EDKP 330

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EDKP 330
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  1. What is epidemiology?
    • The study of how disease is distributed in the population and the factors that influence or determine this distribution
    • •Frequencies and types
    • •Groups with and at risk of disease
    • •Factors that influence their distribution
    • •Findings causes and preventing future cases
  2. Premise behind epidemiology
    • •Disease, illness and ill health are not randomly distributed in the population
    • •Rather, each of us has certain characteristics that predispose us or protect us from certain diseases
  3. CHOLERA Outbreak...explain
    • Dr. John Snow’s Map of 1854
  4. Which country has the highest mean Age mortality?
    Japan- 78 years
  5. Risk Factors for Chronic Diseases
    • obesity, high cholesterol, high blood pressure, poor nutrition, and poor fitness become apparent in children.
    • • It is never too early or too late to become physically active to reduce the risk for chronic disease.
  6. Components of Physical Fitness: Health-Related Fitness?
    • • Cardiorespiratory fitness
    • • Body composition
    • • Musculoskeletal fitness (flexibility, muscular strength, and endurance)
  7. Components of Physical Fitness: Skill-Related Fitness?
    • • Balance
    • • Coordination
    • • Agility
    • • Speed
    • • Power
    • • Quickness
  8. Key point of Health Related Fitness?
    Affects our overall health and energy and our ability to perform daily tasks and activities
  9. PAR - Q
    • •For adults Aged 15-69 years
    • •A conservative screening too
    • l•Developed by Health Canada
    • •Used around the world
  10. World Health Day in  São Paulo, Brazil
    April 7, 2002 São Paulo, Brazil “Move for Health”
  11. Robert Tait McKenzie (1867 - 1938)
    • McGill Undergrad and Medicine
    • -Lecturer in Anatomy

    Naismith kindled McKenzie's interest in gymnastic activities later, at McGill, McKenzie assisted Naismith in teaching gymnastics at the university

    Professor from 1894 to 1904 at McGill started Phys Ed Dept

    Move to Penn

    Published Exercise in Education and Medicine
  12. Edward Hitchcock, Jr. 
    1828-1911

    Dept of PE and Hygiene Amherst College 1861-1911
  13. Dudley Sargent
    • •Hemenway Gymnasium, Harvard 1880
    • •Health, Strength, & Power 1904
  14. R. Tait McKenzie
    • •Penn 1904
    • •Exercise in Education and Medicine 1909
  15. The Jack LaLanne Way to Vibrant Good Health
    • 1960 
    • Guy in funky suit for fitness and shit 
  16. The 5 BX plan
    • 1960 
    • The federal government went on to sell 23 million copies of the 5BX booklet. It was translated into 13 languages. The program was sold to the American air force for $2 million alone.
    • Short program to get fit.
  17. Alameda County Healthy 7
    • •Sleeping 7 to 8 hours
    • •Breakfast every day
    • •Never or rarely snack
    • •At or near ideal weight/ht
    • •Never smoke•Moderate Use of Alcohol
    • •Regular Physical Activity
  18. Jeremy Morris 
    1953

    First modern Physical Activity Epidemiologist
  19. London Bus Drivers Study
  20. Coronary Heart Disease Hypothesis
    This early hypothesis that “men doing physically active work have a lower mortality from coronary heart disease in middle age than men in less active work” was met with “considerable skepticism by medical scientists and practitioners.”
  21. Framingham Heart Study
    • • Modern era of Physical Activity Epidemiology
    • • 1948 - ?
    • • 5209 men and women (30 – 62)
    • • Questionnaires and physical exams
    • • 1967 Physical Activity found to reduce the risk of heart disease• 1971 offspring study
    • • 1995 omni study (500 minority residents)• Now recruiting Grand children (3500)
  22. Tecumseh Community Health Study
    • 1957
    • –8600 people (20+ years)
    • –1961-1965 (cycle two) assess physical activity of Men
    • –1967-1969 cycle three
  23. College Alumni Study (Harvard & Penn)
    • 21000+ (graduated 1916 – 1950)
    • –1962 and 1966
    • –questionnaire/medical exam
  24. Aerobics Center Longitudinal Study
    • –More than 25,000 men and 10,000 women since 1980
    • –Questionnaire and medical exam
    • –Fitness measured by treadmill testing
  25. Kinesiology Disciplines
    •Exercise Physiology

    • •Movement Sciences
    • –Motor Learning
    • –Motor Control
    • –Biomechanics

    •Sport and Exercise Psychology
  26. FITT Concept
    • •Frequency
    • •Intensity
    • •Time
    • •Type
  27. Principles to be considered when prescribing exercise 
    • •Practical goal setting
    • •Genetics
    • •Motivation
    • •Teaching model
    • •Fitness Evaluation
    • •Progressive Overload
    • •Specificity
    • •Modification (injuries)
    • •Periodization
    • •Overtraining
    • •Detraining
    • •Recovery
    • •Compliance
  28. Recommendations for time for achieving Functional Health or High Performance
  29. Recommendation for frequency 
  30. Motivation
    • •Behavioural reinforcement
    • •Intrinsic Motivation
  31. Fitness Evaluation
    • •Assess before after programming
    • •Different Target Populations
  32. Progressive overload
    •Increases in FITT variables

  33. Specificity
    Like specific player.. ie quarter back vs line backer 
  34. Periodization
  35. Recovery
    • •FITT Variables
    • •Age
    • •Experience
    • •Heat / Altitude•Genetics
  36. How is kinesiology and Epidemiology related?
  37. Ten leading causes of death in US in 1900 
    • 1. Pneumonia and influenza
    • 2.Tuberculosis 
    • 3.Diarrhea 
    • 4.Diseases of the Heart 
    • 5.Incranial Lesion of vascular origin 
  38. Ten leading causes of death in the US in 2006 
    • 1. Heart Disease 
    • 2.Cancer 
    • 3. Stroke 
    • 4.Chronic Lower Respiratory Diseases 
    • 5.Accidents 
  39. Surviellance
    • •Public Health Surveillance
    • –Ongoing Systematic, Collection, Analysis and interpretation of data
    • –Helps us understand if certain types of people are great risk
  40. Efficacy Trials
    • •Studies that are used to establish that a certain intervention or public health program can change a certain condition
    • –Hiding cigarettes in stores
    • –BIXI Bikes
    • –Bike Lanes
  41. Small changes can lead tobig results over-time
    A weight stable man (80 kg) who adds2 flights of stairs to his daily activity willreduce his weight by 2.7 kg (5.9pounds) at the end of one year if allelse is held constant
  42. Harvard Alumni
    • •16,936 Harvard alumni, aged 35 to 74,
    • •A total of 1413 deaths during 12 to 16 years of follow-up (1962 to 1978).
    • •Exercise reported as walking, stair climbing, and sports play•Mortality rates declined steadily as energy expended increased from less than 500 to 3500 kcal/wk. Above this rates decreased only slightly.
    • •Rates were 25% to 33% lower among those expending 2000 or more kcal/wk compared to those <2000 Kcal/wk.
    • •Mortality rates were significantly lower among the physically active, with or without adjustment for hypertension, cigarette smoking, body weight, or early parental death.
  43. Aerobics Center Longitudinal study in detail?
    • 1. Max treadmill time and mortality in 10,000 men and 3000 women over about 8 years. Outcome was age adjusted all-cause mortality.
    • –Low fit 3x rate compared to most fit group (men)
    • –Low fit 4x rate compared to most fit (women)

    • 2. Another 8 year follow-up (25,000 men; 7000 women)
    • –High fit (top 20%) had RR = 0.49 compared to low fit…men
    • –High fit (top 20%) had RR = 0.37 compared to low fit…women
    • –adjusted for age, year, smoking, chronic disease
  44. 2008 Physical Activity Guidelines for Americans
    • •First major review of the science on benefits of physical activity in over a decade
    • •Complement previous recommendations
    • •Information and guidance on the types and amount of physical activity that provide substantial health benefits
  45. Children and Adolescents (ages 6-17) Physical activity requirment
    • •1 hour (60 minutes) or more of Aerobic physical activity that is at least moderate:
    • –Most of the 1 or more hours a day should be either moderate- or vigorous-intensity PA
    • –Do vigorous-intensity PA at least 3 days a week
    • •Encourage participation in PA that are:
    •  Age appropriate, enjoyable, offer variety

    •As part of 60 minutes of daily activity to include:

    Muscle-strengthening: Include muscle-strengthening physical activity on at least 3 days of the week

    Bone-strengthening: Include bone-strengthening physical activity on at least 3 days of the week
  46. Examples of moderate-intensity aerobic activities for kids
    • •Children
    • –Brisk walk, hiking
    • –Active recreation (canoeing)

    • •Adolescents–Brisk walk, hiking
    • –Active recreation (canoeing)
    • –Yard work such as raking leaves/ bagging leaves
    • –Softball, baseball that require catching and throwing
  47. Key Guidelines – Adults (ages 18–64) physical activity
    • •Minimum aerobic activity for health–2 hours and 30 minutes (150 minutes/week) moderate-intensity aerobic activity; or
    • –1 hour and 15 minutes (75 minutes/week) vigorous-intensity aerobic activity; or
    • –Equal combination for 150 minutes/week

    •Muscle-strengthening activities that involve all major muscle groups should be performed on 2 or more days of the week

    • For additional health benefits
    • –5 hours (300 minutes) moderate-intensity aerobic activity a week; or
    • –2 hours and 30 minutes (150 minutes) vigorous-intensity aerobic activity a week; or
    • –An equivalent combination (150 minutes)
  48. Key Guidelines – Older adults (ages 64+) Physical actvity 
    • The key guidelines for adults apply to older adults with additional qualifying guidelines:
    • –Guideline for adults who cannot do 150 minutes/week
    • –Balance exercise
    • –Only use relative intensity to determine the level of effort
  49. Adult aerobic physical activity principle
    • •F – Weekly
    • •I – Moderate or Vigorous
    • •T – 150 minutes/week
  50. Youth aerobic physical activity principle
    • •F – Daily
    • •I – Moderate or Vigorous
    • •T – 60 minutes
  51. Flexibility in meeting minimal aerobic 2008 Guideline
  52. Physical Activity Behaviors 
  53. The number one cause of death in the United States?
    Cardiovascular Disease
  54. Cardiovascular Disease
    • •Leading cause of death in Canada
    • •37% of all deaths
    • •Direct/indirect costs $6.8 to $11.6 billion
    • •Examples:
    • –Peripheral vascular disease, congenital heart disease, hypertension, atherosclerosis, stroke, congestive heart failure
  55. Physical Activity does.. 
    • •Decrease low grade inflammation
    • •Increase and maintain heart function
    • •Move toward smoking cessation
    • •Alleviate tension and stress
    • •Counteract a personal history of disease
    • •Increased cardiorespiratory endurance
    • •Decrease and control blood pressure
    • •Reduce body fat
    • •Lower lipids (cholesterol/triglycerides)
    • •Improve HDL
    • •Help control diabetes
  56. Anatomy of heart 
  57. Types of Cardiovascular Disease and Conditions
    • • Heart attack
    • • Atherosclerosis
    • • Angina pectoris
    • • Arrhythmias
    • • Congenital heart defects
    • • Rheumatic heart disease
    • • Congestive heart disease
    • • Bacterial endocarditis
    • • Aneurysms
    • • Hypertension
    • • Stroke
  58. Heart Attack
    • • Coronary thrombosis or myocardial infarction
    • • Lack of blood flow or supply to areas of the heart
    • • Coronary heart disease (CHD)
  59. /Warning signs of a heart attack
    • uncomfortable pressure or pain in the center of the chest that lasts 2 minutes or longer
    • pain that spreads to the shouldersneck or arms or severe pain
    • dizziness
    • fainting
    • sweating
    • nausea
    • or shortness of breath.
  60. Atheresclerosis
  61. Angina Pectoris
    • • Chest pain
    • • Lack of blood flow and oxygen to areas of the heart
    • • Increased risk of heart attack
  62.  Rheumatic heart disease
    —bacterial infection of the heart that damages heart valves
  63.  Congestive heart failure
    —condition that occurs when other diseases have damaged the heart and limited its function
  64.  Bacterial endocarditis
    —infection of the lining or valves of the heart
  65. Other Types of Cardiovascular Disease
    • • Congenital heart defects
    • • Rheumatic heart disease
    • • Congestive heart failure
    • • Bacterial endocarditis
    • • Aneurysms
  66. Aneurysms
    a weakness or bulge in an artery that can burst and lead to massive internal bleeding
  67. Congenital heart defects
    abnormal heart structures, vessels, and valves at time of birth
  68. Electrocardiogram (ECG or EKG)
    • –Record of electrical impulses that stimulate heart
    • •Interpretation
    • –Heart rate/rhythm
    • –Axis of the heart
    • –Enlargement or hypertrophy
    • –Myocardial infarction
  69. Tachycardia
    HR > 100 bpm
  70. Major Unalterable Risk Factors for CHD
    • • Heredity—family history and race
    • • Gender—males are at higher risk
    • • Age—increased age relates to increased risk
  71. Hypertension
    • (High Blood Pressure)
    • • More than 50 million Americans have high blood pressure
    • • Major risk factor for stroke
  72. Systolic Blood Pressure
    The pressure in the vascular system when the heart is contracted
  73. Diastolic Blood Pressure
    The pressure in the vascular system when the heart is relaxed
  74. Normal Blood Pressure
    120 (systolic) over 80 (diastolic)
  75. American Heart Association Blood Pressure Classifications
    • Normal: <130/ <85
    • High normal: 130-139/85-89
    • Stage 1 hypertension (mild): 140-159/90-99
    • Stage 2 hypertension (moderate): 160-179/100-109
    • Stage 3 hypertension (severe): ≥180/ ≥110
  76. Cholesterol
    • • Cholesterol is a fatlike substance found in the body’s cells and bloodstream
    • • The body produces cholesterol primarily through the liver; we also consume cholesterol through our diet.
  77. Two types of Cholesterol 
    • • Two types relevant to CHD are high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C).
    • • HDL-C decreases the risk of CHD
    • • LDL-C increases the risk of CHD
  78. Cholesterol Transport
    • •HDL
    • –Scavenge and transport cholesterol out
    • –Low levels are the strongest predictor of disease
    • •LDL
    • –Tends to release cholesterol
    • –Small particles (type B) pass though inner lining of coronary artery easily
  79. Standards for Cholesterol
    • Total Cholesterol (TC)
    • Desirable: less than 200mg/dl
    • Borderline high: between 200 and 239mg/dl
    • High: 240mg\dl or higher

    • LDL-C
    • Optimal: less than 100mg/dl
    • Borderline high: between 130 and 159mg/dl
    • High: between 160mg/dl and 189mg/dl

    • HDL-C
    • Low: less than 40mg/dl
  80. The Cholesterol Ratio
    Cholesterol ration = TC ÷ HDL - C

    Example: TC = 140, HDL - C = 40

    Cholesterol Ratio = 180 ÷ 40 = 4.5

    recommendation of less than 3.5
  81. Where should your cholesterol be?
    Your total cholesterol level should be below 200 milligrams per deciliter of blood. Your LDL-C count should be less than 130 milligrams per deciliter. It’s desirable that your ratio of total cholesterol to HDL-C be 3.5 or less.
  82. Increasing HDL
    • •Mostly genetic
    • •Aerobic exercise
    • •Weight loss
    • •High dose niacin
    • •Quitting smoking
  83. Decreasing LDL
    • •Anti oxidant vitamins
    • •Dietary changes
    • –Reduce saturated and trans fats
    • –Less Egg Yolks
    • •Losing body fat
    • •Medication•Exercise
    • •Increase fibre intake
    • •Psyllium
  84. Major Risk Factors for CHD
    • • Smoking—doubles the risk for CHD
    • • Diabetes—inability to control blood levels increases the risk of CHD
    • • Obesity—related to many health problems and greatly increases the risk of CHD
  85. number of CHD risk factors that you can control
    high blood pressure, high blood cholesterol, elevated triglycerides, smoking, diabetes, excessive fat, and physical inactivity. Inactive people are twice as likely as active people to die from cardiovascular disease.
  86. Contributing Risk Factors for CHD
    • • Excessive and prolonged stress can increase the risk of CHD.
    • • Personality traits of anger and hostility can increase the risk of CHD
    • • Excessive use of alcohol
  87. Stroke: Brain
    Cerebral thrombosis—blockage of blood flow to the brain. Over 85% of all• strokes

    Cerebral hemorrhage—bursting of an aneurysm or a blow to the head that cause bleeding into the cranium.

    The severity of a stroke relates to the amount of brain tissue affected.
  88. Unalterable Risk Factors for Stroke
    • • Heredity—Family history and race. African-Americans have a much higher risk of stroke than white Americans do.
    • • Gender—Males have a higher risk than females
    • • Age—As age increases the risk of stroke increases
  89. Alterable Risk Factors for Stroke
    • • Hypertension—The major risk factor for stroke.
    • • Smoking
    • • History of transient ischemic attacks (ministrokes)
    • • High red blood cell counts
  90. Contributing Risk Factors for Stroke
    • • High blood cholesterol and triglycerides
    • • Physical inactivity
    • • Obesity
  91. Cardiorespiratory
    —Pertaining to the cardiac (heart) and respiratory (lung) systems.
  92. Aerobic
    Producing energy for physical activity with oxygen.
  93. Anaerobic
    Producing energy for physical activity without oxygen.
  94. Adenosine triphosphate (ATP)
    The chemical compound that is the immediate source of energy for physical activity.
  95. Aerobic means “with oxygen.” As we exercise, our muscles need a steady supply of oxygen to continue contracting and functioning.
  96. Oxygen Consumption
    • As blood leaves the heart and passes through the arteries, it is high in oxygen. As it returns to the heart via the veins, it is lower in oxygen because much of it has been extracted along the way by tissues needing oxygen
  97. Basic Physiology of respiration 
    • •Air taken up into lungs, oxygen diffuses into blood
    • •Oxygen transported in blood bound to hemoglobin
    • •Heart pumps blood to organs and tissues
    • •At cells, oxygen is used to convert food substrates to ATP
    • –Provides energy for physical activity
  98. Cardiorespiratory endurance
    Measure of how pulmonary (lungs) cardiovascular (heart) and muscular systems work together during exercise
  99. Oxygen uptake (VO2)
    –Capacity to deliver and use oxygen–Important way to evaluate cardiovascular health
  100. Benefits of Aerobic Training
    • •Higher maximal oxygen uptake
    • –Amount of oxygen the individual can use
    • –Allows for longer exercise
    • •Increased oxygen carrying capacity of blood
    • –Red blood cell count rises
    • •Decrease in resting heart rate
    • –Increased heart muscle strength
    • •Lower heart rate at given workloads
    • –Greater efficiency of cardiovascular system
    • •Increased number and size of mitochondria
    • –Increased cell ability to produce energy
    • •Increased number of functional capillaries
    • –Allows for more gas exchange at tissue level
    • •Faster recovery time
    • –System can more quickly restore equilibrium post exercise
    • •Lower blood pressure and blood lipids
    • –Reduced risk of cardiovascular disease•Increased fat burning enzymes
    • –Fat lost primarily by being burned in muscle
    • –Reduced % Fat, Reduced waist girth
    • –Increased HDL Cholesterol
  101. Purpose Physical Fitness Assessment
    • –Educate participants regarding their current level of fitness
    • –Motivate individuals to participate in exercise programs
    • –Provide a starting point for individual exercise prescription
    • –Monitor changes in fitness through the years
  102. •VO2 Max (Fick equation)
    VO2 Max = (Max HR X Stroke Volume)x AVO2 diff
  103. Tests of VO2max
    • Physician assessment should be considered before any test
    • •Maximal tests (requires all-out effort)
    • –2.4 km run
    • –Astrand-Rhyming test
    • –12 minute swim test

    • •Submaximal tests
    • –Step test
    • –1.6 km (1 mile) walk test
  104. 2.4 Km Run Test
    • •Predicts according to the time it takes the person to run or walk 2.4 km•Easiest test to administer
    • •Not recommended for beginners, men > 45 and women > 55
    • •An aerobic program of at least 6 weeks is recommended before taking the test
  105. 1.6 Km Walk Test•
    • •Can be used by individuals who cannot run because of low fitness or injury
    • •Requires brisk 1.6 Km walk that elicits heart rate of at least 120 bpm
    • •VO2max–Calculated according to formula
  106. Step Test
    • •Requires little time or equipment
    • •Test takes 3 minutes then heart rate is taken between 5 and 20 seconds afterward
  107. Astrand-Rhyming Test
    • •Simple, practical, popular test
    • •Commonly used in laboratory setting
    • •Conducted on a bicycle ergometer
    • •Heart rate monitored and compared to chart
  108. 12 Minute Swim
    • •Considered a maximal test
    • •Predicting maximal uptake more difficult than land based tests
    • •Greatly affected by skill level
    • •Results are a general approximation
  109. Predicting Caloric Expenditure
    • •Oxygen uptake has value in predicting caloric expenditure in aerobic activities
    • •Heart rate should remain between 110 to 180 bpm
  110. Readiness for Exercise
    • •Low percentage of population truly committed to exercise
    • •More than half drop out within first 6 months
    • •Consider
    • –Self control
    • –Attitude
    • –Health
    • –Commitment
  111. Overload
    To improve a physiological system, you must stress or challenge that system beyond its normal limits.
  112. Specificity
    Your aerobic exercise program must be specifically related to you overall exercise objectives
  113. Individuality
    You should evaluate your fitness level and your exercise goals on a personal level, rather than compare yourself to others.
  114. Reversibility
    When you stop overloading your aerobic system, your aerobic fitness level will, over time, return to its preexercise level.
  115. MHR
    MHR = 220 – Your Age
  116. Component Threshold Upper limitFrequency 3 days per week 5 days per weekIntensity 55% of maximal 90% of maximal heart heart rate; 12 on rate; 16 on the RPE RPE scale scaleTime* 20 minutes per 60 minutes per session session
  117. Exercise Prescription
    • •To develop fitness, the heart muscle must be overloaded
    • •Variables of exercise prescription (FITT)
  118. Intensity
    • •For muscles to develop they need to be overloaded
    • •Cardiorespiratory development
    • –Heart is working at 40 to 85% of reserve
    • –Not fit individuals should begin at 40 to 50%
    • •Heart rate reserve (HRR)
    • –Difference between maximal heart rate and resting heart rate
  119. Intensity
    • •Determined by cardiorespiratory training zone•Maximal heart rate = 220 minus age
    • •Determine resting heart rate•
    • Determine HRR and then training zone
    • •Training zone should align with personal fitness goals
  120. Mode of Exercise
    • •Has to be aerobic
    • –Any activity or combination of activities that will increase heart rate
    • •Has to involve major muscle groups
    • •Must be rhythmic and continuous
    • •Low impact activities reduce the risk of injury
    • •At least 30 minutes daily
  121. Frequency
    • •Starting a program (cardiorespiratory fitness)
    • –Three to five 20 to 30 minute sessions per week
    • –Improves maximal oxygen uptake
    • –More than 5/week and improvements are minimal
    • •Disease prevention/enhanced quality of life
    • –At least 30 minutes, low to moderate intensity
    • –Most days of the week
    • •Weight loss program
    • –60 minute sessions, low to moderate intensity
    • –Most days of the week
  122. Frequency
    • •Benefits of any one exercise session are relatively short term
    • –People should think of exercise as medication and take it daily
    • •People should engage in physical activity 6 to 7 times per week
    • –Depending on intensity, all aerobic exercise/ activity should last from 20 to 60 minutes
  123. The Complete Aerobic Training Program
    • • Warm-up and stretching
    • • Cardiorespiratory endurance exercise
    • • Cool-down and stretching
    • • Flexibility activities• Strength activities
  124. Barefoot Running
    • •Barefoot running goes against years of research
    • •What about rocks and glass? Modern surfaces are harder.
    • •May be OK for very lean
  125. Alternative Physical Activities
    Three 10-minute workouts of moderate activity have nearly the same effect on health as one 30-minute workout at the same effort. But if you’re not one to plan workouts, realize that you can attain health benefits just by living an active lifestyle— so long as your “unstructured” activity is at least equivalent to any “structured” workout that you might plan.
  126. Total energy Expenditure 
    BMEE= 65%

    PAEE= 25%

    TEF= 10%
  127. 24hr ENERGY EXPENDITURE
    RestingMetabolicRate(RMR)~60-75%

    Thermic Effect of Feeding (TEF) ~10%

    Thermic Effect of Activity (TEA) ~15-30%
  128. Accelerometers
    • Calculate velocity...but dont say what type of exercise..
    • active pal 
    • ton of data 
    • inclinometer..yay 
  129. Pedometers
    • •Cheap ones don’t work well
    • •Must wear on hip•Should be anchored
    • •Don’t measure velocity
  130. Direct observation
    • •Direct observation for people or places of interest
    • •Ex/ time active in Phys Ed Class
    • •Urban Areas
    • •Reactivity may be a problem
  131. Self Report
    • •Diaries
    • –Beginning and ending times
    • –Sleeping
    • –Show day to day variability

    • •Interviews
    • –Requires skilled interviewer
    • –Memory cues are used
    • –Some interviews can take minutes
  132. Questionnaires
    • •Can be administered directly to participants or over the phone
    • •Not as much probing
    • •Time frame of interest is critical (ie past week, past month, usual week) Not too far out!
    • •Distant past may be of interest
    • •Recall bias is a problem
    • •Not for Children <12yrs
  133. Surveillance of Populations
    • •Helps understand dose and types of activity done
    • •Look at determinants of PA (individual and environmental)
    • •Compare regions and countries
    • •Compares over time (becoming more or less active)
    • •May help with health policy
  134. BRFSS
    Behavioral Risk Factor Surveillance system
  135. 4 weeks of training is wiped out in..
    2 weeks of no training
  136. Double labelled water
    stable isoltope non-toxic
  137. Aerobic fitness is most important
  138. hypokinetic
    lack of movement
  139. NEAT
    Non energy active thermogenesis
  140. basil metabolic weight
    hospital bed
  141. Optimize aaerobic fitness 
    30min of more 
  142. Borg scale
    If you put a zero it would be life HR
  143. LORD
    • left-oxygenated
    • right-deoxygenated
  144. MET
    1MET=3.5ml-1kg-1min-1

    • 1MET is resting 
    • 3-5.9MET is moderate 
    • 6 and over MET is vigourous 

    800MET per week
  145. Karvonen
    (Max HR-RHR xHRzone(%))+RHR

    aka THR
  146. ROM
    range of motion
  147. MHR reserve
    MHR-RHR
  148. at rest 
    1kcal per minute
  149. Ayurveda
    (knowledge of living)Exercise recommended for rheumatoid arthritis in the9th century B.C.

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