1. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Chapter 4 Cardiorespiratory Fitness

2. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Maximal Oxygen Uptake (VO 2max ) Defined as the greatest rate at which oxygen can be consumed during exercise. Typically expressed in milliliters of oxygen consumed per kilogram of body weight per minute (ml. kg -1. min -1 ). Laboratory criteria for achieving a true VO 2max : –Oxygen consumption plateaus during last minutes –RER increases to 1.15 or higher –HR within 10 bpm of age-predicted HR max –Blood lactate levels rise above 8 mmol/liter

3. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Resting Blood Pressure Blood pressure is the force of blood against the walls of the arteries and veins created by the heart as it pumps blood to every part of the body. Hypertension is a condition in which the blood pressure is chronically elevated above optimal levels (see Tables 4.1 and 4.2). –Diastolic BP of ≥90 mm Hg or systolic BP of ≥140 mm Hg on at least two occasions.

4. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Table 4.1 BP Classification Systolic BP (mm Hg) Diastolic BP (mm Hg) Normal<120and < 80 Prehypertension120-139or 80-89 Stage 1 hypertension 140-159or 90-99 Stage 2 hypertension ≥ 160or ≥ 100

5. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. To take blood pressure, a sphygmomanometer and a stethoscope are needed (see Figure 4.3). Several blood pressure readings by different observers, or on different occasions by the same observer, are recommended. See text for guidelines in take blood pressures.

6. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Exercise Blood Pressure Blood pressure should be taken at least every 3 minutes during exercise testing. Use the 4 th Korotkoff sound for diastolic BP during exercise. See text for additional details. See Figures 4.5 and 4.6.

7. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Heart Rate The RHR can be obtained through auscultation (stethoscope bell), palpation (feeling with fingertips), or ECG recordings. With palpation, use the radial artery at rest, and the carotid artery during exercise. The RHR fluctuates widely; measure upon awakening three mornings in a row, and average.

8. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Exercise Heart Rate Exercise HR can be obtained by ECG, auscultation, or a heart rate measuring device. HR can be measured from the ECG strip several ways: –Use a heart rate ruler (Figure 4.7) –Count the number of large squares between R waves and divide into 300 (see Figure 4.8). –Count the number of millimeters between four R waves and divide into 6,000 (see Figure 4.8).

9. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Nonexercise Test VO 2max Prediction Equations Direct measurement of VO 2max is not always practical (time, expense, technical supervision). Several regression equations are available that predict VO 2max using nonexercise test variables such as age, gender, body composition, and level of physical activity (see text and Physical Fitness Activity 4.5). These equations broadly classify people as having poor, average, or good cardiorespiratory fitness.

10. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Field Tests for Cardiorespiratory Fitness Several field tests have been developed that allow aerobic fitness to be estimated. See the text for these tests: –1-mile and 1.5 mile run tests (see Table 4.3). –Estimation of VO 2max from average running speed during race (see Tables 4.4 and 4.5). –1-mile walk test (Physical Fitness Activity 4.6)

11. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Submaximal Laboratory Tests The submaximal exercise test (physiological response to a fixed workload, or work required to reach a fixed physiological response) makes three assumptions (not entirely accurate however, causing a 10-20% error in estimating VO 2max ): –That a linear relationship exists between HR, oxygen update, and workload (see Figure 4.10). –That the maximum HR at a given age is uniform (=220-age). –That the mechanical efficiency (oxygen uptake at a given workload) is the same for everyone.

12. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Common Submaximal Tests Modified Canadian Aerobic Fitness Test (see text, and Tables 4.6a,b,c, 4.7). YMCA 3-minute step test (see text, and Appendix, Table 22). Queens College Step Test (page 91). See ACSM bench-stepping equation, Box 4.1). Ebbeling submaximal treadmill test (page 92). YMCA submaximal cycle test (text, Figure 4.13, 4.15).

13. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. ACSM Equations for Estimating METS and Energy Expenditure See Box 4.1 for stepping ergometry. Box 4.3: Leg and arm ergometry. Box 4.4: Walking, jogging, and running. Solve end-of-chapter problems.

14. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Maximal Laboratory Tests The graded exercise test to exhaustion, with heart rate monitoring (with ECG in high risk individuals), is considered the best substitute for direct VO 2max measurement. The Bruce and Balke treadmill protocols are commonly used (Figures 4.16 and 4.17). Table 4.8 summarizes equations. Maximal graded cycle tests: Astrand and Storer-Davis (Figures 4.19, 4.20). Wingate Anaerobic Test: Table 4.9.

15. Nieman DC. Exercise Testing and Prescription: A Health-Related Approach. 6/e. Copyright ©2007 McGraw-Hill Higher Education. All rights reserved. Figures 4.22, 4.23, 4.24