Coordinating Committee for Physiotherapist Hospital Authority
Student Health Service Department of Health (5/2007)
Why Exercise?
Dieting alone does not have a long lasting effect on weight reduction, unless complemented with regular physical exercise. Besides, exercise has a lot of other benefits. Exercise can help promote our physical and mental well-being. Regular exercise can improve heart and lung functions, reduce the risk of heart and related diseases, and control weight. It also improves muscle strength and suppleness, as well as joint and muscle flexibility. By exercising regularly, we feel better, work better and cope better with the stresses in life.
Warm-up exercises for the head Put your hands on your waist and stand with your legs apart (a) tilt your head to the left for 3 seconds, then return to the original position (b) tilt your head to the right for 3 seconds, then return to the original position (c) turn your head to the left for 3 seconds, then return to the original position (d) turn your head to the right for 3 seconds, then return to the original position (e) tilt your head upwards for 3 seconds, then return to the original position (f) tilt your head downwards for 3 seconds, then return to the original position Warm-up exercises for the back and tummy (a) twist your body to the left and then to the right
Are You Ready To Start?
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Choose exercises that suit your age and ability Exercise regularly Exercise with friends or family members for fun and support Incorporate exercise into your daily activities e.g. brisk-walking, using the stairs, etc.
(b) straighten your arm and bend your body sideways
Which Exercises Are For Me?
I. Warm-up exercises
(c) put your hands on your back and bend your body backwards
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These prepare your body for the vigorous exercise ahead Warm up for about 10 minutes before vigorous exercise, breathing naturally throughout the process
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Warm-up exercises for the upper and lower limbs (a) raise your arms, stretch your shoulders and elbows backwards
II.
Cool-down exercises
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III.
These help to prevent dizziness or fainting which may result from stopping vigorous exercise too suddenly Perform cool down exercises for about 10 minutes after vigorous exercise The exercises are the same as warm-up exercises except that the speed and range of movements should be gradually decreased
Stretching exercises
(b) straighten your arms and draw circles
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(c) put your hands on your waist, lift your left and right heels alternately
These help to keep your body supple and minimize strains and sprains to your joints, muscles and ligaments Points to note: - Ensure a correct starting position and stretch gradually to the greatest extent. When you feel resistance in the muscle being stretched, stay in that position for 10 to 15 seconds, then relax gradually - Avoid jerky movements - Breathe naturally during stretching - Repeat each movement 2 to 3 times - Do stretching exercises 3 to 7 times a week Please note that the
(d) do steps, lifting your leg until your thigh is parallel to the floor (e) jump and part your legs, straighten and raise both upper limbs, then jump and return to the original position (f) straighten your arms pointing backwards with knees slightly bent. Swing both arms forwards and jump
Examples of stretching exercises are shown below. stretched muscles are shaded Stretching exercises for the upper limbs (a) triceps
(b) chest muscles
(g) stationary jogging
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Stretching exercises for the lower limbs (a) calf muscles (b) inner thigh muscles
IV.
Aerobic exercises
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These help to improve heart and lung functions and muscle fitness, and is effective in weight control Choose exercises that you really enjoy and suit your age and ability e.g. jogging, cycling, swimming, dancing and ball games The level of exercise can be measured by the heart rate during exercise The optimal level of exercise is determined by the ideal range of heart rate which is calculated as follows:
(c) posterior thigh muscles
(d) quadriceps
ideal range of heart rate = ( 50% of maximum reserved heart rate + heart rate at rest ) to ( 85% of maximum reserved heart rate + heart rate at rest ) maximum reserved heart rate = maximum heart rate – heart rate at rest Stretching exercises for the waist and the back maximum heart rate = 220 – age (a) lateral part of the waist heart rate at rest can be measured after resting for 15 minutes For example : the heart rate at rest of a 17 years old boy is 70 beats per minute
• maximum heart rate = 220 – 17
= 203
• maximum reserved heart rate = 203 – 70
(b) back muscles = 133 • ideal range of heart rate = (133 x 50 % + 70) = 137 to = (133 x 85 % + 70) = 183 i.e. 137 to 183 beats per minute
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Physique varies between children. You may plan an exercise training programme for your child with reference to the following table :
V.
Muscle-training exercises
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These help to increase muscle strength and endurance and do not require additional equipment for training Points to note : - Do the exercise series 3 times a week Repeat each movement 10-25 times according to your physical ability. Do the whole series of movement 3 times
Training Week Programme 1 2 3 4 5 6-9 10-13 14-16 17-19 20-23 24-27 28+
Exercise Frequency (times per week) 3 3 3 3 3 3-4 3-4 3-4 4-5 4-5 4-5 3
Starting Stage
Level of Exercise Duration (% of maximum of exercise reserved heart (minutes) rate) 40-50 12 50 14 60 16 60-70 18 60-70 20 70-80 70-80 70-80 70-80 70-80 70-85 70-85 21 24 24 28 30 30 30-45
Examples of muscle-training exercises (a) lower limbs (i) stepping exercise (ii) stand with your back against the wall with your knees slightly flexed as if you were sitting on a chair (iii) kneel with your hands on the floor, then raise one leg with knees flexed at 90∘. Repeat with the other leg
Training Stage
Maintenance Stage
(b)
back - lie in a prone position, then lift up both shoulders and arms
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(c)
abdomen - Sit-ups: Bend your knees, cross your arms in front of your chest and lift up your head and shoulders until the scapulars are not touching the floor
Home Exercise Programme
I. Example of home exercise programme
Every Monday, Wednesday, Friday 10 minutes 20-30 minutes 10 minutes warm-up exercises aerobic exercises (help to train heart and lung functions) cool-down exercises
(d) upper limbs – - Do push-ups with your knees on the floor. If you cannot do this movement, you may modify it by standing up and pushing against the wall with your hands
Every Tuesday, Thursday, Saturday 10 minutes 20 minutes stretching exercises muscle-training exercises
Every Sunday 10 minutes 20-30 minutes warm-up exercises • exercises for training balance, eye-hand coordination, quick response • parents should encourage their child to participate in outdoor activities and non-competitive sports, such as dancing, skipping and cycling. This will prevent him/her from giving up too easily because of fear of failure. It would be better if parents also participate in these activities cool-down exercises
10 minutes
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II.
Suggestions on physical fitness tests at home Here are two examples of simple fitness tests that can be carried out at home once every three months to check whether your home exercise programme is helpful in improving the physical fitness of your child.
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Stepping test (a) place a stable step (about 6 to 10 inches high) against the wall. Do as many steps as possible in 5 minutes (b) record the number of cycles that can be completed in 5 minutes. One cycle is : right foot up, left foot up, right foot down, left foot down; or left foot up, right foot up, left foot down, right foot down (c) the heart rate can be measured at the same time to estimate the level of exercise (d) to ensure safety, the step should be stable and placed against the wall. Choose a step with a height that suits your child’s ability. Use steps of the same height for continuous assessment
Sit-ups (a) lie on your back with your knees bent and arms crossed in front of your chest (b) ask somebody to stabilize your feet on the floor (c) starting from the lying position, lift up your body until your elbows touch your thighs, then return to the lying position. This is counted as one sit-up (d) lie back slowly with your back first. Do not bang your head on the floor (e) for children aged 6-12, record the number of sit-ups that can be done in 1 minute for children aged 13-18, record the number of sit-ups that can be done in 30 seconds. The average number of sit-ups that can be done in Hong Kong children is as follows:
No. of sit-ups in 1 minute Age 6 7 8 9 10 11 12 Boy 18 21 23 24 26 26 30 Girl 16 18 20 21 22 25 24
No. of sit-ups in 30 seconds Age 13 14 15 16 17 18 Boy 18 18 19 20 20 20 Girl 13 14 14 15 15 15
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Sports Injury
I. Common sports injuries in children
III. Management of sports injuries
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abrasions and bruises heat stroke backache muscle cramps
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sprained joints strains in muscles and ligaments head injury
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Safety tips
Keep calm when an accident has occurred. Inform parents or teachers immediately Parents and teachers should know some basic first-aid measures. They should also teach older children how to handle emergencies Manage the wound properly to prevent further injuries e.g. clean wounds with clean water and cover them with dressing or bandage etc. Seek medical attention whenever necessary
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Consult your physician before sports training, especially if your child has a medical condition e.g. heart disease, asthma etc. Parents’ or teachers’ guidance during exercise is important to ensure safety Always warm up before doing exercise and cool down afterwards to lower the risk of strains and sprains Wear appropriate and comfortable clothes and well-padded shoes which support the heels and arches of your feet Take safety precautions e.g. wear helmets and knee protectors for cycling and life jackets for aquatic sports like canoeing, windsurfing etc. Do not exercise immediately after a full meal Beware of the weather and environmental conditions. Avoid doing vigorous exercises in extremely hot weather or high humidity Whatever exercise you choose to do, proceed gradually and exercise regularly according to your own ability. Never expect too much progress after just a few times Do not exercise when unwell or when suffering from an acute infection Stop exercising and take a rest if you feel breathless or dizzy, or if you have nausea or vomiting Do not perform dangerous movements which may harm yourself or others
Notes to Parents
In order to have a good modelling effect on your child, you should actively participate in physical activities, and encourage your child to try various kinds of sports e.g. cycling, swimming, etc. Exercise with your child for fun and support Arrange outdoor activities for weekends or holidays e.g. hiking, picnicking, swimming Join extra-curricular activities with your child Share your child’s feelings and give appropriate advice
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Energy Expenditure in Various Types of Physical Activities
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The unit for energy expenditure is kilocalorie or calorie Energy expenditure differs in different activities. (See table below) e.g. For a child weighing 45kg, 30 minutes of rope jumping will bring about an energy expenditure of 0.162 kilocalories/min/kg x 30 minutes x 45kg = 219 kilocalories
Energy expenditure (kilocalories/ min/kg) 0.021 0.023 0.023 0.028 0.030 0.040 0.047 0.047 0.062 0.064 0.068 0.083 0.094 0.098 0.109 0.113 0.128 0.134 0.138 0.143 0.162 0.162 0.194 0.196 Energy expended by a 45kg child performing 30 minutes of this activity (kilocalories) 28 31 31 38 41 54 63 63 86 86 92 112 127 132 147 153 173 181 186 193 219 219 262 265
Type of Activity Sitting Knitting, Sewing Playing cards Standing Writing Playing piano Playing violin Canoeing Housework Gymnastics Table-tennis Walking Bowling Badminton Tennis Roller-skating Freestyle swimming Running on level ground (run round a football field 4 times, equivalent to 1.6 kilometers, in 11 minutes) Basketball Marching Breaststroke swimming Rope jumping Running on level ground (run round a football field 4 times, equivalent to 1.6 kilometers, in 9 minutes) Judo
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