Programming for Cardiovascular Fitness

1. Programming for Cardiovascular Fitness

2. Cardiovascular Fitness • The ability of the body to utilize oxygen efficiently.

3. Cardiovascular Fitness People engage in aerobic exercise to: • improve their health status or reduce their disease risk • basic health and fitness benefits • while others are primarily interested in enhancing their physical fitness levels • optimal health and fitness benefits

4. Cardiovascular Fitness • The quantity of exercise needed to promote health is less than that needed to develop and maintain higher levels of physical fitness. • You must adjust your exercise prescription according to your client’s primary goal.

5. Cardiovascular Fitness • Improvement is CV fitness is measured by assessing changes in VO2MAX

6. Cardiovascular Fitness • Increases in VO2MAX may range from 5 to 30%. • Individuals with low initial levels of fitness, cardiac patients, and those exhibiting large losses of body weight will demonstrate the greatest percent increase in VO2MAX.

7. Cardiovascular Fitness • Similarly, more modest increases may be expected from healthy individuals with high initial levels of fitness and those who exhibit little change in body weight.

8. Improved Health • When the primary goal for the exercise prescription is improved health, the following guidelines are recommended:

9. Basic Health and Fitness Mode: • Select endurance-type physical activities, including formal aerobic exercise training, house and yard work, and physically active, recreational pursuits.

10. Basic Health and Fitness Intensity • Prescribe at least moderate intensity physical activities • (> 40 - 45% of VO2R or HRR, and 55-64% of HRMAX).

11. Basic Health and Fitness Frequency • Schedule physical activity for most, preferably all days of the week.

12. Basic Health and Fitness Duration • Accumulate at least 30 minutes of activity each day. • Duration varies depending on type of activity.

13. Physical ActivityRecommendations • How much physical activity is required? • For health benefits? • 30 minutes/day • To prevent weight gain? • 60 minutes/day • To prevent weight regain in the formerly obese? • 60-90 minutes/day • Source—U.S. Dietary Guidelines 2005 • S. Blair, 2005.

14. Lifestyle and Energy Expenditure Sedentary Way kcal Active Way kcal Using remote to <1 Getting up and 3 change channel changing channel 30 min of phone 4 Standing for 3 X 10 20 calls—reclining minute calls Using garage door <1 Opening garage 2-3 opener door twice/day Hiring maid to 0 30 min of ironing 152 clean and iron 30 min vacuuming Kcal estimates for 150-160 pound person Taken from article by L. Beil, Dallas Morning News, 1999, S. Blair, 2005

15. Lifestyle and Energy Expenditure Sedentary Way kcal Active Way kcal 30 min waiting for 15 30 min of cooking 25 pizza delivery Buying pre-sliced 0 15 min washing, 10-13 vegetables slicing & chopping Using a leaf 100 30 min of raking 150 blower for 30 min leaves Using a lawn 0 30 min/week each 360 service gardening, mowing Kcal estimates for 150-160 pound person Taken from article by L. Beil, Dallas Morning News, 1999, S. Blair, 2005

16. Lifestyle and Energy Expenditure • Sedentary Way kcal Active Way kcal • Using car wash 18 Washing & waxing 300 • once/month car, 1 hr/month • Letting dog out the 2 Walking dog for 125 • back door 30 min • Drive 40 min, 5min22 15 min walk to bus • walk (parking) stop, 2 X day 60 • Emailing colleague, 2-3 Walk 1 min, talk 3 • 4 min min (standing) 6 • Kcal estimates for 150-160 pound person • Taken from article by L. Beil, Dallas Morning News, 1999, S. Blair, 2005

17. Lifestyle and Energy Expenditure • Sedentary Way kcal Active Way kcal • Taking elevator 0.3 Walking up 3 15 • up 3 flights flights of stairs • Park close as poss, 0.3 Park 1st spot, 2 min 8 • 10 sec walk walk, 5 X week • Cashier unloads 2 Unload full 6 • shopping cart shopping cart • Ride escalator 2 1 flight of stairs, 3 15 • 3 times X week in mall • Kcal estimates for 150-160 pound person • Taken from article by L. Beil, Dallas Morning News, 1999, S. Blair, 2005

18. Lifestyle and Energy Expenditure • Sedentary Way kcal Active Way kcal • 1 hour internet 30 Shopping mall, 145-240 • shopping walking 1 hour • Sitting in car at 15 Parking & walking 70 • drive-in window, inside, 3 X week, • 30 min total of 30 min • Paying at the 0.6 Walking in to pay, 5 • pump 1 X week • Sitting & listening 30 Giving lecture 70 • to lecture, 60 min • Kcal estimates for 150-160 pound person • Taken from article by L. Beil, Dallas Morning News, 1999, S. Blair, 2005

19. Lifestyle and Energy Expenditure Assume a person’s caloric intake remains the same: • Completing all of the tasks reviewed daily or as listed • Active way = 10,500 kcal/month • Sedentary way = 1,700 kcal/month Difference of 8,800 kcal/month is energy equivalent of 2.5 pounds/month or 30 pounds/year • Kcal estimates for 150-160 pound person • Taken from article by L. Beil, Dallas Morning News, 1999, S. Blair, 2005

20. The Exercise and Physical Activity Pyramid From: Rauramaa, R. & Leon, A.S. (1996) Physical Activity and risk of cardiovascular disease in middle aged individuals. Sports Medicine; 22(2):65-69.

21. Optimal Health and Fitness • When the primary goal for the exercise prescription is to attain optimal fitness, the following guidelines should be followed.

22. Optimal Health and Fitness Mode • The greatest improvement in VO2MAX occurs when exercise involves the use of large muscle groups over prolonged periods and is rhythmic and aerobic in nature.

23. Optimal Health and Fitness Mode • A wide range of activities provides for individual variability relative to skill and enjoyment, factors which influence compliance to the exercise program and thus desired outcomes.

24. Optimal Health and Fitness Mode • Resistive exercise such as weight training should not be considered as an activity for increasing VO2MAX

25. Optimal Health and Fitness Mode • Circuit weight training, which involves 10 to 15 repetitions with 15 to 30 seconds rest between weight stations, results in an average improvement in VO2MAX of about 5%, and thus is not generally recommended as an activity for improving CV endurance.

26. Optimal Health and Fitness Mode • It may be desirable to engage in several different activities to reduce repetitive orthopedic stresses and involve a greater number of muscle groups. • Cross train

27. Optimal Health and Fitness Mode • Because improvement in muscular endurance is largely specific to the muscles involved in exercise, it is important to consider unique vocational or recreational objectives of the exercise program when selecting activities.

28. Optimal Health and Fitness Mode • Finally, it is important to consider other barriers that might decrease the likelihood of compliance with, or adherence to, the exercise program (travel, cost, spousal or parent involvement, etc.).

29. Intensity • Intensity and duration of exercise determine the total caloric expenditure during a training session, and are integrally related.

30. Intensity • That is, similar increases in CV endurance may be achieved by a low intensity, long duration session as well as a higher intensity, shorter duration session.

31. Intensity • The risk of orthopedic injury may be increased with the latter; however, programs emphasizing low-to moderate-intensity exercise with a longer training duration are recommended for most individuals.

32. Intensity • Part of the art of exercise prescription is being able to select an exercise intensity that is adequate to stress the cardiovascular system without overtaxing it.

33. Intensity • As a general rule, the more fit the individual, the higher the exercise intensity needs to be to produce further improvement in CV fitness.

34. Optimal Health and Fitness Intensity • ACSM recommends that the intensity of exercise be prescribed as 65 to 90% of maximum heart rate, or 50 to 85% of VO2R or heart rate reserve for optimal fitness improvement.

35. Intensity • VO2R refers to maximum oxygen uptake reserve. • It is calculated by subtracting resting VO2 from VO2MAX

36. Intensity • However, individuals with a very low initial level of fitness respond to a low exercise intensity, for example 40 to 49% of VO2R

37. Intensity • Several important factors to consider prior to determining the level of exercise intensity include:

38. Intensity • Individual’s level of fitness. • Presence of medications that may influence heart rate

39. Intensity • Risk of cardiovascular or orthopedic injury. • Individual preferences for exercise. • Individual program objectives.

40. Intensity • Altitude • Humidity • Temperature • Terrain

41. Intensity • Exercise surface • Equipment

42. Intensity • Several methods may be used to determine exercise intensity.

43. HR Methods • Using HR as a guide to exercise intensity is useful, given the relatively linear relationship between HR and VO2

44. HR Methods • When prescribing exercise intensity based on HR, consideration must be given to potential influences.

45. HR Methods • Given exercise test data, there are several approaches to determining an exercise HR range for prescriptive purposes:

46. HR Methods • Using a straight percentage of Hrmax • Using the HR reserve method. • Plotting HR vs VO2 or exercise intensity during the exercise test.

47. HR Methods • Go over each method (p. 88): • HRmax • Karvonen • Plotting

48. HR Max • Heart Rate max has been traditionally been calculated by 220 minus age. • There is some concern that this technique is not accurate. • It has been recommend that 208 – 0.7(age) be used instead.

49. HR Methods • It is important to note that the HR response to graded exercise is somewhat dependent on the mode of exercise testing.

50. HR Methods • For example, compared to treadmill testing, exercising on an electronic step ergometer elicits higher HRs, and stationary cycling typically results in somewhat lower HRs at the same relative exercise intensities.