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Assessing Cardiorespiratory Endurance

Assessing Cardiorespiratory Endurance. A Fitness Indicator. Determination of Fitness Level. Everyone possesses some degree of cardiorespiratory endurance (CRE)

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Assessing Cardiorespiratory Endurance

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  1. Assessing Cardiorespiratory Endurance A Fitness Indicator

  2. Determination of Fitness Level • Everyone possesses some degree of cardiorespiratory endurance (CRE) • CRE=a health associated component that relates to the ability of circulatory and respiratory systems to supply fuel during sustained physical activity and to eliminate fatigue products after supplying fuel.

  3. VO2 max • VO2 max is the most commonly used index to assess CRE • Definition - The largest amount of oxygen that an individual can utilize during strenuous exercise to complete exhaustion • Has become the accepted measure of CRE

  4. AEROBIC GLYCOLYSIS AND THE ELECTRON TRANSPORT CHAIN

  5. KREBS CYCLE

  6. METABOLISM OF FAT

  7. OXIDATIVE PHOSPHORYLATION

  8. VO2 max • Units • liters/minute or ml/minute (absolute) • ml/kg/min (relative to body weight) • ml/kg of FFM/min (relative to FFM) • Range 15 (sedentary with disease) to 75 (young endurance runner) ml/kg/min • Women about 10-20% lower than men

  9. Methods of Determining VO2 max • Submaximally • Maximally

  10. GXT • Graded Exercise Testing - GXT (incremental increases in workload) • 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]) • if HR does not reach steady state during the stage extend stage 1 minute

  11. GXT • General Guidelines • 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 .5-2 MET increments • closely observe subject for contraindications

  12. Submaximal Assumptions • 1. A steady-state HR is obtained for each exercise work rate • 2. A maximal HR for a given age is uniform (220-age)

  13. Assumptions • 3. Mechanical efficiency (ie. VO2 at a given work rate) is the same for everyone. • This may not be true and it has been suggested that submaximal exercise testing underestimates VO2max in the untrained and overestimates in the trained

  14. Submaximal Assumptions • 4. There is a linear relationship between HR and Workload • 5. HR will vary depending on fitness level between subjects at any given workload

  15. Age vs. HR

  16. Submaximal Protocols • Oxygen consumption for any given WL 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 WL does not vary between subjects

  17. EXERCISE INTENSITY AND OXYGEN UPTAKE

  18. Submax Protocols • HR does vary between subjects • rate of increase in HR depends on fitness level • The more fit you are the lower your HR at any given WL • An untrained person will reach their HR max at a lower WL vs. a trained person of the same age.

  19. HEART RATE AND INTENSITY

  20. HEART RATE AND TRAINING

  21. HR vs. Workload

  22. . HEART RATE, VO2, AND INCREASING WORK

  23. HR vs. WL and VO2

  24. Submaximal Protocols • 1. YMCA - bike • 2. Astrand Rhyming – bike • 3. ACSM - bike • 4. Bruce Protocol - treadmill • 5. McCardles Step Test

  25. YMCA • Multi-stage protocol • 3-4 consecutive 3 minute stages • HR between 110-150 bpm (the HR range at which the relationship between VO2 and WL is most linear)

  26. YMCA Procedures • 1. Adjust seat height (legs nearly straight when extended - 5º bend) • 2. Measure pre-exercise BP and HR with subject seated on bike • 3. Pedal at 50 rpm (if using a metronome - 100x/minute) • 4. Warm-up, zero resistance for 2-3 minute

  27. YMCA Protocol • 5. Stage 1 • .5 kp for 3 minutes • at every stage measure BP at 2.0 min (more often if hypertensive) • at every stage measure HR during last half of minutes 2 and 3 • if HR at 2 and 3 minutes differ by more than 6 bpm extend the stage for 1 min

  28. YMCA Protocol • 6. Stage 2 • Workload in this stage and successive stages depends on HR during stage 1 (p 75 guidelines) • 7. Continue test until HR recorded at two successive WL are between 110 and 150 bpm (for many this occurs during 2nd and 3rd WL)

  29. YMCA Protocol • 8. Note that if HR is greater than 110 at end of 1st stage then only one more stage is necessary • 9. At completion of test reduce resistance to .5kp and allow subject to pedal for at least 4 minutes or until HR falls below 100 bpm and BP stabilizes.

  30. YMCA Protocol • 10. The HR measured during the last minute of each stage is plotted against workload. • 11. The line generated from the plotted points is extrapolated to the age-predicted HR max • 12. A perpendicular line is dropped to the x-axis to estimate the work rate this person would achieve if taken to max.

  31. ACSM Bike Test • 1. 2-3 minute warm-up • 2. Take HR twice during each stage (3 minute stages) and RPE/BP once (similar to YMCA) • 3. If HRs are greater than 110, steady state should be reached (HRs within 6bpm) before increasing the workload

  32. ACSM • Protocol A B C (kgm/min) • Stage 1 150 150 300 • Stage 2 300 300 600 • Stage 3 450 600 900 • Stage 4 600 900 1200

  33. ACSM • Protocol Selection • BW Very Active • (kg) No Yes • <73 A A • 74-90 A B • >91 B C • *very active is defined as aerobic exercise 20 minutes, 3 days/week

  34. ACSM • 5. Terminate test when HR reaches 85% of age-predicted max HR or 70% of HR reserve • 6. Recovery at workload equal to the 1st stage or less for at least 4 minutes with HR, BP, and RPE monitored.

  35. ACSM • Plot HRs from last two stages to determine VO2max much like YMCA.

  36. Astrand Rhyming • Single-stage test (VO2 max is determined using 1 submaximal data point-HR) • Duration of test is 6 minutes

  37. Astrand Rhyming • 1. Adjust seat height (legs nearly straight when extended - 5º bend) • 2. Measure pre-exercise BP and HR with subject seated on bike • 3. Pedal at 50 rpm (if using a metronome - 100x/minute) • 4. Warm-up, zero resistance for 2-3 minute

  38. Astrand Rhyming • 5. Pedal rate is 50 rpm • 6. Determine Workload • unconditioned males - 300 or 600 kgm/min • conditioned males - 600 or 900 kgm/min • unconditioned females - 300-450 kgm/min • conditioned females - 450 or 600 kgm/min • 7. 6 minute test

  39. Astrand Rhyming • 8. At end of 2nd minute of pedaling take HR (BP at 1.25-1.5 min) • want the HR to be between 125-170bpm • if less than 125 increase resistance by 1 kp for men and 1/2 kp for women • if greater than 170 bpm decrease resistance by 1 kp • continue to monitor HR every minute until HR exceeds 125

  40. Astrand Rhyming • 9. At the end of the 5th and 6th minute take HR and average the two values (make sure values are within +6bpm to assure a steady state HR was obtained) • 10. BP at 4:30 and 5:30 • 11. Reduce resistance and cool-down for 4 minutes.

  41. Astrand Rhyming • 10. Determine VO2 from nomogram (p. 73 guidelines, p.69 Heyward) • 11. Age-correction factor (p. 74 guidelines, p.72 heyward) • 12. Convert to relative value

  42. Treadmill Tests • Bruce Protocol • Balke • Ellestad • Others……….

  43. Treadmill Protocols • Bruce and Ellestad • larger increments • use on younger and/or more physically active • Balke-Ware • smaller increments (1MET/stage or lower) • use on older, deconditioned, and/or diseased subjects

  44. Treadmill Protocol • Single-stage (using one data point) even though we may have more than one stage • May need to have a long accustomization period and explanation of procedures before beginning

  45. Bruce Treadmill Protocol • 1. Measure resting BP and HR while standing on the belt of the treadmill • 2. Ask subject to straddle the belt while starting treadmill at 1.7 mph and 0% grade • 3. Ask subject to begin walking and when comfortable release handrails • 4. This is a warm-up and should continue until subject is comfortable

  46. Bruce Treadmill Protocol • 5. Stage 1 • Increase grade to 10% • 3 minutes long • Measure HR at end of each minute and BP at end of each stage

  47. Bruce Treadmill Protocol • 6. 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) – Page 98 guidelines • 7. Once subject reaches proper HR terminate the test at the end of that stage

  48. Bruce Treadmill Protocol • 8. Reduce treadmill speed to 1.7mph and 5% grade and cool-down for 4 minutes. • 9. VO2 is estimated from the last minute of a fully completed stage

  49. Treadmill Protocol • 10. Calculate VO2 from the gender specific equations • Males • VO2=SMVO2 [(HRmax-61)/(HRSM-61)] • Females • VO2=SMVO2[(HRmax-72)/(HRSM-72)] • SMVO2 = submaximal VO2 from table or ACSM equations • HRSM = submax HR from test

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