ACSM

Reconocimiento | ACSM y Uniandes

 

Le comparto la nota que publicó recientemente la Facultad de Medicina de la Universidad de Los Andes sobre el reconocimiento que recibí por parte del Colegio Americano de Medicina del Deporte (ACSM, por sus siglas en inglés) en la pasada convención anual (mayo 31-junio 4, 2016) por mi labor como Director del Centro Regional para América Latina del programa Exercise is Medicine®.

Gracias, primero a Dios, y a todas las personas, colaboradores, estudiantes, colegas e instituciones y empresas que han apoyado la promoción de la actividad física como pilar en el cuidado de la salud durante todos estos años de trabajo en nuestro país.

Siga este link para leer la nota completa.

 

 

Lanzamiento Libro “Prescripción del Ejercicio”

 

Esta fecha (sept 25/2015) es muy especial para mí. Junto a grandes amigos y expertos, iniciaremos en Paipa el tour de lanzamiento del libro que Felipe Lobelo MD PhD y yo escribimos exclusivamente dedicado a la prescripción del ejercicio. El libro “Prescripción del Ejercicio” nace de la necesidad de recopilar las herramientas básicas que los médicos necesitamos para motivar, evaluar y recomendar actividad física a nuestros pacientes. Escrito en español con un lenguaje sencillo, fotografías y videos testimoniales, el libro entrega las recomendaciones y tips más actuales para que todo médico—independiente de su especialidad—pueda realizar una adecuada prescripción del ejercicio.

Creo que todos conocen mi profundo compromiso por mejorar la salud y calidad de vida de nuestros pacientes a través de los estilos de vida saludable, especialmente a través del ejercicio, y es por esto que en este libro entrego conocimientos y recomendaciones que he adquirido en mis años de práctica clínica en Colombia. Creo que nuestros pacientes tienen el derecho a conocer los beneficios del ejercicio para su salud y nosotros, los profesionales de la salud, tenemos el deber moral y ético de hacer la mejor recomendación posible.

Como saben, actualmente la mayoría de las personas tienden a tener una vida sedentaria lo que explica, en gran medida, la creciente epidemia en países Latinoamericanos de infartos, diabetes tipo 2, obesidad, cáncer, trastornos de ansiedad y depresión, entre otros. Estas enfermedades representan una carga insostenible para nuestro países porque disminuyen la calidad de vida y los años de vida productivos de la población, ocasionan muertes tempranas, generan altísimos gastos en salud, y frenan el desarrollo.

La Organización Mundial de la Salud, y otras importantes entidades internacionales como los Centros para el Control y la Prevención de Enfermedades (CDC) y el Foro Económico Mundial, han identificado al ejercicio físico regular como una estrategia indispensable en la lucha contra las enfermedades crónicas, especialmente en países en vía de desarrollo. Por su parte, el Colegio Americano de Medicina del Deporte (ACSM) promueve la inclusión de la prescripción del ejercicio en la práctica clínica a través de su iniciativa global, Exercise is Medicine® (EIM®).

Este libro va de la mano con los contenidos del Curso de Prescripción del Ejercicio desarrollado por nuestro equipo de EIM® en América Latina y avalado por el ACSM. Más de 4000 profesionales de la salud en la región han sido capacitados a través del curso y muchos más podrán acceder a estos contenidos gracias a la publicación de este libro.

No me queda más que agradecer a todas las grandes personas que han aportado para que este proyecto sea una realidad. Expertos, estudiantes, empresarios y los profesionales que atienden a la comunidad día a día, a todos gracias. Desde el equipo de trabajo, y todos los colaboradores, esperamos que este libro cumpla el propósito de ser una guía práctica para usted.

 

Acompáñenos en los próximos lanzamientos del libro [fechas actualizadas]:

Gran Lanzamiento en Paipa: septiembre 25/2015, Hotel Estelar. Vea la fotografías aquí

Lanzamiento en Cartagena: Diciembre 2/2015 Hotel Las Américas.

Lanzamiento en Bogotá: octubre 23/2015, Hotel NH Collection Royal. Pronto tendremos las fotografías.

Lanzamiento en Medellín: noviembre 20/2015, Hotel Estelar Milla de Oro.

Lanzamiento en Cali: [fecha por definir]

Mayor info: redsocial@johnduperly.com

 

¿Dónde puede comprar el libro?

[Actualización:]

Siga el los links para adquirir el libro on-line:

Librería Nacional: compre el libro aquí

Liberería Lerner: compre el libro aquí

Ediciones de la U: compre el libro aquí

Librería Panamericana: compre el libro aquí

—-

El libro estará disponible en las principales librerías del país a finales de septiembre y principios de octubre. También lo puede ordenar a domicilio desde ya a través de Ediciones de la U (Tel: +57 1 4065861, pregunte por Danny Lara).

Promoviendo el ejercicio en toda América Latina

 

Profesor de la Facultad de Medicina de la Universidad de los Andes en Bogotá, Colombia, especialista en Medicina Interna y con un doctorado en Alemania en Medicina del Deporte, Duperly habló sobre la importancia de la actividad física y el ejercicio en la prevención y tratamiento médico de las enfermedades y sobre los programas que se han venido estructurando desde hace cuatro años a través de proyectos como ’Exercise is Medicine’ del Colegio Americano de Medicina del Deporte.

“He dedicado mi vida a esto, fui deportista competitivo y estudié Medicina y desde esa época daba charlas resaltando las relaciones entre el ejercicio y la salud; hice dos posgrados, un doctorado en Ciencia del Deporte y una especialización en Medicina Interna y con este respaldo académico he podido manejar enfermedades crónicas como hipertensión, obesidad, diabetes y cáncer, pues la medicina del deporte mira un aspecto terapéutico de toda la fisiología del ser humano”, comenta el especialista y añade que los médicos de todas las especialidades están de acuerdo con esto y preparados para manejar el tema y poder transmitirlo a sus pacientes.

Él cree que en Latinoamérica hay conciencia sobre el tema, pero que el grupo especializado sigue siendo pequeño. “En la mayoría de nuestros países los especialistas en medicina del deporte son un grupo de 100 ó 200 médicos por país. Una de las iniciativas que estamos promoviendo en este viaje a Ecuador y que la tenemos en 14 países en Latinoamérica es que no necesariamente hay que esperar un posgrado de cuatro años para que un médico pueda hablarle de ejercicio a su paciente. Sería como que la gente no se pueda alimentar bien si no tiene un profesional especializado en nutrición con maestría y doctorado. La población tiene que poder alimentarse bien por conocimiento popular y todo profesional de la salud, médico, nutricionista, fisioterapista, enfermera, debería estar en capacidad de dar consejos básicos sobre qué es una nutrición sana”.

Duperly comenta que cuando el ser humano vivía en la naturaleza como aún viven nuestros campesinos, la actividad física era indispensable para sobrevivir, escapar de los predadores, recolectar, cazar y dedicarse a la agricultura y ganadería. “Realmente la tolerancia del cuerpo humano en una persona joven es gigantesca, puede tolerar ocho horas diarias de entrenamiento deportivo sin problema, pero requiere también de períodos de descanso, recuperación y una nutrición adecuada.

El problema de exceso de actividad física se produce cuando la preocupación principal no es la salud, sino la estética y dejan de tener el descanso y aportes nutricionales adecuados, por lo que pueden caer en excesos como el denominado ‘triada de la mujer atleta’ que suele darse en el caso de las bailarinas y maratonistas de nivel olímpico, quienes, debido a la presión competitiva comen muy poco y entrenan demasiado”, señala Duperly.

Añade que la investigación ha arrojado datos interesantes sobre el rescate de la salud y la fórmula es sencilla: se requiere una hora diaria de ejercicios y se ha comprobado que más de 10 semanales no parece tener beneficios adicionales. “Quien realiza más ejercicio no obtiene más salud, pero sí más satisfacción personal como en el caso de los atletas de alto rendimiento o los deportistas profesionales. Pero entran en una zona que desde el punto de vista de salud es delicada, porque pueden aparecer más lesiones y más problemas metabólicos. El balance nutrición y descanso es vital para el equilibrio”.

 

Entrevista realizada por Laura de Jarrín para la Revista Familia en Ecuador.

Ejercicio es Medicina avanza en América Latina

 

El Centro Regional de Exercise is Medicine para América Latina (EIM® Latam) llevo a cabo el pasado 25 de enero de 2014 el V Encuentro Regional de Exercise is Medicine® en América Latina y el I Encuentro Regional de Conferencistas del Programa Exercise is Medicine® en América Latina.

Un grupo selecto de 56 médicos especialistas de 15 países Latinoamericanos, además de Colombia, fueron convocados a Bogotá para ser capacitados como conferencistas y replicadores del Curso de Prescripción del Ejercicio (tasa de respuesta a la convocatoria de 87.5%).

Laura Garré MD, Uruguay. Fotografía por DrVanne

Laura Garré MD, Uruguay. Fotografía por DrVanne

La delegación internacional estuvo conformada por 31 médicos representantes de Argentina, Aruba, Bolivia, Brasil, Chile, Costa Rica, Ecuador, El Salvador, Guatemala, México, Paraguay, Perú, República Dominicana, Uruguay y Venezuela. Por el lado de Colombia, 25 médicos representaron a Bogotá, Medellín, Cali, Cartagena, Ibagué, Neiva, Bucaramanga, Manizales, Pereira, Tunja y Sogamoso.

De izq. a derecha: Fernando González MD y Claudia Pérez MD, Chile; Pedro Alcántara, Perú. Fotografía por DrVanne

De izq. a derecha: Fernando González MD y Claudia Pérez MD, Chile; Pedro Alcántara, Perú. Fotografía por DrVanne

Cabe recordar que el Curso de Prescripción del Ejercicio es actualmente la estrategia más exitosa de EIM® Latam en sus esfuerzos por posicionar la actividad física como un signo vital en la consulta médica. Con una duración de un día (8 horas), este curso es una oportunidad en educación continuada sobre los conocimientos y las herramientas básicas para la valoración y prescripción de la actividad física. El curso es dirigido a médicos especialistas quienes han manifestado su gran satisfacción con la capacitación para su crecimiento profesional y práctica médica.

Cada uno de los 16 países representados en el pasado evento cuenta ahora con 2 conferencistas nacionales para impartir el Curso de Prescripción del Ejercicio. El reto de cada task force nacional de EIM® para los próximos meses del 2014 es realizar la planeación y ejecución del curso a nivel local. EIM® Latam estará guiando y apoyando este proceso en la medida que cada task force adelante su agenda de actividades. En México, por ejemplo, se llevo a cabo el 30 de enero de 2014 —tan solo cinco días posterior a la capacitación en Bogotá— el primer curso del año en el Hospital Ángeles de Pedregal, México DF. Asistieron en total 31 médicos especialistas, en particular médicos internistas pero también participaron pediatras y deportólogos, y 10 profesionales de otras áreas de la salud. Por otro lado, el task force de EIM® en Colombia tiene como reto capacitar a 1.500 médicos en el 2014. Así mismo, los otros task forces con mayor trayectoria y experiencia previa realizando el curso —tal como Argentina, Brasil, Chile, Ecuador, México, Paraguay, Uruguay y Venezuela— están definiendo sus metas y agenda de cursos para el 2014. Finalmente, Costa Rica y República Dominicana iniciaron su proceso de planeación del primer curso a realizar en sus países.

Nuevos compromisos con la región

El encuentro regional se convirtió en un escenario propio para compartir las experiencias, dudas e ideas de los participantes, fortaleciendo al mismo tiempo la cooperación y apoyo entre ellos mismos. Como resultado, tres países nuevos dieron el paso de unirse a EIM® —Aruba, Guatemala y Bolivia— e iniciaron el proceso de conformar su task force nacional. Con ellos EIM® Latam ahora cuenta con 16 países miembros, cada uno en una etapa diferente en la conformación del task force y en la implementación de estrategias. Por ejemplo, El Salvador, Paraguay y Perú se encuentran en la fase final de consolidación de su task force nacional mientras que los países con mayor trayectoria —Argentina, Brasil, Chile, Costa Rica, Colombia, Ecuador, México, República Dominicana, Uruguay y Venezuela— ya han finalizado la conformación de su task force y sus experiencias sirven como punto de referencia y apoyo para los países más nuevos.

Alfredo Pinzón MD, Bogotá, recibe su certificado de manos de Ricardo Javornik MD, Venezuela. Fotografía por DrVanne

Alfredo Pinzón MD, Bogotá, recibe su certificado de manos de Ricardo Javornik MD, Venezuela. Fotografía por DrVanne

Finalmente, el nivel de compromiso del grupo de trabajo central de EIM® Latam en Colombia solo crece y se solidifica cada vez más al recibir los mensajes de agradecimiento, satisfacción y compromiso de todos los expertos que asistieron al encuentro regional. Los resultados del trabajo colaborativo comienzan a ser evidentes, y cada vez más profesionales, más líderes, más países emprenden la movilización de recursos en pro de la promoción de la actividad física en la comunidad Latinoamericana.

 

Testimonios

Marcelo Lavega MD, Uruguay. Fotografía por DrVanne.

Marcelo Lavega MD, Uruguay. Fotografía por DrVanne.

 

“Gracias a todo el equipo de Exercise is Medicine por la cálida atención, nos sentimos muy cuidados, y quedamos gratamente sorprendidos por el nivel académico y humano de los distintos participantes del evento. Muchísimas gracias y esperamos poder seguir apoyando y haciendo crecer el programa desde aquí” —Marcelo Lavega MD, Uruguay

 

 

 

 

 

 

Christian Mejía MD, Aruba. Fotografía por DrVanne.

Christian Mejía MD, Aruba. Fotografía por DrVanne.

 

“Muchas gracias por este curso tan bien organizado. Llevo poco más de 4 años trabajando con EIM y este es el mejor curso que he tenido hasta ahora.” —Christian Mejía MD, Aruba.

 

 

 

 

 

 

 

Carlos J Jaramillo MD, Colombia. Fotografía por DrVanne.

Carlos J Jaramillo MD, Colombia. Fotografía por DrVanne.

 

“… uno sale reconfortado de un evento como el que ustedes acaban de realizar, donde se aprecia la dedicación en preparar cada detalle tanto en lo académico como lo logístico, para que cada uno obtenga el mayor beneficio profesional, personal y espiritual. La forma tan gallarda de tratar a cada uno de los asistentes, destacando sus talentos y sus desempeños, cohesionan el grupo y compromete para lograr el objetivo de hacer que todos los médicos con los que interactuemos reciban el mensaje de la importancia de indagar por la actividad física que cada paciente desarrolla, felicitar a aquellos que lo hacen ya como una forma de vida y estimular a todos los demás a que lleguen a ese punto.” —Carlos J Jaramillo MD, Colombia.

 

Isabel Cárdenas MD, Bolivia. Fotografía por DrVanne.

Isabel Cárdenas MD, Bolivia. Fotografía por DrVanne.

 

“Mil gracias por la atención que nos dieron en Bogotá, por el conocimiento transmitido y el estímulo para que iniciemos el programa en nuestros respectivos países.” —Isabel Cárdenas MD, Bolivia.

 

 

 

 

 

 

 

 

Visita la galería de fotografías del evento en Flickr

Descarga el PDF del Newsletter de EIM- Febrero 2014 aquí

Fotografías por DrVanne, usadas bajo licencia Creative Commons

El ACSM revela las tendencias del 2014 en fitness

 

En diciembre del 2013 el American College of Sports Medicine (ACSM) publicó los resultados de la encuesta sobre las tendencias en fitness alrededor del mundo. En total 3,815 profesionales —desde entrenadores físicos certificados hasta expertos en fisiología del ejercicio— respondieron la encuesta. Colombia se encuentra en la lista de los países participantes que incluye también a Brasil, Costa Rica, Perú, México, Australia, el Reino Unido, Singapur, España, Holanda y E.E.U.U., entre muchos otros.

TOP 20 FITNESS TRENDS FOR 2014

1. High-Intensity Interval Training (HIIT)*
2. Body Weight Training
3. Educated, Certified, and Experienced Fitness Professionals
4. Strength Training
5. Exercise and Weight Loss
6. Personal Training
7. Fitness Programs for Older Adults
8. Functional Fitness
9. Group Personal Training
10. Yoga
11. Children and Exercise for the Treatment/Prevention of Obesity
12. Worksite Health Promotion
13. Core Training
14. Outdoor Activities
15. Circuit Training
16. Outcome Measurements
17. Wellness Coaching
18. Sport-Specific Training*
19. Worker Incentive Programs
20. Boot Camp

 

Tomado de: ACSM’S Health & Fitness Journal; November/December 2013 – Volume 17 – Issue 6 – p 10-20. doi: 10.1249/FIT.0b013e3182a955e6

Lee el artículo completo aquí

Fotografía de  Living Fitness UK , usada bajo licencia Creative Commons

 

Exercise and the Common Cold

 ACSM Current Comment 

A cold is an inflammation of the upper respiratory tract caused by a viral infection. The common cold is probably the most frequently occurring illness in humans worldwide. More than 200 different viruses cause colds, and rhinoviruses and coronaviruses are the culprits 25-60 percent of the time. Rhinovirus infections often occur during the fall and spring seasons, while the coronavirus is more common during the winter.

The U.S. Centers for Disease Control and prevention estimates that over 425 million colds and flus occur annually in the United States, resulting in $2.5 billion in lost school and work days, and in medical costs. The average person has two or three respiratory infections per year. Young children suffer from six to seven annually.

How does one catch a cold? 

Although still a matter of controversy, growing evidence suggests that at least among adults, cold viruses are passed from person to person primarily by being inhaled into the nose and air passageways (i.e., spread through the air). Viruses can be spread by direct contact with wet nasal discharge, but this may be rare, except perhaps in settings such as day care centers. Severe colds transmit viruses more readily than mild ones because a greater amount of virus is passed into the air by coughing and sneezing. Thus, to hinder the spread of cold viruses, coughs, sneezes and “nose-blows” should be smothered with clean handkerchiefs or facial tissues. It is also a very good idea to wash viruses off the hands with soap and water, and to disinfect one’s surroundings.

Damp, cold or drafty weather does not increase the risk of getting a cold. According to most cold researchers, cold or bad weather simply brings people together indoors, which leads to more person-to-person contact.

Cold Treatment 

Doctors often quip that a cold lasts seven days without treatment, and one week with it. Most nonprescription medications, including antihistamines, decongestants, cough medicines, and analgesics provide only temporary relief of symptoms. These medications can make one feel more comfortable while the body’s immune system gears up to fight off the infection. To get rid of the cold, the immune system must make enough antibodies to destroy the viruses, a process that takes three to four days. Antibiotics that fight bacteria have no value in the treatment of the uncomplicated common cold which is caused by a virus.

Even the old standby – inhaling steam — has little or no beneficial effect on cold symptoms. Vitamin C does not prevent colds, according to most researchers, but may slightly reduce the severity and duration of symptoms. Resting, drinking plenty of hot fluids, and seeking comfort from over-the-counter cold remedies is still all that can be done to treat most colds.

Keeping the immune system in good shape 

Whether one gets sick with a cold after a sufficient amount of the virus has entered the body depends on many factors that affect the immune system. Aging, cigarette smoking, mental stress, poor nutrition, and lack of sleep have all been associated with impaired immune function and increased risk of infection.

Based on current knowledge, good immune function can be maintained by eating a well-balanced diet, keeping life stresses to a minimum, avoiding chronic fatigue, and obtaining adequate sleep. Immune function is suppressed during periods of very low caloric intake and quick weight reduction, so weight loss should be gradual to maintain good immunity.

Can a walk each day keep colds away? 

People who exercise report fewer colds than their inactive peers. For example, one recent survey revealed that 61% of 700 recreational runners reported fewer colds since beginning to run, while only 4 percent felt they experienced more. In another survey of 170 experienced runners who had been training for 12 years, 90% reported that they definitely or mostly agreed with the statement that they “rarely get sick.”

To test this belief scientifically, two well-controlled studies with young and elderly women were conducted. In both studies, women in the exercise groups walked briskly 35-45 minutes, five days a week, for 12-15 weeks, with the control groups remained physically inactive. The results were in the same direction reported by fitness enthusiasts — walkers experienced about half the days with cold symptoms as the sedentary controls.

Other research has shown that during moderate exercise, several positive changes occur in the immune system. Although the immune system returns to pre-exercise levels very quickly after the exercise session is over, each session represents a boost that appears to reduce the risk of infection over the long term.

Can too much exercise hurt? 

Among elite athletes and their coaches, a common perception is that heavy exertion reduces resistance to colds. During the Winter and Summer Olympic Games, clinicians report that “upper respiratory infections abound” and that “the most irksome troubles with athletes are infections.”

To determine whether these anecdotal reports were true, 2,311 marathon runners who ran the 1987 Los Angeles Marathon were studied. During the week following the race, one out of seven runners became sick, which was about five times the rate of runners who trained for, but did not run, the Marathon. During the two-month period before the race, runners training more than 60 miles a week doubled their odds for sickness compared to those training less than 20 miles a week. Researchers in South Africa have also confirmed that after marathon-type exertion, runners are at a high risk for sickness.

The immune systems of marathon runners have been studied under laboratory conditions before and after running 2-3 hours. A steep drop in immune function occurs lasting at least 6-9 hours. Several exercise immunologists believe this allows viruses to spread and gain a foothold.

Rest or exercise when sick? 

Most clinical authorities in the area of immunology recommend:

  • If one has common cold symptoms (e.g., runny nose and sore throat without fever or general body aches and pains), intensive exercise training may be safely resumed a few days after the resolution of symptoms.
  • Mild-to-moderate exercise (e.g., walking) when sick with the common cold does not appear to be harmful. In two studies using nasal sprays of a rhinovirus leading to common cold symptoms, subjects were able to engage in exercise during the course of the illness without any negative effects on severity of symptoms or performance capability.
  • With a symptom complex of fever, extreme tiredness, muscle aches, and swollen lymph glands, 2-4 weeks should probably be allowed before resumption of intensive training.
  • In general, if the symptoms are from the neck up, moderate exercise is probably acceptable and, some researchers would even argue, beneficial, while bed rest and a gradual progression to normal training are recommended when the illness is systemic. If in doubt as to the type of infectious illness, individuals should consult a physician. 

Practical applications 

Although more research is needed, the American College of Sports Medicine (ACSM) supports the viewpoint that moderate physical activity (30 minutes a day, on most, if not all days of the week) exerts less stress on the immune system than does prolonged and intense exercise. Regular and moderate exercise lowers the risk for respiratory infections, a finding consistent with previous reports from ACSM urging people to exercise moderately for enhancement of health and disease prevention. Athletes who must train hard for competition can lower their risk of respiratory infection by following the guidelines listed in this report for keeping the immune system in good shape.

 

Descarga el PDF aquí

Exercise while traveling

 

ACSM current comment

Regular exercise is an important component of a healthy lifestyle. The American College of Sports Medicine, the American Heart Association, and other prominent organizations have issued recommendations to encourage individuals to establish and maintain participation in an exercise program. A potential impediment to an exercise program is the conflict that can be created by a business trip, which is a common event for many Americans. While it is not advisable for an individual to begin an exercise program while on a business trip, it is recommended that exercise habits be maintained while traveling.

Business trips can create a number of conflicts with your exercise program. It is important to recognize potential limitations so that you can plan accordingly and allow yourself to keep up your regimen. Here are some modifications in your exercise program that you might consider while traveling on business:

1. Consider exercise area and/or facility availability in your selection of lodging. If your exercise program includes a running component, you should be aware of restrictions that could exist in some urban areas. Ask hotel personnel for suggestions. If safe running routes are not available, you may find treadmill facilities in the hotel. Some hotels offer in-house exercise areas that might include weight training equipment, a swimming pool, and cardiovascular conditioning equipment. In some cities, perhaps a downtown athletic club will have an agreement with certain hotels whereby guests may use their facilities.

To prevent the muscular soreness that sometimes accompanies exercising new muscle groups or exercising differently (i.e. exercise equipment to which you are not accustomed), you may wish to reduce exercise intensity and duration. You may also consider packing such small pieces of exercise equipment as a jump rope or resistance bands.

2. Plan your trip schedule to include time for exercise. Business trips are fraught with time-crunched schedules and meetings and lunches that leave little extra time for the business traveler. However, there are a number of benefits to including time for exercise in your business trip itinerary. Exercise is known to be a stress reliever. Additionally, the distraction may even help you concentrate better and have the energy and focus to be more productive later. If a meeting is a must, then take attendees out for some exercise! This may provide a more informal setting to discuss matters while allowing you to maintain your exercise schedule.

3. Understand how reduced exercise time affects your fitness level. A common concern of exercisers who know they will not be able to exercise at all or as much due to restrictions imposed by their business trip is that they will suffer a reduction in their physical fitness level. It is important to understand that it is much easier to maintain your current level of fitness than it is to improve your fitness level. Current evidence suggests that you can take up to a week off from exercise training without any significant reduction in your fitness level. During longer trips you should be able to maintain your fitness with a regimen of either aerobic or strength training or both amounting to only twice a week, particularly if you maintain your exercise training intensity during this period of reduced training.

In conclusion, with advance planning and the willingness to make modifications to your exercise program, it is reasonable to incorporate exercise time into the schedule of a business trip. Because travel can be so disruptive to your normal schedule as well as other adjustments you must make (e.g., sleeping accommodations, food), this is NOT the best time to work on increasing your fitness level. Instead, the goal should be maintenance of your current fitness level.

 

Descarga el PDF aquí

Perceived Exertion

 

ACSM current comment

Around the world in health clubs on the walls beside treadmills, stationary bikes and step machines, one often sees a scale going from 6-20. This is called an RPE Scale, which stands for “Rate of Perceived Exertion.” It is a psychophysiological scale, meaning it calls on the mind and body to rate one’s perception of effort. Understanding the meaning and use of this chart will benefit the average fitness enthusiast.

The RPE scale measures feelings of effort, strain, discomfort, and/or fatigue experienced during both aerobic and resistance training. One’s perception of physical exertion is a subjective assessment that incorporates information from the internal and external environment of the body. The greater the frequency of these signals, the more intense are the perceptions of physical exertion. In addition, response from muscles and joints helps to scale and calibrate central motor outflow commands. The resulting integration of feedforward-feedback pathways provides fine-tuning of the exertional responses.

Perceived exertion reflects the interaction between the mind and body. That is, this psychological parameter has been linked to many physiological events that occur during physical exercise. These physiological events can be divided into respiratory/metabolic (such as ventilation and oxygen uptake) and peripheral (such as cellular metabolism and energy substrate utilization.) Previous studies have demonstrated that an increase in ventilation, an increase in oxygen uptake, an increase metabolic acidosis or a decrease in muscle carbohydrate stores are associated with more intense perceptions of exertion. The scale is valid in that it generally evidences a linear relation with both heart rate and oxygen uptake during aerobic exercise.

How is perceived exertion measured? 

The level of perceived exertion is often measured with a 15 category scale that was developed by the Swedish psychologist Gunnar Borg. The Borg scale is shown below:

  • 6 No exertion at all
  • 7 Extremely light
  • 8
  • 9 Very light
  • 10
  • 11 Light
  • 12
  • 13 Somewhat hard
  • 14
  • 15 Hard (heavy)
  • 16
  • 19 Extremely hard
  • 20 Maximal Exertion

© Gunnar Borg 1985

The Borg scale is simple to understand and very user-friendly. However, to use it effectively, it is necessary to adhere to the standard guidelines in measuring perceived exertion. These guidelines are:

1) It should be clear to either the client, patient, or athlete that perceived exertion is a method to determine the intensity of effort, strain, and/or discomfort that is felt during exercise;

2) The range of sensations must correspond to the scale. For example, number 6 should be made in reference to the feelings during rest, whereas number 20 should refer to the maximal level of exertion;

3) Either the RPE should be made specific to the overall body perception or the perception derived from a certain anatomical region of the body such as chest, arms and/or legs. Typically, individuals interested in monitoring the stress of a workout use RPE ratings.

4) It is important to know that when rating one’s perception of exertion there is no right or wrong

answer for the rating. However, the individual must clearly understand the meaning of the descriptors, so careful explanation of the scale is necessary before using.

How can ratings of perceived exertion be used? 

Due to its reasonably linear relation with oxygen uptake and heart rate, RPE can be used to guide the progression of a graded exercise test. This is accomplished by providing subjective confirmation that end-points of the test have been achieved once the terminal rating is reported or by signaling the relative metabolic stress at a given time during the test. Based upon the fact that RPE’s positively correlate to power output over a wide range of intensities, they can also be used to predict aerobic power in a manner analogous to the way that heart rate is employed in submaximal testing.

Ratings of perceived exertion can also be used to prescribe and monitor exercise intensity during a workout. A common approach is to periodically ask a person to rate his or her perceived exertion for a given exercise intensity during a stress test and then match it to an appropriate exercise intensity prescription. Attempting to keep the RPE within a training range similar to heart rate training ranges can be effective. Using this procedure, the target RPE ratings are based upon prior test results, and the person is requested to produce intensity perceived to be similar to the target rating during a workout. The key is close approximation to heart rate in aerobic exercise, where the RPE scale is most often used.

A question is sometimes raised as to whether the intensity produced based on perceptual ratings is actually what it is supposed to be. Several recent studies have attempted to answer this question. These studies have used oxygen uptake as an objective variable and found no difference between the oxygen uptake that was estimated from the prior test results and oxygen uptake that was produced during a subsequent workout. This finding suggests that using a “target RPE” as a guide to regulate exercise intensity is valid.

It is important to note that using the RPE can be especially important in two situations. If heart-rate measurement is difficult for some reason, or if the individual is on medication that alters normal heart rate response to physical stress, RPE can be an excellent tool to regulate and monitor intensity. The RPE scale continues to be a useful tool, offering subjective reflection of physiological responses during physical exercise, and enabling the individual to regulate effort to gain maximum benefit.

 

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Physical Training for Improved Occupational Performance

 

 ACSM current comment

As athletes strive to improve their performance through effective training techniques, so too can workers benefit from optimally planned exercise training programs designed to boost occupational physical performance. Similar to athletics–where skill and fitness demands vary between that of the recreational and the professional athlete–occupational physical demands can vary among employment settings. Physically demanding occupations, such as those found in the armed services, emergency rescue professions, and construction and warehouse industries, require a high degree of physical fitness. Job performance in these occupations can be augmented by participation in formal exercise programs targeted at improving the musculoskeletal and/or cardiorespiratory systems.

Even less physically demanding occupations such as computer or clerical work can benefit from fitness and flexibility training. Tasks involving prolonged and repetitive pushing and pulling, holding, carrying, and lifting can lead to cumulative trauma disorders such as lower back pain, sprains, strains, carpal tunnel syndrome and neck pain. Physical training can be effectively used as both a prevention and rehabilitation tool in occupational settings. In addition to the well-known health benefits of being physically fit, physical training interventions can increase worker productivity by overcoming limitations in job performance due to inadequate muscle strength, power, endurance or aerobic capacity. Physical training can also prevent mismatches between job demands and physical capacities and decrease lost time due to injury-related absenteeism.

Conducting a Job Analysis 

The first step in physical training program design is the completion of a comprehensive job analysis. This analysis should identify the most physically demanding and frequently occurring job tasks (critical job tasks). It will help to refer to written job descriptions and training manuals, observe individuals performing the job and interview subject-matter experts (e.g., ergonomists and occupational therapists). Once the critical physically demanding tasks have been identified, additional information regarding the tasks must be recorded to include mass and distance of loads handled, forces and torques exerted, frequency and duration of task performance, and equipment used to complete the job task. Information specific to the worker must also be recorded, such as body position, movement, and muscle groups employed while performing the task. This information is then used to determine the requisite energy systems and fitness components needed for successful job performance. Based on this information, a physical training program to improve job performance can be developed.

Before initiating a rigorous physical training program, it is essential that employees obtain medical approval for exercise.

Types of Physical Training for Improved Occupational Performance 

Physical training programs for improving occupational physical performance typically assume one of two forms: 1) job- or task specific training and 2) generalized physical fitness training. Task-specific training is accomplished by performing the physically demanding tasks of the job. This must be done in a progressive manner. For example, if the main physically demanding task of a given occupation is to lift 20 boxes weighing 40 kg each from a pallet onto a waist-high shelf, this may be beyond the physical capacity of a new employee. The new worker may need to perform fewer lifts or may take longer to complete the task. Simply performing this task is a form of task-specific training. Once a worker is able to perform this task satisfactorily, the intensity of the exercise can be progressively increased to provide a continual training effect. This can be accomplished by manipulating the load lifted (resulting in strength gains), the lifting rate (resulting in aerobic gains), or the total number of repetitions (resulting in muscular endurance gains).

As the physical capacity of the worker increases (be it strength, cardiovascular endurance, or muscular endurance), the percentage of an individual’s maximum capacity utilized during the job task decreases. This, in turn, decreases the likelihood or risk of injury for that individual. Task-specific training is valid, and may provide improvement in task performance. The drawback is that it may be difficult and expensive to set up. A generalized physical fitness-training program is developed to improve employees’ overall health and physical fitness. The program emphasizes specific muscle groups and energy pathways needed for optimal job performance. For example, a job such as a luggage handler at an airport would involve moving many pieces of heavy luggage from a cart onto a belt, or from a moving belt into the belly of the plane. The periods of rapid lifting are followed by a short rest period while the handler drives the luggage to the next location.

This task is likely to have high strength and aerobic demands, and the individual may be required to work in confined postures. In this case, a general physical fitness program would involve progressive resistance exercise to increase strength and muscular endurance, as well an aerobic training component to improve aerobic capacity. The advantage of a general physical fitness training program is that it increases overall physical capacity and fitness of the individual. The training program is not narrowly focused, thus avoiding muscular imbalance. Increased physical capacity also may be generalized to other tasks. In other words, the employee may improve performance of other tasks, not just the one they were trying to improve. Generalized physical fitness training using standard exercise equipment reduces risk of injury compared with job-specific training. Ideally, a generalized physical fitness-training program is conducted in a corporate-owned or off-site fitness facility under the supervision of an experienced and certified allied health professional with a thorough knowledge of exercise training. One drawback to generalized physical fitness training is that the improvement in job performance is not so great as those obtained from task-specific training. The fact that improved performance may transfer to other tasks may offset this drawback.

Principles and Recommendations for Program Design 

In designing a physical training program for improving occupational performance, several fundamental program-design variables should be considered:

  • exercise selection and order
  • equipment used
  • specificity
  • frequency
  • sets
  • repetitions
  • rest intervals
  • duration
  • variation
  • progression

The main factors influencing these variables are the initial fitness and training status of the worker and the desired outcome and goals of the program (i.e., muscle strength, power, endurance, aerobic capacity, and motor performance).

Jobs with little variation and a high skill or technical component will show the greatest improvements with task-specific training programs, while jobs requiring a variety of body movements and utilizing the various components of muscle fitness will benefit mostly from general fitness programs. The worker or “occupational athlete” can derive as much benefit in terms of improved performance as the Olympic athlete can by participating in optimal physical training programs.

 

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