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Result of the interaction of intensity and duration of exercise
Adaptation response
T/F: HR max equals VO2 max
FALSE.. HR max does NOT equal VO2 max
- About 2x/week
- 8-10 exercises incorporating major muscle groups
- 8-15 reps per exercise
- May be contraindicated depending on CVD dx
Frequency for strength/resistance training
T/F: Duration is inversely proportional to intensity
True.. lower the intensity, the higher/longer the duration
*** 220-age
- EX: 65 y/o: 220-65 = 155HRmax
- Based on age, ideally below age of 50
- Used on healthy population
- NO risk factors
Predicted HR
Exercise session components:
- Prepares CP system for additional work
- Prevents MSK injury
- Should also emphasize weak muscle groups identified
Warm up
What are the (3) ways to calculate intensity?
1. Predicted HR
2. Target HR (Karvonen method)
3. Modified HR reserve from graded exercise test (GXT)
Exercise session components:
- Blended in with warm up and/or cool down
Flexibility
Minimum exercise needed for training adaptation is 20-30 minutes, per research
- Ideal goal: 60 min session
Duration
- 60-80% HR max for the general population
- Can be as low as 40% in elderly (still w/benefit)
- Should not exceed 90% HR max for anyone
- NEVER exceed specified cardiac phase guidelines (if applicable)
Intensity
1. Referral of medical clearance
2. Determine the individuals current functional capacity ("Fitness level")
3. Consider exercise mode, intensity, frequency, and duration
4. Ensure gradual exercise progression
5. Consider safety of exercise prescription (EX: know indications and contraindications)
6. Patient compliance and motivation
7. Regular reexamination and evaluation of functional capacity and prescription levels
Considerations in developing an exercise prescription
Exercise session components:
- Prevents blood pooling in BLE's
- Transports metabolism waste and byproducts
Cool down
- Using a numerical scale it quantifies subjective exercise intensity
- Correlates closely with several variables:
- VO2 peak
- Percent HR reserve
- Minute ventilation
- Blood lactate levels
Development of RPE rating of perceive exertion
Formula: [(200-age)-HRrest]x% HRmax + HRrest
- Based on set % HR intensity as well as resting HR and age-predicted HR
- To calculate modified HR max or target range
- For patients with risk factors (HTN, PAD, DM, high cholesterol, + obesity or elderly, etc)
- Most commonly used by us
- Someone with strong cardiac family history **
Target HR (Karvonen method)
What is target RPE?
12-16/20
3-6/10
- 3-5x/week necessary to exercise
- No more than 2 days off between workouts
- 2 to 3x/week just for maintenance
- Increase frequency slowly for patients with CVD
Frequency to improve VO2 max
- Add 30 bpm from HR resting
- HR = rest HR + 0.8 (HRmax - rest HR)
- Use RPE scale along with this approach!
Quick estimate for patients on beta blockers
For the Karvonen method, subtracting resting HR equals _____
Heart rate reserve
- % HR reserve / % HR max with GXT
- % Maximum MET or functional capacity
- Rating of perceived exertion (RPE)
- Dependent on how far out after an event/procedure
Intensity prescription
Formula: [(Max HR from GXT) - HR rest] x % HRmax + HR rest
- Substitute derived HRmax from GXT in place of age-predicted calculation for HRR formula
- Cardiology may specify intensity range allowed to exercise
- Patients with actual recent cardiac event or procedure
- For people that had GXT
Modified HR reserve from graded exercise test (GXT)
- MUST use RPE scale
- Vagus nn. severed --> rely on catecholamines (hormones) to hormones/adjust HR/BP
- These patients HR are usually higher at rest (around 90); go up about 30 with exercise and takes about 30 seconds to ramp up to 120 and then they plateau
Patients status post heart transplant
What is initial stage when using RPE ?
15-16/20
5-6/10
What is maintenance stage when using RPE scale?
13-14/20
3-4/10
What is improvement stage when using RPE scale?
14-16/20
4-6/10
- Quantifies the subjective sensation of physical exertion
- Correlates closely with several measurable variables such as peak VO2 and % HRRmax
- Original was #6-20
- # (multiplied by 10) correlates to HR in healthy individuals
- Can be used to prescribe intensity
- Especially when a person is taking meds that alter CP response to exercise
BORG RPE scale