Exercise Prescription

Exercise Prescription

Cardiorespiratory Fitness: Estimation from Field and Submaximal Exercise Tests Chapter 7 Reasonable and Expected Values for VO2 Category or Level ml.kg-1min-1 ml.min-1 METS Male

(75 kg) Female (60 kg) Male (75 kg) Female (60 kg) Male (75 kg) Female (60 kg)

3.5 3.5 262 210 1 1 Maximal 20 yrs Old

45-60 35-50 3375-4500 2100-3000 13-17 10-14 Maximal 60 yrs Old 30-40 25-35

2250-3000 1500-2100 8-11 7-10 Elite Endurance Athlete 80 70 23

20 Rest 6000 4200 Textbook, Fig. 7.7, P. 126 Terminology VO2R VO2 reserve capacity VO2R = (VO2max VO2 Resting)

HRR Heart Rate Reserve HRR = (HRmax HR rest) Mode of Activity Use of large muscle groups Legs or legs + arms When small muscles are used the HR response is exaggerated Different modes are equivalent if HR is raised to same level for same period of time or total calories are the same Factors Determining Best Mode

Enjoyable Accessible Orthopedic limitations Body Mass Motor Skill Must do activities that are at least tolerable Fitness and Health ACSM/AHA Current PA Recommendations

Moderate intensity aerobic exercise (3-6 Mets, brisk walking, 50% HRR) for minimum of 30 min, 5 days per week OR, vigorous intensity aerobic exercise (>6 Mets, jogging, 70% HRR) for minimum of 20 min, 3 days per week. Any combination that accumulates 450-750 Met.min per week 500-1000 kcals for 70 kg person 7.2-14.2 kcal.kg-1 Strength training What Counts? Intermitten bouts of at least 10 minutes Occupational tasks (above and beyond typical ADLs) that meet the intensity criteria

Expected Improvement in Fitness VO2max improves 10-30% Lactate threshold improves 10-20% High Intensity Interval Training (HIIT) Characterized by brief, intermittent bursts of vigorous activity, interspersed with periods of rest or low-intensity exercise. Typical work bouts range from 10-60 sec with variable rest periods from 1-4 min. The combination of length of work bout and intensity will determine the appropriate rest interval. Advantages of HIIT

Reduced exercise time with equivalent or better metabolic and cardiovascular benefits Increased skeletal muscle oxidative capacity Increased VO2max Increased resting glycogen content Reduced rate of glycogen utilization Reduced rate of lactate production Increased lipid oxidation Enhanced peripheral vascular structure & function Clinical Advantages of HIIT Improved endothelial function Reversing left ventricular remodeling in heart failure Reducing central body fat and fasting plasma insulin

Disadvantages of HIIT Some will perceive it as too hard Increased trauma with weight bearing activities Must condition the soft and connective tissues before exposure to HIIT Optimal dosage is unknown Long-term benefits/effects are unknown Maintenance Health Benefits 450-750 Met.min per week forever Consistency is the key Fitness Benefits

Maintaining intensity will maintain VO2max IF training is stopped Loss of up to 50% after 1-3 months Loss of 100% after 3-8 months Metabolic Equations for Estimating Gross VO2 (ACSM 2000) Exercise mode Gross VO2 (mlkg-1min-1) Resting VO2 (mlkg-1min-1) Comments Walking VO2 = (Sa x 0.1) + (S x Gb x 1.8)

+ 3.5 1. For speeds of 50-100 m/min-1 (1.9-3.7 mph) 2. 0.1 mlkg-1m-1 = O2 cost of walking horizontally 3. 1.8 mlkg-1m-1 = O2 cost of walking on incline (% grade of treadmill) Running VO2 = (Sa x 0.2) + (S x Gb x 0.9) +3.5 1. For speeds >134 mmin-1 (>5.0 mph) 2. If truly jogging (not walking), this equations can also be used for speeds of 80-134 mmin -1 (3-5 mph) 3. 0.2 mlkg-1m-1 = O2 cost of running horizontally 4. 0.9 mlkg-1m-1 = O2 cost of running on incline (%

grade of treadmill) Leg ergometry VO2 = (Wc/Md x 10.8) + 3.5 +3.5 1. For work rates between 50 and 200 W (300-1200 kgmmin-1) 2. kgmmin-1 = kg x m/rev x rev/min 3. Monark and Bodyguard = 6 m/rev; Tunturi = 3 m/rev 4. 10.8 mlkg-1W-1 = O2 cost of cycling against external load (resistance) 5. 3.5 mlkg-1min-1 = O2 cost of cycling with zero load Arm ergometry VO2 = (Wc/Md x 18.0) + none

+3.5 1. For work rates between 25 and 125 W (150-750 kgmmin-1) 2. kgmmin-1 = kg x m/rev x rev/min 3. 18.0 mlkg-1W-1 = O2 cost of cycling against external load (resistance) 4. None = due to small mass of arm musculature, no special term for unloaded (zero load) cycling is needed Stepping VO2 = (Fe x 0.2) + (F x htf x 1.8 x 1.33) +3.5 1. Appropriate for stepping rates between 12 and 30

steps/min and step heights between 0.04 m (1.6 in.) and 0.40 m (15.7 in.) 2. 0.2 mlkg-1m-1 = O2 cost of moving horizontally 3. 1.8 mlkg-1m-1 = O2 cost of stepping up (bench height) 4. 1.33 includes positive component of stepping up (1.0) + negative component of stepping down (0.33) [a] S= speed of treadmill in mmin-1; 1 mph = 26.8 mmin-1. G= grade (% incline) of treadmill in decimal form; e.g., 10% = 0.10. c W= power output in watts; 1 W = 6 kgmmin -1. d M= body mass in kilograms; 1 kg = 2.2 lb.

e F= frequency of stepping in steps per minute. f ht= bench height in meters; 1 in. = 0.0254 m. b

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