The Art of Exercise Prescription [Compatibility Mode]

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Unformatted text preview: The Exercise “Science Artist” The Art of Exercise Prescription Ch Chapters 7- 8 “….exercise prescription is the successful integration of exercise science with integration of exercise science with behavioral techniques that result in longterm program compliance and attainment of the individual’s goals.” ACSM Guidelines for Exercise Testing and Prescription, 2000, pg 140. Basics: The Exercise Session Activity Pyramid Link to Slide 4 The exercise session – – – – WarmWarm-up Endurance phase Recreational activities (optional) Cool-down Cool- Need to consider the mode Link to Basics: The Exercise Session 1 Individual prescription should be based on Goals Miles per week Surgeon General/Centers for Disease Control Guidelines – Reduce Risk Link to Miles per week, Relative Risk Cardiorespiratory Fitness Link to Slide Cardiorespiratory Fitness Link to Slide 8 – – – – Frequency Intensity Time Type Link to Individual Prescription should be based on Goals Relative Risk Link to Individual Prescription should be based on Goals Link to Individual Prescription should be based on Goals 2 Prescription for Cardiorespiratory Fitness (F.I.T.T) (F.I.T.T) TYPE (Table 7-3) 7– Continuous using large muscle groups (aerobic) F.I.T.T.: Intensity Intensity %VO2R (see page 146 in Guidelines) – Accounts for resting energy expenditure Methods of prescribing INTENSITY INTENSITY – Oxygen consumption responses %VO %VO2R – METs – Heart Rate Methods % HRmax (pk) % Heart Rate Reserve (HRR) Direct Method RPE Target VO2 = (exercise intensity)(VO2pk - VO2rest) + VO2rest VO (exercise intensity)(VO VO – (40 – 85% VO2R) – METs – based on oxygen consumption responses to graded exercise testing (GXT) as calculated above – Link to Example Cardiorespiratory Fitness: HRmax Methods of Prescribing Intensity (con’t) (con’t) Heart rate – HR vs. VO2 (Direct Method) (see Fig 7-3) 7– %HR max (70 – 85 % of HR max) Link Slide 13 – HRR method (Karvonen) (40 – 85% HRR) HRR method (Karvonen) (40 HRR) See – Heart Rate Reserve (prescription of intensity), – Example (Heart Rate Reserve) Rating of perceived exertion (RPE) Link to RPE – See table 7-2 7– Moderate to for healthy population is approximately 121213 on 6 to 20 point scale Cardiorespiratory Fitness: Methods of Prescribing Intens... 3 RPE Appropriate for most clinical populations when you may not have a 1:1 relationship with oxygen consumption and heart rate (i.e. bbblockers) Example (Heart Rate Reserve) Heart Rate Reserve ((prescription of intensity) prescription Peak heart rate (from VO2 pk or age (from predicted max) - -Resting heart rate Heart rate reserve x .80 x .60 + RHR + RHR # 120 .60 72 70 RHR 142 190 Peak heart rate 70 Resting heart rate 120 Heart rate reserve 120 .80 96 + 70RHR 166 beats/min # + Link to Cardiorespiratory Fitness: Methods of Prescribing Intens... 4 Cardiorespiratory Fitness (con’t): Exercise TIME TIME General Guidelines to live by Healthy – 15 – 60 min (avg. 20 – 30) – Consider beginning an unfit person at a low duration and use duration as a progression variable to modify FREQUENCY – 3 – 5 sessions per week Caloric expenditure goals – Need to set a realistic number for a weeks period For risk reduction – 1,000 kcals/wk For fitness – >1,200 kcals/wk – 3 to 7 sessions per week @ at least 60% of HRR Impaired (may need to set intensity as low as 40%) – Functional capacity < 3 METs; 3 sessions of 5 min each, MET daily – Functional capacity 3 – 5 METs; 1 or 2 sessions daily – Functional capacity > 5 METs; Minimum of 3 times per week – (METs x 3.5 x BW kg)/ 200 = kcal/min Rate of Progression of Program Program Supervision (Table 7.5) Supervised Fitness level Initial Conditioning Stage 4 to 6 weeks Maintenance Stage After 6 months Unsupervised Improvement Stage 6 weeks to 6 months Time (weeks) 5 What is the target VO2 at 40% of VO2R for a patient with a 5-MET capacity, I.e. a VO2max of 17.5 ml•kg • -1min • -1 5ml• Target VO2 = =(0.40)(17.5 – 3.5) +3.5 =(0.40)(14.0) + 3.5 =5.6 + 3.5 =9.1 ml•kg • -1min • -1 ml• METS = 2.6 FYI = a straight percentage of 17.5 = 2 METs Link to F.I.T.T.: Intensity 6 ...
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