Chapter 16 Exercise Prescriptions for Health and Fitness

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Chapter 16Exercise Prescriptions for Health
and Fitness

• EXERCISE PHYSIOLOGY
• Theory and Application to Fitness and
  Performance, 6th edition
• Scott K. Powers Edward T. Howley

Presentation revised and updated by Brian B.
Parr, Ph.D. University of South Carolina Aiken
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Introduction

• Physical activity
• Any form of muscular activity
• Can reduce the risk of death from all causes
• Physical inactivity is a primary risk factor for
  coronary heart disease
• Physical fitness
• Set of attributes that relate to ability to
  perform physical activity
• Exercise
• A subset of physical activity that is planned,
  with a goal of improving or maintain fitness

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Prescription of Exercise Dose-Response
Relationship

• The effect (response) of the amount of a drug
  (dose)
• Potency
• Relatively unimportant characteristic
• Slope
• How much change in effect comes from a change in
  dose
• Maximal effect
• Efficacy
• Variability
• Effect varies between and within individuals
• Side effect
• Adverse effect

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The Relationship Between Dose of a Drug and Effect
Figure 16.1
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Pattern of Responses to Exercise

• Acute response
• Occur with one or several exercise bouts but do
  not improve further
• Rapid responses
• Benefits occur early and plateau
• Linear
• Gains are made continuously over time
• Delayed
• Occur only after weeks of training

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Dose-Response

• Exercise dose is usually characterized by
• Intensity
• VO2max
• maximal HR
• RPE
• Lactate threshold
• Frequency
• Number of times (or days) per week
• Duration
• Number of minutes
• Total kcal expended
• Type of activity
• Resistance and endurance exercises

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Dose-Response Relationship for Exercise
Figure 16.2
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Physical Activity and Health

• The health benefits of physical activity
• More related to total number of calories expended
  than exercise intensity
• Benefits depend on baseline activity level
• The ACSM/CDC recommendation
• Every U.S. adult should accumulate thirty
  minutes or more of moderate-intensity (3-6 METs)
  physical activity on most, preferably all, days
  of the week.
• This is minimum for achieving health outcomes
• Additional activity, including vigorous exercise,
  provides additional benefits

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Dose-Response Relationship for Physical Activity
and Health Benefit
Figure 16.3
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General Guidelines for Improving Fitness

• Screening
• Health status screening (PAR-Q)
• Risk of cardiovascular complications is related
  to degree of pre-existing cardiac disease
• Progression
• Moderate-intensity walking (3-4 mph)
• Then increase duration and/or intensity
• Walk?walk/jog?jog
• Warm-up, stretch and cool-down, stretch
• Light exercise and stretching performed at
  beginning and end of exercise session

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Exercise Prescription for CRF

• Frequency
• 24 sessions per week
• Gains level off after 3 to 4 sessions/week
• Duration
• Total work/session should 200-300 kcal
• Must be considered with intensity
• Intensity
• Describes the overload needed to bring about a
  training effect
• 60-80 of VO2max
• Lower in those with low initial fitness level
• Target heart rate range

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Intensity, Duration, and Frequency of Exercise
and VO2 Max
Figure 16.4
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Determining Target Heart Rate Range

• Direct method
• THR range determined from maximal GXT
• HR at 6080 VO2max
• Indirect method
• Heart rate reserve (Karvonen) method
• Subtract resting HR from maximal HR to obtain HRR
• Take 60 and 80 of HRR
• Add each HRR to resting HRR to obtain THR range
• Percentage of maximal HR
• Take 70 and 85 of maximal HR as THR range
• Use RPE scale in addition to HR
• RPE of 1216 is about 40/5085 HRR

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Target Heart Rate Range Determined From GXT
Figure 16.5
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VO2 Reserve (VO2R)

• VO2 Reserve
• Difference between VO2max and resting VO2
• HRR more closely linked to VO2R than VO2max
• Greater difference for those with low fitness
  level
• Calculating target VO2
• Take 60 and 80 of VO2R

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Sequence of Physical Activity

• Walking
• Start at a comfortable speed for 15 minutes
• Gradually increase duration and speed
• Jogging
• Start by adding some running when walking
• Gradually increase speed/duration of running
• Games and sports
• Intermittent higher-intensity activities within
  THR range

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An Example of a Walking Program
Table 16.1
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An Example of a Jogging Program
Table 16.2
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Strength and Flexibility Training

• Muscular strength and flexibility are important
  components of a complete fitness program
• Recommendations
• Dynamic resistance exercises
• Full range of motion
• 8-10 different exercises
• 8-12 repetitions per exercise

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Physical Activity Pyramid
Figure 16.6
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Strength Training

• ACSM recommendation
• One set of 810 exercises
• 812 reps per set
• 23 sessions per week
• Single vs. multiple sets
• One set to achieve health and fitness goals in
  average individuals
• Multiple sets for increasing strength in trained
  individuals
• Maximal strength gains
• 48 sets at 6085 1RM, 23 days per week

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Environmental Concerns

• Environmental conditions can alter exercise heart
  rate
• Adjust exercise intensity in adverse environments
• High temperature and humidity
• Altitude
• Use THR range as a guide for intensity