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Structured Exercise, Lifestyle Physical Activity, and Cardiorespiratory Fitness in the Prevention and Treatment of Chronic Diseases
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Barry A. Franklin, Thomas F. O’Connell
The most effective exercises for the endurance or conditioning phase include walking, graded walking, jogging, running, stationary cycle ergometry, combined arm-leg ergometry, outdoor cycling, swimming, rope skipping, and rowing. Complementary PA recommendations include resistance training (Grafe et al., 2018; Jurca et al., 2005; McCartney et al., 1993; Williams et al., 2007) and increased lifestyle activity (Andersen et al., 1999; Dunn et al., 1999), both of which provide independent and additive benefits to an aerobic exercise regimen. To improve aerobic capacity or CRF, the “minimum” or threshold intensity for training is ~40−50% of the VO2max, which corresponds to ~60−70% of the highest heart rate achieved during maximal or peak exercise testing. For patients who have not undergone recent exercise testing, we recommend the standing resting heart rate plus 20 to 30 beats/minute for the initial exercise intensity, using signs/symptoms and perceived exertion as additional intensity modulators (Franklin & Zhu, 2021). Over time, the exercise intensity should be gradually increased to 50−80% of aerobic capacity, which approximates 70−85% of the highest heart rate attained during exercise testing.
The Role of Physicians in Promoting and Prescribing Increased Physical Activity
Published in James M. Rippe, Increasing Physical Activity, 2020
The intensity level of exercise for most individuals should be “moderate.” A reasonable way of assessing this may be to recommend to patients that they should feel that they are exercising enough to slightly sweat, but they should not be exercising harder than would allow them to carry on a normal conversation if the goal is “moderate physical activity.” Another way of determining exercise intensity is based on heart rate. There are many different equations available to estimate heart rate. Probably the one that is most widely used is the equation 220 minus age, which predicts maximum heart rate. Then take 50–70% of that, which would constitute moderate intensity physical activity.
Exercise and Cardiovascular Disease: a Gender Difference
Published in Ronald R. Watson, Marianne Eisinger, Exercise and Disease, 2020
Patricia A. Brill, Christopher B. Scott, Neil F. Gordon
We have subjectively reviewed the literature concerning cardiovascular health enhancement and physical activity and tentatively propose that an energy expenditure of between 14 and 20 kcal/kg of body weight per week may be optimal.60 The amount and the range of this energy expenditure guideline are certainly premature and do not consider gender or health status differences but, nevertheless, provide a reasonable estimate of what may be needed. Almost any activity apparently can be used to obtain this figure, whether it be gardening, dog walking, ice skating, swimming, weight training, or jogging, provided it can be safely adopted by the sedentary individual. That is, individual activity preferences and safety concerns should represent primary considerations of the physical activity prescription. It is of note, however, that large muscle group activities (in particular, those involving the legs) that have been traditionally defined as aerobic (walking, running, biking, swimming, etc.) usually produce the greatest energy expenditure and, therefore, provide an easier means of obtaining the figures mentioned previously. For those individuals whose main goal is physical fitness improvement along with cardiovascular health improvement, it is recommended that in addition to achieving this level of energy expenditure, the exercise intensity should be sufficient to elicit a heart rate response in excess of 60% of the maximal heart rate.61Table 2 provides some insight into the wide variations of activity and energy expenditure that are available.
Clinical efficacy of aerobic exercise combined with computer-based cognitive training in stroke: a multicenter randomized controlled trial
Published in Topics in Stroke Rehabilitation, 2022
Ting-Ting Yeh, Ku-Chou Chang, Ching-Yi Wu, Chao-Jung Chen, I-Ching Chuang
The participants in the AE group performed progressive resistive stationary bicycle training14 (Figure 1). The participants first underwent 10 minutes of warm-up, followed by 45 minutes of resistive aerobic exercise, followed by 5 minutes of cool-down. The target heart rate during the aerobic period was 40–70% of the participant’s maximal heart rate (HRmax), calculated as (208 − 0.7 × age).15 The exercise intensity progressed as the participants improved their performance. The exercise intensity was increased from the initial 40–50% gradually increased to 60–70% HRmax over the 12 weeks. The therapist monitored closely for any adverse effects of the increased exercise intensity and downward adjustments if the exercise is not tolerated during the session.
A proof-of-concept trial of a community-based aerobic exercise program for individuals with traumatic brain injury
Published in Brain Injury, 2021
Kan Ding, Takashi Tarumi, Tsubasa Tomoto, Kathleen R. Bell, Christopher Madden, Marisara Dieppa, C. Munro Cullum, Song Zhang, Rong Zhang
The AET program was based on the national physical activity guidelines (20) and has been used in our previous studies that showed significant improvement of CRF in sedentary older individuals (21). The intensity, frequency, and duration of the AET program were based on each individual’s maximal heart rate (HR) assessed with peak oxygen uptake (VO2peak) testing, and progressively increased as participants adapted to workloads (21). Participants were instructed to gradually increase exercise intensity (from 50–60% to 70–80% of maximal HR) and duration (from 60 minutes in the first week (20 mins x 3 days) to a total of 150 mins a week by the end of the fourth week (30 mins x 5 days or 50 mins x 3 days)), then maintain this level for the remaining 8 weeks. Each training session included 5-minute warm-up and cool-down periods. Any modes of aerobic exercise were allowed as long as the subject maintained the prescribed training dose. Subjects wore an HR monitor (Polar RS400, Polar Electro, USA) to gauge training intensity. The SAT group received a stretching and toning exercise program that focused on both upper and lower body flexibility. In this group, participants were asked to exercise at the same frequency and duration as AET group but to keep their heart rate below 50% of maximal heart rate during each session. All study visits for the SAT control group were the same as those in the AET group, and all training activities were recorded in a standard log. Heart rate data were downloaded from the HR monitor and reviewed at the end of the study.
The relationship between heart rate and VO2 in moderate-to-severe asthmatics
Published in Journal of Asthma, 2020
Felipe A. Rodrigues Mendes, Renata Nakata Teixeira, Milton A. Martins, Alberto Cukier, Rafael Stelmach, Wladimir Musetti Medeiros, Celso R. F. Carvalho
Asthma is a chronic inflammatory disorder of the airways that causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing (1). Recently, studies from our and other groups have demonstrated that moderate or intense exercise training is an important adjuvant treatment to improve health-related quality of life (HRQoL) (2, 3), asthma control (4–6), airway hyperresponsiveness (7, 8), and physical fitness (2, 4) in subjects with moderate-to-severe asthma. According to the American College of Sports Medicine (ACSM) (9), exercise prescriptions should include intensity, frequency, duration, mode of training, and rate of progression. Intensity is an essential part of a training program (10), and adequate exercise intensity is crucial to achieve benefits and avoid risks.