ACSM Guidelines Chapter 6 - General Principles of Exercise Prescription

What are three ways to minimize the risk of CVD Complications?

(a) following the preparticipation health screening and evaluation procedures (b) beginning a new program of exercise at light-to-moderate intensity (c) employing a gradual progression of the quantity and quality of exercise.

How does the frequency of aerobic exercise vary with intensity?

1. Moderate intensity exercise should be done at least 5 days a week, or vigorous intensity aerobic exercise should be done at least 3 days a week. 2. A weekly combination of moderate and vigorous exercise for 3-5 days per week.

Name the 4 phases an exercise training session should have?

1. Warm-up: at least 5-10 min of light-to-moderate intensity cardiorespiratory and muscular endurance activities 2. Conditioning: at least 20-60 min of aerobic, resistance, neuromotor, and/or sports activities (exercise bouts of 10 min are acceptable if the individual accumulates at least 20-60 min ∙ d −1 of daily aerobic exercise) 3. Cool-down: at least 5-10 min of light-to-moderate intensity cardiorespiratory and muscular endurance activities 4. Stretching: at least 10 min of stretching exercises performed after the warm-up or cool-down phase

Volume of resistance training recommended for ENDURANCE gains

15-25 reps/set under 50% 1RM Older adults: ≥1 sets of 10-15 reps at 40-50% 1RM progressed as tolerated

What is the formula for predicting HR max

220 - age It is simple, but it can under estimate or over estimate measured HR max

1 MET is equal to what VO2?

3.5 mL/kg/min

How is Light intensity Exercise measured?

30%-39% HRR or VO2R 57%-63% of HRmax 37%-45% of VO2max RPE 9-11

How is Moderate intensity Exercise measured?

40%-59% HRR or VO2R 64%-76% HRmax 46%-63% VO2max RPE 12-13

During interval training, how long should the vigorous-to-near max intensity phase last?

45 sec - 4 min

How is Vigorous intensity Exercise measured?

60%-89% HRR or VO2R 77%-95% of HRmax 64%-90% of VO2max RPE 14-17

Volume of resistance training recommended for STRENGTH gains

8-12 reps/set at 60-80% 1RM (60% for untrained, 80% for moderately trained)

What is ACSM's recommended Aerobic Exercise time (duration)?

Accumulate 30-60 min per day (≥150 min per week ) of moderate intensity exercise or 20-60 min per day (≥75 min per week ) of vigorous intensity exercise, or a combination of moderate and vigorous intensity.

Flexibility exercise volume recommendation

Accumulate 60s of stretching per joint, using holds of 10-30 sec. Older adults may benefit from 30-60 sec hold.

What acute effect does static stretching have on muscular power and strength?

Acute power & strength reduction, especially if stretches are held >45 sec.

Recommended frequency of aerobic exercise

Aerobic exercise is recommended on 3-5 d/wk for most adults, with the frequency varying with the intensity of exercise

Name several factors influencing the minimum threshold intensity for benefit.

An individual's current CRF level and other factors such as: age, health status, physiologic differences, genetics, habitual PA social and psychological factors

What is the recommended aerobic exercise duration for weight management?

Between 60-90 minutes per day, especially in people who are sedentary

What are ways to reduce Musculoskeletal Injuries (MSIs)?

By including a warm up, cool-down, stretching exercises, and gradual progression of volume and intensity.

If exercise is only done once or twice a week, how can you get the most out of it?

By including large volumes of exercise in those on or two days a week *****exercising one to two times per week is not recommended for most adults because the risk of MSI, and adverse cardiovascular events are higher in individuals who are not physically active on a regular basis and those who engage in unaccustomed vigorous exercise

In general, how should an ExRx be progressed?

By increasing any component of the FITT principle as tolerated. Avoid large increases in a single area to minimize risk of adverse events, MSI, soreness, etc.

What is considered a reasonable way to increase exercise time/duration?

By increasing duration of exercise every two weeks by 5-10 minutes over the first 4-6 weeks.

What are the recommended methods for gauging exercise intensity?

Heart Rate Reserve VO2R Threshold methods (Ventilatory th or respiratory compensation point)

How long does it typically take to see improvements in flexibility?

Immediate improvement after stretching exercises; chronic improvement with 3-4 months of stretching exercises 2-3x/wk

Describe the overload principle of training.

It says that exercise below a minimum intensity, or threshold , will not challenge the body sufficiently to result in changes in physiologic parameters, incl. increased VO2max

What should the conditioning part of a workout consist of?

It should include aerobic, resistance, flexibility and neuromotor exercise and/or sports activity.

What is a MET-min?

METs x minutes Usually standardized per day or week

2 general goals of including resistance training in the ExRx

Make ADLs less physiologically stressful Prevent, manage, attenuate chronic disease

What is ACSM's Aerobic Exercise Intensity Recommendation?

Moderate to vigorous intensity exercise is recommended for most adults. Light to moderate intensity aerobic exercise can be beneficial in people who are de-conditioned.

Resistance training type recommendation (4 components)

Multi-joint compound exercises using more than 1 group Single joint exercises for each group Core exercises Agonist-antagonist training

Resistance exercise progression recommendations

Progressive overload principle. Increase resistance, sets, or frequency to elicit further improvements.

Resistance training frequency recommendation

RT of each major muscle group 2-3 days per week with at least 48 hrs separating sessions for the same group. Whole body workouts and split workouts are both effective as long as each group is trained 2-3x/wk

Aerobic exercise Type recommendation

Rhythmic aerobic exercise of at least mod intensity involving large muscle groups and little skill recommended to all adults to improve CRF.

Flexibility exercise type recommendations

Series of stretches targeting major musculotendinous units using static, dynamic, & PNF stretches.

Name an additional effective primary method of prescribing and monitoring intensity.

Talk test. Reasonable surrogate for LT, VT, and RCP.

During interval training, how long should the light to moderate phase last?

The light -to-moderate phase of interval training should be equal or longer than the vigorous to heart max phase 1-6 min

During interval training, what aspects of the Ex-Rx can be varied depending on the goals of the training session and physical fitness level of the patient?

The number, duration, and intensity of the work and recovery intervals; the number of repetitions of the intervals; and the duration of the between-interval rest period

What makes the stretching phase different from cool-down?

The stretching phase is distinct from the warm-up and cool-down phases and may be performed following the warm-up or cool-down, as warmer muscles improve ROM.

What should a warmup portion of a session consist of and why should it be done?

The warm-up phase consists of a minimum of 5-10 min of light-to-moderate intensity aerobic and muscular endurance activity The warm-up is a transitional phase that allows the body to adjust to the changing physiologic, biomechanical, and bioenergetic demands of the conditioning or sports phase of the exercise session. Warming up also improves range of motion (ROM) and may reduce the risk of injury

An optimal ExRx should address which aspects of fitness?

cardiorespiratory (aerobic) fitness (CRF) muscular strength and endurance flexibility body composition neuromotor fitness.

Since the accuracy of gauging exercise intensity can be influenced by the method of measurement, what is recommended to ensure accuracy

direct measurement of the physiologic responses to exercise through an incremental (graded) cardiopulmonary exercise test is the preferred method for ExRx whenever possible.

How is exercise volume (quantity) calculated?

frequency x intensity x time

Describe the components and purpose of the cool-down period.

it should involve aerobic and muscular endurance activity of light to moderate intensity that lasts 5-10 minutes. The purpose of the cool-down period is to allow for a gradual recovery of heart rate (HR) and blood pressure (BP) and removal of metabolic end products from the muscles used during the more intense exercise conditioning phase.

Converting METs to kcal/min

kcal/min=[(METs x 3.5 x bodyweight in kg) / 1000] x 5 Usually standardized per day or week

neuromotor exercise recommendations

≥2-3 days/wk of 20-30 mins of exercise involving motor skills, balance, coordination, agility, and proprioceptive training.

Aerobic exercise volume recommendation

≥500-1000 MET-min per week 1000 kcal per week of mod intensity 150 min mod intensity per week step count ≥5400-7900 per day