CV Exercise Prescription

Reasonable and Expected Values for VO 2 Category or Level ml. kg -1 min -1 ml. min -1 METS Male (75 kg) Female (60 kg) Male (75 kg) Female (60 kg) Male (75 kg) Female (60 kg) Rest Maximal 20 yrs Old Maximal 60 yrs Old 60 yrs Old Elite Endurance Athlete

Textbook, Fig. 8-3, P. 117

The Anaerobic Threshold Concept

Terminology VO 2 R VO 2 R VO 2 reserve capacity VO 2 reserve capacity VO 2 R = (VO 2 max – VO 2 Resting) VO 2 R = (VO 2 max – VO 2 Resting) HRR HRR Heart Rate Reserve Heart Rate Reserve HRR = (HRmax – HR rest) HRR = (HRmax – HR rest)

Mode of Activity Use of large muscle groups Use of large muscle groups Legs or legs + arms Legs or legs + arms When small muscles are used the HR response is exaggerated 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 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 Enjoyable Accessible Accessible Orthopedic limitations Orthopedic limitations Body Mass Body Mass Motor Skill Motor Skill Must do activities that are at least tolerable Must do activities that are at least tolerable

Fitness and Health

Intensity Method Lowest Intensity for Health Lowest Intensity for Fitness Highest Intensity for Fitness Optimal Performance % VO 2 R 40%50%85%100% METs HRR40%50%85%100% % HRmax 50%60%90%100% RPE 7 or 1 9 or 2 14 or 4 20 or 10

ACSM/AHA Current PA Recommendations Moderate intensity aerobic exercise (3-6 Mets) for minimum of 30 min, 5 days per week Moderate intensity aerobic exercise (3-6 Mets) for minimum of 30 min, 5 days per week OR, vigorous intensity aerobic exercise (>6 Mets) for minimum of 20 min, 3 days per week. OR, vigorous intensity aerobic exercise (>6 Mets) for minimum of 20 min, 3 days per week. Any combination that accumulates Met. min Any combination that accumulates Met. min Strength training Strength training

What Counts? Intermitten bouts of at least 10 minutes Intermitten bouts of at least 10 minutes Occupational tasks that meet the intensity criteria Occupational tasks that meet the intensity criteria

Expected Improvement in Fitness VO 2 max improves 10-30% VO 2 max improves 10-30% Lactate threshold improves 10-20% Lactate threshold improves 10-20%

Maintenance Health Benefits Health Benefits Met. min per week forever Met. min per week forever Consistency is the key Consistency is the key Fitness Benefits Fitness Benefits Maintaining intensity will maintain VO 2 max Maintaining intensity will maintain VO 2 max IF training is stopped IF training is stopped Loss of up to 50% after 1-3 months Loss of up to 50% after 1-3 months Loss of 100% after 3-8 months Loss of 100% after 3-8 months

CV Function and the Elderly (65 yr+) VO 2 max decreases 5-15% per decade after age VO 2 max decreases 5-15% per decade after age Primary cause is decrease in max CO Primary cause is decrease in max CO Secondary cause is decrease metabolic capacity of muscle Secondary cause is decrease metabolic capacity of muscle Submaximal responses Submaximal responses Same at equivalent relative intensities Same at equivalent relative intensities HR is higher at same absolute power HR is higher at same absolute power

Trainability 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 (males and females) Increase in metabolic capacity of muscle (males and females)

Precautions for the Elderly More susceptible to traumatic exercise More susceptible to traumatic exercise More likely to have underlying disease More likely to have underlying disease Must know health history and risk profile Must know health history and risk profile

Current PA Recommendations for the Elderly Moderate intensity aerobic activity for minimum of 30 min, 5 days per week, OR Moderate intensity aerobic activity for minimum of 30 min, 5 days per week, OR Vigorous intensity aerobic activity for minimum of 20 min, 3 days per week. Vigorous intensity aerobic activity for minimum of 20 min, 3 days per week. Muscle-strengthening Muscle-strengthening Flexibility Flexibility Balance Balance

Moderate and Vigorous Intensity Definitions 10-point scale where sitting is 0 and all-out effort is point scale where sitting is 0 and all-out effort is 10 Moderate intensity is 5-6 and produces noticeable increases n heart rate and breathing. Moderate intensity is 5-6 and produces noticeable increases n heart rate and breathing. Vigorous intensity is 7-8 and produces large increases in heart rate and breathing. Vigorous intensity is 7-8 and produces large increases in heart rate and breathing.

Exercise and Pregnancy Females in good health can and should exercise moderately during pregnancy Females in good health can and should exercise moderately during pregnancy Minimize thermal stress Minimize thermal stress Maintain hydration Maintain hydration Exercise to a level of moderate exertion Exercise to a level of moderate exertion Maintain sufficient caloric intake Maintain sufficient caloric intake Do not exercise in supine position after first trimester Do not exercise in supine position after first trimester Do not perform prolonged Valsalvas Do not perform prolonged Valsalvas Avoid high impact and high risk activities Avoid high impact and high risk activities