CV Exercise PrescriptionCV Exercise Prescription

Reasonable and Expected Values for VOReasonable and Expected Values for VO22

Category or Category or LevelLevel

mlml..kgkg-1-1minmin-1-1 mlml..minmin-1-1 METSMETS

MaleMale

(75 kg)(75 kg)

FemaleFemale

(60 kg)(60 kg)

MaleMale

(75 kg)(75 kg)

FemaleFemale

(60 kg)(60 kg)

MaleMale

(75 kg)(75 kg)

FemaleFemale

(60 kg)(60 kg)

RestRest 3.53.5 3.53.5 262262 210210 11 11

MaximalMaximal

20 yrs Old20 yrs Old

45-6045-60 35-5035-50 3375-3375-45004500

2100-2100-30003000

13-1713-17 10-1410-14

MaximalMaximal

60 yrs Old60 yrs Old

30-4030-40 25-3525-35 2250-2250-30003000

1500-1500-21002100

8-118-11 7-107-10

Elite Elite Endurance Endurance AthleteAthlete

8080 7070 60006000 42004200 2323 2020

Textbook, Fig. 8-3, P. 117Textbook, Fig. 8-3, P. 117

The Anaerobic Threshold Concept

TerminologyTerminology

VOVO22RRVOVO22 reserve capacity reserve capacity

VOVO22R = (VOR = (VO22max – VOmax – VO22 Resting) Resting)

HRRHRRHeart Rate ReserveHeart Rate ReserveHRR = (HRmax – HR rest)HRR = (HRmax – HR rest)

Mode of ActivityMode of Activity

Use of large muscle groupsUse of large muscle groupsLegs or legs + armsLegs or legs + arms

When small muscles are used the HR When small muscles are used the HR response is exaggeratedresponse is exaggerated

Different modes are equivalent if HR is Different modes are equivalent if HR is raised to same level for same period of raised to same level for same period of time or total calories are the sametime or total calories are the same

Factors Determining Best ModeFactors Determining Best Mode

EnjoyableEnjoyableAccessibleAccessibleOrthopedic limitationsOrthopedic limitationsBody MassBody MassMotor SkillMotor SkillMust do activities that are at least tolerableMust do activities that are at least tolerable

Fitness and HealthFitness and Health

Intensity Intensity MethodMethod

Lowest Lowest Intensity for Intensity for

HealthHealth

Lowest Lowest Intensity for Intensity for

FitnessFitness

Highest Highest Intensity for Intensity for

FitnessFitness

Optimal Optimal PerformancePerformance

% VO% VO22RR 40%40% 50%50% 85%85% 100%100%

METsMETs 3-63-6 66 15-1815-18 18+18+

HRRHRR 40%40% 50%50% 85%85% 100%100%

% HRmax% HRmax 50%50% 60%60% 90%90% 100%100%

RPERPE 7 or 17 or 1 9 or 29 or 2 14 or 414 or 4 20 or 1020 or 10

ACSM/AHA Current PA ACSM/AHA Current PA RecommendationsRecommendations

Moderate intensity aerobic exercise (3-6 Moderate intensity aerobic exercise (3-6 Mets) for minimum of 30 min, 5 days per Mets) for minimum of 30 min, 5 days per weekweek

OR, vigorous intensity aerobic exercise OR, vigorous intensity aerobic exercise (>6 Mets) for minimum of 20 min, 3 days (>6 Mets) for minimum of 20 min, 3 days per week.per week.

Any combination that accumulates 450-Any combination that accumulates 450-750 Met750 Met..minmin

Strength trainingStrength training

What Counts?What Counts?

Intermitten bouts of at least 10 minutesIntermitten bouts of at least 10 minutesOccupational tasks that meet the intensity Occupational tasks that meet the intensity

criteriacriteria

Expected Improvement in FitnessExpected Improvement in Fitness

VOVO22max improves 10-30% max improves 10-30% Lactate threshold improves 10-20%Lactate threshold improves 10-20%

MaintenanceMaintenance

Health BenefitsHealth Benefits450-750 Met450-750 Met..min per week min per week foreverforeverConsistency is the keyConsistency is the key

Fitness BenefitsFitness BenefitsMaintaining intensity will maintain VOMaintaining intensity will maintain VO22maxmax IF training is stoppedIF training is stopped

Loss of up to 50% after 1-3 monthsLoss of up to 50% after 1-3 monthsLoss of 100% after 3-8 monthsLoss of 100% after 3-8 months

CV Function and the Elderly (65 yr+)CV Function and the Elderly (65 yr+)

VOVO22max decreases 5-15% per decade max decreases 5-15% per decade

after age 25-30after age 25-30Primary cause is decrease in max COPrimary cause is decrease in max COSecondary cause is decrease metabolic Secondary cause is decrease metabolic

capacity of musclecapacity of muscleSubmaximal responsesSubmaximal responses

Same at equivalent relative intensitiesSame at equivalent relative intensitiesHR is higher at same absolute powerHR is higher at same absolute power

Trainability of the ElderlyTrainability of the Elderly

10-30% increase in VO2max (M & F)10-30% increase in VO2max (M & F) Increase in max SV (males)Increase in max SV (males) Increase in metabolic capacity of muscle Increase in metabolic capacity of muscle

(males and females)(males and females)

Precautions for the ElderlyPrecautions for the Elderly

More susceptible to traumatic exerciseMore susceptible to traumatic exerciseMore likely to have underlying diseaseMore likely to have underlying diseaseMust know health history and risk profileMust know health history and risk profile

Current PA Recommendations for Current PA Recommendations for the Elderlythe Elderly

Moderate intensity aerobic activity for Moderate intensity aerobic activity for minimum of 30 min, 5 days per week, ORminimum of 30 min, 5 days per week, OR

Vigorous intensity aerobic activity for Vigorous intensity aerobic activity for minimum of 20 min, 3 days per week.minimum of 20 min, 3 days per week.

Muscle-strengtheningMuscle-strengtheningFlexibilityFlexibilityBalanceBalance

Moderate and Vigorous Intensity DefinitionsModerate and Vigorous Intensity Definitions

10-point scale where sitting is 0 and all-out 10-point scale where sitting is 0 and all-out effort is 10effort is 10

Moderate intensity is 5-6 and produces Moderate intensity is 5-6 and produces noticeable increases n heart rate and noticeable increases n heart rate and breathing.breathing.

Vigorous intensity is 7-8 and produces Vigorous intensity is 7-8 and produces large increases in heart rate and large increases in heart rate and breathing.breathing.

Exercise and PregnancyExercise and Pregnancy Females in good health can and should exercise Females in good health can and should exercise

moderately during pregnancymoderately during pregnancy Minimize thermal stressMinimize thermal stress Maintain hydrationMaintain hydration Exercise to a level of moderate exertionExercise to a level of moderate exertion Maintain sufficient caloric intakeMaintain sufficient caloric intake Do not exercise in supine position after first Do not exercise in supine position after first

trimestertrimester Do not perform prolonged ValsalvasDo not perform prolonged Valsalvas Avoid high impact and high risk activitiesAvoid high impact and high risk activities