AEROBIC EXERCISE
Dr. Mohamed Seyam PhD. PT.
Assistant Professor Of Physical Therapy
COMPONENTS OF AN EXERCISE TRAINING SESSION
• To maximize safety and effectiveness, the format of each exercise
session should include
1.
Warm-up
2.
conditioning
3.
Cool-down
• A comprehensive exercise program includes both aerobic and
resistance training, flexibility exercises, and guidance about
recreational activities.
Warm-Up
•
period of 5 to 10 minutes
•
low-intensity large muscle activity, such as low-intensity callisthenic-type exercise
or aerobic activity and gentle stretching,
1.
facilitates the transition from rest to exercise, increasing heart rate (HR),
2.
augmenting blood flow, increasing oxygen uptake,
3.
reduce the risk of musculoskeletal injury by increasing connective tissue
distensibility,
4.
improving joint range of motion and function, and
5.
•
enhancing muscular performance.
patients with heart disease may exhibit delayed adaptive circulatory responses to the
onset of exercise, and thus may require longer warm-up periods.
Conditioning
• The conditioning phase includes
endurance,
 resistance, and
flexibility exercises,
• parts of which may be performed on different days.
Methods of Aerobic Exercise
• There are four methods of training that challenge the aerobic
system:
1)
Continuous.
2)
Interval (work relief).
3)
Circuit.
4)
Circuit interval.
Cooldown
•
period of 5 to 10 minutes provides for
1.
gradual physiological recovery after aerobic exercise, which
2.
allows HR and BP to return to near-resting values,
3.
maintains adequate venous return, f
4.
acilitates the dissipation of body heat and removal of lactic acid, and
5.
attenuates the post-exercise rise in plasma catecholamines (which may induce
ventricular arrhythmias).
•
Cooldown is critical for exercise safety for both healthy individuals and those
with disease, as it reduces the risk of postexercise hypotension and myocardial
ischemia.
•
Low-intensity exercise (e.g., slow walking or cycling) and stretching are typical
modes of cooldown exercise.
VO2 max
• Units
• liters/minute
or ml/minute (absolute)
• ml/kg/min (relative to body weight)
• Range
•
15 ml/kg/min (sedentary with disease) to
75 ml/kg/min (young endurance runner).
• Women
about 10-20% lower than men
Methods of Determining VO2 max
•Submaximally
•Maximally
•Karvonen method for calculate
THR
•incremental method for calculate THR
General Guidelines
• Measure
the subject’s HR and BP and RPE at regular intervals
(near the end of each stage [HR, BP, RPE] or every minute [HR])
• All testing begins with a 2-3 min warm-up
• Cool- down at a low intensity for at least 4 minutes - continue
measuring HR, BP and RPE
• increase intensity in 0.5 -2 MET increments
• closely observe subject for contraindications
Submaximal Protocols
• Oxygen consumption for
any given Work Load does not
vary between subjects
• The
slope of the line is about the same for any two given
subjects
• The
rate of increase in O2 consumption with increasing
Work Load does not vary between subjects
Bruce Treadmill Protocol
Stage 1
• Increase grade to 10%
• 3 minutes long
• Measure HR at end of each minute and BP at end of
each stage
Bruce Treadmill Protocol
• The
objective is to reach a steady state HR between 115 and 155
bpm (usually occurs during the first 6 minutes of exercise or by the
end of the 2nd stage)
• Once
subject reaches proper HR terminate the test at the end of that
stage
• Reduce
treadmill speed to 1.7mph and 5% grade and cool-down for
4 minutes.
• VO2
is estimated from the last minute of a fully completed stage
Bruce Protocol ( Maximal Table)
Stage
1
2
3
4
5
6
7
Minutes
3
3
3
3
3
3
3
% grade km/h
10
2.7
12
4.0
14
5.4
16
6.7
18
8.0
20
8.8
22
9.6
MPH
1.7
2.5
3.4
4.2
5.0
5.5
6.0
METS
5
7
10
13
15
18
20
Treadmill Protocol
Calculate VO2 from the gender specific equations
•Males
• Men: VO2max
(ml/kg/min) = 2.94 x T + 7.65
•Females
• Women: VO2max
(ml/kg/min) = 2.94 x T + 3.74
Modified Bruce Protocol
• Used
on diseased and elderly populations.
• The
modified Bruce protocol starts at a lower workload than
the standard test and is typically used for elderly or sedentary
patients.
• The
first two stages of the modified bruce test are performed
at a 1.7 mph and 0% grade and 1.7 mph and 5% grade,
• The
third stage corresponds to the first stage of the standard
bruce test protocol as listed above.
Modified Bruce Protocol ( Submaximal Table)
Stage
1
2
3
4
5
6
7
Minutes
3
3
3
3
3
3
3
% grade km/h
0
2.7
5
2.7
10
2.7
12
4.0
14
5.4
16
6.7
18
8.0
MPH
1.7
1.7
1.7
2.5
3.4
4.2
5.0
METS
3
4
5
7
10
13
15
Treadmill Protocol
• Protocols
• Test
should be individualized
time should ideally be 8-21 min
• Increments
of 10-15 W/min or 1-3%/min grade can be
used for the elderly
Advantages of Submaximal Testing
1.
Safer
2.
Don’t need highly trained personnel
3.
No physician supervision required (if symptom
and disease free)
4.
Controlled pace (motivation not a factor)
5.
Quick assessment
Disadvantages of Submaximal Testing
1. VO2 max is error rate of (10-20%)
2. Don’t get a measure of true maximal HR
• Estimates
of max HR using 220-age can vary by +15 bpm
for individuals not directly measured (of the same age).
Advantages and Disadvantages
of a Maximal Test
Advantages
1. More accurate
Disadvantages
1. Motivation is a factor
2. More risk involved
3. Time
4. Cost of equipment (if using metabolic cart)
Karvonen method for calculate THR
• MHR
= 220 – AGE
• MHR
= 206.9 - (0.67 x age)
• THR
MOR ACCURATE
= THR = ((HRmax − HRrest) × %Intensity) + HRrest