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Growth and Deveiepment
A person's age and musculoskeletal and nervous system devel--
opment affect posture, body proportions, body mass, body
movements, and reflexes.For apparellfly acme 3n tee:emy
people, the prescription can immediately include mo era

bic conditioning, strength training, and stretching.1""
tensity on most if not all days of the week. Thorough .Chmcal
evaluations should be completed prior to recommending any
exercise regimen. In addition, the report indicates that exel'ClSe
can prevent gestational diabetes, even in very obese chants. Nutrition

Both undernutritiuizt .mti wrcwttlt'itiou can influence body

alignment and uzubzitt}. l'onrl} tourishcd people may have
\fitamin D deficiency causes

muscle weakness and fatigue. bone deformity during grouth. li..idCL]ULlIC calcium intake and

vitamin D synthesis and intake increase the risk of osteoporo-
sis. Obesity can distort mmcment and stress joints, adversely

affecting posture. balance. and joint health. Personal Values and Attitudes

Whether people value regular exercise is often the result of
family influences. In families that incorporate regular exercise
in their daily routine or spend time together in activities. chil-
dren learn to value physical activity. Sedentary families. on the
other hand, participate in sports only as spectators. and this
lifestyle is often transmitted to their children. With the increase
in TV, computer, and video activities. youth are increasingly
sedentary with attendant declines in health. Values about phys-
ical appearance also influence some people's participation in
regular exercise. People who value a muscular build or physi-

cal attractiveness may participate in regular exercise programs

to produce the appearance they desire. Choice of physical activity or type of exercise is also influ-

enced by values. Choices may be influenced by geographic loca-
tion and cultural role expectations. For many, thinking of exercise more as "recreational movement," "enhancement
Well'beinga" and essential part of daily self-care" may help
overcome perceptions that exercise is drudgery.Nurses must assess
each client for potentially motivating factors such as the follow--
ing: degree of fun or challenge of any given activity; use of mu--
sic; opportunities for socializing and group cohesion and having
an exercise partner; positive sensations of the exercise experi--
ence; pleasurable feelings associated with increased stress reduc-
tion; increased energy and fitness; mastering the activity; goal
setting and progress; daily logs or weekly written schedules;
competition with oneself or others; promotion of a sense of ac-
complishment; weight management; empha31s on self--talk about
how exercise will prevent fatigue, depression, weight gain, or
anxiety; and the need to explore less intense and challenging,
noncompetitive activities (Oberg, 2007).Clients Who experience orthostatic hypoten--
sion, impaired equilibrium, and gait dlsturbance should befginlex-
ercising in supervised environments: For example, athatl 0r
sedentary person may need to begin Wlth a Prescnptionf 13:18:11:
phasizes stretching, strengthemng, and developinen 0d h 1th
rather than aerobic training. The most recent recommendations from the Ameflcan
College of Obstetricians and Gynecologists (Olson, Slkkat
Hayman, Novak, & Stavig, 2008) suggest that healthy pregnemt
women should exercise 30 minutes or more with modefa'te.The design of individualized exercise
prescriptions that tailor exercise mode and dose and address
these varying states with each person will ensure greater adher--
ence to an exercise program (Ruppar & Schneider, 2007).Initially, walk-
ing involves a wide stance and unsteady gait, thus the term
toddler.O I '
Nurses, taking into account motivation to part1c1pate, medical
conditions and level of fitness, and safety issues, can use individ-
ualized exercise prescriptions to encourage exercrse and activity
in all of their clients.From 6 to 12 years of age, refinement of motor skills con--
tinues and exercise patterns for later life are generally deter--
mined.In adolescence,
growth spurts and behaviors such as carrying heavy book bags
on one shoulder and extended computer use may result in 1305'
tural changes that often persist into adulthood.For example, preschoolers master riding a tricycle,
dancing, running, jumping, using crayons to draw, fastening or
using zippers, and brushing their teeth.Adults between 20 and 40 years of age generally haYe few
PhySiCal Changes affecting mobility, with the exceptlon of
pregnant women.Exercise behavior may be improved by address-
ing an individuals' awareness of their physiological response to
activity and exercise.All extremities are generally flexed but can be pas-
sively moved through a full range of motion.As the neurologic
system matures, control over movement progresses during the
first year.Pregnancy alters center of graVitY and aff'eCtS
balance.Motiva-
tional states influence our behavior and choices, and vary widely
from day to day.In those who are building toward a fitness
goal, these parameters will change over time to increase the
client's level of conditioning (Oberg, 2007).Gross motor development occurs in a head--to--toe fashion, that
is, progression from head control, to crawling, to pulling up to
a standing position, to standing, and to walking, usually after the
first birthday.Immobility can impair
the social and motor development of young children.Many schools provide physical education and
competitive sports programs to enhance physical activity.Pre-
scriptions should include frequency of the activity, intensity, and
time (the FIT model).Newborn movements are reflexive
and random.Gross motor development precedes fine motor skills.Pos-
ture in school-age children is usually excellent.Options include
informal and fun activities such as dancing to music.The contralateral motion of crawling, however
brief, is an important building block for walking.From ages 1 to 5 years, both gross and fine motor skills
are refined.