ACE 6th Edition Chapter 8: Cardiorespiratory Training: Physiology, Assessments, and Programming
ACE 6th Edition Chapter 8: Cardiorespiratory Training: Physiology, Assessments, and Programming 1

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Chapter Goals:

  • Find the acute and chronic physiological responses to cardiorespiratory training.
  • Know the key considerations we look at for the environment and cardiorespiratory training.
  • Be able to explain the procedures in the assessment of ventilatory threshold. 
  • Look into the results for the different cardio assessments and then apply them to programming for cardio training.
  • Find the considerations we take into account for programming and limiting sedentary time. 
  • Be able to list the three phases of the ACE IFT Model for Cardiorespiratory Training.
  • Make a cardio training program that is personalized for clients and ranges from physically inactive people to endurance athletes using the assessment and programming tools from each phase of the ACE IFT Model. 


Human beings are designed for movement. We move in order to secure food, escape from danger, attract partners, and many other activities every day that allow us as a species to thrive. 

Since we need to move in order for us to survive, the organ systems involved in the metabolism of energy are going to function the best when they are subject to physical challenges.

Actual physical activity will lead the body to make improvements in the work capacity. 

People need to make time and structure their days in ways that will lead to intentionally increasing the physical capacity of our bodies. 

Anatomical Systems

Personal trainers need to have a solid knowledge base for the anatomy and physiology that involves cardiorespiratory training. We also refer to cardiorespiratory training as aerobic training or simply cardio. 

It is important that we know the majority of acute and chronic physiological effects that occur in the body when we subject ourselves to this style of training. 

Cardiovascular System

The cardiovascular, or the circulatory system as its also called, is a closed-circuit system that is made up of the heart, the blood vessels, and the blood within them. 

Blood is used to travel a circular route through the heart and into the arteries, following to the capillaries and into the veins, and then all of this comes back to the heart to repeat the cycle. 

Along with the respiratory system, the heart and the blood vessels work to deliver the nutrients and oxygen to the tissues of the body while also working to removing the products of waste like CO2 and metabolic by-products. 

Blood links the internal environment of the body to the external environment with the transportation of the materials between the two. 

The categories of blood vessels will be the:

  • Arteries and arterioles, and these will carry the oxygen-rich blood away from the heart.
  • Capillaries, and these provide the sites for gas, nutrient, and waste exchange between the vessels and the tissues. 
  • Venules and veins, which work to return the blood back to the heart. 

The heart is the main pump of the blood to the body. the organ is located between the lungs and lies just left of the center, behind the sternum. The heart is made up of atria and ventricles, four in total.

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The right side of the heart receives the blood that is low in oxygen and then pumps through the lungs to receive the oxygen and go to the left side of the heart where the blood is pumped to circulate the rest of the body. 

One cardiac cycle is the period of time from the beginning of one heartbeat to the beginning of the next. 

Respiratory System

The respiratory system is what makes it possible for the body to exchange gases between the external and the internal environment and the tissues. This is made up of the nose, nasal cavity, pharynx, larynx, trachea, bronchi, and the lungs. 

Air enters through the nostrils and the mouth, and the air is warmed up and passes to the pharynx and then the larynx. We breathe around 5 – 6 liters of air every single minute when at rest, and then upwards of 30 liters per minute of air when exercising. From the larynx, the air will go to the trachea, and then the bronchi of the lungs. Then it will be exhaled once the exchange has occurred. 

The muscles of inspiration, or the drawing in of air, are the pec minor, scalenes, and the sternocleidomastoid. This is when we are exercising. When we are regularly breathing, we just use the diaphragm and the external intercostals. 

For expiration, or the expiring of the air out of the body, we use no other assistance when resting, but during exercise, we introduce the use of the abs, internal obliques, serratus posterior, and the internal intercostals. 

Physiology of the Cardiorespiratory System

The Cardiorespiratory fitness levels are defined as the capacity of the heart and lungs to deliver the oxygen to the working muscles during times of exercise. 

We have three basic things that must happen so that we can provide adequate blood and nutrients to the tissues:

  • Getting the oxygen to the blood.
  • Distributing the blood and delivering this oxygen to the active tissues. 
  • And, extracting the oxygen from the blood to complete the production of ATP that needs to occur. 

The oxygen carrying capacity of the blood is found mainly by two variables: the ability to adequately ventilate the alveoli in the lungs and the concentration of hemoglobin present in the blood. 

Hemoglobin is the molecule in the blood that is used to carry the oxygen around. 

Cardiac output is the product of the heart rate and the stroke volume, also simply the quantity of blood that is output per heartbeat. 

Physiological Adaptations to Acute and Chronic Cardiorespiratory Exercise

Muscular System

The organ systems that are stressed during physical activity and exercise need to have specific types of exercise to adapt the way they are needed. 

We choose the style of training to match the types of muscle fibers and things we wish to work. We have endurance training working for the slow twitch muscle fibers, and the high intensity training for the fast twitch fibers. 

With training we see the growth of capillaries around the fibers that are being recruited, and this works to enhance the delivery of oxygen to them. 

For the higher intensities, we may see the fast twitch fibers primarily used, and this could see enhances in the number of anaerobic enzymes that are present. 

Cardiovascular System

The heart muscle will hypertrophy when it needs to provide more cardiac output to the muscles. 

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The main adaptations that will happen are things such as larger stroke volume, since there is no increase in the maximal heart rate of a person. 

Respiratory System

The muscles of the respiratory system changes are less seen when compared to that of the changes in the heart and the circulatory system. The muscles will change though in the slightest to allow for more efficiency. 

The adaptations to the cardiorespiratory system will begin with the first bout of exercise, but they will not be truly measurable for weeks. 

Max oxygen uptake, or the VO2 max, will increase with training, but it will reach a peak and plateau at around the 6 month mark. 

Another significant change is in the ability for the body to store glycogen for use during exercise. 

The main adaptations to exercise training will usually occur during the use of steady state exercise that is done at moderate intensity levels. 

Steady state is used to refer to intensity of exercise where the demands physiologically and the energy needed are both met by the intake and the delivery of oxygen to the systems of the body. 

A lot of recent research has suggested that you see greater improvements when doing high-intensity interval training. And we see this when we look at VO2 max. 

Environmental Considerations when Exercising

One big condition to be aware of is exercise done in the heat. This introduces some extra need for hydrating and for increased risk of dehydration and things like heat stroke. 

So, it is important that people pay attention to the possibility of heat exhaustion, stroke, and dehydration when working out in these conditions. 

Exercising in the cold is a major problem when it comes to dealing with the excessive loss of body heat. This means it could result in hypothermia and even frostbite. These conditions must be watched to ensure they do not happen in the body. 

Some things to keep in mind when we workout in the cold is to wear several layers of clothing, allow for the adequate ventilation of sweat, wear clothing that is still breathable, replace the body fluids lost just like you do in the heat, and monitor your overall body weight well. 

Exercising at high altitudes should be something to be aware of, as the higher the altitude, the less available oxygen is in the air. 

Exercising in air pollution is something to take into account, especially for those that workout in cities, as this is where it is higher. 

General Guidelines for Cardiorespiratory Exercise for Health and Fitness

Some specific guidelines for adults between the ages of 18 and 64 are outlined in the 2018 physical activity guidelines for Americans. 

First, any amount of exercise is more desirable when compared to none at all. There should be an effort to simply sit less throughout the day. 

Second, we should perform 150 – 300 minutes of moderate intensity exercise throughout the week, or 75 – 150 minutes of high insanity or vigorous activity per week. You can also perform a combination of these two.

Third, we should participate in muscle strengthening activities involving the major muscle groups at least two days every week. 

Make sure to know the principles of aerobic training when looking at the Frequency, Intensity, Time, Type, Volume, Pattern, and Progression. These are the main variables used for training types. 

We use ventilatory threshold one and two for different exercise intensities. 

We also break these thresholds down to three different zones of working out. 

Zone 1 is reflective of low to moderate intensity exercise with the heart rate below ventilatory threshold one. 

Zone 2 is reflective of moderate to vigorous intensity exercise with the heart rates going from ventilatory threshold one to just below the ventilatory threshold two.

Zone three is reflective of the vigorous to very vigorous intensity exercise done with the heart rates at or higher than ventilatory threshold two. 

For progression when it comes to cardiorespiratory training, we see the use of a few principles. 

  • The principle of overload is first, and this states that with the additional stresses put on the organs and the systems in a timely and appropriate way, then we will see physiological adaptation and improvements happen. 
  • The principle of specificity is next, and this states that in order for us to achieve the results and adaptations that we desire, we must train the body specifically in that way. 

Assessments for Cardiorespiratory Fitness

The ventilatory threshold assessment is based on the physiological principle of variation. During the submaximal exercise, ventilation increases linearly with oxygen uptake and carbon dioxide production. 

The talk test is one thing we use to determine how hard a client is working. This works by talking and holding a conversation with the person working out and determining when they begin to be unable to have fluid and uninterrupted conversation. When this occurs, we see them entering into the ventilatory threshold 1. This is just a way to determine this. 

Ventilatory threshold 2 assessment involves looking into the onset of blood lactate accumulation. When this point of the blood lactate accumulating faster than the body can buffer and remove it, then we see the ventilatory threshold two starting. 

Components of a Cardiorespiratory Workout Session

We have three basic components of the cardio sessions. These are the warmup, conditioning, and cool down phases. 

The warmup is what begins the session, and this is a period of lighter exercise that is before the phase of conditioning and needs to last for 5 0 10 minutes. This is a period where the goal is to warm the body up and prepare for the exercise session. 

The conditioning phase is the phase of the workout where we are working on our goals and is the prime part of the whole workout. This is the part that is planned and uses the steady state or interval training to achieve the goals. 

The last phase is the phase of cool down. This is like the warmup, but it is in reverse. The goal is to bring the body back down to the state it was in prior to exercising. 

ACE 6th Edition Chapter 8: Cardiorespiratory Training: Physiology, Assessments, and Programming 2
ACE CPT Chapter 1: Role and scope of practice for the personal trainer 2
ACE 6th Edition Chapter 8: Cardiorespiratory Training: Physiology, Assessments, and Programming 3

Tyler Read

Tyler Read, BSc, CPT. Tyler holds a B.S. in Kinesiology from Sonoma State University and is a certified personal trainer (CPT) with NASM (National Academy of sports medicine), and has over 15 years of experience working as a personal trainer. He is a published author of running start, and a frequent contributing author on Healthline and Eat this, not that.

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