ACSM's Health & Fitness Journal®: July – August 2019 CEC Course #2: Aquatic Exercise for Health: Probing the Depths of HIIT for Cardiometabolic Training

Available ACSM CECs: 2.0

Description:

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

Learning Objectives:

•How to integrate aquatic activities as part of a well-rounded program for patients or clients who could benefit from immersion and/or exercise in water.

•Advocate for a shallow water aquatic interval exercise Rx to clients who aim to expand their volume and intensity of activities without increased risk for injury.

•Use water’s properties within the context of safe training principles to prescribe a water-specific exercise prescription that can effectively offer clients a “gateway” to adopting a fun alternative to traditional land-based training options.

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3 simple evidence-based teaching strategies to help children with autism through exercise.

Parents of children with autism have rated exercise as the number one treatment, according to the National Survey of Autism Treatment Effectiveness. Research shows that exercise can improve on-task behaviors, language development and academics, while also reducing maladaptive behaviors. A 2017 study from Rutgers University (Olin, et al., 2017) has also shown that 10 minutes of low-intensity exercise was able to reduce echolalia (verbal repetition of phases or words) and hand-flapping, which are common behaviors associated with autism.

Despite these incredible results, fitness professionals and those who work in fitness centers continue to struggle with how to teach this community. The reason is simple: trainers do not know to use the same evidence-based teaching strategies that have been proven effective in the classroom.

1. It’s About Using Visuals

Engaging a person with autism into an exercise routine, or any new routine, will take time, creativity, and visual supports or pictures. Visual supports help bring in structure, routine, and sequence that many children with autism require in order to carry out their daily activities (Rao and Gagie, 2006). Visual supports, when implemented correctly, allow students with autism the freedom to engage in life, regardless of impairment (Hodgdon, 2007).

As the saying goes, “a picture is worth a thousand words.” By reducing your verbal instruction - or completely removing it - and replacing it with a picture of an exercise can make the difference in getting those with autism to make the exercise connection.

2. Make Exercise Part of their Routine

Those on the autism spectrum benefit from following a structured schedule from the minute they wake up. This is the same as many of us; hit the alarm clock, brush teeth, take a shower, get dressed, eat breakfast, go to work. The only difference is a person with autism may be using a visual support as they do each activity. Structure and routine are what keeps many on task in daily living, school, and it must be implemented in an exercise session.

It is critical that an exercise program is thoughtfully integrated into their daily or weekly routine. For example, the day typically doesn’t end at the end of a school day. Many go to various therapy sessions throughout the week for additional help. Educate parents that even one exercise session per week can be beneficial. Begin by having the family or individual choose ONE day and time per week to get started – and do NOT change that day or time.

3. Remember that Perfection is NOT the Goal – Persistence is

One of a personal trainer’s responsibilities is to instruct perfect form. When a client is using improper form, the typical words to correct it are “no” and “try again.” Those with autism hear or have heard “no” or “try again” more than you will ever know – especially in the schools. A trainer’s first goal should be to make exercise a positive experience.

ACSM recommends 30-60 minutes of moderate aerobic activity per day and for resistance exercise anywhere from 8-20 repetitions per exercise. These are realistic guidelines for most but not for those with autism. Start your clients out slowly. Engage them in a few exercises but not for an extended period of time, it may be only 3-8 minutes of aerobic activity and 1-2 muscular fitness or flexibility exercises for 2-8 repetitions.

If you get them moving, even for three minutes or 5 reps, that is a WIN for the client, you, and the parents! Of course you’ll want to gradually increase the amount of time the client spends being physically active, but remind them, their families and yourself that they are just getting started. Don’t focus on the form (as long as they are not being unsafe) – your primary focus needs to be about building the relationship.

Ready to learn more?

Take the next step with ACSM's Autism Exercise Specialist CEC Course!

Author: 

David S. Geslak, BS, ACSM-EP

As a Para-Educator and Fitness Coordinator at a school for children with autism, Coach Dave experienced first-hand the challenges of teaching exercise. By understanding that students with autism learn differently, he developed a system that has become a breakthrough in effectively teaching exercise. Twelve universities have incorporated his program into their Adapted Physical Education and Special Education Programs. He also created the ACSM/EC Autism Exercise Specialist Certificate.

Coach Dave graduated from the University of Iowa with a degree in Health Promotion, is an ACSM Certified Exercise Physiologist, Certified Strength and Conditioning Specialist, and a former student assistant strength and conditioning coach for the University of Iowa Football Program.

References

Olin S, McFadden B, Golem D, et al. The effects of exercise dose on stereotypical behavior in children with autism. Med Sci Sports Exerc. 2017; 49(5):983-90.
 
Rao SM, Gagie B. Learning through seeing and doing: Visual supports for children with autism. TEACHING Exceptional Children. 2006; 38(6):26–33.
 
Hodgdon LA. Cram101 textbook outlines to accompany: Visual Strategies for Improving Communication: Practical Supports for School and Home. 1st ed. Hodgdon (ME): Academic Internet Publishers; 2007.

More from David Geslak

The second edition of the Physical Activity Guidelines for Americans was published by the Department of Health and Human Services (DHHS) in November 2018. Background data and development procedures were presented at the ACSM Annual Meetings in 2018 and 2019 and were published in Medicine & Science in Sports & Exercise (MSSE) and other major medical journals.

One significant conclusion of an extensive literature review is that the least active men and women die or become disabled younger and more frequently due to heart disease and other chronic diseases than even their slightly more active peers. What is now well established is that the least active are at greatest risk, and for these people even small amounts of activity performed on most days decreases risk of heart attack, stroke and other chronic conditions such as heart failure, type 2 diabetes and colon cancer.  

In people who are somewhat more active but do not meet the core guidelines of 150-300 minutes/week of moderate intensity aerobic activity (or 75-150 minutes per week of vigorous intensity activity) adding more activity throughout the week provides additional health benefits even if they don’t achieve these guidelines. “More is better” applies here for people doing no or very little activity such as walking as well as for people who are doing some but less than the 150-300 minutes/week target.

These new recommendations are based on very large amounts of data published since the 2008 Physical Activity Guidelines for Americans, and they confirm the core recommendations for moderate and vigorous intensity aerobic activity. Members of the Guidelines Advisory Committee reviewed data from numerous studies conducted throughout much of the world including information on people from a wide range of demographics. More activity resulted in lower risk regardless of age, sex, BMI, race/ethnicity and many existing health conditions. Increased physical activity appears to be a central component of maintaining good health for everyone.

Short bouts now count

The key change in the aerobic activity recommendation in 2018 was to remove the “10-minute bout duration requirement.” In prior physical activity guidelines by DHHS, ACSM, CDC and the American Heart Association since 1995, for a bout of aerobic activity to count towards the weekly goal it needed to be at least 10 continuous minutes in duration. In the second edition (2018) DHHS guidelines it states:

Bouts, or episodes of moderate-to-vigorous physical activity of any duration may be included in the daily accumulated total volume of physical activity. The 2008 Physical Activity Guidelines for Americans recommended accumulating moderate-to-vigorous physical activity in bouts of 10 minutes or more because not enough evidence was available to support the value of bouts less than 10 minutes in duration. The 2018 Advisory Committee concluded that bouts of any length contribute to the health benefits associated with the accumulated volume of physical activity. Even a brief episode of physical activity like climbing up a few flights of stairs counts.

This change of not requiring a continuous bout of at least 10 minutes will likely increase time spent being active reported by people who accumulate a lot of activity (usually steps) by moving about frequently but briefly throughout the day (more people will “meet guidelines “ doing what they did before). Also, this change puts a premium on using wearable activity trackers for monitoring activities such as walking or moving about throughout the day as most trackers are designed to record each minute of continuous activity.

Not discussed in the guidelines is how to deal with activity duration collected by self report verses by activity trackers. Research is needed on how MVPA duration accumulated throughout the day collected by self report compares with that recorded by activity trackers. Does the aerobic activity target for good health need to be the same for self report activity and activity recorded using wearable devices?  

Learn more about the Physical Activity Guidelines for Americans, Second Edition.

William Haskell, Ph.D., FACSM, is a Professor of Medicine, Emeritus, at Stanford University in Stanford, California. He is also a member of the Stanford Cancer Institute. Dr. Haskell served as the 27th President of the American College of Sports Medicine from 1983-1984. He presented the D.B. Dill Historical lecture at the ACSM Annual Meeting in 2019. His presentation was titled "Guidelines for Physical Activity and Health:
Evolution Over 50 Years."

ACSM’s Exercise Testing and Prescription is a practical resource that walks students through the process of selecting and administering fitness assessments.

This book features a wide range of online resources, includes laboratory materials and activities that provide opportunities for hands-on learning, and a library of journal articles that helps students connect research to practice. Download your free pdf sample of Chapter 8: General Principles of Exercise Prescription to see more. 

Go to book page and Download

During this presentation Lee Burton discusses the process in which you can ensure you are focusing on how well your client or athlete is performing during exercise and activity, not just how often.

About the course:

This course includes an online video from ACSM’s Health & Fitness Summit and a corresponding online quiz. All course content will be presented to you electronically upon completion of your purchase. This includes all videos, quizzes, and certificates (certificates awarded upon successful completion of the quizzes).

Available ACSM CECs 3.0

Learning Objectives for ACSM/FMS - Move Well then Move Often:

• Provide fundamental principles which should allow more effective exercise design
• Identify movement pattern dysfunctions
• Understand how to use movement screening to identify mobility and stability problems

Purchase and earn CECs

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