Victoria Chiropractor: Research Review: Physical Exercise Guidelines


Youth


- Prior to adolescence, youth gain strength through neurological adaptations

o Hypertrophy unknown

- Focus on co-ordination and technique

- Must be supervised by certified professional

- Minimal risk of growth plate injury under supervision

- Begin with:

o 5-10mins dynamic warm-up

o 1-2 sets of 8-15 reps at light-moderate load (30-60% 1RM) for 8-12 exercises

o 2-3 days per week with at least 1 day between

o Simple exercises to gain confidence

- Strength

- Balance/coordination (unstable surfaces)

- Plyometric

o <10 reps of each drill

o Use yielding surfaces


Osteoporosis


- Youth

o Minimum 60mins weight bearing activity daily

o 10-20 mins of impact activities 3x/week

- Adulthood

o Moderate to high intensity weight-bearing activities

▪ Explosive exercises are best

o 30-60mins 3x/week

- FAT/RED-S

o Increase energy intake to 30kcal/kg FFM

o Psychological intervention

- Post-Menopause (age 65-85)

o Weight bearing endurance exercises 30-60mins 3-5x/week

▪ But not high impact exercises

o Strength training to load the spine and hips 3x/week

- Supplement

o Pre-menopause: 1000mg ca, 400IU vit D

o Post-menopause: 1200mg ca, 800-1000IU vit D

▪ Some cases require 1000-2000IU vit D


T2 Diabetes


- Goal is to improve insulin action by transiently upregulating GLUT-4 expression on cells

- Precautions

o Hyperglygemia: Caution when BG levels above 16.7mmol/L, ensure feeling well

and adequately hydrated

o Hypoglycemia: When BG levels less than 5.5mmol/L in diabetics taking insulin or

secretagogues should consume up to 15g CHO prior to exercise to prevent

hypoglycemia

o Those with CVD should exercise in cardiac rehab clinic only

o No weight bearing exercise with foot ulcerations

- Aerobic exercise

o 150min/week at moderate or greater intensity

▪ 30mins 5x/week with no more than 2 consecutive days between bouts

due to transient nature of exercise-induced improvemnets in insulin

action

o Moderate intensity (40-60% VO2 max) – brisk walking

o Additional benefits from vigorous exercise

- Resistance training

o In addition to aerobic

o Moderate to vigorous (50-80% 1RM) resistance training at least 2-3x/week


Pregnancy


- Woman who has been previously active may continue their exercise during the first

trimester to a maximum of 30-40 minutes at a frequency of 3-4 x a week as tolerated

- 1st Trimester: Maintenance of pre-pregnancy activity level

- 2nd Trimester: Increase training, if desired, by 5-10%

- 3rd Trimester: Maintain exercise level and reduce impact

o Warm-up and cool-down exercises are recommended with each exercise

sessions, including range of motion exercises and static stretching for major

joints and muscle groups, respectively

- Frequency -

o Women who did not exercise regularly prior to pregnancy should not start an

exercise program until the second trimester

o It is currently recommended to exercise at a frequency of 3 times per week,

progressing to a maximum of 4 to 5 times per week

- Intensity

o Heart rate is less reliable in pregnancy for determining exercise intensity

o The modified heart rate target zones, as outlined in the PARmed-X, are

recommended for use in measuring exercise intensity in pregnant women

o Borg’s 15-point Rating of Perceived Exertion (RPE) scale and the “talk test” are

recommended as alternate methods of quantifying exercise intensity. A target

range of 12 to 14 is suggested in pregnancy

o The “talk test” implies that a pregnant woman can carry on a verbal conversation

during exercise, if she is exercising at a safe intensity

- Time

o When first beginning an exercise program, it is recommended that the woman

begin with 15 minutes of continuous exercise

o The duration of exercise may be gradually increased, as pregnancy progresses, to

30 minute sessions

- Type

o Aerobic and strength-conditioning exercises are recommended in pregnancy

o Less strenuous but continuous aerobic exercise (i.e. brisk walking, stationary

cycling, cross-country skiing and swimming) are recommended

o Avoid any exposure to hyperbaric, hyperthermic, humid or hypoxic

environmental conditions

o Avoid aerobic activities with increased risk of blunt abdominal trauma and loss of

balance (i.e. downhill skiing, horse-back riding, gymnastics)

o Avoid exercises in supine position after the fourth month of pregnancy, to

prevent hypotensive episodes

o Avoid breath-holding during weight-training exercise

o Abdominal exercises are not recommended if diastasis recti develops



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Dr. Mike Hadbavny

Victoria Sports Chiropractor FRCCSS(C)

If you are interested in learning more about how chiropractic care can be effective for your particular condition or health goals, contact Dr. Mike Hadbavny at 250-881-7881 today to make an appointment and discover the many benefits of seeing a chiropractor in Victoria BC. Contact us today.

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