Aerobic Conditioning

Indications

Decreased endurance with exercise

Decrease ability to perform functional activity

• Stairs

• Community mobility

• Household chores

Decreased aerobic capacity

Benefits of Aerobic Conditioning

Improved cardiovascular and peripheral (muscular) endurance

Decreased anxiety and depression

Enhanced physical function

Enhanced sense of well being

Contraindications to aerobic conditioning

Unstable heart rates

Uncontrolled hypertension

Acute infection

Aortic aneurysm

Severe aortic stenosis

Acute or poorly controlled congestive heart failure

Active or recent myocarditis

Acute thrombophlebitis

General Recommendations for Aerobic Physical Activity

Children: Age 6–17: 60 min of moderate-vigorous aerobic ex per day

Adults: Age 18–65: 30 min of moderate intensity ex 5 days/wk or 20 min of vigorous activity 3 days/wk

CDC – 80% of Americans do not get the recommended amount of exercise

 Department of Health and Human Services recommends these exercise guidelines:

Aerobic activity. Get at least 150 minutes a week of moderate aerobic activity — such as brisk walking, swimming or mowing the lawn — or 75 minutes a week of vigorous aerobic activity — such as running or aerobic dancing. You can also do a combination of moderate and vigorous activity, preferably spread throughout the course of a week.

Strength training. Do strength training exercises at least twice a week. Consider free weights, weight machines or activities that use your own body weight — such as rock climbing or heavy gardening. The amount of time for each session is up to you.

What must be monitored?

Heart Rate

Blood Pressure

Rate of Perceived Exertion

Respiratory Rate

Oxygen saturation

Skin (color, sweating)

Aerobic Capacity 

VO2 max (also maximal oxygen consumption, maximal oxygen uptake, peak oxygen uptake or maximal aerobic capacity) is a measure of the body’s capacity to use oxygen

Maximal oxygen consumption reflects the aerobic physical fitness of the individual, and is an important determinant of their endurance capacity during prolonged, sub-maximal exercise.

VO2 max is reached when oxygen consumption remains at a steady state despite an increase in workload.

Myocardial Oxygen Consumption 

is a measure of the oxygen consumed by the myocardial oxygen

At rest, the myocardial muscle extracts 70-75% of the oxygen from the blood flowing through the heart

During exercise, the demand for oxygen increases. To meet this demand, there is an increase in coronary blood flow to meet oxygen demands

METs  

is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2 per kg body weight x min.

Represents a method for expressing the energy cost of physical activities as a multiple of the resting metabolic rate.

The energy cost of an activity can be determined by dividing the relative oxygen cost of the activity (ml O2/kg/min) x by 3.5.

Deconditioning

Occurs with prolonged bed rest

Often seen in patient with extended acute illness or long-term chronic conditions

Deconditioning Effects Assoc. with Bed Rest

Decreased muscle mass, strength, cardiovascular function, total blood volume, plasma volume, heart volume, orthostatic tolerance, exercise tolerance and bone mineral density

Overload Principle

stress on an organism that is greater than the regular stress placed on it.

To improve cardiovascular or muscular endurance, an overload must be applied to the system/ organism

The overload must be above the training stimulus threshold for conditioning/adaptation to occur

Training stimulus thresholds are dependent on the individual’s health, level of activity, age and gender

A conditioning response generally occurs at 60 – 90% of maximal heart rate (50-80% of VO2 max)

Venous Pooling

Exercise causes an increase in cardiac output. This increase in cardiac output is necessitated by the active muscles' need for oxygenated blood, and lots of it. For large amounts of blood to be circulated to the active tissue, an equally large amount of blood must be returned. Blood pooling can occur with rapid cessation of exercise due to an inadequate amount of blood returning to the heart.

During exercise, your muscles aid the amount of blood returned to the heart by contracting with more force around the blood vessels. This causes the blood to easily resist the forces of gravity and return quickly to the heart for re-oxygenation and re-circulation. When you stop exercising quickly, the muscles are no longer contracting against your blood vessels – gravity causes the blood to pool in the lower extremities. When this occurs, you may feel faint or dizzy or experience a loss of consciousness.