KIN 511

Hypokinetic Disease and Physical Activity
Winter 2014

This course will explore the relationship between chronic, progressive disorders/diseases and hypokinesis (low physical activity). Primarily, metabolic processes will be addressed with explicit guidelines developed to utilize exercise as an adjunct therapy. Emphasis will be given to hypokinetic disorder/disease processes which have been successfully treated to some extent by safe and effective exercise programs.

Instructor:           L.R. Brilla

Office Hours:      MWF 10; T 10-12; and by appointment
 Phone:                650-3056

511 PHYSICAL ACTIVITY AND HYPOKINETIC DISEASES (3) Prereq: KIN 413 or equivalent and permission of instructor. Survey of effects of physical activity on disease processes related to hypokinesis: cardiovascular disease, obesity, diabetes, osteoporosis, arthritis. Overview of needs of special populations: geriatrics, children.

The goals and objectives of this course align with Healthy People 2020 goals identified by U.S. Department of Health & Human Services:

Healthy People overarching goals:

The course objectives are:

• Discuss the major hypokinetic diseases afflicting Americans

• List major risk factors and unalterable risk factors for hypokinetic diseases

• Discuss lifestyle choices that prevent hypokinetic conditions

Course Competency: All students will develop competency in using Adobe DreamWeaver software

Text: Physical Activity and Health by Claude Bouchard, Steven N. Blair, William L. Haskell, Published by Human Kinetics, 2006. ISBN 0736050922, 9780736050920 . (recommended)           


Typically, each student will devlop a comprehensive presentation on a hypokinetic topic. A comprehensive bibliography from 2000 to present must be included; at least 50 references on the topic should be included under appropriate subheadings on the research template provided on Canvas. The information will be used to develop a section of a web page on hypokinetics. The web page will include descriptive health information, links in three categories (good, adequate, and poor resources), and the bibliography. Interactive sections are also encouraged. Each week, students will present the current status of their project. At the completion of the course, the web pages will be uploaded to the College of Humanities and Social Sciences Center for Healthy Living Education web page for public use.Students will also generate public comment statements for Healthy People 2020.

Web pages need to be updated periodically. For Winter 2014, in lieu of developing a new web page, students will select five of the current topics to update.If some are recent, then other sections of the site will be assigned for updating. The present web pages may be used as a starting point. References are linked to the open access article or PubMed abstract, if not publically accessible. All links must be checked to ensure there are no broken links.

Presentation                                                      300 pts.    
Comprehensive bibliography                               100 pts.
           TOTAL                                                  400 pts.
Resulting Grades:
A:        360+
B:        320 - 359  
C:        280 - 319  
D:        240 - 279

F:		<240
Plus (+) and minus (-) grades are also given for A, B, and C grades in a small range (e.g. 89-89.9% is B+; 90-90.9 is A-)

	1. Arthritis
	2. Adherence/Lifestyle Behaviors
	3. Aging	
	4. Blood Pressure
	5. Cancer
	6. Connective Tissue Disorders
	7. Depression
	8. Diabetes
	9. Low Grade Inflammation
	10. Metabolic Syndrome
	11. Muscle Disorders
	12. Non-alcholic Fatty Liver Disease
	13. Obesity
	14. Osteoporosis
	15.  Renal Disorders 
	16. Sarcopenia
	17. Skeletal Disorders                 
	18.  Stress
	20. Sleep
 	21. Low Back Pain


Topics presently published on Center for Healthy Living website




Week 1   

Topic Selection; Introduction to DreamWeaver and web site template

Week 2   

Presentations: Introduction (Index Page)

Week 3   

Presentations: Description

Week 4

Presentations: Causes

Week 5

Presentations: Associated Factors

Week 6

Presentations: Exercise Effects

Week 7

Presentations: Additional Resources

Week 8

Presentations: References

Week 9

Presentations: Edits

Week 10

Upload web sites to CHL website




Definitions: Health, Fitness, and Physical Activity

Product vs. Process

Products refer to states of being such as physical fitness, health and wellness. These are also commonly referred to as outcomes and they are frequently used as dependent measures in research. Process refers to behaviors or lifestyles that are frequently used as independent measures for research purposes. Examples of processes or lifestyle behaviors are physical activity, exercise, sports, etc.

Product Definitions

Physical Fitness
A set of attributes that people have or achieve relating to their ability to perform physical activity (U.S. Department of Health & Human Services, 2008).
This definition from Physical Activity and Health: A Report of the Surgeon General is the most common currently used definition of physical fitness. An alternative definition is: Physical fitness is a state of well-being with low risk of premature health problems and energy to participate in a variety of physical activities. Most experts agree that physical fitness is both multidimensional and hierarchical Bouchard, Blair, Haskell (2006) presented a comprehensive model for physical fitness that includes morphological fitness, bone strength, muscular fitness, flexibility, motor fitness, cardiovascular fitness, and metabolic fitness. A simple multidimensional hierarchical model (see Figure 1) is consistent with recent definitions in the literature (ACSM, 2011; USDHHS, 2008).

Figure 1. Common Physical Fitness and Fitness Related Terms


Physical Fitness











Cardiovascular Fitness



Bone Integrity









Muscle Strength



Reaction Time




Health-Related Physical Fitness (From Surgeon General's Report on Physical Activity and Health, USDHHS, 2008).
Health-related physical fitness consists of those components of physical fitness that have a relationship with good health. The components are commonly defined as body composition, cardiovascular fitness, flexibility, muscular endurance, and strength.

Body Composition: A health-related component of physical fitness that relates to the relative amounts of muscle, fat, bone and other vital parts of the body.

Cardiovascular Fitness: A health-related component of physical fitness that relates to ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity.

Flexibility: A health-related component of physical fitness that relates to the range of motion available at a joint.

Muscular Endurance: A health-related component of physical fitness that relates to the muscle's ability to continue to perform without fatigue.

Muscular Strength: A health-related component of physical fitness that relates to the ability of the muscle to exert force.

Skill-related Physical Fitness (From Surgeon General's Report on Physical Activity and Health, USDHHS, 2008)
Skill-related physical fitness consists of those components of physical fitness that have a relationship with enhanced performance in sports and motor skills. The components are commonly defined as agility, balance, coordination, power, speed and reaction time.
Possession of skill-related fitness abilities enhances ability to perform in sports but only has an indirect connection with health. The skill-related components of fitness are agility, balance, coordination, power, speed, and reaction time. It is assumed that people who possess skill-related fitness will be more likely to engage in regular activity and for this reason will have enhanced health-related fitness and a lower risk of hypokinetic diseases.

Agility: A skill-related component of physical fitness that relates to the ability to rapidly change the position of the entire body in space with speed and accuracy.

Balance: A skill-related component of physical fitness that relates to the maintenance of equilibrium while stationary or moving.

Coordination: A skill-related component of physical fitness that relates to the ability to use the senses, such as sight and hearing, together with body parts in performing motor tasks smoothly and accurately.

Power: A skill-related component of physical fitness that relates to the ability to the rate at which one can perform work.

Speed: A skill-related component of physical fitness that relates to the ability to perform a movement within a short period of time.

Reaction Time: A skill-related component of physical fitness that relates to the time elapsed between stimulation and the beginning of the reaction to it.

Physiological Fitness
Physiological fitness includes non-performance components of physical fitness that relate to biological systems that are influenced by one's level of habitual physical activity. (adapted from Bouchard, et al., 1990). 
The concept of physiological fitness was introduced in a publication of the first international consensus statement of current knowledge of physical activity (Bouchard, et al., 1990). Some of the sub-components of physiological fitness that have gained acceptance are metabolic fitness, morphological fitness, and bone integrity.

Metabolic Fitness
The state of metabolic systems and variables predictive of the risk for diabetes and cardiovascular disease which can be favorably altered by increased physical activity or regular endurance exercise without the requirement of a training-related increase inVO2max. (Adapted from the American College of Sports Medicine, 2011).
Though Depres, et al. (1990, 1991) are first credited with using the term metabolic fitness it was first used widely after it was described in the proceedings of the second International Consensus Conference on Physical Activity, Fitness and Health (Bouchard, et al, 1994). The use of the term metabolic fitness in the position statement describing the quality and quantity of physical activity needed to attain health-related benefits (ACSM, 2011) establishes it as a major fitness component. The International Consensus statement noted that metabolic fitness included such sub-components as blood glucose levels, blood lipid levels, and blood hormone levels. The reason for the identification of metabolic fitness as a separate component of fitness is because “…it is now clear that lower levels of physical activity (particularly intensity) than recommended (by this position stand) may reduce the risk for certain chronic degenerative diseases and improve metabolic fitness and yet may not be of sufficient quantity or quality to improve VO2max.” (ACSM, 2011).

Morphological Fitness
A non-performance component of fitness related to body composition factors such as body circumferences, body fat content, and regional body fat distribution (adapted from Bouchard, et al., 1994).
Morphological fitness measures are often related to metabolic fitness components. Those measures used to assess body composition are also used to assess morphological fitness, as are measures such as body mass index, waist circumference, and waist to hip ratio.

Bone Integrity (Bone Strength)
A non-performance component of fitness related to bone mineral density.
Bone strength was identified as a component of physical fitness in the first International Consensus Statement (Bouchard, 1990). Because measurement is expensive and requires special instrumentation and a high degree of expertise, there are no currently used field measures that are used extensively. There is general consensus, however, that bone integrity is related to habitual physical activity.

Motor Skills
Motor skills are non-fitness abilities that improve with practice (learning) and relate to one's ability to perform specific sports and other motor tasks.

Hypokinetic Diseases or Conditions
Hypokinetic diseases are conditions related to inactivity or low levels of habitual activity.
The term “hypokinetic” was coined by Kraus and Raab in their book Hypokinetic Disease (Kraus & Raab, 1961). This term is now widely accepted and can be used to describe many of the diseases and conditions associated with inactivity and poor fitness such as those conditions outlined in Physical Activity and Health: A Report of the Surgeon General (USDHSS, 2008).

Health is a state of being associated with freedom from disease and illness that also includes a positive component (wellness) that is associated with a quality of life and positive well-being. (Bouchard, et al., 1990).
More than 50 years ago the World Health Organization defined health as more than freedom from illness, disease, and debilitating conditions. Recent public health documents (USDHHS, 2008) have acknowledged the positive component of health (wellness).

Wellness is a state of being describing a state of positive health in the individual and comprising biological and psychological well-being as exemplified by quality of life and a sense of well-being. (USDHHS, 2008).
The suggestion by the World Health Organization that health had a positive component led to the use of the term wellness. The term wellness is now widely used to describe the state of being representing the positive component of health (USDHHS, 2008). The Health Goals for the Nation for the Year 2020 (USDHHS, 2008) uses quality of life measures such as self-rated health, a healthy days index, and an activity days indicators of health and wellness. Other wellness or quality of life indicators include vitality, hardiness, and vigor.

Quality of Life
A term that connotes an overall sense of well being. (USDHHS, 2008).
Kaplan and Bush (1982) introduced the term health-related quality of life (HRQL). However, for public health use, two types of global quality of life are identified: health-related quality of life and quality of life (not health related). Health related quality of life is limited to those aspects that can clearly be shown to affect mental or physical health. Examples include functional status and well-being. Non-health related quality of life includes such factors as happiness and life satisfaction. Individual quality of life is identified as related to specific people or individuals. Community quality of life relates to groups of people or communities (USDHHS, 2008).

Process Definitions

Healthy Lifestyles or Behaviors
There are many healthy lifestyles or behaviors that contribute to fitness, health and wellness. In this course the processes or healthy lifestyles that are defined relate primarily to one healthy lifestyle: physical activity. The importance of other healthy lifestyles such as nutrition and stress management is acknowledged.

Physical Activity (Adapted from USDHHS, 2008; Bouchard, et al., 1990).
Bodily movement that is produced by the contraction of skeletal muscle and that substantially increases energy expenditure.
The first International Consensus statement on physical activity, fitness and health suggested that physical activity was an umbrella term (see Figure 2) that was that had multiple dimensions. Forms of physical activity such as exercise, sports (among others) are considered as sub-categories of physical activity.


The Sub-categories of physical Activity


Exercise (training)
Exercise is leisure time physical activity conducted with the intention of developing physical fitness. 
Since the first International Consensus statement on physical activity, fitness and health the distinction has been made between physical activity and exercise noting that exercise is a specific form of physical activity dedicated to improving physical fitness. Physical training is another term that is used as a synonym for exercise.

Leisure Activity
Leisure activity is physical activity undertaken during discretionary time. 
Research in physical activity often separates leisure physical activity from vocational activity. Leisure activity includes exercise but all forms of leisure activities are not exercise.

Figure 3. Complex relationships among physical activity, physical fitness, health, wellness and other factors (Adapted from Bouchard, et al., 1990)

Students with disabilities
The university is committed to providing support to students with disabilities. Any disability (physical, learning, emotional or psychological) can obtain services on campus. An accommodation plan can be generated that is shared with the instructor. For exam accommodations, remember to have the form completed by the instructor at least one week before the exam date.
Reasonable accommodation for persons with documented disabilities should be established within the first week of class and arranged through Disability Resources for Students: telephone 650-3083; email ; and on the web at

As a community, Western is committed to integrity in all aspects of academic and campus life. An excellent resource for guiding students is Western’s newly created Integrity website. This site is a clearinghouse of resources that encourages and educates about integrity; moreover, it is regularly updated.
University Catalog in Appendix D—Academic Honesty Policy and Procedure—delineates rights and responsibilities.

Student Assistance
Western encourages students to seek assistance and support at the onset of an illness, difficulty, or crisis.
• In the case of a medical concern or question, please contact the Health Center: 650-3400 or chw/student_health  
• In the case of an emotional or psychological concern or question, please contact the Counseling Center: 650-3400 or
 • In the case of a health and safety concern, please contact the University Police: 650-3555 or www.
• In the case of a family or personal crisis or emergency, please contact the Dean of Students: 650-3775 or

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This syllabus is subject to change. Changes, if any, will be announced in class. Students will be held responsible for all changes.