Aerobic Fitness Estimations VO2peak and Exercise Planning using simple software designed by Assoc Pr

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Aerobic Fitness Estimations (VO2peak)and
Exercise Planning using simple softwaredesigned
by Assoc Prof Steve Selig
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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age

• Included on this CD is
• this Information and Tutorial PowerPoint
  presentation. Note the next slide is a Table of
  Contents that will come alive (hotlinks) when you
  view this file as a Slide Show
• The following are also included on the CD in the
  case that you decide to purchase the software
• Activation Program RUN this program, and send
  the output back to Steve Selig
• Security Program INSTALL this program, as it is
  needed to run the software
• You have NOT been supplied with the actual
  software. If you decide to purchase, this will be
  sent to you separately after completing the above
  processes.

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Contents

• Concept of the software
• Uses of the software
• Reliability of the software
• Main menu on each worksheet
• PEAK data and age comparison
• Add extra weight for certain clients in the
  exercise TEST
• Use the recommended step height, or .
• Select your own step height
• Enter HRpeak if you know it, or
• Predict HRpeak 208 - 70 of age
• METs ratio of exercise to rest
• Exclusion of bad data
• Exercise prescription overview
• Exercise Plan STEP exercise based on heart rates
• Exercise Plan STEP exercise based on STEP height
  and speed
• Exercise Plan WALK / JOG exercise based on speed
  and grade

• Exercise Plan CYCLE exercise based on watts
• Add extra weight for certain clients in the
  exercise PLAN
• Calorie counter
• Detailed Advice and Instructions
• Heart rates measurement many methods
• Troubleshooting problems with HR record
• Special points about each of the modes of
  exercise ALL modes
• TREADMILL mode
• STEP mode
• CYCLING mode
• Borg 6-20 RPE scale
• Exercise Record Sheet
• Disclaimer
• Warnings
• Price indications and conditions
• Installation instructions

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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age
Go to Contents

• There are three different packages to predict
  VO2peak
• STEP
• TREADMILL (or alternatively WALK / JOG outside)
• LEG CYCLE

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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age
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• The STEP test is based on the published journal
  article-
• Selig SE, Gosling CM, Carlson JS. A multi-stage
  step test protocol for people with low exercise
  capacity, Clinical Kinesiology, 200054(3)67-71.
  
• The treadmill and cycle ergometer packages use
  predictive equations as published in the 7th
  edition of the American College of Sports
  Medicine Guidelines for Exercise Testing and
  Prescription (2006).

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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age
Concept of the Software This software will allow
you to administer accurate and reliable exercise
tests that could previously only be generated in
high tech, specialized laboratories. You can
conduct exercise testing anywhere with little
equipment and basic training.
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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age
Concept of the Software The software works by
establishing each individuals unique heart rate
/ work rate signature for the three modes of
exercise. These relationships are then used to
estimate VO2peak and sub-maximal VO2, and enables
the user to design individualised exercise
programs based on exercise intensity (eg power,
speed, METs, heart rate or VO2peak) and volume
(eg duration or calories). Individualised
intensities and volumes of training sessions are
also simple to calculate and archive.
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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age

• The software can be used to
• estimate VO2peak once (for comparison against age
  and gender) or more than once (to chart progress
  or evaluate a program)
• conduct exercise tests to either sub-maximal or
  maximal peak intensities, and that either or both
  can be used to program

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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age

• The software can also be used to
• design an individualised exercise program for a
  client based on their actual exercise test data
• estimate the intensity and volume of an exercise
  session, again based on a clients exercise test
  data
• chart historical data for multiple exercise tests
  and exercise sessions

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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age

• The software can be used for
• patients living with chronic disease or injury
  and with low capacity for exercise
• AND
• healthy clientele with average to very high
  capacity for exercise
• BUT NOT
• Elite athletes these should be tested in an
  AIS-accredited laboratory

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Exercise testing software, designed and developed
by Dr Steve Selig, trading as Fit at Any Age
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MAIN MENU
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PEAK data and age comparison
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Add extra weight for some clients
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Use the recommended step height, or
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or . select your own step height
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Enter HRpeak if you know it, or ..
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Enter HRpeak 1 to predict HRpeak 208 70
of age
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See graph to compare fitness against age peers
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METs ratio of exercise energy to resting energy
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Exclusion of heart rates due to anticipation (see
next 2 slides BEFORE and AFTER exclusion)
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BEFORE exclusion of heart rates due to
anticipation
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AFTER exclusion of heart rates due to
anticipation
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Exercise prescription
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Exercise prescription
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Exercise plan STEP exercise based on heart rates
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Exercise plan STEP exercise based on STEP height
and speed
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Exercise plan WALK / JOG exercise based on speed
and grade
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Exercise plan CYCLE exercise based on watts
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Exercise plan extra weight can be added for
certain clients
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Exercise plan if you select duration, calories
per set and also the number of sets to lose 1 kg
of fat are calculated
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Detailed Advice and Instructions
1. All of these tests are designed to be
incremental that is to start from low levels of
exercise that even the most impaired patients can
manage, and progress either up to VO2peak or stop
before that at a sub-maximal exercise level. If
you stop at a sub-maximal VO2, then it is still
possible to estimate VO2peak so long as you know
HRpeak from say a previous exercise stress test.
In either case (i.e. peak or sub-maximal test),
the sub-maximal levels of exercise should be
accurate and reliable for prescribing sub-maximal
exercise. 2. VO2peak tests in patients are
similar to VO2max tests in athletes, except that
athletes achieve a plateau for at least a couple
of minutes in both oxygen consumption (VO2max)
and heart rate HRmax). Patients just touch the
plateau before fatiguing. 3. Sub-maximal VO2s
are based on standard algorithms (formulae) that
predict VO2 from the relevant sub-maximal
workload or power, and are expressed in
ml.kg-1.min-1 after adjusting for the persons
body weight that must be measured or known. Each
mode of exercise has its own formula or formulae.
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Detailed Advice and Instructions
4. The special feature of this suite of software
is that the exercise test results are
individualized by analyzing each clients
unique Work Rate Heart Rate relationship for
the particular mode of exercise. This also
enables each exercise prescription to be
individualized (compare other prescriptions that
use look-up tables and are unsuitable for
patients as they are mostly based on healthy,
young individuals with a body mass of 70 kg). If
maximal (peak) heart rate (HRpeak) is known (from
a previous peak exercise test, or this exercise
test), then you will gain the full power of the
software by being to derive VO2peak and of
VO2peak for your exercise prescription. But if
HRpeak is not known, then the software is still
very usable for sub-maximal exercise
prescriptions. The only data missing from the
exercise prescription will be of peak data such
as 70 of VO2peak.
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Detailed Advice and Instructions

• 5. VO2peak is based on each individuals
  relationship between sub-maximal work rates and
  heart rates (and therefore sub-maximal VO2s)
  that are then extrapolated up to HRpeak and from
  this, peak power and VO2peak are calculated.
  There are four main methods for knowing or
  predicting HRpeak in an individual
• The test itself is a peak exercise test, with the
  volunteer stopping at the point of fatigue.
• A previous exercise test was conducted to peak
  exercise intensity (e.g. a cardiac stress test
  supervised by a cardiologist) in this case, the
  persons medical conditions and especially any
  heart rate modulating medications must not have
  changed substantively since the test. For
  instance, if the patient has since commenced a
  beta-blocker or vasodilator or changed the dose,
  then the previous HRpeak is no longer valid.
• The individual knows his / her HRpeak from
  previous high intensity exercise or a
  post-competition heart rate. The same comments
  apply regarding medical conditions and
  medications as per b, above.
• If none of a, b or c applies, then you can enter
  the number 1 in the HRpeak box and the software
  will use the validated predictive formula HRpeak
  208 70 of age (Tanaka et al., J Am Coll
  Cardiol. 2001 Jan37(1)153-6). This formula is
  NOT valid for many medical conditions, or for
  patients taking medications such as beta
  blockers, vasodilators or digoxin.
• If none of a, b, c or d apply, then leave HRpeak
  blank on the spreadsheets and the software will
  not calculate VO2peak and of VO2peak. The
  sub-maximal exercise prescription should still be
  accurate and reliable.

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Heart rates can be measured using many methods

• ECG here you can read off the HR output from the
  instrument (but check the accuracy), or simply
  count the number of R waves on the monitor or
  printout in a given time interval (e.g. 15-30
  sec, see ECGs 1 and 3, below), or for noisy
  ECGs, print off some ECG and measure the average
  distance (time interval) between R waves to
  derive the HR (see ECG 2, below). Ask someone in
  your facility for help with any of these methods
  you should be able to get an accurate HR at all
  times when using an ECG, even if the patients
  ECG record is very noisy (ECG 2) or the cardiac
  rhythm is irregular (ECG 3). ECG is the gold
  standard for measuring HR during exercise. It
  obviously provides a lot more information than
  just HR.

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Heart rates can be measured using many methods

• Heart Rate Monitor. Note these may be highly
  inaccurate for some rhythms, including high
  levels of ectopic activity or atrial fibrillation
  (aF, see ECG 3, above). The simplest way to test
  for this is to palpate (feel) the radial pulse
  for rate AND rhythm (regular or irregular) before
  starting exercise, and simultaneously check the
  accuracy of the HR monitor.
• Pulse Oximeter. These are usually very accurate
  and reliable and are excellent to also track the
  patients oxygenation during exercise, but not
  all rehabilitation facilities have them. However,
  the finger cuff types are relatively inexpensive.
  They are an excellent backup or alternative to
  ECG.
• Palpation skilled operators can measure heart
  rate by palpation during cycling exercise, but
  not usually treadmill or step. For these, it is
  permissible to stop exercise for 15-30 sec
  between exercise levels so long as you reach
  steady state again at the next work level. This
  will normally necessitate increasing the duration
  of each exercise stage to say 2 minutes. Pulse
  can be taken at the radial or brachial arteries,
  but it is unsafe to take a carotid pulse during
  exercise or recovery. Apical pulse (lower region
  of the heart located on the lower left chest) is
  also an excellent site for ease and reliability,
  but permission must be granted by the client as
  this involves placing the hand on the lower
  chest. Alternatively, ask the client to count
  their own apical pulse.

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Troubleshooting problems with HR record for
exercise testing
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Troubleshooting problems with HR record for
exercise testing
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Troubleshooting problems with HR record for
exercise testing
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Troubleshooting problems with HR record for
exercise testing
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Troubleshooting problems with HR record for
exercise testing
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Special points about each of the modes of
exercise All three modes

• The three modes covered by the suite of software
  are treadmill, cycling, and step exercise. For
  each, there are customized protocols
  available- this means that the person
  administering the test can design any combination
  of exercise (starting intensity, rate of
  increment) to suit the client. For treadmill and
  leg cycling, there are also established
  protocols, such as the Bruce, Balke and Naughton
  treadmill protocols. The published step protocols
  are mostly single-stage and are therefore
  considered inferior to customizing a graded
  incremental protocol that is encouraged here.
  Guidelines for this are given in the step section
  below.
• VO2peak tests should last 4-12 minutes in
  patients and always be incremental in nature
  (single intensity tests are very common but do
  not provide enough information about sub-maximal
  VO2s and are not good for prescribing exercise).
  Any shorter than 4 min and the linear
  relationships will not be established any longer
  than 12 min and the patient will fatigue before
  reaching VO2peak.
• Sub-maximal tests should last 4-10 minutes.

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Special points about each of the modes of
exercise All three modes

• The software can be used as a single measure to
  assess a clients current exercise capacity, or
  used repetitively for a client to assess
  progress, to adjust a program, or to evaluate the
  effectiveness of an exercise program or other
  intervention.
• For optimal pre- and post-program comparisons in
  an individual client, use the same ergometer,
  start intensity, and rate of progression for all
  testing in the client. Try to test at a similar
  time of day, and control other factors that
  affect exercise performance. These include recent
  food and fluid intake, rest and exercise for 48
  hours prior to the test. Record all of this at
  the first test and use again. Do NOT interfere
  with a clients medications or any other aspect
  of their medical management.
• For patients, it is better to increase power a
  little each minute, rather than a lot every three
  minutes. That is why the Bruce treadmill protocol
  that prescribes large increases in both speed and
  gradient every three minutes (see treadmill
  software below) is not as useful as the other
  treadmill protocols. For the customized protocols
  for each of the three modes of exercise, try to
  design the minute increments in power or work of
  similar size each minute (e.g. 10 watts per
  minute) and moderate in size (to enable the
  person to exercise for 4-12 minutes).

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Special points about each of the modes of
exercise All three modes

• You need to include warm-up and cool-down
  procedures and be aware that naïve patients may
  lack skill and may suffer muscle soreness either
  immediately or delayed. This tenderness may
  persist for up to 48-72 hours after the test, but
  not longer. Use normal sports first aid
  procedures to deal with this.
• You may wish to build in a 3-5 minute warm-up
  period at the starting intensity for each mode.
  Also, never stop exercise suddenly at the end of
  the test instead, quickly ease the patient down
  to a low level of exercise and use an active
  recovery for several minutes to gradually bring
  their heart rates down to near the pre-exercise
  level.
• For some ergometers / test protocols, patients
  need to be closely monitored, often with a
  spotter standing beside them. This applies to
  motorized treadmills and step tests, particularly
  near the end of the test when the patient
  fatigues and may stumble, hit the front of the
  treadmill or step, or come backwards off the
  treadmill.
• You need accurate and reliable heart rate and
  ergometer measurements.
• HR should be measured at the end of each exercise
  intensity (usually one minute intervals) to give
  time for steady state ( fully evolved
  physiological response) to each exercise level.
  For example, if you are about to increase power
  from 100 to 110 watts, then measure HR just
  before the increase. ).

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Special points about each of the modes of
exercise All three modes

• Perceived exertion should be recorded for each
  intensity. Use the 6-20 point Borg scale (see
  scale below 6 is meant to represent 60 bpm and
  20 is meant to represent 200 bpm, but obviously
  this is extremely variable and subjective). Ask
  the patient how they feel at the 40 sec mark of
  each minute, and this gives you 20 sec to decide
  whether to increase the intensity further. Once
  they reach 15 ( Hard) on the scale, also ask
  them after 10 sec of the new higher workload so
  that you can stop if they are not able to
  continue at this intensity any longer. VO2peak
  tests normally reach 17-18 points (but not 19)
  for patients, whilst sub-maximal tests should
  reach 11-16 on the Borg scale.
• You may wish to measure blood pressure,
  particularly during the first test.
• Each worksheet has an exercise prescription /
  session data section. You can use these either to
  prescribe exercise or to measure exercise
  training intensity (METS multiples of resting
  exercise metabolism 1 MET resting metabolism)
  and training volume (calories used for a given
  duration of exercise at that intensity). Session
  data can be used to track progress of a client
  over a period of time. To do this, you can copy
  the aggregate session data to another worksheet
  Client History. This aggregate data is found at
  the bottom of the exercise prescription / session
  data section that you have been using on that
  day. Client History sheets are graphical time
  records of client exercise tests and exercise
  training intensities (both maximum and average
  for a session) and volume (calories). You can
  store up to 26 sessions (e.g. daily or weekly
  records) on each of these sheets, and more can be
  stored by copying the Client History sheets. You
  can also store historical data of the exercise
  tests (VO2peak data) on the same worksheet.

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Special points about each of the modes of
exercise All three modes

• Exercise prescriptions provide both intensity
  data (METS, power on an ergometer, treadmill
  speed and grade, and also VO2peak if HRpeak is
  known) and volume of exercise (calories used for
  a given duration of exercise at that intensity).
  You can generate exercise prescriptions across
  virtually the full range of the clients exercise
  tolerance from very mild exercise to high
  intensity effort. The most accurate way to do
  this with this software is to input desired heart
  rates and other intensity and duration data, and
  the software will then calculate the work that
  will be performed and the energy that will be
  expended. This heart rate method of programming
  and measuring exercise performance during
  training uses the individuals unique heart rate
  work rate relationship that was established
  during the most recent exercise test.
• Exercise prescriptions and session data can also
  be generated without using heart rates. This is a
  little less accurate as it only partially relies
  on the individuals unique heart rate work rate
  relationship, but is still very useful in the
  situation that you do not want to record heart
  rate during exercise training sessions.
• Each workbook (i.e. for each of the three modes)
  has worksheets for MALES and FEMALES that are
  found on the ABOUT page and named at the bottom
  of the screen. Selecting a worksheet from the
  ABOUT page will automatically resize the sheet
  to suit your PC settings.

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Special points about each of the modes of
exercise All three modes

• Clicking recalculate on the main menu page is a
  useful tool to check that the software is
  working. The main time to use this is on first
  installation or re-installation.
• You should adopt sound practices for the
  management of the workbooks and worksheets. The
  licence permits unlimited copying of the software
  (either whole workbooks or worksheets) on the
  licensed PC, but copies will not work on other
  PCs, including networked PCs. It is recommended
  that if you want to retain a clients data in the
  software, you should save the whole workbook
  under the clients name and then delete all
  unused sheets (go to Edit ? Delete Sheet). For
  repeat testing in the client, simply copy the
  relevant worksheet (go to Edit ? Move or Copy
  Sheet ? Select the Sheet ? Create a Copy). If you
  want to rename the original and/or copied sheets,
  then double click the sheet name on the lower
  toolbar and rename it.
• The suite of software is designed to be used for
  healthy people of all ages including those who
  are already fit, and for patients or those with
  risk factors who have impaired capacities to
  exercise. The software and exercise protocol
  recommendations are NOT designed for highly
  trained elite athletes. The latter should undergo
  DIRECT measurements of VO2max in accredited
  Sports Science Laboratories.

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Special points about each of the modes of
exercise TREADMILL

• Try to work out the best starting combination of
  speed (e.g. 4 or 6 kph) and gradient (e.g. 0, 1
  or 2). You may be able to do this whilst
  observing the client during the warm-up or having
  knowledge of their exercise capacity. Low and
  moderate level clients usually prefer constant
  speed at a slow to brisk walking pace with
  increments in grade only.
• Note that gradient must be entered into software
  in percentage units, not degrees! Also make sure
  that you increase gradient intensity using , not
  degrees.
• Gait (for typical adults) changes from walking to
  jogging in the range of 5-6 kph. Therefore it is
  inadvisable to use a speed in this range as the
  strength of prediction is lower (ie the ACSM
  predictive algorithm changes from walking to
  jogging).
• Monitoring of blood pressure, ECG and even heart
  rate are more challenging on a treadmill, but can
  be readily done by a skilled operator.
• Treadmill exercise is functional and relates well
  to exercise prescription. Walking (even up a
  grade) is preferable to jogging or running for
  rehabilitation. It is generally better to use a
  brisk walk with steep grade in high level
  patients, rather than have them jog or run.
• For clients with moderate to high aerobic
  capacity, try adding some extra weight (worn
  around the torso using a weighted vest or small
  back pack weighted with sand) as this will
  challenge them aerobically and permit a better
  prediction of VO2peak.
• For clients with musculoskeletal or neurological
  impairments, but with moderate to high aerobic
  capacity, extra weight may also be added to
  challenge them aerobically, whilst not
  aggravating or limiting them by their
  musculoskeletal or neurological impairments.
• Delayed or immediate muscle soreness can occur
  with treadmill if using a steep gradient. This is
  because the calf muscles are being asked to
  contract under stretch (eccentric work). Apply
  ice immediately after on the calf muscles and
  advise them on icing at home.

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Special points about each of the modes of
exercise TREADMILL

• For moderate and high level patients, you can
  also increase the effort levels by adding extra
  weight to the torso (see Table 1, below). A vest,
  backpack or waist belt can be worn, adding extra
  weight such as sand, disc weights or lead this
  can be as little as 1-2 kg and as much as 10 kg
  (dont forget to include the weight of the vest
  or backpack). Try to distribute the weight evenly
  around the torso (back, waist, and even chest and
  abdomen). It is not recommended to carry weight
  in the hands, or on the wrists or ankles, as this
  will probably interfere with both breathing and
  exercise efficiencies and test accuracy. The
  treadmill software is clever enough to cope with
  added weights such as weights worn on a vest or
  back pack. Both versions of VO2peak
  (ml.kg-1.min-1 and l.min-1) are automatically
  adjusted to the extra weight. NOTE an exercise
  test should be performed with this extra weight
  in order to generate the correct set of heart
  rates. Then the new higher levels of calorie
  expenditure will be calculated without disturbing
  any other features of the software.

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Special points about each of the modes of
exercise TREADMILL
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Special points about each of the modes of
exercise STEP

• This is not designed for use with a cross trainer
  or any stepper that requires the person to
  overcome any resistance other than gravity on
  either the way up or way down.
• Unlike most step tests, it is designed as a
  multi-stage test (one minute increments in step
  rate, NOT step height) and is much better than
  single stage tests for prescribing exercise.
  Traditional step tests are only used to predict
  VO2peak.
• The computer will pick a suitable step height to
  use, based on each individuals height, but if
  you do not have a bench of this size, then you
  can vary this by putting in the actual height of
  your bench. That said, it is better (more
  functional and safer) to use a low bench height
  for rehabilitation clientele and so you should
  try to use a step bench of similar height to the
  one chosen in the software. You may want to use a
  slightly higher step height for moderate and
  higher level patients. Either way, you need to
  measure the height of the step in cm.
• A good starting step frequency for patients is
  12-14 complete step cycles (up-up-down-down) per
  minute, as this will also include a built-in
  warm-up.
• You should increase step frequency by 2 cycles
  per minute every minute. Use a metronome set to
  four times the rate of step cycles required so
  that each beat corresponds to one part of the
  up-up-down-down tempo (see Table 2, below).

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Special points about each of the modes of
exercise STEP

• Participants should be asked to stop once they
  can no longer lock out the knees (fully extend)
  on the ascent phase. They are also not permitted
  to run at any time to keep up to the speed.
  Participants are permitted to change the leading
  leg once per minute so long as the tempo is not
  broken
• For clients with moderate to high aerobic
  capacity, try adding some extra weight (worn
  around the torso using a weighted vest or small
  back pack weighted with sand) as this will
  challenge them aerobically and permit a better
  prediction of VO2peak.
• For clients with musculoskeletal or neurological
  impairments, but with moderate to high aerobic
  capacity, extra weight may also be added to
  challenge them aerobically, whilst not
  aggravating or limiting them by their
  musculoskeletal or neurological impairments.

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Special points about each of the modes of
exercise STEP

• For moderate and high level patients, you can
  also increase the effort levels by adding extra
  weight to the torso (see Table 3, below). A vest,
  backpack or waist belt can be worn, adding extra
  weight such as sand, disc weights or lead this
  can be as little as 1-2 kg and as much as 10 kg
  (dont forget to include the weight of the vest
  or backpack). Try to evenly distribute the weight
  around the torso (back, waist, and even chest and
  abdomen). It is not recommended to carry weight
  in the hands, or on the wrists or ankles, as this
  will probably interfere with both breathing and
  exercise efficiencies and test accuracy. The step
  test software is clever enough to cope with added
  weights such as weights worn on a vest or back
  pack. Both versions of VO2peak (ml.kg-1.min-1 and
  l.min-1) are automatically adjusted to the extra
  weight. NOTE an exercise test should be
  performed with this extra weight in order to
  generate the correct set of heart rates. Then the
  new higher levels of calorie expenditure will be
  calculated without disturbing any other features
  of the software.

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Special points about each of the modes of
exercise STEP
Custom-made STEP platforms (rated up to 250 kg
body mass) are available from OEM Engineering
Pty Ltd (ACN 074 159 327 ABN 88 074 159
327) 43 MacBeth Street BRAESIDE VIC
3195   Phone  [phone] Fax      9587
4259 Email oemeng_at_bigpond.com
Note any Step platform in the range of 15-35 cm
can also be used
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Special points about each of the modes of
exercise CYCLING

• Work on a cycling ergometer must be measured as
  POWER in watts. The best type of cycle ergometer
  is an electronically-braked machine, as it
  automatically adjusts resistance against your
  pedaling velocity to MAINTAIN A CONSTANT POWER.
  Monark cycle ergometers are also suitable (see
  next slide)
• It is highly recommended that you use the same
  cycle ergometer(s) for all testing, as this
  eliminates the error of power or speed
  measurement between one ergometer and another,
  and helps to strengthen the comparisons between
  before and after tests within one individual. Use
  the same exercise protocol (start intensity and
  rate of increase) for all repeat testing in an
  individual.
• For patients with low tolerance to exercise (e.g.
  NYHA Functional Class II or III), start at 10-30
  watts (lt 15 kph), and increase exercise each
  minute by 10 watts.
• For patients with higher tolerance to exercise
  (e.g. NYHA Functional Class I), start at 40-60
  watts (18-21 kph), and increase exercise each
  minute by 15-20 watts.
• The road speed data is one of the outputs in
  the software and gives a theoretical rather than
  actual road speed for a stationary bike, as it
  takes no account of wind resistance. But it gives
  people a good idea of how power relates to road
  speed on a bike.

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Special points about each of the modes of
exercise CYCLING

• As the software requires the input of power in
  WATTS, you may be able to calculate these from
  the output of your cycle ergometer.
• For instance, if you are using a Monark, use this
  conversion table

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Ratings of Perceived Exertion (RPE) Borg 6-20
point scale
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Exercise Record Sheet Dr Steve Selig may be
able to help you with analysis /-interpretation
of your test data. Please send data in this
format to Dr Selig if you require this form of
assistance.
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Disclaimer
This software is not a substitute for clinical
or professional judgment on the part of the
clinician or exercise programmer. Of itself, it
does not generate exercise test or program data,
but depends on the accurate and reliable
collection of these at the exercise facility.
Therefore the author accepts no responsibility
for the accuracy, reliability or validity of any
exercise data, nor the safety or efficacy of any
exercise program that may be generated from test
data.
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Warnings

• Before embarking on any exercise test or program,
  ensure that there are no contraindications to
  safe participation. Exercise limitations for each
  individual should be documented before
  commencement. This may require a prior
  consultation with a medical practitioner. For
  older clients or those with significant risk
  factors or pre-existing disease or impairment,
  the medical practitioner should decide beforehand
  whether the exercise test is to be of sub-maximal
  or maximal intensity, and whether a medical
  practitioner needs to be in attendance. These
  opinions should be available to the person
  administering the test.
• If a medical condition of a client changes at all
  during the course of an exercise program, then
  repeat testing and programming should be
  conducted before resuming the exercise program.
  This includes, but is not restricted to, changes
  in medications.
• Be aware that many medical conditions or
  medications affect one or more of heart rate,
  rhythm and cardiac function, blood pressure and
  circulation, heat tolerance or exercise tolerance
  (often more than one of these are affected
  together), and that the effects of medical
  conditions or medications on any of these
  physiological responses can work in either
  direction (i.e. increase or decrease). For more
  information or advice on these, consult a
  clinical exercise specialist. These include
  Exercise Physiologists accredited by the
  Australian Association of Exercise and Sport
  Science http//www.aaess.com.au/ , or the
  American College of Sports Medicine
  http//www.acsm.org/ , or consult publications
  produced by either of these bodies or similar
  authorities.
• All new clients should seek the professional
  guidance of an accredited exercise leader. Check
  the qualifications of the leader.
• Ensure that your facility is able to accurately
  measure both heart rate and work rate as the
  software integrity relies on these measurements.
  Do NOT use this software unless accurate
  measurements are available.

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Terms and Conditions

• All prices represent ANNUAL licence fees.
• Licence Expiry date appears each time the
  software is opened. Warning do not try to extend
  the licence by backdating your computer (except
  for small adjustments such as daylight saving),
  as this will cause the software to crash.
• All customers receive a 30 day FREE trial without
  obligation.
• Business includes Gymnasiums, Medical Clinics,
  Rehabilitation Clinics, Hospitals, Universities,
  Schools, Professional Sport and Individuals
  trading as Businesses.
• Individual refers to any persons not using the
  software to generate income or profit.
• Upgrades refers to the provision of newer
  versions of the software to existing clients.
• Re-install refers to re-installation of
  existing software on the same PC, and is applied
  in the situation when a PC has its other software
  upgraded (eg later version of Windows).
• Prices refer to software with instructions and
  this Helpfile, to be delivered by CD-ROM or
  email.
• All Prices are for self-installation. Extra fees
  apply for on-site assistance with installation
  (POA). The software runs on Microsoft Excel (1998
  or later).
• Business prices are for the 1st PC within a
  business, and then for 2nd and subsequent PCs.
• The software will not work on additional PCs
  within a network (eg intranet) unless additional
  PC fees are paid.
• All Prices are for a single transaction spanning
  not more than 21 days orders for additional PC
  installations and/or additional software packages
  within a business must be received within 21 days
  of the 1st PC order, otherwise the additional
  order is treated as a new order.
• Software can be customized (eg company logo or
  other company identifying features, and/or
  software adjustments). Logos and company features
  will be installed for a nominal fee. Software
  adjustments POA.
• Prices do not include any hardware (PC or
  exercise equipment).
• Training of personnel in the use of the software,
  or education packages for cardio-respiratory
  exercise testing and programming are available
  for additional fees (see bottom of Table).
• All Prices are exclusive of GST. Invoices are
  issued at the time of delivery.
• Software is delivered within 7 days of order.

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Installation Advice

• Ensure that you copy the software into the PC
  that is licensed it will not work on other PCs
  even if they are networked to the licensed PC.
• Create a directory or folder to store the
  software, and perhaps another one to store client
  copies of the software.
• Copy all the contents of the CD-ROM into your
  software directory or a folder created by you for
  this purpose. Remove the CD-ROM and keep it in a
  safe remote location.
• Using Windows Explorer or My Computer, open the
  directory or folder.
• Find and install the DEPLOY software by clicking
  setup.exe in the Security dll folder and then
  follow the prompts. If your PC is part of a
  network, then you may need administrator access
  and/or assistance from your IT department to
  install this part of the software.
• Run the program Selig Software - Get Activation
  Details V2.0. Email the output of this program
  to steve.selig_at_vu.edu.au

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Installation Advice

• Dr Steve Selig will generate and then email back
  to you the individual licence codes for your
  software packages (treadmill, step and/or leg
  cycle) for installation into the packages that
  are on your CD-ROM. Once you receive them, then
  this is what you need to do to install the
  licence codes into each Excel Workbook
• Open each EXCEL workbook
• Set MACRO security for EXCEL to medium. You only
  need to do this the FIRST time you install the
  software. Steps- TOOLS ? OPTIONS ? SECURITY ?
  MACRO SECURITY ? select MEDIUM.
• Go to Files ? Properties ? Custom
• In the Properties box in this window, click
  Document
• Copy the security code string for that particular
  package (treadmill, step, and/or leg cycle) into
  the Values box above the Properties box
• Click Modify ? OK
• Copy the date of the end of the licence in the
  exact format supplied to you for that particular
  package (treadmill, step, and/or leg cycle) into
  the Values box above the Properties box
• Click Modify ? OK
• Save the workbook
• Check that it is now working by clicking the
  Recalculate button on the ABOUT (front page) of
  the workbook.
• Repeat all of the above steps for any other
  packages that you have been supplied

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Installation Advice

• Alternatively, Step 7 may be done by other
  means-
• Dr Steve Selig may perform these steps at your
  site this arrangement can usually be made within
  the Melbourne metropolitan area at no/low cost to
  the customer, OR
• You may have made prior arrangements to perform
  Steps 5, 6 7 by email and so the software
  packages that have been supplied on this CD-ROM
  already have the individual licence codes
  installed and will run on the licensed PC(s).
• You only need to click Recalculate on the main
  menu (i) after installation or re-installation
  and (ii) to check that the software is running
  correctly. If the software is correctly
  installed, then (i) it will recalculate all data
  values and (ii) all worksheets will now be
  displaying some sensible data with no error
  messages. Buttons for each worksheet can be found
  on both the ABOUT (front) page and the bottom of
  the screen. The buttons on the ABOUT (front) page
  are designed to resize each worksheet to suit
  your PC settings, so this method is preferable.
  Each workbook has been sent to you with some old
  data displayed so that you can (i) see how the
  sheets work and (ii) check that the software is
  working properly. Delete this old data, or
  over-write it with real data. But be sure to
  remove all the old data once you start inputting
  data from real clients.
• Repeat Step 9 for any other workbooks that have
  been supplied to you.
• Start using the software and ENJOY.

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Installation Advice
Copying the software and protecting your Master
copy The licence permits unlimited copying of the
software on the licensed PC, but copies will not
work on other PCs, including networked PCs.
Copies can be useful for archiving an individual
clients data in order to chart progress the
easiest and most reliable method for doing this
is to save each new test for a client as a new
workbook as this will best preserve the menu
settings. To save disk space, delete the sheets
that you do not need (eg MALE for a FEMALE
client), and also CONDITIONS worksheet. To
protect your Master copy, you should copy the
software to other destinations (e.g. other names
in other folders) immediately after installation
and before first usage. If you experience
problems with installation, then please contact
Dr Steve Selig Email steve.selig_at_vu.edu.au Phone
int 61 3 9919 4421 Mob [phone]