1. Physical Exams Symposium Measuring fitness

2. Measuring Fitness Mark D. Hopkins, M.D. Board-Certified Orthopedic Surgeon

3. Measuring fitness Sit ups Push ups Pull ups

4. Weight Measurement Versus Waist Measurement Which is better Or should we be doing it another way? Cost Effectiveness Time Effectiveness

5. SIT UPS

12. PUSH UPS

15. PULL UPS

16. MEASURING FITNESS

18. In order to measure, we must define…

19. MEASURING FITNESS Encarta Definition: The ability of the human body to function with vigor and alertness, without undue fatigue, and with ample energy to engage in leisure activities, and to meet physical stresses.

20. MEASURING FITNESS CDC: Set of attributes a person has in regards to a person’s ability to perform physical activities that require aerobic fitness, endurance, strength, or flexibility and is determined by a combination of regular activity and genetically inherited ability.

21. MEASURING FITNESS

22. Fitness parameters Cardio-respiratory endurance Muscular Strength Muscular endurance Flexibility Body Composition

23. MEASURING FITNESS Components of fitness: Limit Strength, Starting Strength, Explosive Strength, Agility, Flexibility, Static Balance, Dynamic Balance, Muscular Endurance, Speed Endurance, Cardio-respiratory endurance, Muscle Mass, Percent Body Fat, Freedom from Stress, Freedom from Disease or Injury, Preventive Lifestyle

24. MEASURING FITNESS

25. Benefits Decreased risk of hypertension, colon cancer and diabetes Increased well being Decreased risk of coronary artery disease Increased immunity Decreased incidence of depression

26. BODY COMPOSITION Weight – BMI – Body Mass Index Wt in lbs Ht” X Ht” X 703 = BMI220 lbs 75” X 75” X 703 = 27.5 Wt in kg Ht M X Ht M = BMI 99.79 kg 1.905M X 1.905M = 27.5

27. BODY COMPOSITION

28. CDC Definitions Underweight – less than 18.5 Recommended – 18.6 – 24.9 Overweight – 25.0 – 29.9 Obese – 30 or greater 64.5% of adults in U.S. are overweight

29. BODY COMPOSITION Advantages Easy and inexpensive Increased BMI correlates with increased risk of heart disease, diabetes, hypertension, some cancers and osteoarthritis

30. BODY COMPOSITION Disadvantages BMI does not distinguish fat from muscle

31. BODY COMPOSITION

34. Waist measurements Fat around waist – more likely to develop health problems than if around hips and thighs. This is true even if BMI is normal. Women with waist more than 35 inches Men with waist more than 40 inches

35. BODY COMPOSITION Body fat percentage May be a better measure of risk American Council of Exercise Guidelines women men Essential fat 10-12% 2-4% Athletes 14-20% 6-13% Fitness 21-24% 14-17% Acceptable 25-31% 18-25% Obese 32% 26%

36. BODY COMPOSITION

37. Measuring body fat Skin fold: accuracy varies greatly based on user’s abilities BIA: Bioelectrical Impedance Analysis accuracy 8% plus or minus Cadaver analysis: The only direct method, but impractical HW: Hydrostatic Weighing: gold standard, not easy, expensive DXA: Dual energy xray absorpiometry, low dose radiation exposure, trained tech, expensive equipment BODPOD: new, expensive technology

38. BODY COMPOSITION Do you feel lost?

39. CARTILAGE REGENERATION Reversing the aging process… HTO, microfracture, OATS, carticel, chondroitin, glucosamine, hyaluronase, gene therapy

40. CARTILAGE REGENERATION Divided into relieving load bearing, with secondary repair, metabolic engineering, direct and indirect repair, transplantation and direct chondrocyte cell DNA modification

41. CARTILAGE REGENERATION HTO, High Tibial Osteotomy

42. CARTILAGE REGENERATION Microfracture

43. CRATILAGE REGENERATION OATS – Osteochondral autograft resurfacing mosaicplasty

44. CARTILAGE REGENERATION OATS

45. CARTILAGE REGENERATION Carticel

46. CARTILAGE REGENERATION Chondroitin Analysis of Glucosamine and Chondroitin Sulfate Content in Marketed Products and the Caco-2 Permeability of Chondroitin Sulfate Raw Materials Abimbola O. Adebowale, PhD, Donna S. Cox, MS, Zhongming Liang, MS, Natalie D. Eddington, PhD,* Pharmacokinetics-Biopharmaceutics Laboratory, Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, Maryland

47. CARTILAGE REGENERATION Glucosamine

48. CARTILAGE REGENERATION Hyaluronase

49. CARTILAGE REGENERATION Gene therapy

50. QUESTIONS?