Advanced Fitness Assessment and Exercise Prescription (chapter 4-5)

cardiorespiratory endurance

is the ability to perform dynamic exercise involving large muscle groups at a moderate to high intensity for prolonged periods

absolute VO2

measure of rate of oxygen consumption and energy cost of non weight bearing activities

continuous exercise test

type of graded exercise test that is performed with no rest between workload

discontinuous exercise test

type of graded exercise test that is performed with 5 to 10 min of rest between increments in workload

graded exercise test

a multistage submaximal or maximal exercise test requiring the client to exercise at gradually increasing workloads; may be continous or discontinous used to estimate VO2max

gross VO2

total rate pf oxygen consumption, relfecting the caloric cost of both rest and exercise

maximal exercise test

graded exercise test in which exercise intensity imcreases gradually until the VO2 plateaus or fails to rise with a further increase in workload

net V02

rate of oxygen consumption in excess of the resting VO2; used to describe the caloric cost of exercise

ramp protocals

graded exercise tests that are individualized & that provide for continuous, frequent (every 10-20 sec) increments in work rate so the VO2 increases linearly

rating of perceived exertion

a scale used to measure a client's subjective rating of exercise intensity

respiratory exchange rate

ratio of expired CO2 to inspired O2

submaximal exercise test

graded exercise test in which exercise is terminated at some predetermined submaximal heart rate or workload; used to estimate VO2 max

VO2 Max

maximum rate of oxygen utilization of muscles during exercise

VO2 Peak

measure of highest rate of oxygen consumption during an exercise test regardless of whether or not a VO2 plateau is reached

Talk test

Is a measure of the client's ability to converse comfortably while exercising and its based on the relationship between exercise intensity and pulmonary ventilation

Initial conditioning, improvement and maintenance stage

Name the 3 stages of progression for cardiorespiratory exercise programs

Initial conditioning stage

May last 1-6 weeks depending on your clients rate of adaption to the exercise program

Improvement stage

Usually lasts 4-8 months. During this stage the rate of progression is more rapid

Maintenance stage

After achieving the desired level of cardiorespiratory fitness. Stage continues on a regular, long term basis if the individual has a lifetime commitment to exercise

Continuous training

Involves one continuous aerobic exercise bout performed at low to moderate intensities without rest intervals

Discontinuous training

Consist of several intermittent low to high intensity exercise bouts interspersed with rest periods

Interval training

Involves a repeated series of exercise work bouts interspersed with rest or relief periods

Multimodal exercise programs

You should set exercise frequency and weekly net caloric expenditure goals for each client

Volume of exercise

The frequency, intensity, & time of exercise

MET-min

Is an index of energy expenditure and is calculated by multiplying the MET value of activities by the number of minutes the activity is performed per week

Water Based Exercise

(Continuous Exercise)

Warm up- 20 min of stretching before entering pool

Endurance phase- 30 min of continuous walking and dancing in the water

Resistance phase- 10 min of resistance exercises performed underwater with dumbbells, barbell-like devices & leg pads

Cool down- 10 min of relaxation and floor exercises outside of the pool

Cycling(indoors) , walking,

Name type A activities

Jogging and running,

Rowing

Name type B activities

Aerobic dancing, swimming

Name type C activities

Basketball, hiking

Name type D activities

FITT-VP

Frequency Intensity Time Type- Volume & Progression

4 phases of Cardiac Rehab

Phase I- in patient education

Phase II- monitored Program (36 sessions 12 weeks) 3 leads EKG

Phase III- maintenance phase

Phase IV- general fitness or continual for life

6 min walk test qualifications for stoppage

Chest pain, paleness, shortness of breathe, leg cramps, if they want to stop

6 min later walk test qualifications

Heart failure

PVD

COPD Patients

Name the procedures for administering a graded exercise test

1. Measure HR & BP

2. Begin 2-3 min warm familiarize client with exercise equipment

3. Monitor HR, BP, RPE. A steady HR should be reached do not increase workload until steady HR his reached

4. BP should be measured near end of last minute of each exercise stage

5. RPE should be assessed near end of the last minute of exercise stage

6. Monitor clients physical appearance & symptoms

7. Discontinue test if criteria are reached, clients request, or any indications for stopping occur

8. Patient cool down by exercising at low work rate

9. During recovery continue measuring post exercise HR&a BP for at least 5min

Extend recovery period if abnormal response occurs

10. If client has signs or discomfort or in an emergency use passive cool down with client sitting or supine position

Indications for termination of graded exercise test in low risk adults

1. Onset of angina or angina like symptoms

2. Drop in systolic BP

3. rise in BP

4. Shortness of breath. Wheezing, leg cramps or claudication

5. Signs of poor perfusion

6. Failure of HR to rise with increased exercise intensity

7. Noticeable change in heart rhythm

8. Clients request to stop

9. Physical or verbal signs of fatigue

10. Failure of the testing equipment

Bruce

1. 4.6

2. 7.0

3. 10.2

4. 12.1

5. 14.9

Modified Bruce

1. 2.3

2. 3.5

3. 4.6

4. 7.0

5. 10.2

Balke Population

Active & sedentary men and women

Bruce

Active & sedentary men and women

Cardiac patients and elderly persons

YMCA cycle ergometer sub maximal exercise test protocol

The YMCA protocol is a cycle ergometer submaximal test for women and men

6 min walking test

Purpose: assess aerobic endurance

Application: measure ability to perform ADL

Equipment: 5x 20yard or cone 23 ft apart

Test procedures: instruct participants to walk normally

Scoring: calculate the total number of laps

Safety tips: place chairs around in case client needs to sit or rest. Stop if patient shows signs of overexertion

Validity and reliability: test detects expected performance of daily living

Phases of workouts for exercise prescription

Warm up (5-10min)

Endurance conditioning(20-60)

Cool down (5-10)

Stretching >10min to

40% to 90% vo2max or HRR (heart rate reserve)

55% to 80% for most individuals

The initial exercise intensity for apparently healthy adults is

Prescribing exercise intensity for GOOD healthy adults

HRR 65-80%

HRmax 80-91%

RPE Moderate-hard

Interval Training

(Discontinuous training)

Involves a repeated series of exercise work bouts interspersed with rest or relief periods

Guidelines for multimodal exercise prescriptions

Modes: select at least 3 per week from type A & B activities

Frequency: 3-7 sessions per week

A, b, c activities at least 3x per week

Intensity: RPE between 5-9 on 10 point scale

Duration: at least 15min prefer 20-30

Caloric expenditure: 1000 to 2000 kcal/wk group c and d can be used to reach goal but cannot count as required aerobic activities

Know this

For the average person aerobic training programs generally produce 5% to 20% increase in vo2 max. Sedentary inactive persons may improve as much as 40% in aerobic fitness, while elite athletes may improve only 5%

General principles of exercising testing

1. Use a calibrated treadmill or stationary cycle ergometer

2. Begin GXT with 2-3 min warm up

3. Exercise intensity at start should be lower than maximal capacity

4. Increase intensity .5 mets for patients with disease and 2 mets or greater for healthy individuals

5. Observe contraindications for testing and indications to stop test

6. Monitor HR at least 2x or every minute. During each stage

7. Measure BP& RPE once during each stage.

8. Monitor client appearance and symptom.

9. Terminate test when client heart rate reaches 70% HRR or 85% HR or any emergency situations

10. Cool down 5 min or longer

11. Exercise tolerance in METs should be estimated

12. Testing area should be private and quiet. Room temp 70-72 F humidity 60% or less