1. Designing a CR Exercise Program Exercise Prescription

2. The Goal is the Key! n Improvements in Health vs. Improvements in Fitness (ACSM) –Health - something is better than nothing –Fitness - no pain no gain

3. Health Recommendations n Mode –endurance type –recreational and household chores included (gardening, yardwork, etc…)

4. Fitness n Mode –Rhythmical –using large muscle groups –activities aerobic in nature (running, swimming, cycling, etc…)

5. Health vs. Fitness n Fitness Intensity –60-90% of Max HR or 50-85% of VO 2max n Health Intensity –at least >45% VO 2max

6. Health vs. Fitness n Fitness Frequency –3-5 days/week n Health Frequency –most if not all days of the week

7. Health vs. Fitness n Fitness Duration –20-60 minutes of continuous activity n Health Duration –at least 30 minutes of accumulated (possibly discontinuous) activity each day

8. Mode n Exercise Modalities have been classified into three groups n Group1 –constant intensity –not dependent on skill –initial phase/improvement phase –walking, running, stairclimbing, cycling

9. Mode n 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

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

11. Mode n Whatever Works!! (within reason) n If a person finds the activity enjoyable they will adhere to the program

12. Intensity n Selecting the right intensity is an art- form n Common Sense - the more fit the higher the intensity and vice versa

13. HR Method n 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

14. Example n What should the HR training range for a 40 year old be? n 220-40 = 180 n 180 x.6 = 108 b/min n 180 x.9 = 162 b/min

15. HR Method n 2. Karvonen Method n HR reserve –takes into account resting HR –Target HR = (%HRR) (HR max - HR rest) + HR rest

16. Example n Target HR = (%HRR) (HR max - HR rest) + HR rest n ((.6 (180 - 65)) + 65) = 134 b/min n ((.9 (180 - 65)) + 65) = 169 b/min

17. What HR? n Where in the range should you exercise? n Table 5.1 - based on initial fitness level n Minimum, Average, Maximal HR values that a person should be exercising

18. VO2 Method n 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

19. Example n What should the VO2 training range for a person with a max of 40ml/kg/min? n 40 x.5 = 20ml/kg/min n 40 x.85 = 34ml/kg/min

20. HR Method n 2. VO2 reserve Method –takes into account resting VO2 –Target VO2 = (%VO2) (VO2 max – VO2 rest) + VO2 rest

21. Example n VO2 HR = (%VO2) (VO2 max – VO2 rest) + VO2 rest n ((.85 (40 – 3.5)) + 3.5) =34.5 n ((.50 (40 – 3.5)) + 3.5) =21.75

22. Intensity n 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

23. Example n What range of intensities (METS) should a person with a VO2max of 42 ml/kg/min n 42 x.5 = 21 n 42 x.85 = 35.7 n 21 / 3.5 = 6 METS n 35.7 / 3.5 = 10 METS

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

25. Duration n Healthy 20-30 minutes n Sedentary or diseased multiple session to accumulate 20-30 minutes n Minimum Goal is 150-300 kcal per session and 800-900 kcal per week during in n Progress to 800-2000 kcal per week

26. Frequency n Minimum is 3 days/week n Increase to 5 days/week n Maintained with 2-4 days/week