Fysieke fitheid, fysieke activitiet in relatie tot gezondheid
Wat is fysieke activiteit? Een door skeletspieren geproduceerde beweging (dynamisch) en/of houding (statisch) die gepaard gaat met een toename van het energieverbruik (Caspersen 1985) Op verschillende niveau s: In werksituatie Verband houden met vervoer Huishoudelijk werk Sport, ontspanning, vrije tijd
Fysieke training Het regelmatig uitvoeren van geplande fysieke activiteiten met de bedoeling fysieke fitheid en/of gezondheid gunstig te beinvloeden binnen een bepaalde tijdsperiode (Caspersen 1985) Acute effecten (vb. insulinegevoeligheid) Chronische effecten (vb. toename spiervolume)
Meten van fysieke activiteit Vragenlijsten: IPAQ Baecke Dagboekmethode Meten van verplaatsing: Stappenteller Accelerometrie Meten van energieverbruik Draagbare spirometrie
Pro-contra s Hanteerbare methode versus betrouwbare methode Vragenlijsten vs spirometrie Graad van fitheid deel genetisch bepaald Effecten van training ook deels genetisch bepaald Zijn fitte personen actieve en omgekeerd? (Bouchard 1994)
Fysieke fitheid WHO (1968): het vermogen om op een bevredigende manier spierarbeid te verrichten Clarke (1979): Physical fitness is the ability to carry out daily tasks with vigor and alertness, without undue fatigue and with ample energy to engage in leisure time pursuits and to meet the above average physical stress encountered in emergency situations
Fysieke fitheid Algemene fitheid: Energetische mogelijkheden Aeroob Anaeroob Kracht Maximaal statisch Maximaal dynamisch Krachtuithouding Explosieve kracht
Fysieke fitheid Evenwicht Coordinatie Testing via Eurofittestbatterij Prestatiegerelateerde fitheid Gezondheidsgerelateerde fitheid
Exercise training in chronic internal disease: casus diabetes mellitus Prof. Dr. Patrick Calders Rehabilitation Sciences and Physiotherapy Ghent Arteveldehogeschool/University of Ghent
Which training modus is the most optimal? Endurance Strength? Combined exercise
Endurance training volume: 8w - 12m frequency: 2-3 times/week duration per session: 30-90min intensity: 70-85% max HR 60-75% peakvo2
Endurance training in DM BMI = Exercise capacity Total cholesterol? Fat Mass Endurance training Triglycerides HbA1c QOL? Lean Body Mass = of Strength training?
Fysieke training in DM: effecten Krachttraining: grote spiergroepen van OL, BL en romp Strength training large muscle groups of LL, UL, trunk volume: 6 weeks 6 months time per session: 30-60 min intensity: 50-75% 1RM frequency: 2-3/week
Strength training in DM BMI = Exercise capacity Total cholesterol? HbA1c Strength training Triglycerides = Fat Mass = of Muscle strength Lean Body Mass
Pro and contra van both exercise modes Endurance training Strength training Positive: Aerobe capacity Strength UL= / LL = Hba1c/Glycemia: Fat mass: Positive: Aerobe capacity Strength Hba1c/Glycemia: Lean Body Mass: Negative: Lean Body Mass : Negative: Fat mass : =
Essential question Can a combined endurance and strength training modus increase the positive effects and deminish the negative effects?
DiaCoTra Purpose To investigate the effect of combined endurance and strength training on indices of obesity, physical and metabolic fitness in type-ii diabetes patiënts (n=17) compared to endurance training (n=16) and no training (n=11). Inclusion and exclusion criteria BMI : 25-35 HbA1c: 6,5 9 age: 30 65y Excluded: angiopathy, neuropathy, retinopathy, and other metabolic problems
DiaCoTra Combined exercise training Frequency: 3x/week Total volume: 3 months Intensity: 60-85% HRR 60-85% 1RM Endurance training Warming up cycling Strength LL running Strength UL stepping Cooling down 10min 10min 10min 10min 10min 10min 10min running cycling stepping running cycling Warming up Cooling down 10min 10min 10min 10min 10min 10min 10min No training Daily activities no supervised training
DiaCoTra Antropometry Strength, 6MWT, STS, CPX HbA1c and glycemia inclusion End of training period 0 m 3 m
DiaCoTra Antropometry 100 BW (kg) 32 BMI (kg/m2) 95 31 30 90 85 pre post 29 28 27 pre post 80 combined endurance control 26 combined endurance control 112 110 108 106 104 102 100 98 96 94 Waist (cm) combined endurance control pre post
DiaCoTra Indices of exercise capacity 3 2,8 2,6 2,4 2,2 2 1,8 1,6 1,4 1,2 1 * peakvo2 (L/min) combined endurance control pre post 6MWT (meter) STS (number/30s) 600 580 560 540 520 500 * * pre post 18 16 14 12 10 8 6 4 2 * pre post 480 combinad endurance control 0 combined endurance control
DiaCoTra Indices of muscle strength LL (kg) UL (kg) 75 65 70 60 65 60 55 55 * * 50 * pre post 45 * pre post 50 40 45 35 40 combined endurance control 30 combined endurance control * *
DiaCoTra Indices of diabetes HbA1c (%) Glycemia (mmol/l) 7,8 7,5 7,2 6,9 * * * pre post 8,5 8 7,5 7 6,5 * * pre post 6,6 6 6,3 5,5 6 combined endurance control 5 combined endurance control * *
Cardio Vascular Risk 1,30 1,275 * groep 1 2 3 1,25 1,225 1,20 1,175 1,15 1 2 hdl * = COM vs. C
Conclusion Exercise training in patients with type II diabetes mellitus Endurance and combined exercise training have a positive effect on physical and metabolic fitness. The effects of combined exercise training are stronger compared to endurance training.