Aqua aerobic for obese individuals

Overeight is a condition in which an individual's weight exceeds the population norm or average, which is determined by height and weight tables based on gender, height, and frame size. Although a standard approach, the definition lack the ability to account for significant muscle mass. A better measure might be percentage body fat, but this approach takes additional time and effort and thus has not replaced the simpler method in all situations.

Obesity is a condition in hich there is an excess of body fat, frequently resulting in a significant impairment of health. Obese individuals are at a level of 20 percent or more above ideal body weight. Obesity is generally defined and accepted as above 20 percent body fat for males and above 30 percent body fat for females. There is some variance in obesity thresholds as determined by different organizations or criteria. 

Although not all large adults are unhealthy, various health risks are associated with obesity, including the following:

• Premature death
• Type 2 diabetes
• Heart disease
• Stroke
• Hypertension
• Gall bladder disease
• Osteoarthritis
• Sleep apnea
• Asthma
• Breathing problems
• Cancer (endometrial, colon, kidney, gallbladdeer, and postmenopausal breast cancer)
• High blood cholesterol
• Complications of pregnancy
• Menstrual irregularities
• Stress incontinence
• Psychological burden including depression and social stigmatization

Benefits of exercise

There are many ways in hich exercise is beneficial to the obese participant. Exercise helps promote negative energy balance and aids in weight loss efforts. With exercise, there is a higher likelihood that weight lost is fat weight, muscle weight is spared or improved. Additional benefits include the following:

• Reduced risk for chronic disease
• Improved circulation
• Stronger heart and lungs
• Increased stamina, strength, and endurance
• Lower resting blood pressure and pulse
• Improved body composition
• Increased life span
• Self confidence and awareness
• Positive changes in mood
• Relief of depression and anxiety
• Increased mental well being
• Positive coping strategies

There are several advantages to exercising in the water:

• Reduced impact pressure and load are experienced because of the water's buoyancy.
• Hydrostatic pressure increases circulation and reduces swelling.
• The cooling effect of the water allows for more comfortable exercises.
• Water ''covers up'' or hides the body, making many larger adults feel less self conscious when they exercise.

Program considerations

Dress is an important issue with this population. Exposing their body in the pool area might be the number one deterrent or excuse for not participating in an exercise program. Let participant know where they can find bike shorts and supportive exercise bras that can be worn in the water and suggest the option to wear a shirt over their swimsuit if that makes them feel more comfortable.

Be aware that some larger adults might have special needs in exercise programming. Remind them to wear shoes on the pool deck to prevent slips and falls. Using Vaseline can help to prevent chaffing where areas of the body rub together during repetitive movements.

Gneral program considerations include the following:

• Obese individuals need safe and comfortable accessto enter and exit the pool. Steps, ramps, and laddersin the shallow area of the pool serve this purpose. Some participants might require assistance to raise their body weight out of the water.
• Some participants might need alternatives for impacting. Body mass can affect range of motion, and mofidications might need to be given for more stretchingand toning exercises.
• Avoid exercises that cause discomfort or discourage participants with larger bodies. Do include movements for coordination, balance, range of motion, and improved body alignment.
• Stress proper body alignment and form. Cue proper knee and foot position, as many participants have lower leg and ankle misalignments.
• Use appropriate music and movement tempo. Some larger participants might be comfortable at a slightly slower tempo because of a larger body mass and additional frontal surface area that increase intensity.

Recommended water temperature

A temperature range of 26.5 to 30 degrees C is recommended for obese participants. Overheating can be an issue for obese participants, even in the water, because of increased thermal insulation.

Recommended tempo

The lower and middle range of typical recommended tempo ranges (125 to 150 bpm shallow and 100 to 135 bpm deep) are recommended for obese participants because of their larger body mass and more surface area 

Recommended water depth

Waist to armpit depth is the suggested range for shallow water programming, optimal depth will be influenced by a parfticipant's total buoyancy and height. 

Recommended program formats

Interval programming works well for a multifitness level class for obese participants. Working above and belo aerobic threshold, above and at aerobic threshold, and within tha target heart rate range will accommodate most levels of fitness. Circuit training also allows for multifitness levels to be successful within a class.