 1RM) with shorter rest periods (30-60 seconds) and higher volume (three to four sets of ten to 12 repetitions).46 Table 2.3 Resistance training exercises Table 2.3 Resistance training exercises In a generally healthy population, resistance training can be performed with exercise machines or with free weights. Examples of resistance-training exercises are provided in Table 2.3. Multi-joint, multi-planar exercises commonly...
Wade (1997) showed how African-American males' self-evaluation was more positively associated with lighter skin colour than their female counterparts' was, and that African-American women were more successful at resisting cultural messages of physical attractiveness. This may be because women's weight is judged less negatively by African-American men than by Caucasians. A different reason could be that African-American women who identify strongly with an ethnic heritage and history that values and celebrates full-figured bodies are able to resist the media's emphasis on thinness. Although this work pertains to body image, as opposed to skin disease, it is still important to realise that the way a person feels about their body and the way they look can be different as a result of their cultural background. Although the effect of the media is important, it can affect different people in different ways.
As the result of the increased cardiovascular risk in diabetic patients, exercise stress testing is vital to identifying blood pressure responses, arrhythmias, heart rate responses, and risk stratification in these patients. Ideally, patients need to burn a minimum of 1000 calories weekly with aerobic exercising and participate in resistance training. This should be achieved with a minimum of three sessions a week, with aerobic exercising gradually increasing to 45 minutes for maximum benefit. Each session should be preceded by a warm-up period and conclude with deceleration activities to allow for gradual transition from the higher demands of the accelerated phase of the workout (12).
Generally, aerobic exercises, such as swimming and walking, are preferred. Resistance training, although beneficial, can be somewhat hazardous in patients with orthopedic or vascular problems, although properly designed resistance programs can be beneficial. Light weight repetitions are very effective and can be used extremely well to maintain tone.
A 34-year-old male motor mechanic was admitted with a 3-day history of severe swelling of the right arm. He had been undertaking physical activity, including weightlifting, training for about 1.5 h four times a week. There was no history of trauma. The patient felt discomfort, but no severe pain in the arm. The superficial veins were distended. The colour of the hand and forearm was slightly cyanotic. The pulses in the radial and ulnar arteries were palpable. No bruits could be heard along the brachial, supraclavicular or axillary arteries. The rest of the examination was unremarkable. The patient did not use any medication.
Progressive resistance training was found to significantly reduce depressive symptoms and improve quality of life measures as compared with an attention-control group in a 10-week programme involving 32 elderly subjects with mild to moderate depressions 211 . Intensity of training was a significant independent predictor of decrease in depression scores. In contrast, aerobic exercise in a walking group was not found to have a significantly different effect than a social contact group in the treatment of moderate depression in old age 212 .
Seen in 50-60 of adolescent boys and usually occurs during Tanner stages 2 or 3. It is usually painful and may be unilateral or bilateral. It gradually appears and gradually disappears within 1 year of onset. Pubertal changes that occur during Tanner stages 2 and 3 include growth spurt, growth of testes and penis, spermarche, acne, axillary perspiration, and appearance of pubic hair. The boy in this case should be reassured and followed monthly. If the gynecomastia does not resolve, it will be necessary to rule out Klinefelter syndrome, adrenal tumors, gonadal tumors, hyperthy-roidism, hepatic disorders, and the use of drugs, especially marijuana and bodybuilding steroids.
Two papers have been published on a study of eight well-trained male athletes in Denmark who consumed either a lacto-ovo-vegetarian or non-vegetarian diet for 6 weeks (cross-over design).31,32 Both diets consisted of 57 total energy as carbohydrates, 14 protein, and 29 fat. Maximal aerobic capacity, aerobic endurance time to exhaustion, muscle glycogen levels, and isometric strength were unaffected by changes in the diet. This study demonstrated that when macronutrient intake is held constant, switching between a vegetarian and non-vegetarian diet should not be expected to have an influence on exercise performance.
Muscular hypertrophy from diverticulosis, sharp hairpin turns, colonic collapse, or marked fluid retention. In these areas, the 3D fly-through may be suspended, with transition to 2D MPR through a given region. In addition, in areas where multiple focal findings are being detected in 3D raising the concern for stool retention, evaluation in 2D MPR may allow a better overall characterization. Thus, given differences in image quality and anatomy which vary within or between patients, complementary use of 2D or 3D can be selectively utilized for improved visualization. In general, 3D endoscopic views can provide improved visualization of these morphological features. One exception would be the visualization of the highly characteristic stalk of a pendunculated lesion in a segment with marked muscular hypertrophy of diverticulosis. In this setting, 2D MPR may offer an advantage, due to the impaired endoscopic visualization within the thickened folds (Fig. 7.6). Fig. 7.6a,b. Pedunculated...
The type of exercise performed depends on the desired goal. If a woman wants to build muscular strength, then resistance training is appropriate. Endurance training (walking, running, cycling, swimming) is required if a woman wants to improve her cardiovascular health and endurance. Yoga and t'ai chi are therapeutic alternatives to the rigors of strength and endurance training that can reduce stress, increase strength and flexibility, and improve cardiovascular parameters. A certified yoga or t'ai chi instructor should be consulted for more information on the styles of each.
Empirical scientific evidence has demonstrated the positive benefits of exercise, such as improved strength, reduced anxiety, improved blood lipid profile, and decreased risk of cardiovascular disease. The modality required to obtain these benefits can vary from a structured exercise program (resistance training and walking running) and alternative therapies (yoga and t'ai chi) to daily physical activity (mowing the lawn and climbing stairs).
Regular physical exercise can reduce the risk of osteoporosis and delay the physiological decrease of BMD.9 Exercise training (walking, jogging, stair-climbing) in healthy, sedentary, postmenopausal women results in improved bone mineral content.10 Weight-bearing exercise results in increased bone mineral content, but the bone mass reverts to baseline levels when weight-bearing exercise is discontinued.11-13 In the elderly, progressive strength training is a safe and effective form of exercise that reduces risk factors for falling and may enhance BMD.14 No randomized prospective studies have systematically compared the effects of various activities on bone mass. Recommended activities include walking and jogging, weight-training, aerobics, stair-climbing, field sports, racquet sports, court sports, and dancing. Swimming is of questionable value to bone density because it is not a weight-bearing activity. There are no data on cycling, skating, or skiing. Any increase in physical...
Irritability poor muscular development and muscle tone abdominal distention hypotonia of all muscles anterior fontanellc open softening of occipital and parietal bones with elastic recoil ( craniotabes) enlargement of costochondral junctions ( rachitic rosary) bowing of legs lineal chest depression along diaphragm ( Harrison's groove).
A distinction must be made between physical activity and exercise. Physical activity refers to any bodily movement produced by skeletal muscles and that results in energy expenditure, such as mowing the lawn, grocery shopping, and doing household chores.4 Exercise, on the other hand, is physical activity with the purpose of improving some component(s) of fitness (muscle strength and endurance, cardiorespiratory endurance, body composition, flexibility), such as regular participation in an endurance-training or strength-training program at an intensity that will confer physiological and performance benefits.2 Resistance training
The exercise prescription for endurance training offers variety, similar to resistance training. The American College of Sports Medicine recommends 20-60 minutes a day, three to five days per week at an intensity equal to 60-90 of age-predicted maximum heart rate (HRmax 220 age).50 Intensity and duration are related inversely, such that a reduction in intensity requires an increase in duration. Any of these variables can be manipulated within and between exercise sessions. For example, in a three-days-a-week exercise program, day one 40 minutes of treadmill walking at 65 HRmax, day two ten minutes of bicycling at 70 HRmax, ten minutes of intervals at 90 HRmax, then five minutes at 60 HRmax, and day three 20 minutes of swimming at 80 HRmax. All three variations can provide health and fitness benefits.
Stress testing is imperative before embarking on an exercise program. Blood pressure should be controlled and guided by the response to exercise testing. Self-monitoring of blood glucose is particularly important in patients taking insulin. Although exercise does not normally aggravate diabetic neuropathy and may even reduce or delay the risk of ophthalmic complications, straining, as seen in heavy resistance training, should be avoided by those with proliferative retinopathy because of the increased risk of vitreous hemorrhage and retinal detachment. It is not known whether patients who have undergone laser procedures can tolerate more aggressive resistance activity (13).
The ILS intervention stressed brisk walking as the means to achieving the activity goal, although other activities of similar intensity (aerobics, dance, bicycle riding, skating, swimming) could also be applied to the goal. (No more than 75 min wk of strength training could be applied to the goal.) Participants were encouraged to increase their activity slowly and to exercise at least three times per day 5 d wk for at least 10 min per session. Although most participants completed their activity on their own, two supervised exercise classes were offered at all clinics each week. Participants at high risk for adverse events related to underlying coronary artery disease were given an exercise tolerance test before starting the activity intervention.
Diverticular disease is exceedingly common, and is seen as focal outpouchings of the colonic lumen projecting beyond the colonic wall on 2D axial and 2D MPR images. Three-dimensional endoluminal images demonstrate the internal orifices projecting from the colonic lumen (Fig. 14.2 and Fig. 14.3). Occasionally, muscular hypertrophy of diverticulosis can cause colonic wall thickening, but in these segments, we usually observe diverticula interposed throughout the regions of colonic wall thickening. Filling defects can be associated with diverticular disease. The most
Decreased muscle tone and reduced flexibility associated with aging can reduce intensity of orgasm and sometimes require changing sexual positions to reduce pain. These can be managed through lifestyle changes such as daily exercise and stretching and resistance training.
Over 70 of USA and UK women do not get adequate physical exercise.1,2 Active women have a graded reduction in CHD risk compared with sedentary women.30,31 Regular physical activity can also help to lower blood pressure, prevent diabetes, decrease total and LDL cholesterol, raise HDL cholesterol, and help to treat or prevent obesity.32 Every woman should accumulate 30 minutes or more of moderate-intensity physical activity on most days of the week.33,34 Strength training and flexibility are two other additional components of physical fitness.12,32
Strength training should be a component of any exercise program.45 Whole-body, multi-joint strength-training programs may be beneficial to shorten the time of each session while still gaining benefits. A whole-body, multi-joint strength program performed two to three days per week could include exercises such as a lunge, squat, medicine ball swing, standing dumbbell row, and stability ball dumbbell chest press (refer to the list of resources at the end of this chapter for more information). These exercises can be performed in the home with little equipment and can be adapted to fit any schedule and available space.
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