1 designing cardiorespiratory exercise program. 2 developmaintain cardiorespiratory endurance...
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Designing Cardiorespiratory
Exercise Program
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develop maintain
Cardiorespiratory endurance
Aerobic exercise program
improve
Health status
reduce
Disease risk
needinterestsagegenderphysical fitness levelexercise habits
US Dept. of Health& Human Service, 1996 Guidelines For Exercise Prescription For Improved Health
1. Mode: Select endurance-type physical activities, including formal aerobic exercise training, house and yard work, and physical active, recreational pursuits.
2. Intensity: Prescribe at least moderate intensity physical activities (≥ 45% Vo2max).
3. Frequency Schedule physical activity for most, preferably all, days of the week.
4. Duration: Accumulate at least 30 minutes of activity each day. Duration varies depending on type of activity.
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Successful Programming
• Leadership, education and motivation from YOU are very important to a successful program
• YOU teach your client why regular exercise necessary, how the exercise is performed safely and effectively and help them to incorporate regular exercise into their life
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Successful Programming• 35% of adults, 18-64 yrs, engage in regular physical activity
• 50% will drop out within 6 months
• The most common reasons– overweight– low self-motivation– anxiety– no spousal support– inconvenient exercise facility– exercise intensity is too high– no social support during and after exercise
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Exercise prescription for cardiorespiratory fitnessMode of exerciseIntensity of exerciseDuration of exerciseFrequency of exerciseRate of progressionStages of progression
Essentials of a cardiorespiratory exercise workoutAerobic training methods and modes
Continuous trainingDiscontinuous training
Personalized exercise programsCase study
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Modes of exerciseLarge muscles groups in continuous, rhythmical activities
Initial and improvement stage :*easy to maintain a constant exercise intensity*not highly dependent on participant’s skill
Maintenance stage: *rate of energy costs highly related to skill level*exercise highly variable in terms of energy costs & skill: limited for fun not emphasize the competitive - high risk & symptomatic
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Classification of Aerobic Exercise Modalities1998, V.H. Heyward
Classification of Aerobic Exercise Modalitiesa
Group I activitiesCycling (indoor)JoggingRunningWalkingRowingb
Stair climbingb
Simulated climbingb
Nordic skiingb
Aerobic ridingbc
Group II activitiesAerobic dancingBench step aerobicNordic skiing (outdoor)HikingRope skippingSwimmingWater aerobic
Group II IactivitiesBasketballCountry and western dancingHandballRacquet sportVolleyballSuper circuit resistance training
a Group I activites provide constant intensity and are not dependent on skill; Group II activities may provide constant or variable intensity, depending on skill. Group III activities provide variable intensity and are highly dependent on skills.b Machine-based activiesc May not provide adequate training intensity for above-average fitness levels
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Thomas et al (1995) :* treadmill jogging, skiing, stepping, rowing, cycling - higher PER in cycling (Fig 5.2)* subjects exercising on 7 different exercise at a somewhat hard intensity (RPE = 13 -14) for 15 -20 minutes experienced a greater total O2 consumption for treadmill jogging compared to stepping, rowing, skiing, cycling aerobic riding. (Fig 5.2)Heyward (1996), Hoffman (1996) :* treadmill jogging may be superior to other aerobic exercise in term of energy costs when exercise modes are equated using subjective rating RPE.* steady-state exercise HR higher for treadmill jogging compared to cycling and aerobic riding (Fig 5.2)
Which mode of exercise leads to the greatest improvement?
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How easy the exercise intensity can be graded andadjusted in order to overload the cardiorespiratory systemthroughout the improvement stage aerobic dance / bench step : quicker cadences, increase heights,
Some comments about rope skipping:* 60-80 skips/min = 9 METs > maximum MET capacity of most sedentary individuals* not easy to graded because doubling the rate of skipping increase the energy requirement by only 2 to 3 METs* average energy costs of 11.7 to 12.5 METs for skipping at rate 125, 135, 1nd 145 skips/min. Rope skipping is a strenuous exercise that may not be well suited as a form of graded, aerobic exercise.
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Intensity of exercise* expressed as a percentage of maximal aerobic capacity VO2 max* intensity and duration are inversely related* low to moderate intensities of longer duration are recommended for most cases
Higher intensityRisk of injury
Discourage continued participation
ACSM - initial exercise intensity for apparently healthy adults - 50-85 % VO2max (60-90 % of HRmax)
lower intensity, 40-50 %VO2max may be sufficient to provide health benefits for sedentary people with lowinitial cardiorespiratory fitness level.
intensity can be prescribed using MET, HR, or RPE methods
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MET methodstep1. Asses VO2max using a graded exercise teststep 2. Determine the minimum, average, and maximum intensity
For example: VO2max is 35 ml/kg/min 35 ml/kg/min = 10 METs
Minimum40% - 4 METs
Average60-70% - 6-7 METs
Maximum85% - 8.5 METs
The exercise prescription for this case, an apparently healthy,active person should include activities that produce an averageintensity of 6 -7 METs.
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Now, you have the required exercise intensity in METs. How touse this required METs to tell your client how fast is the running speed.
A woman should jog on a level course to be exercising at an intensity of 8 METs, how fast she should run?1. Convert METs to ml/kg/min VO2 = 8 METs x 3.5 ml/kg/min = 28 ml/kg/min2. Substitute known values into the ACSM running equation VO2 = (speed m/min x 0.2) + 3.5 ml/kg/min 28 - 3.5 ml/kg/min = speed m/min x 0.2 speed = 122.5 m/min3. Convert speed to mi/hr 122.5 ÷ 26.8 = 4.57 mi/hr4. Convert mi/hr to minute per mile pace Pace = 60 min/hr ÷ 4.75 mi/hr = 13.1 min.mi
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Heart Rate methodBased on the assumption that HR is a linear function ofexercise intensity
HR vs. MET graphing method
Percentage of maximal HR reserve (% HRR) method
Percentage of maximal HR (% HRmax) method
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HR vs. MET graphing method
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Percentage of maximal HR reserve (% HRR) method
Target HR=(% HRR) x (HR max - HR rest) + HR restACSM : 50-85 % HRR
Age 42 HR max 220 - 42 = 178 bpm Resting HR = 68 bpmExercise intensity = 60% HRRTarget exercise HR = 60% x (178 - 68) + 68 = 134 bpm For people at different initial fitness level, use deVries (1980) guidelines
Prescription of Exercise Intensity
Using % HRR Method for Various Fitness Levels Low (%) Average (%) High (%) Minimum HR 40 60 70Average HR 50-60 70-75 80-85 Maximum HR 75 85 90
Target HR = % HRR (HRmax –HRrest) + HRrest
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Percentage of maximal HR (% HRmax) method
% of HR max is related to % of VO2max69-89 % HR max correspond to 50-80 % VO2max
ACSM : 60-90 % HRmax
% HRR70% x (180 - 80) + 80= 150 bpm
% HRmax70 % X 180= 126 bpm
age 40, HR rest 80 bpmACSM% HRmax x 1.15
126 x 1.15 =145 bpm
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Comparison of Methods forPrescribing Exercise Intensity for Healthy Adults
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Limitations of HR methods
Using HR exclusively to develop intensity recommendationsfor your clients’ exercise prescriptions may lead to large errors in estimating relative exercise intensity (% VO2max) for someindividuals. This is especially true when HRmax is predicatedfrom age (220-age) instead of being directly measured. In about30% of population, an age-predicted prescription of 60% HRRmay be as low as 70% and as high as 80% of the actual HRmax(Dishman 1994). Also, medication, emotional state, andenvironmental factors such as temperature, humidity, and airpollution can affect your clients’ exercise training heart rate. Please consider alternative methods for monitoringexercise intensity - combination of HR and RPE
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Rating of Perceived Exertion (RPE) method
The RPE scales are valid and reliable tools for assessing the level of physical exertion during continuous, aerobic exercise (Birk and Birk 1987; Borg and Linderholm 1967; Dunbar etal. 1992)
RPE Intensity HRR
11 light 50%
12 minimum13 somewhat hard 60%
16 hard maximum 85%17 very hard
Advantage do not needto check HR
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Duration of exercise
ACSM - 20-30 minutes of continuous aerobic activity
Apparently healthcan sustain 60-85%VO2max20-30 minutes
Poorly conditioned40% VO2max 10 minutes
Multiple sessions/ dayto accumulate 20 to 30 min
Sedentary40-60% VO2max20-30 min
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Caloric cost of exercise can be used to estimate the duration of exerciseACSM - minimal thresholds of 150 - 300 kcal /session or 800 -900 kcal / weekInitial stage : 200 - 600 kcal / weekThrough improvement stage :goal is increase from 800 to 2000 kcal / week by gradually increasingfrequency, duration and intensity of exercise
Woman, 60-kg (132 lb.) exercise intensity of 7 METs, 5 times / week,goal:1500 kcal / week, or 300 kcal / session
1MET = 1 kcal/kg/hr 7 METs for 60-kg 420 kcal/hr 7 kcal/min300 kcal ÷7 kcal/min = 43 minExercise Prescription: duration 43 min, frequency 5 / week intensity 7 METs anything else?
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Frequency of exerciseACSM : 3- 5 times /week* sedentary (functional capacity = 5-8 METs) should exercise a minimum of 3 / week to produce significant changes in cardio.)* increase to 5/week as the fitness level increases* in term of improving VO2max, the sequence of exercise sessions seems to be less important than the total work performed during the training.* similar improvement, trained every other day (M-W-F) and 3 consecutive days (M-T-W)* ACSM : exercising on alternate days during the initial stage of training to lessen the chance of bone or joint injury
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Rate of progression* the greatest conditioning effects : first 6-8 weeks
improvement 1st month 3% per week 2nd month 2% per week thereafter 1% or less per week
For continued improvement, the cardiorespiratory systemmust be overloaded by adjusting the intensity and duration of exercise to the new level of fitness
* for average person, 5-20% increase inVO2max* inactive : may 40%* elite athletes may only 5% because they begin at a level much close to their genetic limits
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Physiological Changes Induced byCardiorespiratory Endurance Training
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Stages of progression
I, F, D periodically
Overload to cadio. / mus. progressively
Continued improvementsgraduallyone element at a time
Older / less fit D, not I
Initial conditioning stageImprovement stageMaintenance stage
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Initial conditioning stage
lasts 4 - 6 weekstime to familiar with exercise trainingprescribe stretching exercise low-intensity aerobic exercise low-intensity resistance exerciseACSM : 40-60%VO2max; at least 12-15 min; 20 min in 4 - 6 weeks; 2 - 3 times / weekHave your clients progress slowly by increasingexercise duration first, followed by small increasesin exercise intensity.
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Improvement stage
lasts 4 to 5 months (16 - 20 weeks) duration every 2 - 3 weeks frequency from 3 - 5 times
*Frequency, intensity and duration systematically and slowly progress, increasing one element at a time, until the client’s fitness goal is reached. * Cardiac patients, elderly, less fit - ACSM : duration should be at least 20 - 30 minutes before increasing intensity
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Maintenance stage*for maintaining the level of fitness achieved by the client at the end of the improvement stage*begins 6 months after the exercise program begins and should be continued on a regular, long-term basis if the client has made a lifetime commitment to exercise
amount of exercise in this stage < in improvement stage
frequency can be decreased, for example, jogging 5 / week to2-3 / week
a variety of enjoyable physical activities helps to counteractboredom and to maintain the client’s interest level
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Essentials of a cardiorespiratory exercise workout
Warm-up 5 - 10 min
blood flow to working muscle
body temperature
Chance of muscle and joint injury
Chance of abnormal cardiac rhythms
Conditioning phase - 20 - 60 min
Cool-down5 min
low intensity
Prevents pooling of blood in extremitiesReduces possibility of dizziness / faintingStretching exercises reduce chance of musclecramps / muscle soreness
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Personalized Exercise Programs
Training goal
age
gender
Physical fitness level
Exercise preferences
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Medical history
Physical condition
Lifestyle characteristics
interests
Designingexercise program
Prior to
Summarize info in
Case study Accurate / safeindividualizedexercise program
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