Designing a CR Exercise Program

Exercise Prescription

The Goal is the Key!

Improvements in Health vs. Improvements in Fitness (ACSM)– Health - something is better than nothing– Fitness - no pain no gain

Health Recommendations

Mode– endurance type– recreational and household chores

included (gardening, yardwork, etc…)

Fitness

Mode– Rhythmical– using large muscle groups– activities aerobic in nature (running,

swimming, cycling, etc…)

Health vs. Fitness

Fitness Intensity– 60-90% of Max HR or 50-85% of VO2max

Health Intensity– at least >45% VO2max

Health vs. Fitness

Fitness Frequency– 3-5 days/week

Health Frequency– most if not all days of the week

Health vs. Fitness

Fitness Duration– 20-60 minutes of continuous activity

Health Duration– at least 30 minutes of accumulated

(possibly discontinuous) activity each day

Mode

Exercise Modalities have been classified into three groups

Group1 – constant intensity – not dependent on skill– initial phase/improvement phase– walking, running, stairclimbing, cycling

Mode

Group 2– constant or variable intensity– dependent on skill– can be used in initial phase if individual is

skilled– use to add variety in improvement stage– aerobics, hiking, in-line skating

Mode

Group 3– variable intensity– highly dependent on skill– usually for the maintenance phase– basketball, handball, volleyball

Mode

Whatever Works!! (within reason)

If a person finds the activity enjoyable they will adhere to the program

Intensity

Selecting the right intensity is an art-form

Common Sense - the more fit the higher the intensity and vice versa

HR Method

1. % of Max HR– Max HR = 220 - age– Intensity = 60-90% Max HR, so………– 0.6 x Max HR and 0.9 x Max HR = exercise

intensity range

Example

What should the HR training range for a 40 year old be?

220-40 = 180 180 x .6 = 108 b/min 180 x .9 = 162 b/min

HR Method

2. Karvonen Method HR reserve

– takes into account resting HR– Target HR = (%HRR) (HR max - HR rest) +

HR rest

Example

Target HR = (%HRR) (HR max - HR rest) + HR rest

((.6 (180 - 65)) + 65) = 134 b/min ((.9 (180 - 65)) + 65) = 169 b/min

What HR?

Where in the range should you exercise?

Table 5.1 - based on initial fitness level Minimum, Average, Maximal HR values

that a person should be exercising

VO2 Method

1. % of Max VO2– Max VO2– Intensity = 50-85% Max VO2, so………– 0.5 x Max VO2 and 0.85 x Max VO2 =

exercise intensity range

Example

What should the VO2 training range for a person with a max of 40ml/kg/min?

40 x .5 = 20ml/kg/min 40 x .85 = 34ml/kg/min

HR Method

2. VO2 reserve Method– takes into account resting VO2– Target VO2 = (%VO2) (VO2 max – VO2

rest) + VO2 rest

Example

VO2 HR = (%VO2) (VO2 max – VO2 rest) + VO2 rest

((.85 (40 – 3.5)) + 3.5) =34.5 ((.50 (40 – 3.5)) + 3.5) =21.75

Intensity

MET Method– 1 MET = 3.5 ml/kg/min– ie., VO2max = 35 ml/kg/min = 10 METS– 50% of 10 METS = 5 METS– 85% = 8.5 METS– Find activities that correspond to these

values

Example

What range of intensities (METS) should a person with a VO2max of 42 ml/kg/min

42 x .5 = 21 42 x .85 = 35.7 21 / 3.5 = 6 METS 35.7 / 3.5 = 10 METS

RPE Method

Rating Scale Usually want a rating between 11-16 Use in combination with HR method RPE 11-16 = 50 - 85% HRR

Duration

Healthy 20-30 minutes Sedentary or diseased multiple session

to accumulate 20-30 minutes Minimum Goal is 150-300 kcal per

session and 800-900 kcal per week during in

Progress to 800-2000 kcal per week

Frequency

Minimum is 3 days/week Increase to 5 days/week Maintained with 2-4 days/week