Aerobic endurance exercise

Step 3 of Exercise program design

Pasted image 20260317002843.png

Individualised based on
- results of clinical evaluation/history/fitness tests
- low vs high risk patient
- demographic characteristics
- goals of the patient
- behavioural characteristics
For most adults, an exercise program including aerobic, resistance, flexibility and neuromotor exercise training is indispensable to improve and maintain physical fitness and health
Some individuals will want to or need to include only some of the health-related components of physical fitness in their training regimen or exercise less than suggested by the guidelines
Performing some exercise is beneficial, especially in inactive or deconditioned individuals
- should be encouraged except where there are safety concerns

Aim:
- increase cardiorespiratory fitness and health
  - aerobic activities using large muscle groups in a continuous, rhythmical fashion
Types of exercises categorised according to skills/number of body parts
- A: cycling, walking, aqua aerobics,...
- B: jogging/running, rowing, spinning, step aerobics,...
- C: aerobic dancing, rope skipping, swimming, cross-country skiing,...
- D: basketball, soccer, racket sports,...
Continuous training method
- More expensive(?)
- Higher intensity
Interval training method
- peak workload intensity (Ppeak)
- Peak workload duration (tpeak)
- Recovery load (Prec)
- Recovery duration (trec)
- Mean load (Pmean)
- Number of intervals
≠ categories
- Long intervals: 3-15 minutes at 85% to 90% of VO2peak
- Moderate intervals: 1-3 minutes at 95-100% of VO2peak
- Short intervals: 10 seconds at 100% of peak power output or using BORG
- !!!! AND one can play with INTENSITY in all of these categories
Low intensity interval training
High intensity interval training
Choice of exercise also depends on 'how easily the exercise intensity can be graded' and adjusted
- E.g. bench step aerobicc
  - different heights
  - different cadences
  - adding handheld weights
- Rope skipping
  - 11.5-12.7 METs
  - no change with increasing speed

Overload principle!
- minimum intensity is needed (= minimum threshold) to challenge the body to result in increased physical fitness.
Initial intensity for apparently healthy ranges between 40-50% (moderate) to 85-90% HRR or VO2 reserve
- ≠ between individuals
- ≠ health benefits aimed for
There is a positive dose response of health/fitness benefits that results from increasing exercise intensity

Pasted image 20260317153412.png

Moderate (e.g. 40-59% HRR or VO2R) to vigorous (e.g. 60-89% HRR or VO2R) intensity aerobic exercise is recommended for most adults, and light (e.g. 30-39% HRR or VO2R) to moderate intensity aerobic exercise can be beneficial in individuals whoa re deconditioned or older individuals

Number of sessions/week
Depends on
- goals: health vs fitness
- fitness level: poor vs fair to excellent
- preferences, time constraints
- duration, intensity
3 days a week is sufficient to improve but 3-5 days seems optimal
- improvements in cardiorespiratory fitness (CRF) are attenuated with exercise frequencies more than 3d/week and a plateau in improvement with exercise done more than 5d/week
- vigorous intensity exercise performed more than 5d/week might increase the incidence of MSK injury, so this amount of vigorous intensity, physical activity is not recommended for adults who are not well conditioned

moderate intensity, aerobic exercise done at least 5d/week
vigorous intensity, aerobic exercise done at least 3d/week
a weekly combination of 3-5d/week of moderate and vigorous intensity exercise is recommended for most adults to achieve and maintain health/fitness benefits

Most adults should accumulate 30-60 mins/day (>/= 150min/week) of moderate intensity exercise, or a combination of moderate and vigorous intensity exercise daily to attain the recommended targeted volumes of exercise
This recommended amount of exercise may be accumulated in one continuous exercise session or in bouts of >/= 10 mins over the course of a day
Durations of exercise less than recommended can be beneficial in some individuals
Accumulated bouts of 10 mins
- Evidence for VO2max
- Little evidence with regards to other risk factors
Weekend warrior
- Lower rates of mortality compared to sedentary
- Only in individuals without CV disease

Physiological changes enable the individual to increase the total work performed.
Greatest conditioning effect: week 1-8
- +3%/ week first months
- +2% /week in month 2
- +1%/week from month 3 on
Overload (adjustments in intensity/duration/frequency) is needed for continuous progression
- Age: slower in elderly
- Health status
- Initial fitness level: more in less fit (40 % in sedentary vs 5% in elite)

Progression should be made during exercise program, in which first duration / frequency of the exercise session should be achieved before increasing the exercise intensity
When changes in physical fitness occur as a result of training, the VT1 and VT2 should be re-assessed to re-establish a proper exercise intensity, if feasible
General rule: 5- 10% per week
Take it slow!
- MONITOR for adverse effects (adjust downward if not well tolerated!)