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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
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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