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  • Fit Pregnancy Guidelines| A Simple Guide

    by David Barr | Aug 06, 2019

    Pregnancy ACSM

    Learning Objectives:

    1. Identify the physiological demands of exercise for endurance training in pregnancy.

    2. Identify and address any contraindications to endurance training in pregnancy.

    3. Discover ways to empower women to exercise during pregnancy.


     

    Fit Pregnancy Guidelines

    The American College of Obstetricians and Gynecologists (ACOG) as well as the US Department of Health and Human Services encourage the participation of exercise during pregnancy. By following evidence-based guidelines, we can ensure a beneficial and safe training plan for our pregnant clients. We know physical activity is important, but how can we gain trust with our pregnant clients to help them best understand their bodies during this time of change? By understanding the physiological demands of endurance training during pregnancy, the better we can serve this population.

     

    Similar to the general population, ACOG recommends at least 150 minutes of moderate-intensity aerobic activity for healthy pregnant women, and agree that the benefits of exercise at this time greatly outweigh the risks. Helping our clients to establish healthy habits and routines may continue to benefit them long after baby is born.

     

    The acute physiological responses to exercise (heart rate, cardiac output, stroke volume, etc.) are increased during pregnancy. If a woman does not have any medical contraindications, it is appropriate to monitor exercise intensity using the rate of perceived exertion. According to ACOG, “Minute ventilation increases up to 50 percent, primarily as a result of the increased tidal volume.” This makes it harder for pregnant women to reach an anaerobic threshold with less available oxygen. They also note that, “Aerobic training in pregnancy has been shown to increase aerobic capacity in normal weight and overweight pregnant women.”

    "Similar to the general population, ACOG recommends at least 150 minutes of moderate-intensity aerobic activity for healthy pregnant women"

     

    In addition to respiratory changes, circulation and blood pressure also may respond by decreasing, in order to sustain mom and baby from a circulatory standpoint during pregnancy. This is why it is recommended that pregnant women avoid or modify any supine positions after week 16 of pregnancy. Also, the baby’s weight in this position can decrease venous return as well as cardiac output, resulting in hypotension.

     

    In addition to the physiological changes a woman experiences during pregnancy, it’s crucial to recognize the anatomical changes as well, especially the shift in center of gravity as pregnancy progresses. Lordosis may result in increased joint and/or discomfort in other areas. Metabolic demands also increase by approximately 300 kilocalories per day. Consider working with a Registered Dietitian Nutritionist to discuss individual energy needs.

     

    ACSM’s Guidelines for Exercise Testing & Prescription: Contraindications for Exercising during Pregnancy

    • Relative
      • Severe anemia
      • Unevaluated maternal cardiac dysrythmia
      • Chronic bronchitis
      • Poorly controlled Type 1 diabetes mellitus
      • Extreme morbid obesity
      • Extreme underweight
      • History of extremely sedentary lifestyle
      • Intrauterine growth restriction in current pregnancy
      • Poorly controlled hypertension
      • Orthopedic limitations
      • Poorly controlled seizure disorder
      • Poorly controlled hyperthyroidism
      • Heavy smoker

    • Absolute
      • Hemodynamically significant heart disease
      • Restrictive lung disease
      • Incompetent cervix/cerclage
      • Multiple gestation at risk for premature labor
      • Persistent second or third trimester bleeding
      • Placenta previa after 26 week of gestation
      • Premature labor during the current pregnancy
      • Ruptured membranes
      • Preeclampsia/pregnancy-induced hypertension

    How can I help?

    Pregnancy can make a woman feel inspired and motivated to adopt healthy habits for the well-being of her baby. Consider using motivational interviewing to help set goals for training during exercise. Use training sessions to educate your pregnant client on the changes she is experiencing while training in a new body. Helping her better understand these changes can lead to increased communication between trainer and client, and a more positive overall experience with a fit pregnancy.

     

    References:

    Author:

    Katie Hake RD ACSM-CPT  Katie Hake is a registered dietitian nutritionist and an ACSM certified personal trainer. In addition to her private practice, Katie Hake Health & Fitness (KatieHake.com), LLC,  she works as a metabolic dietitian for children and adults with rare genetic metabolic disorders. She loves teaching group fitness classes and empowering women to find their fierce through the joy of eating and moving.

    Read more from Coach Katie

    ACSM Guidelines Pregnancy
    6 Fit Pregnancy Tips | For Clients, Coaches and Trainers
     
    The views expressed are those of the author and do not necessarily reflect those of the ACSM.

     

  • Paradigm Shift in Physical Activity Research: Do Bouts Matter?

    by Caitlin Kinser | Aug 02, 2019
    physical activity bout duration

    Traditionally, physical activity recommendations have focused on accumulating moderate-to-vigorous physical activity (MVPA) either in a continuous manner, such as going for a 30-minute run, or in short bouts performed throughout the day (i.e. three bouts of 10 minutes). These recommendations were supported by the 1996 U.S. Surgeon General’s Report on Physical Activity and Health. Nearly a decade later, the 2008 Physical Activity Guidelines for Americans (PAG) supported similar recommendations, stating that “aerobic activity should be performed in episodes of at least 10 minutes.”

    The primary recommendations from these two reports are similar1 and provide many examples for how people can engage in MVPA that aligns with their physical capabilities and personal preferences. The table below highlights several examples of MVPA that were used in the Surgeon General’s Report and the 2008 PAG. These examples illustrate the relationship between duration and intensity; that is, less strenuous activities require a longer duration to elicit comparable health-benefits.

    1996 Surgeon General’s Report on Physical Activity and Health

     2008 Physical Activity Guidelines for Americans

    • Brisk walk for 30 minutes (moderate)
    • Playing volleyball for 45 minutes (moderate)
    • Raking leaves for 30 minutes (moderate)
    • Swimming laps for 20 minutes (moderate-to-vigorous*)
    • Playing basketball for 15-20 minutes (moderate-to-vigorous*)
    • Running 1.5 miles in 15 minutes (vigorous)
    • Brisk walking for 30 minutes on 5 days / week (moderate)
    • Running for 25 minutes on 3 days / week (moderate)
    • Aerobic dance class for 30 minutes once/week (vigorous); 30 minutes of running once/week (vigorous); 30 minutes of brisk walking once/week (moderate)

    *Note: Depending on the intensity, an activity can be moderate or vigorous intensity. One minute of vigorous physical activity is equal to approximately two minutes of moderate physical activity

    The 2018 Physical Activity Guidelines Advisory Committee (PAGAC) recognized that most daily activity is sporadic and is typically performed in bouts that are less than 10 minutes in duration. Additionally, many behavioral recommendations that emerged from the 2008 PAG, such as climbing stairs or parking the car farther away, did not support the notion that aerobic activity should be performed in episodes of at least 10 minutes. With the advent of accelerometers and technological improvements in physical activity trackers, the PAGAC felt it was important to review the current scientific landscape to determine whether physical activity bouts of less than 10 minutes provided health benefits, or if the benefits of physical activity were only achieved when the bout of activity was at least 10 minutes.

    To address this issue, the 2018 PAGAC extended its review of the literature to include observational studies since, due to prior recommendations, randomized control trials did not evaluate bouts of physical activity of less than 10 minutes in duration. The committee concluded that the scientific evidence unequivocally supports that MVPA accumulated in bouts of at least 10 minutes can improve a variety of health-related outcomes. Additionally, the evidence also suggests that MVPA, accumulated in bouts of less than 10 minutes, is associated with favorable health-related outcomes, including improvements in:

    • Body Mass Index, adiposity and obesity
    • Resting blood pressure
    • Cholesterol and triglycerides
    • Fasting glucose, fasting insulin and HbA1c
    • Metabolic syndrome
    • C-reactive protein
    • Cardiovascular risk score
    • Frailty
    • Multimorbidity
    • All-cause mortality

    The findings by the 2018 PAGAC that engaging in any amount of MVPA, regardless of the length of the bout, have health-enhancing effects, and led to the removal of the 10-minute bout criteria in the Physical Guidelines for Americans, 2nd edition. This is of particular importance for individuals who are unwilling or unable to engage in physical activity for at least 10 minutes. Additionally, these findings will have an extensive impact on physical activity surveillance and health messaging.

    While further research is needed to strengthen the emerging evidence that the total amount of physical activity, regardless of intensity and bout duration, is beneficial to one’s health, it is important to acknowledge this potential paradigm shift in physical activity research and recommendations. The key message is that any amount of MVPA counts and whether it be taking the stairs, parking further away or going for a short walk, there are many “little” things we can do to substantially improve our health.

    Learn more about the Physical Activity Guidelines for Americans, 2nd Edition



    1] The primary recommendation from the Surgeon General’s Report on Physical Activity and Health was to expend about 150 calories of energy per day, or 1000 calories per week for health benefits, whereas the key guidelines for the 2008 PAG encourages adults to achieve 150 minutes of MVPA per week for substantial health benefits.

    Kyle Sprow, MPH, CSCS is a Cancer Research Training Award Fellow with the National Cancer Institute. He was part of the federal staff that supported the Physical Activity Guidelines Advisory Committee and the development of the second edition of the Physical Activity Guidelines for Americans.

  • Featured CEC Quiz | Strategies for Partnering with Health Care Settings to Increase Physical Activity Promotion

    by David Barr | Aug 01, 2019

    ACSM's Health & Fitness Journal®: July – August 2019 CEC Course #4 | Clinical Applications: Strategies for Partnering with Health Care Settings to Increase Physical Activity Promotion

    Available ACSM CECs: 2.0

    ACSM Clinical Quiz CEC

    Health and fitness professionals as well as health care providers have the shared goals of promoting and supporting patients’ health. Research findings support that partnerships should be encouraged to “bridge the gap between physicians and fitness professionals”.

    Description:

    This course includes an online ACSM's Health & Fitness Journal® Article and a corresponding online quiz.

    Advocating for physical activity promotion in the health care setting is critical to increasing awareness and support for physical activity promotion; however, building and fostering partnerships across multiple sectors of society will be essential in linking patients to community resources to support regular physical activity.


    Read the free article

    Purchase the course and earn CECs

    Bundle quizzes and save 50%


    More Courses

    ACSM CEC Quiz March 2019Might Plight: The Social Anxiety Felt by Men in the Weight Lifting Environment
    ACSM CEC Quiz Health Fitness Journal Your Guide to Fixing Client Burnout
  • ACSM Guidelines for Strength Training | Featured Download

    by David Barr | Jul 31, 2019

    ACSM Resistance Training Guidelines Strength Training

    Download ACSM's Guidelines for Strength Training Infographic

     

    People of all ages and abilities who regularly participate in resistance exercise reduce risk of numerous diseases, improve quality of life and reduce mortality


    Authors:
     Fiataraone Singh, Maria; Hackett, Daniel; Schoenfeld, Brad; Vincent, Heather K.; Wescott, Wayne.


    Highlighted topics include:

    • Key Physiological Benefits of Resistance Exercise
    • Components of an Exercise Plan

    Go To Resource Download

    View More Popular Strength Training Content

    Kyle Kercher Strength Conditioning ACSM
    5 Things You Need to Know | Starting a Strength Program in your Facility


    Back Squat Deficit
    Squat Technique and Coaching | Top 3 Videos


    More Recommended Resource Downloads:

    Women Heart Disease Download Women and Heart Disease

    Healthy Eating Resource Download Creating a Healthy Eating Pattern
  • EMERGENCY – Every Second Counts & You Must Know What To Do

    by David Barr | Jul 25, 2019

    ACSM Emergency Planning

    Do you know what to do if an emergency happens at your facility?


    Facility Safety is multi-faceted and everyone’s responsibility to ensure a safe environment for all users and all staff members.  It is imperative to always be prepared for the worst with regard to anything that may happen from medical emergencies, fire, earthquake, flood, storm, power outages, staff and member hostility danger, active shooter, contamination, etc.

    Do you know what to do if an emergency happens at your facility? The job task analysis (on which examination questions are based) for each of the ACSM Health Fitness certifications and the ACSM Clinical Exercise Physiologist certification, state that an exercise professional should know and/or be able to perform as part of their job, different aspects of preparing for and being involved in emergency situations:

    • ACSM-GEI “Respond to emergencies to minimize untoward events by following procedures consistent with established standards of care and facility policies.” (Domain IV. Professional Responsibilities, section F)
    • ACSM-CPT “Develop a comprehensive risk management program (including an emergency action plan and injury prevention program) consistent with industry standards of care” (Domain IV Legal and Professional Responsibilities, section B)
    • ACSM-EP “Develop and disseminate risk management guidelines for a health/fitness facility to reduce member, employee, and business risk.” (Domain IV. Risk Management and Professional Responsibilities, section A)
    • ACSM-CEP “Evaluate the exercise environment and perform regular inspections of any emergency equipment and practice emergency procedures (e.g., crash cart, activation of emergency procedures) per industry and regulatory standards and facility guidelines.” (Domain VI: Legal and Professional Responsibilities, section A)

    Please refer to the individual job task analysis for the specific lists of knowledge and skills. Knowing what the documented emergency response system is for your facility is important to every certified professional.


    ACSM's Health Fitness Facility Standards Guidelines Download pdf

    ACSM’s Health/Fitness Facilities Standards and Guidelines, Fifth Edition provides standards and guidelines for emergency planning and policies that health/fitness facilities need to consider in order to provide a reasonably safe environment for employees, members and users. A foundational component is a written emergency response policy and procedure.

    Emergency Planning and Policies Standard 1. Facility operators must have written emergency response policies and procedures, which shall be reviewed regularly and physically rehearsed a minimum of twice annually. These policies shall enable staff to respond to basic first-aid situations and other emergency events in an appropriate and timely manner.

    Having an emergency response system is critical to providing a reasonably safe environment for members, users, and staff as well as being a sound risk management practice. For health/fitness facilities, emergency response systems must be developed in order to provide the highest reasonable level of safety for member and users.

    If you’re not sure what the emergency response plan is for your facility, ask. Know what the plan is before an emergency arises. As an exercise professional, you can actively contribute to making sure your facility maintains up-to-date emergency policies and procedures. An example of a safety program manual is included ACSM’s Health/Fitness Facilities Standards and Guidelines, Fifth Edition. Safety plans, and particularly emergency plans, should not be copied or implemented directly from the example manual, from those published in textbooks, or from plans developed by other health/fitness organizations or facilities. It is important that individual plans and policies be specifically developed and tailored for each individual organization and facility. Every organization/facility has unique factors that must be carefully considered when developing such plans. These factors include, but are not limited to the:

    • Type and nature or health/fitness program activities
    • Number of clients or users and their demographics
    • Staff size and training
    • Facility size and layout
    • Local EMS response time

    Safety and emergency plans should be approved by a health/fitness organization’s management, legal counsel, insurance provider, and appropriate experts (e.g., a medical director or liaison, local EMS personnel).

    You can learn more about current standards and guidelines for developing emergency planning and policies in ACSM’s Health/Fitness Facilities Standards and Guidelines, Fifth Edition.

    Download your free sample

    Authors:
    Bill McBride ACSM 
    Bill McBride
    President & CEO, BMC3 – Bill McBride Consulting, Coaching & Club Management
    Co-Founder, President & Chief Executive Officer, Active Wellness

    Bill is a health club industry veteran with over 25 years of experience leading and managing all aspects of commercial health clubs, medical fitness centers, residential, community, multi-tenant and corporate fitness sites.  He co-founded Active Wellness, LLC and owns a health club consultancy - BMC3. Bill has served as Chairman of the International Health, Racquet & Sportsclub Association (IHRSA) Board of Directors, President of the Mid-Atlantic Club Management Association (MACMA) and served on the Industry Advisory Board for the American Council of Exercise (ACE).  He is actively engaged as an author on industry education, serves on several fitness related technology company Advisory Boards, serves on the Medical Wellness Association (MWA) as a Faculty Member and The Medical Fitness Network (MFN) Advisory Boards.  He recently also served on the ACSM Facility Standards & Guidelines 5th Edition Committee as an Editor.  Bill consults & speaks regularly on industry topics throughout the world.

     
    Daniel Connaughton

    Daniel P. Connaughton, EdD, ACSM-EP

    Professor and Associate Dean for Faculty Affairs in the College of Health and Human Performance at the University of Florida

    Prior to his career in academia, Dan held management positions in recreation, aquatic, and health/fitness programs. His teaching and research are primarily focused on the study of law, policy, and risk management in sport, recreation, and fitness programs. He has authored or coauthored three textbooks, several book chapters, and over 115 peer-reviewed research articles. Furthermore, he has served as the principal investigator on over $12.5 million of externally funded contracts and grants, including research funded by the AHA that investigated implementation constraints and risk management practices related to AED in sport and recreation programs. Over the course of his career, Dan has received several teaching and research awards. He is also a research fellow with the Sport and Recreation Law Association and the Research Consortium of SHAPE America.


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