EXSC 428 Exam 01 - Cardiorespiratory Exercise Prescription

%HRR Method (Karvonen) Values of %HRR correspond to values of % VO2R Equation: Target HR = (int. frac.)(HRmax - HRrest) + HRrest - Use true HR if known. - Measure Arrest under appropriate conditions - The % HRR method is much better than % HR max for the professional setting.

%HRR method is much better than %HR max for the professional setting

AT REST: - _____% HRR - _____% (error) for VO2 Max (Range 5-20%) - The error is _____ (smaller/larger) at _____ (higher/lower) intensities. - The lower the fitness the more the error - HRR does not equal VO2 max

0, 10, larger, lower

Sweat Production - Average person produces up to _____ L per hr during maximum exercise - Can be 2-3 L per hr when acclimated to the _____.

1, heat

2008 Physical Activity Guidelines for Americans For Children (6-17 yrs) - Should do _____ hr or more of physical activity every day, primarily moderate or vigorous intensity _____ (anaerobic/aerobic) activity - The _____ (moderate/vigorous) intensity activity should be done at least 3 days per week. - The overall activity should include muscle and bone-strengthening activity at least _____ days per week.

1, vigorous, 3

2008 Physical Activity Guidelines for Americans For Adults - Doing half of the recommended volume of exercise amounts to _____% decreased heart disease risk. - Doing recommended volume of exercise amounts to _____ % decreased heart disease risk. - Doing twice the recommended volume of exercise amounts to _____ % decreased heart disease risk. - Doing 5X recommended volume of exercise amounts to _____% decreased heart disease risk.

14, 14, 20, 25

How much to drink? - 8oz every 15 min, even if you're not thirsty? - not true - Enough to prevent weight loss of about _____% - Also safe to drink based on thirst.

2

Physical fitness, activity and CVD risk - _____% reduced risk of heart disease when implementing the most amount of fitness available (most fit). - The greatest amount of physical activity lowers risk of heart disease by _____ %. - In comparison, the greatest amount of fitness lowered risk of heart disease by _____%. - Improving your fitness is the most recommended way to reduced heart disease risk.

30, 30, 60

Conclusion: Minimal Intensity for Healthy Subjects - _____% of VO2R is threshold training intensity if VO2max > 40 ml/min*kg - _____% of VO2R is minimal effective training intensity if VO2max < 40 ml/min*kg - Clients with higher initial fitness? -- Helgerud et al., 2007: no increase with 47% or 72% VO2R with baseline of 58 ml/min*kg; 9% increase with intervals at 85% * Karvonen said it was 70% - not what we use today * 30-40% is what we use today.

45, 30

Karvonen et al., The effects of training on heart rate Conclusion: - "At least _____% of the available range of pulse rates" is required for a training effect - "In order to cause an increase of the maximum oxygen uptake, training must be _____. Misguided philanthropism in the administration of athletic training programs may deprive them of their major effects. - Professional adopted %HRR for exercise prescription, but many assumed that %HRR values equaled %VO2Max values. * This is NOT true. At rest: - _____% HRR - _____% VO2 Max

70, intense, 0, 5-10

Exercise intensity and insulin sensitivity Elderly women randomized to: - Vigorous intensity: _____% VO2 max - Moderate intensity: _____% VO2 max - Control Training volume: - Equal for exercise groups: 1200 kcal/wk, 9 months Results - Only the vigorous group increased insulin sensitivity

80, 65

Is %HRR equal to %VO2 max or %VO2 Reserve Subject - 63 subjects (33M, 30 F); 18-40 years old; apparently healthy Protocol - _____ and _____ measured at rest - Incremental cycle exercise performed in _____ minute stages - HR and VO2 measured at end of each stage, and at maximum Analysis - HR at each stage expressed as % of difference between rest and max (%HRR); compared to % VO2 max and to % VO2R at each stage.

HR, VO2, 3

Interval vs. Continuous training in heart failure Heart failure patients randomized to: - Treadmill walking 4 min 90% & 3 min 70% HRmax - Treadmill walking at 70% HR max - Control Exercise volume - Equated per session; 3 times/wk, 12 weeks Heart failure, means that heart is weak and doesn't pump well. Results - Interval training proved to be more beneficial

Interval training proved to be more beneficial

What is the threshold intensity? Is there a minimal exercise intensity that must be used or exceeded to obtain improved aerobic fitness? _____ et al., (1957) - 70% of HRR is threshold intensity - But only 6 subjects, all fit, were used. _____ (1990) - 40-50% of HRR or VO2 max is threshold _____ and _____ (2002) - Performed analysis of past training studies to convert exercise intensity to %VO2 R units

Karvonen, ACSM, Swain, Franklin

Overall risk of sudden cardiac death Effect of regular exercise - Overall risk is reduced in those who exercise regularly - Risk is reduced with increased exercise intensity Inactive - 1.0 Light - 0.86 Moderate - 0.67 Vigorous - 0.54 - _____ exercise lowers the risk to almost half. - If you never exercise and suddenly engage in vigorous exercise, the risk of sudden heart attach is extremely high.

Overall risk is reduced in those who exercise regularly, vigorous

_____ _____ - The BORG 6-20 RPE scale is preferred over his 0-10 scale. - It's best if the client has experienced a max test while providing RPE values, to serve as a reference for exercise prescription. - RPE is highly subjective, not a precise indicator of effort (use conversion table as rough estimate) - Talk Test: for a moderate intensity, exercise at a level that makes it harder to breathe, but still allows you to speak in complete sentences; difficult to speak complete sentences indicates ventricle threshold, transition to vigorous intensity

Perceived Exertion

ACSM Adopts VO2R for Ex Rx ACSM position stand, 1998 - "The ACSM is now relating HRR to VO2R rather than a percentage of VO2max. Using _____ improves the accuracy of the relationship, particularly at the lower end of the intensity scale. It is incorrect to relate HRR to a level of VO2 that starts at zero rather than a resting level." ACSM Guidelines, 2000, 2006, 2010 - "The ACSM recommends an intensity of exercise corresponding to.. between _____% to _____% of oxygen uptake reserve (VO2R) or HR reserve." ACSM position stand, 2011; Guidelines 2013, 2016 - 30-59% VO2R or HRR for deconditioned - 40-89% for most adults

VO2R, 40-50, 85

%HRmax method - ACSM states that 30/40 - 89% _____ corresponds to 57/64-95% of _____. - Use true HR max if known; otherwise, estimate as 220-age or 208 - 0.7(age) *the %HRmax method is NOT preferred since it does not account for variations in resting HR.

VO2R, HRmax

2008 Physical Activity Guidelines for Americans For Seniors (65+ yrs) - Should follow the _____ (children/adult) guidelines to the extent they are able. - Should do exercise to maintain or improve _____ if at risk of falling. * Individuals with disabilities should follow the age-specific guidelines to the extent they are able.

adult, balance

Sodium content of fluids Sweat: 0.5-2.3 g/L - About 1.2 g/L on average _____ _____: 3.2 g/L - 135-145 mEq/L Gatorade: 0.5 g/L V8: 2.0g/L

blood plasma

Fluid Balance - Exercising at 12 kcal/min for 1 hr, we make 110 ml of water from the _____ we burn. - And we release 490 ml of water from our _____ - If we sweat 1 L in that hr, less than half a L (about 400 ml) may come from _____ _____ and need to be replaced.

carbs, glycogen, body fluids

ASCM Guidelines FITT Principle - _____: 3-5 days per week (but can be daily) - _____: 30/40-89% of VO2 Reserve or HRR As low as 30% for deconditioned 40-60% moderate and 60-89% vigorous for most adults - _____: 20-60 mins - _____: continuous, rhythmic, large muscle mass

frequency, intensity, time, type

Risk of Heart attack depends on _____ of exercise (vigorous) per _____.

frequency, week

Effect of training intensity on VO2 max - Found that the _____ (lower/higher) the intensity the more improvement for _____ *Higher intensities leads to higher VO2 max.

higher, fitness

_____ Symptoms: - Nausea, fatigue, unconsciousness, death Causes: - Drinking water, even gatorade, to replace sweat dilutes the blood plasma which causes swelling of tissues, including cerebral edema. *Is it ***** or heat illness - plasma Na+ < 135 mEq/L (*****) - rectal temp > 38 degrees C. (heat illness)

hyponatremia

Risk of Vigorous Exercise Orthopedics? Risk due to _____, not cardio intensity. - Walking 3.4 mph, flat; net 11 ml/min*kg - Walking 3.4 mph, 11%; net 26 ml/min*kg - Running 5.0 mph, flat; net 25 ml/min*kg Heart attack possible... - In those with pre-existing heart disease - Increased sympathetic drive; increased BP; increased clotting - However - If you do NOT have heart disease you can exercise as intense as you wish.

impact

Karvonen et al., The effects of training on heart rate Purpose: To find which _____ was effective of improving aerobic fitness Subject: 6 medical students Training: Running on a treadmill 60 or 70% of HRR, 5 times a week. * Karvonen did not measure VO2 max - He made an error when implementing by only measuring _____ of treadmill.

intensity, speed

Historical Background for HRR and VO2R _____ et al., 1957 - First use of HRR for establishing exercise intensity ACSM position stand, 1990 - %HRR is equivalent to %VO2 _____ for purposes of exercise prescription Swain and Leutholtz, 1997 - %HRR is equivalent to %VO2 _____, not to %VO2max ACSM position stand, 1998 - Adopted Swain and Leutholz position ACSM position stands, 2011

karvonen, max, reserve

Notes - Between beats, _____ (right/left) ventricle is filling with blood - "End diastolic volume." Blood is then ejected. This is called the _____ _____. - A healthy adult at rest, ejection fraction is about _____%. With exercise the EF _____ (increases/decreases) - 40% or less of ejection fraction is typical of _____ _____. Very large heart with a left stretched ventricle due to low EF. "Smaller left ventricle is a good thing." - Increase of ejection fraction was found from implementing vigorous exercise. - As blood rubs against the endothelium, flow-mediated dilation is _____ (increased/decreased).

left, stroke volume, 60, increases, heart failure, increased

2008 Physical Activity Guidelines for Americans For Adults (18-64 yrs) - Should do 2 hr 30 min of _____ (moderate/vigorous) intensity, or 1 hr 15 min of _____ (moderate/vigorous) intensity aerobic activity per week, or an equivalent combination of the two. - Doing 5 hr of moderate intensity or 2 hr 30 min of vigorous intensity aerobic activity provides more health benefits. - Should also do muscle-strengthening activity for all major muscle groups at least _____ days per week.

moderate, vigorous, 2

Handling Heat Stress _____: - Slow down - Use ice sock - Drink cold fluids - Exercise indoors Heat _____: - Stop, move to cool location - Apply cold, wet, towel - Drink cold fluids Heat _____: - Call 911 - Do the burrito

prevention, exhaustion, stroke

Injuries Avoid overuse injuries: warm up, cool down, stretch Treatment of injuries: _____

rice

Training for Performance - _____ = (economy)(% of max sustained)(VO2max) - _____ workouts - Aerobic _____. - _____ workouts

speed, endurance, intervals, pace

2008 Guideline Extra Notes Moderate intensity aerobic activity: - I can ____ but not ____ - Eg. Brisk walking Vigorous intensity aerobic activity: - I can only say a few words without stopping to catch my breath - Eg. Jogging * People without diagnosed conditions (such as diabetes, heart disease) and without symptoms (such as chest pain, dizziness) do not need permission from a physician.

talk, sing

ASCM Guidelines FITT Principle - _____: Duration of activity * This is all _____ - 30/40 - 89% of VO2 Reserve or HRR - Difference between resting and maximum - 1 MET = 3.5ml/min*kg = average resting oxygen for adults - Elite male athletes are in low _____, VO2max - Elite female athletes in the _____, VO2max Aerobic exercise = continuous, _____, and large _____ _____ - E.g. walking, jogging, biking, swimming, etc. * _____ _____ _____ uses the most muscle mass of any aerobic activity - A bunch of anaerobic activities does not make an aerobic exercise - E.g Crossfit

time, cardiorespiratory, 80s, 70s, rhythmic, muscle mass, cross country skiing

Greater Health Benefits of Higher Intensities? Epidemiological studies suggest that: - _____ (moderate/vigorous) intensity exercise is better than _____ (moderate/vigorous) intensity exercise at reducing incidence of CHD and several risk factors for CHD. Clinical trials suggest that: - Vigorous intensity exercise is better than moderate intensity exercise at reducing _____ _____, improving _____ control, and improving _____ fitness, but not _____ _____. These findings held even when total EE was controlled.

vigorous, moderate, blood pressure, glucose, aerobic, weight loss

Warm up and Cool down - _____ _____: 5-10 min of light intensity aerobic exercise prior to the prescribed workout. - _____ _____: 5-10 min of light intensity aerobic exercise after the prescribed workout. Note: Stretching is not a warm-up by itself. * These are not included in the 20-60 min TIME recommended duration Cool downs are recommended because - _____ _____ cleared by energy reuse - veins are dilated causing blood to go into muscles, when you neglect cool downs, the muscle pump stops, and blood pooling happens, resulting in less blood returning to heart, thus stroke volume decreases, thus cardiac output decreases, and blood pressure decreases. Not enough blood the the rest of the body essentially. *venous return was less due to blood pooling leaving people with feelings of dizziness.

warm up, cool down, lactic acid

What to drink? Exercise < 1hr: drink plain _____. Exercise > 1hr: - Add Na: 460-690 mg/L (Gatorade is 450) - Add K: 80-200 mg/L (Gatorade is 130) - Add carbs: 50-100 g/L (Gatorade is 60) or complex carbs in endurance drinks (E.g. Perpetuem) After exercise: - consume carbs (_____g) and protein (_____g) immediately, and after two hours. - drink enough to finish rehydrating

water, 100, 33

Prescribing Intensity _____: from 30/40 - 89% VO2R - Based on MET level from table - Calculate from ACSM equations _____ _____ - %HRmax method - %HRR method _____ Exertion - RPE scales - Talk test

workload, heart rate, perceived