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 exercise that uses large muscles and is repetitive at a high to moderate intensity for a long time. The goal for this is to increase heart rate and respiration for the right physiological stress to occur. This is what we call overload.

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

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 the frequency, intensity, duration, volume, and progression of the client’s workouts to avoid challenging the client too far over the overload level.

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Design of a Cardiorespiratory Training session

Warm-up

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

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.

Cool-Down

This is the opposite of a warmup. It brings the body from work to rest essentially. Typically, this will last about 10 minutes and gradually decrease in intensity.

Exercise Prescription for Cardiovascular Endurance

Frequency

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.

Intensity

The intensity needed should achieve overload. For people with lower fitness levels, 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 heart rate formulas to estimate the intensities of this type of exercise. Some of these use the basis of age.

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Oxygen Uptake Reserve

When we use the VO2R, we find 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 to their client’s exercises. 

Heart Rate and Heart Rate Reserve

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

• Target HR (lower end of the range) = (max HR) X 0.64
• Target HR (upper end of the 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 are used to rate the client’s overall feeling while exercising. The common scale is 6 – 20 and the standard threshold for cardio benefits is within an RPE of 12 – 16.

The trainers and clients should usually use verbal descriptors to find their RPE. 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 the exercise where the client cannot speak normally due to the energy and force they put out. They might have moments of having to breathe 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 client’s fitness level, health, interests, and skill. Typically, these skills involve large muscle groups rhythmically and repetitively. They can be weight bearing or not. 

The activity should interest the client 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.

Sedentary people 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 exercise volume 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.

Progression

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

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