Exercise Prescription
Selected Terms
• Activity Pyramid A graphic summary of guidelines underlying both
the lifestyle and formal exercise approaches to physical fitness.
• aerobic fitness The ability to continue or persist in strenuous tasks
involving large muscle groups for extended periods of time. Heart and
lung fitness based on performing such activities as running, cycling,
swimming, and sports, 3-5 days per week, at 50-85% VO2max, for 2060 minutes each session.
• cool-down The transition period after the aerobic session where one
slowly decreases the heart rate by keeping the feet and legs moving
for 5 to 15 minutes through mild aerobic activity.
• F.I.T. guidelines Frequency, intensity, and time guidelines for
building aerobic fitness.
• flexibility exercises A system of exercises that improve the range of
motion around the body’s joints.
• formal exercise program An approach to building physical fitness
based on specific guidelines for aerobic and muscular fitness. A
specific time and place is designated to exercise.
Glossary (continued)
• Frequency of exercise The number of exercise sessions per week
recommended for building aerobic fitness in the exercise program. To
build both aerobic fitness and keep body fat at healthy levels, one needs
to exercise at least 3-5 days each week. The lifestyle approach
recommends at least 30 minutes of physical activity on most days of the
week.
• high intensity weight lifting Development of muscular strength when the
weight is heavy and the repetitions to maximum are low, about 4 to 6.
• high or vigorous intensity 75% and higher of the maximum heart rate
reserve or VO2max. This level of effort is for athletes desiring a high level of
fitness.
• intensity of exercise The intensity of effort needed to build aerobic
fitness: between 50% and 85% of the maximum heart rate reserve. If the
fitness level is low, intensity of effort can start at 40%, with a gradual
progression towards a higher intensity.
• lifestyle approach to physical activity Emphasizes that everyone should
attempt to accumulate 30 minutes or more of moderate-intensity physical
activity over the course of most if not all days of the week.
• light intensity 40% to 59% of the maximum heart rate reserve or VO2max.
This intensity range is reserved for those starting an exercise program
after years of inactivity.
Glossary (continued)
• low intensity weight lifting Development of muscular endurance when the
weight is somewhat light and the repetitions to fatigue are high, about 15 to
20.
• maximum heart rate The maximum attainable heart rate at the point of
exhaustion from all-out exertion. The maximum heart rate can be estimated
by using the formula 220 minus the age.
• maximum heart rate reserve The difference between the maximum heart
rate and the resting heart rate.
• moderate intensity weight lifting Development of both muscular strength
and endurance when the weight is moderate and the repetitions are 8-15.
• moderate intensity 60% to 74% of the maximum heart rate reserve or
VO2max. This is the normal training range for most people.
• muscular fitness Muscular strength, muscular endurance, and flexibility,
gained by lifting weights, doing calisthenics, engaging in physical labor, and
stretching 2 to 3 times per week.
• overload principle To develop muscular strength and endurance, push the
muscles to fatigue, lifting weights that are heavier than one is accustomed
to.
• overtraining Defined as pushing exercise training beyond one’s ability to
recover, leading to incapacitating fatigue, injury, and a loss of desire to
Glossary (continued)
• progressive resistance principle The resistance or pounds of weight
against which muscles work should be increased periodically as gains in
strength and endurance are made until one reaches the desired level.
• repetition One weight-training or calisthenic movement
• repetitions maximum The maximum number of repetitions that one can lift
a certain weight.
• RPE scale The rating (R) of perceived (P) exertion (E) scale is a number
scale between six and 20 that indicates how the exercise feels to an
individual at a given moment.
• set A certain number of weight-training or calisthenic repetitions.
• static stretching Exercises that slowly apply a stretch to a muscle group,
with this position held for 10 to 30 seconds.
• training heart rate The exercise heart rate, estimated with this formula:
Training heart rate = [(maximum HR - resting HR) x 0.50 to 0.85] + resting
HR.
• training heart rate zone The heart rate range between 50% and 85% of
maximum heart rate range for all age groups.
• warm-up The 5 to 20 minute transition period that precedes the aerobic
exercise session. The primary purpose of the warm-up is to prepare the
body for vigorous exercise by performing mild-to-moderate aerobic activity.
What to do with what you’ve
got…
• So far you’ve:
– Met the client, obtained consent, conducted a health
history, and ascertained their goals
– Risk stratified
– Chosen appropriate tests to conduct based on goals
and health history
– Calculated the results of their tests
– Where do you go from here????
– Let’s look at some different types of training for
each of the areas we’ve assessed.
Systems for building fitness
• The lifestyle approach
• Seeks to increase opportunities for physical activity
throughout the daily routine and accumulate 30 minutes or
more over the course of most if not all days of the week.
This is the minimum amount of physical activity that
improves the quality of life while decreasing the risk of most
chronic diseases. Additional health and fitness benefits can
be achieved by adding more time in moderate-intensity
activity, or by substituting more vigorous activity.
• The formal exercise program
• Builds aerobic and muscular fitness to high levels through an
exercise system based on specific frequency, intensity, and
time guidelines.
Physical Activity
Pyramid
• The CDC-ACSM lifestyle approach
and ACSM formal approach to
exercise prescription are
components of the same
continuum of physical activity
recommendations that meet the
needs of almost all individuals to
improve health status.
Physical Activity Pyramid
• The lifestyle approach to fitness is at the base of the
Activity Pyramid. This is a good start and brings basic
health and fitness benefits. But higher levels of
aerobic and muscular fitness can be achieved by
working up the Activity Pyramid.
• The formal exercise program is summarized on
levels 2 and 3 of the Activity Pyramid.
– The aerobic or cardio-respiratory stage of a
comprehensive physical fitness program consists of three
segments:
• Warm-up---the 5 to 20 minute transition period that precedes the
aerobic exercise session.
• Aerobic exercise---brisk walking, swimming, cycling, running, or
active sports for 20-60 minutes, 3-5 days per week.
• Cool-down—the warm-up in reverse. Keep the feet and legs moving
for 5 to 15 minutes after intense exercise by walking, jogging lightly,
or cycling slowly.
Physical Activity Pyramid
(Continued)
– Muscular fitness means having strong and enduring
muscles, and flexible joints.
• Muscular strength and endurance---gained by lifting weights, doing
calisthenics, and engaging in hard physical labor (e.g., chopping
wood). Perform a minimum of 8-10 separate exercises that train
the major muscle groups. Perform one set of 8-12 repetitions of
each of these exercises to the point of fatigue, and do this at least
2-3 days per week.
• Flexibility---stretch at least 2-3 days a week and involve at least
four repetitions of several stretches that are held 10-30 seconds at
a position of mild discomfort.
• Reduce sitting time. Americans spend far too
much time sitting watching TV, playing video games,
viewing the Internet, driving cars, and watching
other people play sports.
Ways to Increase Lifestyle
Physical Activity
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Walk, cycle, jog, or skate to work, school, or the store
Park the car farther away from your destination
Get on or off the bus several blocks away
Take the stairs instead of the elevator or escalator
Walk the dog
Play sports with the kids
Take fitness breaks instead of coffee breaks
Perform gardening, landscaping, or home repair
activities
• Avoid labor-saving devices as much as practical
• Take a walk after supper instead of watching TV
Exercise Prescription = the process of
designing a regimen of physical activity in
a systematic and individualized manner,
based on results of fitness tests.
• Five essential components of
exercise prescription
– Frequency
– Intensity
– Time
– Type
– Progression
Cardio-respiratory Endurance
• Step 1 Warm-up
– Slowly elevate the pulse and body temperature to an aerobic training level by first
engaging in 5-20 minutes of easy-to-moderate aerobic activity.
• Step 2 Aerobic Exercise
– F.I.T. guidelines: Based on current fitness level, follow the F.I.T. guidelines
– Fitness
Low Fitness
Average
High
• Frequency (sessions/week)
3
• Intensity (% HR reserve)
40-59%
• Time (minutes/session)
10-19
3-4
60-74%
20-29
5 or more
75-85%
30-60
– Intensity Calculate personal training heart rate using this formula:
– Training heart rate = [(Maximum HR - resting HR) x intensity %] + resting HR
– Aerobic Exercise Mode (Type) Select 2-3 exercise modes based on personal
goals.
• Step 3 Cool-down
– Slowly decrease the heart rate and body temperature by engaging in mild-tomoderate aerobic activity for 5-15 minutes.
Mode (Type) of Exercise
• If frequency, intensity, and duration of
training are similar, and a minimum of
200-400 Calories are expended during
the session, the training result is
independent of the mode of aerobic
activity.
An Exercise Program To Build Flexibility
Step 1 Warm-up aerobically
– Never stretch unless the muscles and joints are
warm from 5-15 minutes of moderate aerobic activity.
Step 2 Follow these minimum flexibility program
guidelines:
– Frequency: 2-3 days per week, or after each aerobic
workout.
– Time: hold each position short of the pain threshold for 1030 seconds, and repeat four times (total time, about 15
minutes). Relax totally, letting your muscles slowly go limp
as the tension of the stretched muscle slowly subsides. Be
sure that you do not stretch to the point of pain to avoid
injury and a tightening recoil of the muscle.
– Stretching positions: Improve flexibility in several body
areas with 8 specific stretching exercises.
Muscular Strength and
Endurance:Total Fitness Workout
• A good “total fitness” workout routine that would take
about 1 to 1.5 hours to complete could be organized
as follows:
– Warm-up: 5-10 minutes of easy-to-moderate aerobic activity.
– Aerobic exercise: 20-30 minutes of moderate-to-vigorous
aerobic activity.
– Cool-down: 5-10 minutes of mild-to-moderate aerobic
activity.
– Stretching: 5-15 minutes of static stretching, emphasizing all
major muscle groups and joints.
– Weight lifting: 20-30 minutes of weight lifting, one set of 8-12
repetitions of 8-10 different exercises covering all the major
muscle groups.
Muscular Strength and
Endurance
• ACSM recommends this minimum
muscular fitness training program:
– 2-3 d/wk, minimum of 1 set of 8-12 reps of
8-10 different exercises.
– Older people (50-60 yrs of age and above)
may want to emphasize lighter weights and
more reps (10-15).