ACE Personal Trainer Manual, 4th edition Chapter 13: Mind-Body Exercise 1 1

Learning Objectives This session, which is based on Chapter 13 of the ACE Personal Trainer Manual, 4th ed., reviews many of the popular forms of mind-body exercise and offers practical suggestions for how trainers can incorporate mind-body techniques into training sessions. After completing this session, you will have a better understanding of: The neurological foundations of mind-body exercise The classical forms of mind-body exercise—yoga, tai chi, and qigong The roots of contemporary forms of mind-body exercise, including Pilates and Nia The role of mind-body exercise in chronic disease management The general precautions associated with each of these types of exercise

Introduction Any form or level of physical activity can be “mind-body.” Mind-body exercise is physical exercise executed with a profound inward mental focus. Regular participation in mind-body exercise has been associated with: Improved muscular strength, flexibility, balance, and coordination Increased mental development and self-efficacy

Neurobiological Foundations of Mind-body Exercise Muscle afferents have direct access to mechanisms of perception. Projections of the muscle afferent pathways to the cortex Muscle fiber–brain pathways are involved in affective responses to muscular contraction. The hypothalamus–pituitary CRH interface is truly the consummate “mind-body connection.”

Roots of Contemporary Mind-body Exercise Programs The Asian yoga and tai chi disciplines are at the root of most contemporary mind-body exercise programs. Yoga A complex system of physical and spiritual disciplines that is fundamental to a number of Asian religions Tai chi Derived from the practice of qigong (also called chi kung) Best described as a moving meditation

Differentiating Characteristics of Mind-body Exercise Mind-body exercise is attentive to the present moment and is process-oriented. Mind-body exercise generally relies on self-monitoring of perceived effort, breathing, and nonjudgmental self-awareness. Conventional aerobic and resistance-training programs can manifest mind-body qualities. Mind-body exercise can assist in the management of a number of chronic diseases, including: Cardiovascular disease (CVD) Diabetes Arthritis

Benefits of Mind-body Exercise Hatha yoga has been helpful in improving: Arthritis Asthma Low-back pain Postural problems Tai chi has been helpful in improving: Anxiety Blood pressure Depression

Common Components of Mind-body Exercise Programs Meditative/contemplative Proprioceptive and kinesthetic body awareness Breath-centering or breathwork Anatomic alignment or proper choreographic form Energycentric

Yogic Breathing Yogic breathing training (pranayama) The practice of voluntary breath control, consisting of conscious inhalation, retention, and exhalation The fundamental purpose of breathwork is to develop the ability to: Sustain relaxed attention to the flow of the breath Refine and control respiratory movements Integrate awareness and breathing to reduce stress and enhance psychological functioning

General Precautions With Hatha Yoga Programs Hemodynamic and cardiac ventricular responses Those who are initially deconditioned or have a chronic disease should: Minimize acute rapid changes in body position in the early stages of hatha yoga training Use slower transitions from one yoga pose to the next Ashtanga, Iyengar, and Bikram yoga asanas and sequences are appropriate for higher-functioning clients. Clients with cardiovascular or pulmonary disease should avoid breath retentions and breath suspensions.

Qigong Exercise Qigong is a system of self-healing exercise and meditation that includes healing: Postures Movement Visualization Breathwork Meditation There are two general categories of qigong: Active, or physical, qigong exercise (dong gong) Tranquil, or passive, qigong (jing gong) Many qigong styles are named after animals whose movements they imitate.

Tai Chi Tai chi chuan is a complex martial arts choreography of 108 flowing graceful movements. It is commonly accepted that all tai chi styles follow three similar essential principles: Major distinguishable styles of tai chi: Original Chen style Yang style Chang style Wu style Sun Style

Contemporary Mind-body Exercise Programs Pilates A form of movement re-education in which the exerciser learns to overcome faulty compensatory movement patterns Alexander Technique Corrects unconscious habits of posture and movement that may be precursors to injuries Feldenkrais Method Awareness Through Movement (ATM) and Functional Integration Combination of verbal direction and manual-contact techniques to enhance kinesthetic awareness and coordination Nia Classes blend movements and concepts from a variety of mind-body programs Includes a moderate-level aerobic component that fosters spontaneity Native American and Alaskan Spiritual Dancing Ethnic mind-body routines that integrate nature into the movements

Assessing Outcomes There are a variety of methods, other than muscular strength and flexibility measures, available to objectively measure the response to mind-body exercise. Quality of life Blood pressure Pulmonary function Balance control Anxiety and tension Spirituality

Quality of Life and Blood Pressure Quality-of-life measures are reasonably well suited for characterizing the overall functional response. www.qmetric.com Blood pressure Baseline and serial resting blood pressure measurements after four to six weeks of mind-body exercise are appropriate outcome measures.

Pulmonary Function and Balance Control Pulmonary function measures FEV1 (maximum forced expiratory volume in one second) is a valid assessment outcome when baseline FEV1 is less than 80%. Balance control Balance assessment is appropriate for evaluating the response to mind-body exercise programs in which balance control is a primary component.

Anxiety and Spirituality Anxiety measures May be helpful in evaluating stress and tension The Spielberger State Trait Anxiety Inventory (STAI) assesses anxiety-proneness (trait) and the current level of anxiety (state). The STAI Computer Program is an inexpensive administration and scoring program that is an alternative to paper-and-pencil versions. www.mhs.com Spirituality Spirituality assessment tools may be used before and after a period of mind-body exercise training. Brief Serenity Scale Mindful Attention Awareness Scale Spirituality Index of Well-Being

Indications for Mind-body Exercise Two key considerations for selecting mind-body exercise for clients with chronic disease management: Only use forms where the intensity of effort begins with very low physical effort and can be graduated slowly. Only those with stable chronic disease states should consider mind-body exercise. Characteristics of mind-body exercise programs that are helpful for those with stable chronic disease include: Can be taught at a relatively low-intensity level and can be individualized Decrease real-time cognitive arousal and stress hormone activation Enhance proprioception and kinesthesis Can improve muscular strength, posture, and balance Can improve self-efficacy and confidence

Personal Trainers and Mind-body Exercise Personal trainers can teach a client to use two mind-body techniques that are the focuses of nearly all stress-reduction programs: Sustained attention to the present Internal awareness Meditation and yogic-breathing exercises can be integrated with existing warm-up and cool-down exercises. Personal trainers can incorporate muscle sense and breathing work into the aerobic phase of an exercise session. Personal trainers can incorporate select yoga poses into the flexibility and strength-training components of the program. The popular tree pose can be included as part of a circuit of exercises to help stimulate balance control. Diaphragmatic breathing work can be presented to clients, many of whom will find it very therapeutic.

Summary Mind-body exercise continues to emerge as an effective fitness and health-enhancement modality. This session covered: Neurobiological foundations of mind-body exercise Roots of contemporary mind-body exercise programs Differentiating characteristics of mind-body exercise Benefits of mind-body exercise Mind-body exercise modalities and programs Contemporary mind-body exercise programs Assessing outcomes Indications for mind-body exercise Personal trainers and mind-body exercise