Definition of Terms Physical activity - is defined as any bodily movement produced by skeletal muscle that results in expenditure of energy.

ergy. Leisure physical activity is a physical activity undertaken during discretionary time. Lifestyle physical activity is characterized as integration on numerous shorts bouts of moderate activity into daily living. Exercise is leisure - time physical activity conducted with the intention of developing physical fitness Physical fitness is s measure of a persons ability to perform physical activities that require endurance, strength of flexibility and is determined by combination of level of physical activity and genetically inherited physical characteristic.

Health Benefits of Physical Activity Contributes to physiological stability and high level functioning and assists individuals in actualizing their physical performance potential. Decreases the risk for: Obesity Heart diseases Diabetes Hypertension Stroke Risk for colon cancer Enhances physiological well being Reduces the risk of depression Improves mood as well as self concept and self esteem Increases strength and agility Improves the functional capabilities of individual with capabilities 1. Moderate intensity - Activity that refers to a level of effort that burns 3.5 to 7 kilocalories per min (kcal/min) or 3 to 6 metabolic equivalent (METS) - Includes: Walking briskly Bicycling Swimming Dancing

2. Vigorous Intensity Activity - It at a level of effort that burns more than 7 kcal/min or greater than 6 METS. - Includes: Jogging Swimming continuous laps Bicycling uphill Minimum amount of activity required for health benefits burns approximately 150 kcal of energy per day or approximately 1000 kcal per day. The exercise prescription for middle age men is about 2000 kcal per week or equivalent to 3 miles a day

Genetic and Environment Effects on Activity Level Genetic research Is likely to identify foods that do not increase fat depositions, ages when the body is more receptive to change and people with certain genes that are more receptive to specific behavior changes.

Life Span Patterns of Physical Activity Fueled the realization that a number of risk factor for cardiovascular disease. - Including Obesity High blood pressure Elevated cholesterol - Modifiable risk factor Coronary heart disease Elevated cholesterol lever Smoking Hypertension Inactivity

Determinants of Physical Activity in Children and Adolescents 1. Physical Activity Related to Gender For boys Changes in attitude toward For Girls Changes in attitude toward - Changes in the activity preferences. - Parental transport to activities. Reported less representation of self athletic and lower levels of past and current physical activity. Family influences during childhood have a positive effect on the physical activity patterns that children develop. 2. Physical activity related to Ethnicity and Socioeconomic Status Children of Asian Were less active than children in other ethnic groups. Posed major problems to parents 1. Socio economic status 2. cost of participation 3. Factors related to increased physical activity Factors that increase the likelihood of children History of being active Preference for physical activity over sedentary pursuits Goals or interventions to be active Achievement orientation Intention to be active Perceived physical competence and Opportunities to be active Physical education Perceived competence or self efficacy. Parental transport to activities and level of activity of the parent.

Factors that increase the likelihood of Adolescent History of being active Achievement orientation Intention to be active Perceived physical competence Opportunities to be active such as o Involvement in community sports o Not being sedentary after school and on weekends.

Social influences for adolescent 1. Active parental support 2. Encouragement from significant others 3. Level of activity of siblings

Role of Schools in Promoting Physical Activity Promoting the involvement of children to physical activities Teaching personal value of regular activity Encouraging continuing involvement in moderate to vigorous activities both at school and at home

Role of Community in Promoting Physical Activity Family based activity Community based recreational programs and physical activity Family based program encourage parents to be active with their children in relationship building experiences Community based programs will establish norms of physical activity participation for youths. Such as Community runs, Community all sports day, Neighborhood walking groups.

Determinants of Physical Activity in Adults 1. 2. 3. 4. 5. Past behavior Social variable Self efficacy Perceived benefits Barriers to physical activity

Males have increasing interest in the physical activity among women. Only 40% of women participate in regular physical activity Unmarried woman generally profile as more active than do married women. Because of. o Multiple family obligations o Work pressure Intervention Home based programs Results Increase HDL and lower total cholesterol

Older adults Changes in attitude towards o Age o Convenience of facilities o Cost o Opportunities for physical activity with others o Fear of resultant illness or injury o Disability o Sensory impairment Encourage them to: Feel socially supported by family, friends and caregivers. They had to feel the confident in their ability to participate in physical ability.

The Process of Physical Activity Behavior Change Process Models Use to specify the mechanisms underlying the adoption and maintenance of physical activity behavior.

Transtheoretical Model or Stages of Change Model Proposes that individuals engaging in a new behavior move through a series of changes. PRECONTEMPLATION not intending to make change. CONTEMPLATION considering change PLANNING OR PREPARATION making minor changes ACTION actively engaged in major behavior change MAINTENANCE sustaining the behavior over time Extension: TRANSFORMED STAGE having participated regularly in physical activity for 5 more years and being 100% confident in personal ability to remain physically active for life.

This reveals that: Women were more likely than Men to be in the contemplation or action stages and less likely to be in the maintenance stage. Working women with young children in the home were more likely to be in the lower stages of exercise adoption that were women without young children. Precontemplation were significantly older, had lower exercise knowledge, perceived lower psychological benefits from exercise, had lower family support for exercise, and did not perceive exercise as important compared to the action groups. Both the precontemplation and the contemplation groups perceived more barriers to exercise than did the action group. Person in maintenance also scored more barriers to exercise than did the action group. Person in maintenance scored the highest on the benefits of exercise. The transformed stage had a higher reported level of physical activity and more positive towards role modeling an active lifestyle than did those in the maintenance group.

Intervention in Primary Care to Promote Physical Activity NURSES AND PHYSICIANS in primary care have multiple opportunities to engage in physical activity counseling. The AMERICAN NURSES ASSOCIATIONs recommends that every primary care visit be seen as an opportunity to promote an active lifestyle.

Routinely advised clients to engage in moderate intensity physical activity for a total of 30 minutes on most days of the week. Counseling in primary care should assist children and adolescent to select activities they enjoy and not focus solely on the competitive sports. Children should be encourage to engage in activities they enjoy and activities that can be carried into adulthood and are easily incorporated into their daily life year around. Adults client in primary care should be asked about their physical activity habits at work, home and during leisure to determine if these activities are of sufficient frequency, intensity, and duration to confer health benefits. Adults should be assisted in planning program of physical activity that is medically safe, enjoyable, convenient, realistic, and structured to achieve self selected goals. Barriers to physical activity counseling sometimes cited by health professionals includes; 1. Lack of time. 2. Lack of perceived effectiveness as a councilor. 3. Lack of proper training to fulfill this role. Clients are quick to recognize the extent to which their provider has actually experienced the challenges and the ups and downs of adopting and maintaining a regular program of physical activity The physical appearance of health care providers also provides powerful cues to clients as to whether they actually practice what they preach

Tailoring the behavioral intervention program The individual is likely to enhance its effectiveness. Consider to developing or using existing computer based tailoring programs to optimize their physical activity counseling skills.

Intensity of Physical Activity Vigorous Physical Activity At least 20 minutes x three times per week. At 60% or more of maximum heart rate.

Moderate Physical Activity 30 minutes daily x on most days of the week through a combination of activities. Recently moderate physical activity has been proposed as having some of the same health protective benefits as vigorous activity. Warming up - To increase blood flow to the heart and skeletal muscles, enhance oxygenation of tissues and increase flexibility of muscles before physical activity. - 7 to 10 minutes. Walking briskly Arm circles Jumping jacks Leg exercises Wall pushups -

Cool down period - Allows the heart rate to decrease gradually, preventing pooling of blood in the muscles and resultant lightheadedness. - 5 to 10 minutes. Slow walking, Jogging Cycling

Risk of Physical Activity An overly aggressive approach to physical activity may exaggerate existing clinical conditions and put patients, particularly older adults at risk for untoward effects. If an individual has an undiagnosed physical activity heart condition, strenuous physical activity could create arrhythmias. Overstraining muscles and joints may result in muscle soreness and joint pain. Intervention in the Community to Promote Physical activity Community interventions are an approach to increasingly physical activity in population groups. If a large number of communities implement these interventions, it would contribute significantly to attaining the physical activity goals.