The document discusses aerobic and anaerobic metabolism and different types of physical exercise. It explains that aerobic metabolism occurs in the presence of oxygen to break down nutrients into energy through various cellular processes. Anaerobic metabolism occurs without oxygen to produce energy, resulting in the build-up of lactic acid. The document also outlines different types of physical exercise including aerobic exercise, strength training, and stretching exercise, and their health benefits.

1. fundamental physiotherapy
Learning objective
• To know metabolism
• To understand aerobic metabolism
• To understand an aerobic metabolism
• To understand physical exercise
• To know types of physical exercise
10/5/2021
Eyayaw A. 1

2. Metabolism
 refers to the processes body uses to break down
nutrients, form compounds the cells can use for
energy and use those compounds to fuel cellular
functions.
 body secretes enzymes to break down food into
sugars, proteins, and fats.
 Then, each cell body can take these in and use them
in aerobic or anaerobic metabolic processes to form
adenosine triphosphate (ATP), which is the fuel
used in the cell.

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Eyayaw A. 2

3. Aerobic metabolism
 is the way body creates energy through the
combustion of carbohydrates, amino acids,
and fats in the presence of oxygen.
 Combustion means burning, which is why this is
called burning sugars, fats, and proteins for energy.
 Aerobic metabolism is used for the sustained
production of energy for exercise and other body
functions.
 Examples of exercises that use aerobic metabolism
include walking, running, or cycling with sustained
effort.
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Eyayaw A. 3

4.  is also why your lungs absorb oxygen to be carried by
hemoglobin in the blood to your tissues.
 The oxygen is used in aerobic metabolism to oxidize
carbohydrates and the oxygen atoms end up attached to
carbon in the carbon dioxide molecule that is excreted.
 The only byproducts of the process of aerobic metabolism of
carbohydrates are carbon dioxide and water.
 body disposes of these by breathing, sweating, and urinating.
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Eyayaw A. 4

5. Aerobic metabolism
 As the body breaks down glucose, a simple sugar
molecule, in the first dozen steps, it produces a
compound called pyruvate.
 When this compound enters the mitochondria, or
powerhouse, of the cell, aerobic metabolism occurs
in which this compound is oxidized and turned into
carbon dioxide and water.
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Eyayaw A. 5

6.  The body transforms the food we eat into ATP.
 When ATP is broken down it releases ADP + P + energy.
 The body can re synthesise ATP by the reverse reaction:
ADP + P + energy = ATP.
 The body cannot store much ATP (only enough for about 2-
3s of intense activity)
 so any energy required needs to be produced immediately.
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Eyayaw A. 6

7.  ATP can be resynthesised from the breakdown of
carbohydrates (into glucose), fats (into fatty acids
and glycerol), and protein (into amino acids).
 Any excess glucose can be stored in the muscles and
liver as glycogen.
 Glycerol can be converted into glucose when
glycogen stores have been depleted (e.g. marathon).
 At rest most of our energy comes from fats, during
exercise energy is mostly supplied from
carbohydrates.
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Eyayaw A. 7

8.  When oxygen is present the complete breakdown of glucose
is possible.
 This occurs in the mitochondria and produces CO2, H2O,
and energy.
 The advantages of aerobic energy production is that there
are no fatiguing by-products, the energy sources are usually
abundant and lots of ATP can be produced.
 The breakdown of glucose into energy (ATP) involves 3
stages: glycolysis, Kreb’s cycle, and the electron transport
chain.
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Eyayaw A. 8

9.  The initial stage of glucose breakdown.
 This stage is identical in both the aerobic
and anaerobic systems).
 Some complicated reactions take place but
all you need to know is….
 Pyruvic acid is produced (pyruvate).
 2 ATP are used and 4 ATP produced.
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Eyayaw A. 9

10.  This follow’s on from glycolysis and only occurs in
the presence of oxygen.
 Pyruvic acid from glycolysis is added to coenzyme A
to produce acetyl coenzyme A to start the cycle.
 Again, lots of complicated reactions take place but all
that you need to know is that 2 ATP are produced.
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Eyayaw A. 10

11.  The final stage of glucose breakdown.
 Once again, numerous complicated chemical reactions take
place but all that you need to know is that 32 ATP molecules
are produced.
 Large amounts of oxygen are required at this stage (thus it is
aerobic energy production).
 So, at the end of these 3 stages 38 molecules of ATP are
produced and 2 are used (net production = 36 ATP).
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Eyayaw A. 11

12.  Fatty acids are broken down by a process called beta-
oxidation to acetyl CoA which enters the Kerb's cycle
(and eventually electron transport chain).
 Even more ATP can produced from fat than from
glucose (during electron transport chain) but far more
O2 is required.
 Fat is therefore an excellent energy source at rest or
low intensity exercise but cannot be used during high
intensity exercise when a lack of O2 becomes a
limiting factor.
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Eyayaw A. 12

13.  aerobic exercise is done at a heart rate below 85% of
maximum heart rate and doesn't use vigorous muscle
contractions.
 body is able to maintain a constant energy stream by
breaking down carbohydrates and fats with aerobic metabolic
processes.
 At a moderate-intensity level of exercise, there is enough
breathing and muscles' need for ATP is slow and steady
enough that can break down glycogen into glucose and
mobilize stored fat to break down for energy.
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Eyayaw A. 13

14.  Cardiac hypertrophy and increased resting stroke
volume (SV).
 Decreased resting HR.
 Increased muscle stores of glycogen.
 Increased capilliarisation of muscle and increased
number and size of mitochondria.
 More efficient and effective transport and use of O2
means that fat is used more during exercise
 Maximal oxygen consumption (V02 max)
increases.
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Eyayaw A. 14

15.  If your goal is to lose weight through exercise, aerobic
metabolism is your friend as it takes fat out of the fat
cells and burns it to produce energy for the muscles.
 It also burns up the available and stored sugars
(carbohydrates) in your cells, so any excess won't be
processed into fat.
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Eyayaw A. 15

16.  is the creation of energy through the combustion of
carbohydrates in the absence of oxygen.
 This occurs when your lungs cannot put enough oxygen
into the bloodstream to keep up with the demands of your
muscles for energy.
 It generally is used only for short bursts of activity, such as
when you sprint when running or cycling or when you are
lifting heavy weights.
 When there isn't enough oxygen in the bloodstream,
glucose and glycogen cannot be fully broken down to
carbon dioxide and water.
 Instead, lactic acid is produced, which can build up in the
muscles and degrade muscle function.
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Eyayaw A. 16

17. Anaerobic Metabolism
 The metabolic pathway leading to lactate formation is called
anaerobic glycolysis .
 Anaerobic metabolism is particularly important in short-
duration, high-intensity exercise.
 With extreme exertion, most of the adenosine
triphosphate (ATP) for contraction is generated from a net
breakdown of creatine phosphate and an acceleration of
the conversion of glycogen or glucose to lactate.
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Eyayaw A. 17

18.  but, strictly speaking, it should be termed O2-
independent glycolysis.
 Contrary to popular opinion, blood lactate
accumulation during intense exercise is not a
‘threshold’ response to inadequate O2 delivery.
 Rather, muscle lactate production increases as a
continuous function of work rate.
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Eyayaw A. 18

19. In anaerobic glycolysis, the glucose is
converted to lactate
Lactate in muscle is released into
bloodstream.
Then ,Transported to the liver
Liver converts lactate into glucose via
gluconeogenesis
The newly formed glucose is transported to
muscles to be used for energy again .
The
Cori Cycle
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Eyayaw A. 19

20. Anaerobic capacity (AC)
 is defined as the maximal amount of adenosine
triphosphate (ATP) re-synthesized via anaerobic
metabolism during a specific mode of short-
duration maximal anaerobic exercise.
 The anaerobic energy system produces significantly
less ATP than its aerobic counterpart and leads to
the build-up of lactic acid.
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Eyayaw A. 20

21.  During exercise in which the work rate is increased
progressively, there are a number of factors that
promote muscle lactate production.
 1.Hormonal acceleration of muscle glycogen breakdown
by the rising concentrations of epinephrine in the blood
stream.
 2.The greater recruitment of fast glycolytic (type II b)
muscle fibers at high exercise intensities.
 3.The metabolic acidosis arising from the increasing
reliance on carbohydrate oxidation at high work rates
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Eyayaw A. 21

22. Lactic Acid and Exercise
 Lactic Acid and Exercise
 Lactic acid is a by-product of anaerobic glycolysis and
anaerobic metabolism, both of which occur during
strenuous exercise.
 Although lactic acid is used as a fuel by the heart, an
excessive amount of lactic acid in skeletal muscles slows
down contractions
 When your muscles use anaerobic metabolism, lactic acid
is produced in muscle cells.
 With moderate-intensity exercise, it is able to diffuse out
of the cells,
 but with vigorous muscle contractions it builds up. As it
build up more and more lactic acid, muscles burn and are
fatigued.
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Eyayaw A. 22

23. What Happens During Anaerobic Exercise
 Anaerobic metabolism produces lactic acid, which can
build up in the muscles to the point where you "feel the
burn.
 This burning sensation is a normal side effect of
anaerobic metabolism.
 Fast twitch muscle fibers rely more on anaerobic
metabolism for quick contractions, but they fatigue
more quickly as well.
 High-intensity intervals turn a normally aerobic exercise
like endurance running into an anaerobic exercise.
 Anaerobic metabolism is needed once you exceed 90%
of maximum heart rate.
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Eyayaw A. 23

24. Energy metabolism in muscle
• Muscle contraction requires high level of ATP
consumption
• Without constant re synthesis, the amount of ATP
is used up in less than 1 sec. of contraction
Skeletal
Muscle
Red Fibers
(Type I)
Suitable For
Prolonged effort
Aerobic metabolism
(With O2 supply)
White Fibers
(Type II)
Suitable for
fast,
strong
contractions
Anaerobic
metabolism
(Without O2 supply)
The muscles can not store
energy for more than 1-2 sec.
So, they need constant re
synthesis.
• Prolonged effort running for long time
• Fast, strong contractions weight lifting
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Eyayaw A. 24

25. White muscle fibers (anaerobic)
 White muscle fibers are suitable for fast,
strong contractions
 They mainly obtain ATP from anaerobic
glycolysis.
 During intense muscle activity
(weightlifting, etc.) O2 supply from blood
quickly drops, then the muscle will use
anaerobic glycolysis.
 They have supplies of glycogen that is
catabolized and undergoes glycolysis. -They are white because
they have less
mitochondria, capillaries
and myoglobin
-They make energy from
glycogen breakdown
fast 10/5/2021
Eyayaw A. 25

26. metabolism
in muscle
anaerobic
(without O2)
white fibers
ATP from
anaerobic
glycolysis
product :
lactate
lactate converted
to glucose by cori
cycle (liver)
aerobic
(with O2)
red fibers
ATP from
fatty acid
product:
CO2 and
H2O
fatty acid broke
down by :
1-B-oxidation
2-krebs cycle
3-respiratory chain
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Eyayaw A. 26

27. 10/5/2021
Eyayaw A. 27

28. physical exercise
 It is any bodily activity that enhances or maintains
physical fitness and overall health and wellness.
 It is performed for various reasons including
strengthening muscles and the cardiovascular system
as well as for the purpose of enjoyment.
 Frequent and regular physical exercise boosts the
immune system, and helps to prevent from
cardiovascular disease.
 It also improves mental health, helps prevent
depression, helps to promote or maintain positive self-
esteem.
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Eyayaw A. 28

29. Types of physical exercise
Aerobic exercise
 Aerobic exercise takes place in the presence of
oxygen and involves aerobic metabolism of
glucose.
 The exercise is low in intensity and sustained for
a longer period than strength training.
 which speeds up heart rate and breathing, is
important for many body functions.
 It gives heart and lungs a workout and increases
endurance. 10/5/2021
Eyayaw A. 29

30.  it also help to relax blood vessel walls, lower blood
pressure, burn body fat, lower blood sugar levels,
reduce inflammation and raise "good" HDL cholesterol.
 Combined with weight loss, it can lower "bad" LDL
cholesterol levels, too.
 Over the long term it reduces risk of heart disease,
stroke, type 2 diabetes, breast and colon cancer,
depression, and falls.
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Eyayaw A. 30

31. Strengthening exercise
• Strength training or progressive resistance training
(PRT), is a training in which the resistance against which
a muscle generates force is progressively increased over
time.
• The maximal weight or resistance a person can lift or
move to complete the movement is defined as the one-
repetition maximum (1 RM).
• Prescriptions of repetitions at what RM vary depending
on prior experience with PRT and co-morbidities.
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Eyayaw A. 31

32. • One recommendation (Level IIA evidence) from the
American College of Sports Medicine and the American
Heart Association suggests
• 8–10 exercises be performed on two or more
nonconsecutive days per week with 10-15 repetitions using
the major muscle groups.
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Eyayaw A. 32

33. Strengthening exercise contd.
• Muscle hypertrophy and increased strength, along with the
changes in body composition, the hormonal and nervous
systems,
• have a positive impact on the daily activities of living and
functional independence of the older adult.
• Strength training can also have substantial benefits for
protection from injury in the elderly, as falling is strongly related
to hip weakness, poor balance, and postural sway.
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Eyayaw A. 33

34. 10/5/2021
Eyayaw A. 34

35. 3. Stretching exercise
 Stretching helps maintain flexibility.
 But aging leads to a loss of flexibility in the
muscles and tendons. Muscles shorten and don't
function properly. muscle cramps
 That increases the risk for and pain, muscle
damage, strains, joint pain, and falling, and it
also makes it tough to get through daily activities,
such as bending down to tie your shoes.
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Eyayaw A. 35

36. Stretching exercise cont.
 Likewise, stretching the muscles routinely makes
them longer and more flexible.
 which increases range of motion and reduces pain
and the risk for injury.
 Aim for a program of stretching every day or at
least three or four times per week.
 Warm up your muscles first, with a few minutes of
dynamic stretches.
 That gets blood and oxygen to muscles, and makes
them amenable to change.
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Eyayaw A. 36

37.  Then perform static stretches (holding a stretch
position for up to 60 seconds) for the calves, the
hamstrings, hip flexors, quadriceps, and the muscles
of the shoulders, neck, and lower back.
Single knee rotation
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Eyayaw A. 37

38.  Starting position: Lie on back with legs extended
on the floor
 Movement: Relax your shoulders against the
floor. Bend your left knee and place your left foot
on your right thigh just above the knee.
 Tighten your abdominal muscles, then grasp your
left knee with your right hand and gently pull it
across your body toward your right side. Hold 10
to 30seconds.
 Return to the starting position and repeat on the
other side.
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Eyayaw A. 38

39. 4. Balance exercises
 balance is the ability to control the body center of
mass to the base of support in order to maintain up
right posture or functional equilibrium in dynamic
activities.
 Improving your balance makes you feel steadier on
your feet and helps prevent falls.
 It's especially important as we get older, when the
systems that help us maintain balance—our vision, our
inner ear, and our leg muscles and joints—tend to
break down.
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Eyayaw A. 39

40. 10/5/2021
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42. THANK YOU
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Eyayaw A.