Prescription of Exercise for Health, Wellness, and Fitness.
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Transcript of Prescription of Exercise for Health, Wellness, and Fitness.
Medical Clearance Identify high-risk individuals Information used for exercise
prescription For motivation (BP, body fat, etc.) Baseline values To identify illnesses at early stages
Cardiopulmonary Disease Signs & Symptoms Pain, discomfort in chest, neck,
jaw, arm SOB w/ mild exertion Dizziness or syncope Orthopnea or paroxysmal
nocturnal dyspnea
Cardiopulmonary Disease Signs & Symptoms Ankle edema Palpitations or tachycardia Intermittent claudication Known heart murmur Unusual fatigue or SOB w/ usual
activities
Initial Risk Stratification
1. Apparently Health: asymptomatic & apparently healthy w/ 1 major coronary risk factor (CRF)
2. Increased Risk: signs or symptoms suggestive of possible C-P or metabolic disease and/or 2 major CRF
3. Know disease: known cardiac, pulmonary, or metabolic disease
Prior to Exercise
ACSM Guidelines Medical examination and exercise
test might not be necessary if moderate exercise is undertaken gradually in people without symptoms of cardiopulmonary disease
Exercise Prescription
Overload - exercise @ intensity higher than normal
frequency intensity duration
Specificity
Intensity Considerations
Level of fitness Medications that influence HR Risk of CV or orthopedic injury Exercise preference Program objectives
Exercise Prescription - Intensity
Percentage of HRmax
HR reserve method
plotting HR vs VO2 or exercise intensity during exercise test
Monitoring Exercise Intensity
40 y.o.
Max HR = 220 - 40 = 180 bpm
THR70% = .70 * 180 = 126 bpm
THR90% = .90 * 180 = 162 bpm
HRR Method - Karvonen Formula
Obtain standing resting HR (HRrest)
HRR = HRmax - HRrest
Calculate 60% and 80% of HRR
HRR Method - Karvonen Formula
Add each of these values to HRrest
THR = HRrest + 0.60(HRmax - HRrest)
THR = HRrest + 0.80(HRmax - HRrest)
Exercise Prescription - Percentage of HRmax
70 - 85% of HRmax
60 - 80% of VO2max/HRR
45% of VO2max or less is effective for some
%HR %VO2max
50 2860 4070 5880 7090 83100 100
HR and VO2 Relationship
% HRmax %VO2max
50 2860 4070 5880 7090 83100 100
%VO2max = 1.43 %HRmax – 44.2
Monitoring Exercise Intensity Utilize HR Method (70-85%)
Create a range of 10-15% (e.g. 70-85%)
Strive for 70%
Lower intensities may be effective
Other Methods of Monitoring Exercise Intensity Metabolic Equivalent - MET
Rest = 1 MET (3.5 ml O2/kg min)
MET Method of Monitoring Exercise Intensity 70% HRmax = 60% VO2max
Age 40 / VO2max = 50 O2/kg min
Target: 30 O2/kg min
METS: 30/3.5 = 8.6 METS
Various MET Values Sitting: 1.0 Walking (2.5 mph): 3.0 Walking (3.5 mph): 4.5 Mopping: 4.5 Mowing Lawn: 6.5 Swimming (crawl - 2.5 ft/sec): 15.0 Horseback riding (gallop): 8.0
Other Methods of Monitoring Exercise Intensity
6 No exertion at all7 Very, very light Extremely light89 Very light Very light
1011 Fairly light Light1213 Somewhat hard Somewhat hard1415 Hard Hard (Heavy)1617 Very hard Very hard1819 Very, very hard Extremely hard20 Maximal exertion
Exercise Intensity
% HRmax %VO2max RPE Classification orIntensity
<35 <30 <10 Very light35-59 30-49 10-11 Light60-79 50-74 12-13 Moderate80-89 75-84 14-16 Heavy>90 >85 >16 Very heavy
Exercise Program Warm-up Flexibility / Stretching Training Aerobic Training Cool Down Flexibility Training
Resistance Training
Principles of Training
Overload Higher level of exercise Induce a training effect Achieved thru manipulating Athletes, sedentary, pathological
Specificity - Aerobic Capacity
Running Test Swimming TestPre-Training
Post-Training
%Change
Pre-Training
Post-Training
%Change
VO2max(mL/kgmin)
54.9 55.7 +1.5 46.6 51.8 +11.0