Exercise Programs

Variables in Program Design

An exercise session will typically start with a light warm-up (low-level exercise and stretching) and end with a cooldown (e.g., low-level exercise followed by stretching) to allow for a gradual increase and decrease in muscular activity and metabolic intensity.

The basic variables of an endurance training program design are as follows:

• 1.
  Intensity: This typically refers to the percentage of maximum oxygen consumption or percentage of maximum heart rate or heart rate reserve that results in a heart rate range for each individual to target during the exercise session. Exercise is typically done in a continuous form, but in some cases, intervals training might be used for more advanced athletic training programs. Ratings of perceived exertion (RPE) using the classic 6 to 20 Borg Scale can also be used to modify the intensity, especially when the heart rate range is predicted (e.g., using the Karvonen formula) rather than obtained directly from a graded exercise test (American College of Sports Medicine [ACSM], 2006). Program guidelines: Exercise with a target of 60% or 70% of the predicted maximal heart rate (HRmax = 220 – age) or 50% to 85% of the Vo2max when directly determined from a graded exercise test or 50% to 85% of the heart rate reserve (Karvonen formula: [(HRmax – HRrest) ? %Intensity + HRrest]). The key is to target a lower range, with peak heart rates not going over the upper limit. With a graded exercise test for patient populations, the function capacity is set clinically at the upper limit where no ECG or symptoms exist.
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• 2.
  Frequency: This refers to the number of times per week an exercise session should be planned. The ACSM recommends a frequency of three to five exercise sessions per week. For beginners, 48 hours of rest between exercise training sessions is recommended, and for advanced programs where exercise training is done each day, careful variation/periodization in the program whereby the same workout volume and intensity are not used each time is needed for optimal progression.
• 3.
  Duration: This refers to the length of time that an activity should be continued. The ACSM recommends that an exercise session be performed for between 20 and 60 minutes, not including warm-up and cooldown activities.
• 4.
  Volume: This refers to some measure of total work, including miles or kilometers covered, number of intervals, number of steps, and so on. The volume becomes an important factor in varying the training sessions.
• 5.
  Mode: This refers to the type of exercise used. Typically one uses whole-body exercise modes if both the upper and lower body muscles are capable of movement. Exercises such as running, jogging, stepping, cycling, swimming, cross-country skiing, aerobic dancing, and step aerobics are used to stimulate whole-body metabolism and the needed heart rate responses. When testing for fitness levels, one needs to keep in mind mode-specific testing, taking the modality that is most frequently used. For advanced athletes, using the same modality may be required, but careful variation/periodization is needed to avoid injury and overtraining.

Progression of the Aerobic Exercise Prescription

Each exercise training program should be individualized. For the fitness enthusiast, the activity should be enjoyable, especially for the average person interested in lifelong fitness and health outcomes. Cross-training using different modes of exercise can also help avoid overuse injuries and keep the exercise training fun. The exercise should start at the lower end of the prescription until physical and mental toleration is achieved. If the person is highly deconditioned, it should even start lower. A classic concept, “doing too much too soon,” is a major reason for early program injuries and/or overtraining even in advanced athletes.

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