Cardiorespiratory Fitness

• Cardiorespiratory Fitness (CRF) centers on the heart, blood vessels, and lungs' physiological abilities.
• These systems work together in order to deliver oxygen and remove carbon dioxide during cellular respiration.

Physical Activity vs. Exercise

• Physical activity involves exercise modes like walking, jogging, swimming, or gardening, either individually or combined, for aerobic activity.
• Exercise is planned and structured physical activity to maintain or improve physical fitness.

FITT-VP Principle for Aerobic Exercise

• The FITT-VP principle includes frequency, intensity, time, type, volume, and progression.

Frequency

• It is recommended to exercise at least 3 days per week.
• Spreading sessions across 3-5 days may be most effective for reaching recommended physical activity amounts.

Intensity

• Moderate (40%-59% HRR) or vigorous (60%-89% HRR) intensity is generally advised.

Time

• Aim for 30-60 minutes daily (≥150 minutes weekly) of moderate exercise.
• Aim for 20-60 minutes daily (≥75 minutes weekly) of vigorous exercise.
• One may also combine moderate and vigorous activities.

Type

• Aerobic exercise should involve major muscle groups in a continuous or intermittent manner.

Volume

• Accumulate 150 minutes weekly of moderate intensity exercise.

Progression

• Gradually increase overload in response to body adaptations.

Considering Individual Fitness

• One may consider time restrictions, physical barriers, a person's CRF, goals, likes, dislikes and exercise habits when prescribing it.
• It is possible to engage in 3-5 days a week with varying exercise modes and intensities.

Frequency and Volume Recommendations

• A frequency of two or less times per week may not elicit positive cardiovascular changes without a moderate to vigorous intensity.
• Moderate to vigorous intensity exercise twice a week may increase CRF and achieve personal goals.

Intensity Metrics and ACSM Recommendations

• Light intensity is 30%-39% Heart Rate Reserve (HRR), 2.0-2.9 METs, or RPE scale 2-3.
• Moderate intensity is 40%-59% HRR, 3.0-5.9 METs, or RPE scale 4-5.
• Vigorous intensity is 60%-84% HRR, >6 METs, or RPE scale 6-8.

Rate of Perceived Exertion

• Borg RPE Scale can be used to measure the Rate of Perceived Exertion
• The Borg Scale measure on a scale of 6-20, and Verbal Descriptor of Effort
• The Modified Borg RPE on a scale of 0-10, and Verbal Descriptor of Effort
• RPE scales help individuals and clinicians assess how hard an individual feels they are working.
• It is a reliable and valid measure of work intensity or exertion.
• Characteristics vary among male and female, young and older, lean and obese, sedentary to very active, medicated and non-medicated, and healthy individuals with comorbidities.

When to Use Borg RPE Scales

• As a tool to measure and monitor exercise or physical work intensity.
• Complementing other intensity measures with a person's own perception of effort.
• Assisting heart rate (HR) measures when HR may be blunted or less reliable due to medications or comorbidities.

Guidelines for Borg RPE Scale Use

• Use the Borg Scale to estimate aerobic exercise HR.
• Add a zero to each number because the scale is closely correlated with HR.
• Add a zero because the scale is closely coordinated with heart readings

ACSM (American College of Sports Medicine) Initial Intensity recommendations

• Initial intensities of 11 to 12 are recommended for unconditioned individuals.
• RPEs from 13 to 16 are used for most individuals (“somewhat hard” to “hard” verbal descriptors).
• An RPE of 16 is approximately equal to 85% Max HR

Borg CR-10 Scale

• Studies show that heart rates can vary significantly person-to-person at the same workout intensity.
• The CR-10, offers a simpler scale that is not based on heart rate
• Use a simple 0-10 scale used with verbal descriptors of perceived exertion

Time Duration & ACSM Recommendations

• Moderate exercise lasts 30-60 minutes daily.
• Vigorous exercise lasts 20-60 minutes daily.
• A combination of moderate and vigorous exercise will be beneficial.
• Physical activity bouts of ≤10 minutes will have favorable health benefits in sedentary or deconditioned individuals.

Components of Volume

• Volume modes include the types of exercises or physical activities.
• Volume is a product of frequency, intensity, and session duration.
• Adults are recommended to accumulate 150 min/week of moderate intensity aerobic exercise OR accumulate 75 min/week of vigorous aerobic exercise.

METs in Caloric Expenditure

• METs are an index of energy expenditure (EE).
• One MET is the rate of EE while sitting at rest.
• 1 MET equals an oxygen uptake of 3.5 mL/kg/min.

Frequency Recommendations for Children & Adolescents

• Daily activity should include vigorous intensity at least 3 days/week.
• Moderate intensity means a noticeable increase in HR and breathing, while vigorous intensity indicates substantial increases in those.
• Type of activity should be enjoyable and developmentally appropriate.

Exercise Modifications for Older Adults

• Any modality that does not impose excessive physical stress should be used.
• Examples: Aquatic exercise or stationary cycle if tolerance to weight-bearing activity is limited

Exercise for Older Adults

• Older adults need medical clearance, and it will be important for older adults to start slow and progress gradually

• Emphasis should be placed on moderate and vigorous intensity aerobic activities

• Incorporate light warm-up and cool-down periods to prevent sudden changes in blood pressure and reduce injury risk.

• Use tools like the RPE scale to monitor exercise intensity, as some medications may alter heart rate responses.

• Aim for aerobic activities most days of the week, depending on the individual's capacity

• Focus on moderate-intensity aerobic activities, such as brisk walking, swimming, or cycling

Type of Activity

• Choose low-impact activities that reduce stress on joints and bones.
• People with arthritis or osteoporosis in particular, should consider water-based activities.

Incorporate Strength and Flexibility Training

• Combine aerobic exercise with strength training and flexibility exercises to provide a comprehensive fitness program.
• Training ensures a safe exercise environment to prevent falls and injuries, this may include using non-slip mats, stable chairs for seated or standing support, and proper footwear.
• The user should be cautious of symptoms like dizziness, chest pain, or excessive fatigue, and advise stopping exercise and consulting a healthcare provider if such occur.

Hydration and Nutrition

• Encourage adequate hydration before, during, and after exercise, especially as older adults may have a diminished sense of thirst.
• Nutrition should support their exercise level and overall health needs.

Social Factors for Older Adults

• Make exercise a social activity to improve adherence and provide social support, which is important for mental health.
• Tailor activities to the individual's preferences to increase enjoyment and long-term participation.

Progression

• Increase any components of the FITT-VP principle based on an individual's tolerance.
• It is suggested to start low and go slow to reduce risk for adverse C-V events or injury as well as adherence to a consistent exercise program.

Caloric Expenditure

• Exercise volume and METs determine this during exercise.

Key Takeaways

• CRF is the body can use the pulmonary and skeletal muscle system to work as a group to use energy
• Aerobic exercises have specific recommendations to follow set as a guideline to help the user improve body functions
• Exercise volume can be looked at as the most important variable when considering intensity and time.
• Use HR and the Borg 6 point scale to measure Intensity.
• People across all life spans have different adaptations so the recommendation will change with age.

Exercise Intensity

• Various methods may be used to determined exercise intensity. One is to measure the heart rate.
• Exercise can be influenced by a person's current well being and their personal exercise history.
• Key factors to consider include youth and older adults and any indicators to terminate the session

Heart Rate Estimate

• To select one, a person must be aware that estimated values have error ratings.
• A recommended formula: HRmax = 208 - (0.7 x age)
• HRmax declines with age; Further to fine tune predicted HRmax driven exercise prescription– RPE may be used in addition to HR methods.

Target Heart Range

• This will allow a percentage for exercise training at an appropriate intensity level.
• Calculation for 40% and 59% Target Heart Rate = [(HRmax – HR rest) x % intensity] + HRrest
• Talk about zones and use the ACSM table to get the proper heart rate

To find a proper exercise level with intensity

• Monitor HR with the HHR and HR Maximal and use RPE scale as a monitoring tool
• Cardiac medication and health issues should be assessed by the health advisor prior to planning the exercise prescription.

Counting Talk Test (CTT)

• During the exercise the user will maintain a percentage of the count during exercise.
• CTT has moderate to good correlations with heart rate reserve (HRR) and rating of perceived exertion RPE
• Exercise is easily facilitated and monitored and adjusted with specialized equipment.

RPE Scale

• This scale requires multiple indicators to assess an intensity number due to personal differences
• Linear relationship between HR and exercising.

Measurements and Caloric Expenditure

• The RPE, %HHR, METs can all be related to where a user sits on the measurement scale of caloric expenditure

Youth and HR Max

• Recommended range for youth is between 5-8
• Modified RPE is also recommended when working with youth.
• The user should be aware only 21.6percent of the US youth population meet the requirements.

Terminating Exercise

• Check HR often
• So, a dropping HR during an increasing workload is alarming and could be a medical emergency.
• A drop in SBP and exaggerated exercise response indicates the exercise should cease. SO does chest pain, pallor,cyanosis or side effects

Adjusting an Exercise Prescription

• When adjusting prescriptions and programs, consider how to safely execute a series of movements that take into account an individual's current fitness level.
• Consider and describe factors associated with the "Envelope of Function"
• Adjust the training principles of overload, periodization, progression ,Reversibility SAID and other variables to allow for a safe exercise protocol plan.

Envelope of Function

• The area between the lowest and highest amount of tolerated or needed to make the body preform at a homeostatic state
• Key actions that influence its function include detraining homestasis and injuries

Overload Training

• Used to improve performance
• A gradual increase of exercise that stimulates the target muscle group to exceed its current ability
• The intensity duration and activity should be applied so adaptation occurs

SAID

• Specific Adaptation to Imposed Demands
• The user or exercise is very specific to the target action.

Reversibility

• A lack of specific exercise that can results in the body's deconditioning over time
• Must be a plan to help the body revert to appropriate levels

Regression And Periodization

• Can be broken down into workload
• To avoid fatigue implement techniques to make sure the user stays fresh
• Involves creating large blocks of time to stimulate physical changes during exercise

Polarized Training

• Relies on monitoring various intensities to optimize specific results
• Low steady to high intensity actions all effect the workout and ability to preform

Types of Training Protocols

• Continuous Training involves the user working without stopping.
• Types are: long slow distance, moderate intensity and high intensity

Intervall

• Involves short bursts with medium rest times
• The user needs to understand the terms and ratios in relation to time.
• All will improve work load

Exercise Type and Intensity

• Can include repetitions, intensity, time, frequency
• Interval, Tabata and sprint are a few examples
• Each is recommended at different exertion levels