Testing & Prescription Powerpoint 8

Here are 8 methods used in Exercise Science for prescribing intensity of aerobic exercise?

% max HR % VO2max % HR Reserve %VO2 Reserve METs Kcal/min RPE Talk Test ACSM "favors" using %VO2R or %HRR for prescribing intensity of aerobic training

METs

Another useful way to express exercise intensity < 3 METS = Light Activity 3-6 METS = Moderate Activity > 6 METs = Vigorous Activity

Stretching

At least 10 minutes of stretching exercises performed after the warm-up or cool-down phase

Conditioning

At least 20-60 minutes of aerobic, resistance, nueromotor, and/or sports activities (exercise bouts of 10 minutes are acceptable if the individual accumulates at least 20-60 minutes of daily aerobic exercise)

Warm-up

At least 5-10 minutes of light to moderate intensity cardiorespiratory and muscular endurance activities Advantages: Increases blood flow more O2 delivery to muscles, more CO2 removal, more blood to skin for cooling Increases body temperature most enzymes work faster at slightly elevated temperatures More oxygen dissociates from hemoglobin to tissues May reduce risk of musculoskeletal injury by increasing connective tissue extensibility and improving range of motion May reduce risk of ischemic ST-segment depression or ventricular dysrhythmias associated with sudden increases in exertion

Cool-down

At least 5-10 minutes of light to moderate intensity cardiorespiratory and muscular endurance activities Advantages: Maintains adequate venous return of blood to the heart, reducing risk of post-exercise hypotension and dizziness Facilitates dissipation of body heat Promotes more rapid removal of lactic acid than stationary recovery Helps attenuate effects of exercise-related rise in epinephrine Omission of a cool down in the immediate post-exercise period theoretically increases the opportunity for cardiovascular complications. Presumably, the sudden termination of exercise results in a transient decrease in venous return, possibly reducing coronary blood flow when HR and myocardial oxygen demands still may be high. Consequences may be include ischemic ST-segment depression, with or without angina symptoms, serious ventricular dysrhythmias, or combinations thereof. Cool-down is a critical ingredient of a comprehensive, safe program for both healthy participants, as well as patients with disease.

So, how do we calculate MET-min per week?

Calculated as the product of the number of METs associated with one or more physical activities and the number of minutes the activities were performed; usually standardized per week or per day as a measure of exercise volume. Example: Tom's weekly volume of aerobic exercise in kcal/week Frequency = 4 days/wk Time = 30 min/session Max HR = 175 bpm Resting HR = 74 HRR = 175-74 = 101 Target HR = (101 x .60) + 74 = 135 bpm

Talk Test

During aerobic exercise, if people can carry on a conversation, they are probably exercising in the light-moderate range.

Making Sense of the Exercise Prescription

Effective exercise prescription requires that an exercise professional be able to translate scientific principles and theory into language and ideas that are easy for a client to understand and apply. In addition, an understanding of some of the theories of behavior change may help the practioner to tailor the exercise prescription to each client's individual needs.

Aerobic Exercise Time

Exercise time/duration is prescribed as a measure of the amount of time physical activity is performed. It is recommended that most adults accumulate 30-60 minutes of moderate intensity exercise, 20-60 minutes of vigorous intensity exercise, or a combination of moderate and vigorous intensity exercise per day to attain the volumes of exercise recommended. However less than 20 min. of exercise per day can be beneficial especially in previously sedentary individuals. For weight management, longer durations of exercise (greater than or equal to 60-90 min) may be needed, especially in individuals who spend large amounts of time in sedentary behaviors. The recommended time/duration of physical activity may be performed continuously (one session) or intermittently and can be accumulated over the course of a day in one or more sessions of physical activity that total at least 10 min. sessions. Exercise outs of greater than 10 minutes may yield favorable adaptations in very deconditioned individuals, but further study is needed o confirm the effectiveness of these shorter bouts of exercise.

FITT

F-frequency I-intensity T-time T-type

The appropriate aerobic exercise intensity is one that:

Is safe Enhances VO2max Compatible with the person's lifestyle and preferred exercises Achieves the desired caloric output

Martti J. Karvonen, M.D, Ph.D.

Karvonen´s name is well-known to the researchers and practitioners in sports and exercise medicine all over the world, especially through the "Karvonen equation" (Training heart rate=[maximal heart rate-resting heart rate] X desired exercise intensity + resting HR) to determine individually effective target exercise training heart rate. (From ACSM Bulletin, March 17, 2009)

Aerobic Exercise Frequency

Moderate intensity aerobic exercise done at least 5 days a week or vigorous intensity aerobic exercise done at least 3 days a week or a weekly combination of 3-5 days a week of moderate and vigorous intensity exercise is recommended for most adults to achieve and maintain health/fitness benefits. Vigorous intensity exercise performed more than 5 days a week might increase the incidence of musculoskeletal injury, so this amount of vigorous intensity, physical activity is not recommended for most adults.

Aerobic Fitness Type (mode)

Rhythmic, aerobic type exercises involving large muscle groups are recommended for improving CRF. The principle of specificity of training should be kept in mind when selecting the exercise modalities to be included in the prescription. The specificity principle states that the physiologic adaptations to exercise are specific to the type of exercise performed. Ex: walking, leisurely cycling, aqua-aerobics, slow dancing, jogging, running, rowing, aerobics, spinning, elliptical exercise, stepping exercise, fast dancing, swimming, cross country, skating, racquet sports, basketball, soccer, down-hill skiing, and hiking

What are some of the factors to consider when selecting the type of exercise for aerobic training?

Risk of injury Physical limitations Access Interests of client

Where is most of your blood located?

Systemic

VO2 Reserve

The difference between maximum VO2 and resting VO2 Resting VO2 is taken to be 3.5 mL/kg/min Example (Joe): VO2 max was 45 ml/kg/min 45 ml/kg/min - 3.5 ml/kg/min VO2 Reserve = 41.5 ml/kg/min

Exercise Prescription

The first step in developing an exercise prescription is to determine the client's goals. GOALS must be realistic, measurable, and achievable. When the goals have been determined, apply the FITT principle to address these goals. The FITT principle stands for frequency, intensity, time (duration), and type (mode) of exercise; it provides a simple way to outline the components of an exercise prescription. Whether a client wants to improve cardiorespiratory fitness or gain muscular endurance, whether he or she wants to lose weight, recover from heart surgery, or train from the Olympics, the exercise professional can use the acronym "FITT" to delineate an appropriate exercise prescription.

General Considerations for Exercise Prescription

The principles of exercise prescription presented in this chapter are intended to guide health/fitness, public health, clinical exercise, and health care professionals in the development of an individually tailored exercise prescription for the apparently healthy adult whose goal is to improve physical fitness and health and may also apply to adults with certain chronic diseases, disabilities or health conditions, when appropriately screened. Recreational and competitive athletes will benefit from more advanced training techniques than are presented in this chapter. A program of regular exercise for most adults should include a variety of exercises beyond activities performed as part of daily living. Common components of the exercise prescription seem to be helpful at least under some circumstances to reduce musculoskeletal injury and complications. These include warm-up and cool-down, stretching exercises, and gradual progression of volume and intensity.

Progression

The recommend rate of progression in an exercise program depends on the individual's health status, physical fitness, training responses, and exercise program goals. Progression may consist of increasing any of the components of the FITT principle of prescription as tolerated by the individual. During the initial phase of the exercise program, increasing exercise time and duration is recommended. An increase in exercise/duration per session of 5-10 minutes every 1- weeks over the first 4-6 weeks of an exercise training program is reasonable for the average adult. Progression in the FITT-VP principle of prescription should be made gradually avoiding large increases in any of the FITT-VP components to minimize risks of muscular soreness, injury, undue fatigue, and the long-term risk of overtraining.

Volume

The results of epidemiological studies and randomized clinical trials have shown there is a dose-response association between the volume of exercise and health/fitness outcomes.` Volume of recommended aerobic exercise per week: 500-1,000 MET-min per week 1,000 kcal per week

RPE

The typical RPE range that is associated with physiological adaptation to endurance exercise is 12-16 on the Borg scale ("somewhat hard" to "hard")

ACSM's Expanded FITT Principle

This edition of the guidelines employs the Frequency (how often), Intensity (how hard), Time (duration or how long), and Type (mode or what kind), with the addition of total Volume (amount) and Progression (advancement) or the FITT-VP principle.

What is the most common type of aerobic exercise in our population?

Walking

What are some of the advantages of walking as an exercise mode for aerobic fitness training?

Walking may be the activity of choice for most individuals because it is readily accessible, offers tolerable exercise intensity, and is an easily regulated exercise for improving health outcomes and CR fitness. Even extremely slow walking (<2 mph) approximates 2 METs and may impose metabolic loads sufficient for exercise training in lower-fit subjects. Brisk walk training programs provide an activity intense enough to increase aerobic capacity and decrease body weight and fat stores in previously sedentary, middle aged men. Variations of conventional walking training, including walking with a 3 to 6 kg backpack load and swimming pool walking offer additional options for those who wish to reduce body weight and fat stores, improve CR fitness or both. Brisk walking, which can be attained by healthy, habitual walkers can elicit an aerobic training stimulus comparable to

4 Main Components of an Individual Training Session

Warm up Conditioning Cool Down Stretching