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Exercise Prescription

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Title: Exercise Prescription


1
Exercise Prescription
  • Aerobic Fitness

2
Principles of Training
  • Overload Harder work than the body is
    accustomed to.
  • Training Variables (FIT Principle)
  • Frequency - number of times per week
  • Intensity - level of the effort at any given
    time speed, weight, hills, water resistance,
    etc.
  • Time - duration, reps/sets in weight training
  • Frequency and duration together are often
    referred to as training volume. In weight
    training volume is often reps/sets (volume per
    exercise session).

3
Principles of Training
  • Specificity - Adaptations that occur are specific
    to the type of training performed.

4
Principles of Training
  • Progression
  • Gradually increase the overload in an exercise
    program over time.
  • Prevents possible injury and frustration.
  • NOTE Increase training volume first, then
    intensity.

5
Principles of Training
  • Progression Sedentary but low risk
  • Table 7-1, Page 149
  • Initial Stage 4 wks.
  • Improvement Stage - 20 wks.
  • Maintenance Stage lifelong !

6
Principles of Training
  • Reversibility
  • Training adaptations (improvements) will be lost
    if training is stopped for a prolonged period of
    time.
  • In general, the faster the adaptation occurred,
    the sooner it will be lost once training stops.

7
Aerobic Fitness
  • Target Heart Rate, METs, and RPE
  • Target Heart Rate
  • Target HR range 55/65 90 HRmax
  • Heart Rate Reserve (Karvonen) Method
  • Target HR range 40/60 80 HRR
  • THRR (HRmax RHR) x .40/.50 to .85 RHR

8
Aerobic Fitness
  • Target Heart Rate, METs, and RPE
  • Target VO2
  • VO2 Reserve
  • (VO2 max VO2 rest) x intensity VO2 rest

9
Aerobic Fitness
  • Target Heart Rate, METs, and RPE
  • 3. Metabolic Equivalents (METs)
  • One MET 3.5 ml/kg/min (VO2)
  • Target METs Target VO2 (ml/kg/min)/3.5
    ml/kg/min
  • Target VO2 based on reserve (R) concept
  • VO2R (VO2max VO2rest) x intensity
    VO2rest
  • Note current ACSM recommendations suggest using
    of VO2R instead of of VO2max

10
Aerobic Fitness
  • Target Heart Rate, METs, and RPE
  • RPE Rating of Perceived Exertion
  • Category Scale (6-20) Borg Scale
  • Category-Ratio Scale (0-10)
  • Table 4-7, Page 77.

11
Aerobic Fitness
  • Target Heart Rate, METs, and RPE
  • General Points for THR, METs, and RPE
  • These all represent exercise intensity.
  • THR and RPE are most commonly used.
  • METs (target VO2) can be problematic because
  • METs cannot be easily monitored in many exercise
    settings.
  • METs will vary with skill level and conditioning
    in various exercises (e.g., running vs.
    swimming).
  • THR can be problematic if it is based upon
    predicted HRmax (220 age error of 10 bts/min)

12
Aerobic Fitness
  • Target Heart Rate, METs, and RPE
  • Caloric Expenditure Guidelines
  • Another guide for exercise prescription
  • Expend 150 400 Kcal/day (150 for low fitness
    level)
  • Caloric cost of exercise
  • Kcal/min METs x 3.5 x BW (kg)/200
  • Note Caloric expenditure takes into account all
    three components of overload (FIT).

13
Aerobic Fitness
  • Exercise Duration and Frequency
  • Duration
  • The duration is dependent upon the intensity.
  • To achieve health/fitness benefits, ACSM
    recommends 20 60 min of continuous or
    intermittent (10-min bouts) of exercise at 60
    80 of HRR (VO2R).
  • Higher intensity can allow for less time.
  • Lower intensity should be accompanied by a longer
    duration.

14
Aerobic Fitness
  • Exercise Duration and Frequency
  • Frequency
  • ACSM recommends 3 5 days per week.
  • If intensity is low, greater than 3 days/week may
    be necessary to achieve weight loss goals.

15
Aerobic Fitness
  • Metabolic Calculations
  • Metabolic calculations are used to
  • Determine predicted maximal exercise aerobic
    capacity (VO2max)
  • Determine exercise intensities based on test data
    (THRR, VO2R/METs, RPE)
  • Establish treadmill, cycle, and stepper settings
    to achieve target exercise intensities.
  • Appendix D!!

16
Aerobic Fitness
  • Metabolic Calculations
  • Key Terms
  • Gross VO2 represents both the resting and
    exercise VO2 components.
  • Net VO2 represents only the exercise VO2
    component.
  • Absolute VO2 represents the oxygen consumption
    for the total person (l/min).
  • Relative VO2 represents the oxygen consumption
    per unit of body weight (ml/kg/min).

17
Maintenance of Training Effect
  • Training adaptations are maintained if intensity
    is maintained, even if frequency and duration are
    reduced.
  • This applies to both muscular adaptations and
    aerobic adaptations.
  • Training improvements begin to decline relatively
    quickly with complete inactivity (as soon as two
    weeks). Principle of reversibility.

18
Special Populations
  • Cardiopulmonary Patients (Chapters 8)
  • Primary goal is to regain functional capacity
    (i.e. return to work status, ability to perform
    tasks of daily living).
  • Primary consideration is to establish exercise
    intensity below threshold for onset of problems.
  • Cardiac patients
  • Pulmonary Patients

19
Special Populations
  • 2. The Obese (Chapter 9)
  • Primary goal is likely fat reduction while trying
    to maintain lean body mass.
  • Obese individuals will likely lose lean body mass
    along with fat mass, but the goal is to minimize
    this.
  • Focus will be on aerobic activity.
  • Generally recommended to reduce/expend 500 1,000
    kcal/day to lose body fat. Acceptable loss is 1
    of body weight/week (1.0 2.0 lbs/week for avg.
    person).
  • Exercise objective is to expend gt300 kcal/day.
  • Should not reduce total kcal/day intake below
    1,200 kcal.

20
Special Populations
  • 3. Diabetics (Chapter 9)
  • Goal is to follow general fitness guidelines and
    maintain blood glucose homeostasis.
  • Monitor blood glucose before, during, and after
    exercise if taking insulin or oral medication.
  • Avoid exercise at peak insulin times.
  • Do not exercise if blood glucose is gt 300 mg/dl
    or gt240 mg/dl with urinary ketone bodies.
  • Take CHO if blood glucose is lt 80 mg/dl.
  • Note Table 9-2 (page 209) provides summary of
    extreme glycemic signs and symptoms.

21
Special Populations
  • 4. Hypertensives (Chapter 9)
  • General goal is to provide well-rounded fitness
    program that minimizes risks associated with
    hypertension.
  • Follow general recommendations for aerobic FIT,
    with slight reduction in intensity (40 - 70
    VO2R).
  • Emphasis on aerobic activity.
  • Monitor blood pressure before, during, and after
    exercise.
  • Avoid high-intensity resistance training (lower
    intensity, higher repetitions).
  • Clients should maintain hypertensive medications,
    if prescribed.
  • Do not exercise if resting SBP gt 200 mm Hg or DBP
    gt 115 mm Hg.
  • Stage 3 hypertensives should begin
    pharmacological treatment prior to starting
    exercise program (controlled BP prior to
    starting).

22
Special Populations
  • 5. Pregnant Women (Chapter 9)
  • Exercise is generally O.K. for pregnant women
    with no complications.
  • Intensity should be moderate (high intensity not
    recommended).
  • Factors to consider
  • Avoid high-impact activities vertical or
    horizontal!
  • Be cautious with activities requiring balance as
    center of gravity changes during pregnancy.
  • Avoid large increases in body temperature.
  • Proper hydration and increased caloric intake for
    exercise and fetal needs are important.

23
Special Populations
  • 6. Children (Chapter 10)
  • Primary goal is to have participate in regular
    physical activity (not necessarily exercise).
  • Attention should be paid to avoid injuries due to
    improper exercise/activity.
  • Overuse injuries, often the most common form of
    injuries in children.
  • Be cautious of too much activity (volume) and
    high intensity.
  • Be cautious of exercise in heat and cold
    environments. Children do not respond to
    extremes as well as adults.

24
Special Populations
  • 7. Elderly (Chapter 10)
  • Generally follow the same prescription guidelines
    for the regular adult population.
  • Consider mode orthopedic and balance friendly
  • Consider accessibility
  • Consider group setting for adherence
  • Duration vs. intensity frequent shorter bouts

25
Questions?
26
End Prescription
  • Aerobic Fitness
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