ACSM CPT Chapter 15: Cardiorespiratory Training Programs

ACSM CPT Chapter 15: Cardiorespiratory Training Programs

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    Chapter Objectives:

    • Know the cardiovascular exercise guideline development over time.
    • Use the FITT-VP principles of prescribing exercise for cardiovascular training.
    • Know the physiological basis for the cool down and warm up.
    • Be able to use the metabolic equations and MET values for finding workload.

    General Training Principles

    Cardiorespiratory endurance is the ability for someone to do exercise that uses large muscles and is repetitive at a high to moderate intensity for a long period of time. The goal for this is to have an increase in heart rate and respiration for the right physiological stress to occur. This is what we call overload.

    Overload is the same as the last chapter when used for resistance training, but now for cardio. Instead of increasing strength, we will be increasing the effectiveness of our cardiorespiratory system.

    The benefits of having cardiorespiratory endurance are these: 

    • Decreases in the risk of dying prematurely from any and all causes, but mostly diabetes and heart disease.
    • Reducing the death from cancer.
    • More likelihood of better habits associated with health benefits.

    The trainer must work to balance frequency, intensity, duration, volume, and progression of the client’s workouts in order to avoid challenging the client too far over the overload level.

    Design of a Cardiorespiratory Training session


    The warmup phase is used to gradually prepare the body for the endurance phase where we are working hard. It takes us from rest to work. This is usually done with an activity like a brisk walk. For general purposes, this phase is going to be 5 – 10 minutes of a low intensity exercise of choose.

    The benefits are:

    • Potential reductions in injury susceptibility for muscles and joints due to the increase in connective tissue extensibility.
    • Possible joint range of motion and function improvements.
    • Potential muscle performance improvements.
    • Possible prevention of ischemia in the heart which occurs with sudden strenuous exertion.

    Endurance Phase

    This is the higher level of intensity and the phase that has us performing the overloaded need to train and produce the right cardiorespiratory adaptations.


    This is the opposite of a warmup. It is bringing the body from work to rest essentially. Typically, this will last about 10 minutes and it is gradual in the decreases of intensity.

    Exercise Prescription for Cardiovascular Endurance


    The best frequency and recommended one by the ACSM is 3 – 5 days per week. The frequency however will vary on the chosen intensity. This has an inverse relationship. If the intensity is low, the frequency should be higher, and vice versa.


    The intensity needed should achieve overload. People who have lower levels of fitness, the intensity could be as low as 45% of their oxygen uptake to produce this.

    Methods of Estimating Intensity for Cardiorespiratory Endurance Exercise

    We often use the VO2 max or the maximal hear rate formulas to estimate the intensities of this type of exercise. Some of these use the basis of age.

    Oxygen Uptake Reserve

    When we use the VO2R we are finding the target range for the client to stay in. The equation is as follows for a range of 40% to 89%:

    Target VO2 (lower end of the range) = ((0.4) X (VO2max – VO2rest)) + VO2 max

    Target VO2 ((upper end of the range) = ((0.89) X (VO2max – VO2rest)) + VO2 max

    Some environmental conditions may make the relative intensity higher than the one prescribed.

    Trainers need to monitor the response of their client’s exercise. 

    Heart Rate and Heart Rate Reserve

    The formula for target heart rate based on percent of heart rate max for a range of 64 – 76% but up to 95% HRmax. This is recommended by the ACSM.

    • Target HR (lower end of range) = (max HR) X 0.64
    • Target HR (upper end of range) = (max HR) X 0.95

    The Karvonen method is this: 

    • Target HR (lower end of range) = ((0.4) X (HRmax – HRrest)) + HRrest 
    • Target HR (upper end of range) = ((0.85) X (HRmax – HRrest)) + HRrest

    Ratings of Perceived Exertion

    These are subjective and used for rating the overall feeling of the client while they are exercising. The common scale is 6 – 20 and the standard threshold for the benefits of cardio are within an RPE of 12 – 16.

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    The trainers and clients should use verbal descriptors to find their RPE most of the time. It is also the preferred method when working with older adults.

    Talk test

    The talk test is used for clients when they are doing cardio. This test looks for the point in exercise where the client cannot speak in a normal way due to the amount of energy and force they are putting out. They might have moments of having to breath without finishing a sentence. The goal should be to exercise close to this point.

    Exercise Type or Mode

    The mode is determined while considering the fitness level, the health, interests, and the skill of the clients. Typically, these skills involve large muscle groups in a rhythmic and repetitive way. They can be weight bearing or not. 

    The activity should be of interest to the client in order for them to stick with it. Some activities include things like walking, running, swimming, biking, skating, and many others.

    Time or Exercise Session Duration

    ACSM recommends 30 – 60 minutes per day of moderate exercise, 20 – 60 minutes per day of vigorous, or some combination of these.

    People who are sedentary should start at the lower end, with even separate bouts of 10 minutes a few times in one day being an option to reach these times.

    Volume or Amount (Calories Expended)

    The volume of exercise is the product of intensity, time, type, and frequency. This volume is used for estimating the overall caloric expenditure of the program. We usually express this value as kcal/day or a variant of that.


    This is the same as the one we use for resistance training. This sees to it that the cardio system adapts without going past the level of overload.

    With progression we increase the intensity, frequency, and duration of the endurance phase gradually which results in more volume being done over time.

    ACSM CPT Chapter 15: Cardiorespiratory Training Programs 1
    ACSM CPT Chapter 15: Cardiorespiratory Training Programs 2
    ACSM CPT Chapter 15: Cardiorespiratory Training Programs 3

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