ACE Personal Trainer Manual 5th Edition

Chapter 11: Cardiorespiratory Exercise: Programming and ProgressionsLesson 11.2

© 2014 ACE

• After completing this session, you will be able to: Interpret general guidelines for intensity of

cardiorespiratory exercise for health, fitness, and weight loss

Interpret general guidelines for duration of cardiorespiratory exercise for health, fitness, and weight loss

Interpret general guidelines for exercise progression of cardiorespiratory exercise for health, fitness, and weight loss

LEARNING OBJECTIVES

© 2014 ACE

• Exercise intensity – the most important element of the exercise program to monitor

• Methods for monitoring exercise intensity: Heart rate [% maximum heart rate

(MHR); % heart-rate reserve (HRR)] Ratings of perceived exertion (RPE) VO2 or metabolic equivalents (METs) Caloric expenditure Talk test/first ventilatory threshold (VT1) Blood lactate and second ventilatory

threshold (VT2)

INTENSITY

© 2014 ACE

INTENSITY: HEART RATE

• Using percentage of MHR or HRR is the most widely used approach for programming and monitoring intensity: Accuracy requires knowledge of the individual’s MHR Given the risk of a maximal-effort test, MHR is normally

determined via mathematical formulas (e.g., 220 – age)• Numerous variables impact MHR:

Genetics Exercise modality (e.g., MHR varies between running and cycling) Medications Body size – MHR higher in smaller clients due to smaller heart

and stroke volume Altitude – lowers MHR reached due to a client’s inability to train

at higher intensities Age – MHR varies significantly among people of the same age

© 2014 ACE

INTENSITY: HEART RATE

• Concerns with 220 – age formula: Tends to overestimate MHR in younger adults Underestimates MHR in older adults

• This may lead to over- or underestimating exercise intensities: Overtraining – risk of injury and a potentially negative experience Undertraining – potential boredom and insufficient challenge Risk of cardiovascular complications – strongly related to

inappropriately high exercise intensities Guiding exercise on the basis of estimated age-based MHR is

discouraged• ACSM suggests formulas with standard deviations closer to 7

bpm: 206.9 – (0.67 x age) 208 – (0.7 x age)

© 2014 ACE

INTENSITY: HEART RATE

© 2014 ACE

RECOMMENDED EXERCISE INTENSITY

© 2014 ACE

KARVONEN METHOD

• The Karvonen formula – or heart-rate reserve (HRR) – should be based on measured MHR measured to yield the most accurate results.

• HRR considers potential RHR differences by determining a HRR from which training intensities are calculated.

• This reduces discrepancies in training intensities between individuals with different RHR and accommodates the training adaptation that lowers RHR, therefore expanding HRR.

© 2014 ACE

KARVONEN METHOD

© 2014 ACE

USE OF KARVONEN METHOD

© 2014 ACE

RATINGS OF PERCEIVED EXERTION

• RPE – a subjective numbering system shown to be capable of defining the ranges of objective exercise intensity

• There are two versions of the RPE scale: The classical (6 to 20) scale The contemporary category ratio (0 to

10) scale• RPE ratings of moderate to hard span

the range of recommended exercise training intensities.

• The RPE system works well for approximately 90% of people.

• With practice, clients can usually learn to use the scale fairly effectively.

© 2014 ACE

SESSION RPE

How does the concept of “session RPE” expand your understanding of intensity?

Use this technique to monitor the intensity of your own workouts and develop multiple scenarios that will help you reach a weekly RPE goal.

© 2014 ACE

INTENSITY: VO2 OR METABOLIC EQUIVALENTS

• Due to the inaccuracy of estimating %VO2max or %VO2reserve (VO2R), a program based on metabolic or ventilatory responses is better.

• METs – multiples of an assumed average metabolic rate at rest of 3.5 mL/kg/min: Very easy and intuitive to understand (e.g., at 5.0 METs, they are

working five times harder than resting) RMR is not exactly 3.5 mL/kg/min in every individual, or even in

the same person at all times The utility of using METs rather than directly measured VO2 is so

substantial that it more than makes up for any imprecision Light (<3 METs) Moderate (3–6 METs) Vigorous (>6 METs)

© 2014 ACE

MET VALUES

© 2014 ACE

INTENSITY: CALORIC EXPENDITURE

• When the human body burns fuel, oxygen (O2) is consumed, which yields calories to perform work.

• The number of calories produced per liter of O2 consumed varies according to the fuel utilized:4.69 kcal per liter of O2 for fats5.05 kcal per liter of O2 for glucoseA value of 5 kcal per liter of O2 is sufficiently

accurate• Caloric expenditure – calculated in terms of

the gross or absolute VO2 during an activity:The measured or estimated total quantity of

O2 consumed per minute x 5 kcal/liter O2

© 2014 ACE

INTENSITY: TALK TEST

• At about the intensity of VT1, the increase in ventilation is accomplished by an increase in breathing frequency – it is no longer possible to speak comfortably.

• Ask clients to recite something familiar, such as the Pledge of Allegiance.

• Then ask, “Can you speak comfortably?” If yes, the intensity is below the VT1. If less than an unequivocal “yes,” the intensity is

probably right at VT1. If “no,” the intensity is probably above or nearer to VT2.

• The talk test is based off an individual’s unique metabolic or ventilatory responses.

© 2014 ACE

BLOOD LACTATE AND VT2

• Lactate – produced at a higher rate as exercise intensity increases• At approximately 50% power output during incremental exercise, the

ability to remove lactate becomes limited, and a net accumulation of lactate in the blood begins

• Lactate threshold – the point when lactate production becomes greater than lactate removal, resulting in an initial rise in blood lactate values VT1 and the increase in blood lactate occur at about the same intensity• VT2 – the point at which high-intensity exercise can no longer be

sustained given the accumulation of lactate that begins to overwhelm the blood’s buffering system

Defined as the onset of blood lactate accumulation (OBLA) and represents the “shutdown” point; the HR turnpoint (HRTP)

Exercise immediately below this OBLA marker represents the highest sustainable intensity.

Considered an excellent marker of performance – usually lasting 20–30 minutes in duration

© 2014 ACE

VENTILATORY RESPONSE TO INCREASING INTENSITY

© 2014 ACE

THRESHOLD DETECTION

• Schematic of the detection of the first and second thresholds based on increases in ventilation (VT1 and VT2), on lactate (LT and 4 mmol/L), and on the non-linearity of the HR increase

• This provides for the possibility of three effective training zones based on two thresholds.

© 2014 ACE

THREE-ZONE TRAINING MODEL

• VT1 and VT2 provide an easy way to divide intensity into training zones that are determined without any use of MHR: Zone 1 reflects heart rates below VT1

o A client can talk comfortably Zone 2 reflects heart rates from VT1 to just below VT2

o The client is not sure if he or she can talk comfortably Zone 3 reflects heart rates at or above VT2

o The client definitely cannot talk comfortably

© 2014 ACE

DURATION

• Exercise duration – the amount of time spent performing the physical activity

• Can also be expressed as exercise quantity• Benefits gained from exercise and physical

activity are dose-related: Greater benefits are derived from greater

quantities of activity Activity expending ≤1,000 kcal/week generally

produces improvements to health Greater quantities expending ≥2,000 kcal/

week promote effective weight loss and significant improvements to overall fitness

© 2014 ACE

CONSIDERATIONS FOR DURATION

• Exercise quantity may be performed: As one continuous bout, or Intermittent bouts

• Accumulated throughout the day lasting a minimum of 10 minutes each

• Trainers must place the needs and abilities of their clients first: Assess current conditioning levels, tolerance,

and availability Select suitable durations and progressions Aspire only to attain the recommendations

when appropriate

© 2014 ACE

EXERCISE DURATION GUIDELINES

• Moderate-intensity exercise for at least 30 minutes a session, a minimum of 5 days per week for a total of 150 minutes per week, or

• Vigorous-intensity exercise for at least 20–25 minutes a session, a minimum of 3 days per week for a total of 75 minutes per week, or

• A combination of both• Those seeking to manage or lose weight:

50–60 minutes of moderate-intensity exercise or activity each day, 5–7 days a week, for a total of 300 minutes, or

A total of 150 minutes of vigorous exercise or activity per week, performed a minimum of three days a week, or

A combination of both

© 2014 ACE

PRINCIPLES OF EXERCISE PROGRESSION

• Overload – when additional timely, appropriate stresses are placed on the organs or systems, physiological adaptations and improvements occur.

• The rate of progression depends on: The individual’s current conditioning level Program goals Tolerance for discomfort associated with raising training load or volume• Specificity – physiological adaptations made within the body are

specific to demands placed upon that body Often called the SAID principle – specific adaptations to the imposed

demands A training program should progress to mimic the demands of that

activity to provide the specific stimuli that elicit appropriate adaptations.

© 2014 ACE

EXERCISE PROGRESSION

• Exercise duration – initially the most appropriate variable to manipulate

• Start with developing adherence: Build exercise sessions by 10%, or 5–10 minutes every week or two over the first 4–6 weeks

• Increase frequency, then intensity, keeping progressions consistent with the client’s goals

• To limit the risk or burnout or orthopedic injury from overuse: Include multiple modalities

o Cross-training, walking, cycling, elliptical training, etc. Include multiple variations within a modality

o Steady-state exercise, interval training, Fartlek training, etc.

© 2014 ACE

SUMMARY

• Exercise intensity is arguably the most important element of the exercise program to monitor.

• At the same time, it is the most difficult element to present quantitatively and there are numerous methods by which a trainer can program.

• Benefits gained from exercise and physical activity are dose-related, in that greater benefits are derived from greater quantities of activity.

• Ultimately, exercise needs to become an enjoyable and positive experience and the rate of progression must be taken into consideration.