Designing Exercise Training 2slides

6/24/2019
Designing Exercise Training
(Basic Principles)
Nur Basuki, M.Physio
(Senior Lecturer)
What is exercise training?
Exercise training can be defined as maintaining a regular habit
of exercise at levels greater than those usually performed.
Tubuh akan merespon secara spesifik terhadap latihan yg
diberikan
 Aerobic exercise  perub pd cardiovascular
 Weight training  perub pd massa otot dan kekuatan
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Prinsip Dasar Latihan
OVERLOAD
Sebuah system atau jaringan harus dilatih pada level melebihi level
yang sudah ada.
SPECIFICITY
Efek khusus latihan hanya didapatkan oleh tubuh yg terlibat dalam
latihan
REVERSIBILITY
Hasil peningkatan yg telah dicapai akan kembali lagi bila TIDAK
dipertahankan
F
I
T
T
rekwensi
ntensity
ime
ype
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LATIHAN UNTUK MENINGKATKAN
CARDIORESPIRATORY FITNESS
JENIS LATIHAN: Aerobic exercise
Intensitas Latihan
 Merupakan bagian terpenting dalam menyusun program
latihan
 Untuk orang sehat intensitas yg sesuai SEDANG –
TINGGI
 Pada kasus deconditioning  RINGAN - SEDANG
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Hal-hal yang perlu dipertimbangkan dalam
menentukan intensitas
• Obat-obatan yg dapat mempengaruhi HR (mis:Beta
blocker)
• Level fitness
• Resiko terhadap penyakit kardiovaskuler dan orthopedic
injury
• Klien preference
• Tujuan program
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Rumus untuk menghitung perkiraan Max HR
Author
Rumus
Populasi
Fox (1971)
220-usia
Grup kecil dari laki2 dan wanita
Astrand (1952)
216.6 – (0.84 X Usia)
Laki-2 dan wanita umur 4-34 th
Tanaka (2001)
208 – (0.7 X Usia)
Laki-2 dan wanita sehat
Metode untuk menghitung Intensitas latihan
Metode HRR
Metode VO2R
Metode HR
Metode VO2
Metode MET
{(HR max – HR rest) X % intensity} + HR rest
{(VO2 max – VO2 rest) X % intensity} + VO2 rest
HR max X % intensity
VO2 max X % intensity
{(VO2max)/3.5mL.kg-1.min-1} X % intensity
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Contoh menentukan Intensitas latihan
Dengan Metode HR
Seorang laki-laki umur 45TH
Intensitas yg diharapkan = 70% - 80%
Rumus THR = HR max X Intensitas yg diharapkan%
 Lakukan penghitungan estimasi HR max, jika data pengukuran Hrmax
tidak tersedia.
 HR max = 220 – 45 = 175
 Tentukan THR range:
 THR = 175 X 0.7 = 123 bpm (batas bawah)
 THR = 175 X 0.8 = 140 bpm (batas atas)
 THR range = 123 – 140 bpm
Contoh menentukan Intensitas latihan
Dengan Metode HRR (Heart Rate Reserve)
Seorang laki-laki umur 45 tahun, HR rest = 70 bpm
Intensitas yg diharapkan 50% - 60%
Rumus = {(Hrmax – HR rest) X % intensity} + HR rest
1. Hitung HR max (jika penghitungan HR max tidak tersedia
 HR max = 220 – Usia = 175 bpm
2. Hitung HRR
 HRR = HR max – HR rest = 175 – 70 = 105
3. Tentukan intensitas latihan
 %HR = 0.5 X 105 = 52.5
 %HR = 0.6 X 105 = 63
4. Tentukan target HR range
 Batas bawah = 52.5 + 70 = 122.5
 Batas atas = 63 + 70 = 133
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Contoh menentukan Intensitas latihan
Dengan Metode RPE (Rate of Perceived Exertion)
1. Dikembangkan oleh Gunnar Borg
2. Pasien diminta untuk mempersepsikan beratnya aktivitas
3. Sering digunakan pada pasien yg menggunakan B-blocker
4. Ada 2 versi
 Original (6-20)
 Revisi (1 – 10)
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Contoh menentukan Intensitas latihan
Dengan Metode Talk test
 The talk test is one of the easiest ways monitor your exercise intensity.
 You don't need any equipment, like a heart rate monitor
 If you can talk and sing without puffing at all, you're exercising at
a low level.
 If you can comfortably talk, but not sing, you're doing moderate intensity
activity.
 If you can't say more than a few words without gasping for breath, you're
exercising at a vigorous intensity
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High Intensity Interval Training
Moderate Continuous Training has been proven in increasing
physical fitness (VO2 max) of patients with coronary artery
diseases (CAD) (Clark et al, 2005).
However, it was argued that Conventional Cardiac
rehabilitation (continuous endurance exercise)  might be
suboptimal for CAD patients with higher level of fitness
(Conraads et al, 2015)
The effectiveness of High Intensity Interval Training for patients with
coronary heart disease have been studied, however the results is still
conflicting [12-18]. (Warburton et al, 2005; Moholdt et al, 2012; Moholdt
et al, 2009; Currie etal, 2013; Keteyian et al, 2014; Pattyn et al, 2016)
Warburton et al (2005) studied 14 patients with CAD 6 months after
having CABG or angioplasty. They found that Aerobic Interval Training
(AIT) had similar effect in increasing VO2 max with Aerobic
Continuous Training (ACT). However interval training resulted in a
greater improvement in time to exhaustion during High intensity test
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Moholdt et al (2009) and Mohold et al (2012) also found
similarly. However Moholdt et al (2009) also found that after
following for 6 months, AIT was better than ACT.
On the other hand, Keteyian et al (2014) in a study of 18
patients more than three weeks post Myocard Infract or
more than four weeks post CABG found that high intensity
interval training is better in increasing VO2 max compare
to moderate intensity continuous training.
Aerobic Interval Training Protocol
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2
2
2
2
2
2
2
8 X 2 min @ 85-95% HR max
90
80
2
70
2
2
2
5 min
WA
2
2
2
5 min
CD
60
WA = Warming Up
CD = Cooling Down
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Frekwensi Latihan
Menurut American College of sport medicine dan American
Heart Association :
> 5hr/minggu (intensitas sedang)
> 3hr/minggu (intensitas tinggi)
Intensitas yg tinggi berhubungaan dengan peningkatan
resiko cidera
Durasi Latihan
 Intensitas sedang > 30 menit secara kontinyu
 Intensitas tinggi > 20 menit secara kontinyu
 Jika dipenggal minimum 10 menit
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Progressivitas Latihan
 Peningkatan dosis latihan tergantung pada status kesehatan
individu
 Peningkatan dosis latihan dapat dilakukan pada semua
komponen FITT
 Pada fase awal, peningkatan durasi yg direkomendasikan
 Peningkatan durasi 5-10 min per sesi setiap 1-2 minggu dalam
4-6 minggu pertama wajar untuk semua org dewasa
ACSM, 2011
Weight Training
At the beginning of early mobilization
concept, dynamic exercise/aerobic
exercise is a type of exercise that is
recommended.
On the other hand, isometric exercise
is not recommended
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Tujuan latihan dengan beban
(weight training/lifting)
Memperbaiki kekuatan otot & daya tahan
Meningkatkan rasa percaya diri
Meningkatkan ADL
Mempertahankan independence
Menurunkan beban kerja otot saat melakukan ADL
Mencegah berkembangnya penyakit lain spt osteoporosis, type 2
diabetes mellitus & obesity
 Memperlambat penurunan kekuatan otot krg menua
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Kriteria pasien yg boleh mengikuti strength
training
1. Pasien dg resiko rendah dan sedang, bisa juga pada
resiko tinggi tetapi dg supervisi
2. Mereka yg membutuhkan kekuatan otot untuk bekerja
maupun aktivitas rekreasi
3. Dimulai min 5 minggu post MI atau cardiac surgery, dan
pernah mengikuti 4 minggu program rehab jantung
4. Dimulai min 2 - 3 minggu pasca transcatheter procedure
(i.e., PTCA or other), dan pernah mengikuti 2 minggu
program rehab jantung
5. Tidak ditemukan kondisi2 berikut:
Congestive heart failure (CHF),
Uncontrolled dysrhythmias,
Severe valvular Disease
Uncontrolled hypertension,
Unstable symptoms (AP)
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