Generalized Approach to Translating Exercise Tests and Prescribing Exercise.

Carl Foster,John P Porcari,James D Anholm,Daniel Boullosa,Jos J De Koning,Salvador J Jaime,Giancarlo Condello,Daniel Bok,Alejandro Lucia,Cristina Cortis,Andrea Fusco,Jose A Rodriguez-Marroyo,Kim Radtke

doi:10.3390/jfmk5030063

Abstract

Although there is evidence supporting the benefit of regular exercise, and recommendations about exercise and physical activity, the process of individually prescribing exercise following exercise testing is more difficult. Guidelines like % heart rate (HR) reserve (HRR) require an anchoring maximal test and do not always provide a homogenous training experience. When prescribing HR on the basis of % HRR, rating of perceived exertion or Talk Test, cardiovascular/perceptual drift during sustained exercise makes prescription of the actual workload difficult. To overcome this issue, we have demonstrated a strategy for “translating” exercise test responses to steady state exercise training on the basis of % HRR or the Talk Test that appeared adequate for individuals ranging from cardiac patients to athletes. However, these methods depended on the nature of the exercise test details. In this viewpoint, we combine these data with workload expressed as Metabolic Equivalent Task (METs). We demonstrate that there is a regular stepdown between the METs during training to achieve the same degree of homeostatic disturbance during testing. The relationship was linear, was highly-correlated (r = 0.89), and averaged 71.8% (Training METs/Test METs). We conclude that it appears possible to generate a generalized approach to correctly translate exercise test responses to exercise training.

Highlights

Exercise is a very positive health behavior
The main finding of this viewpoint was that it appears possible to generalize previous studies [38,39,40,41,42,43,44] intended to “translate” exercise test responses into exercise prescriptions, by expressing the workload as Metabolic Equivalent Task (METs). It appears that steady state exercise training at 65–75% of the workload yielding a particular marker of exercise intensity (i.e., % HRR, Rating of Perceived Exertion (RPE), Talk Test) during exercise testing will yield comparable responses during exercise training
The results are consistent with the finding of de Koning et al [45] that ventilatory threshold (VT) occurs at about 50% of peak power output and that most exercise training, whether for athletes [26] or non-athletes [19], takes place at intensities

Summary

Introduction

Exercise is a very positive health behavior. As far back as Hippocrates in the 4th century Before Common Era (BCE) and Galen in the 3rd century BCE, the concept of mens sana in corpore sano “a healthy mind in a healthy body” has been one of the cornerstones of medical practice. Despite the development of significant diagnostic and therapeutic medical options, the incidence of both diseases rose steadily through the first 70 years of the 20th century and began to decline after the 1962 publication of the United States Surgeon General’s recommendations against smoking [2] and Cooper’s Aerobics in 1968 [3], which essentially launched the “jogging” movement. There is, paradoxically, a slight excess in mortality above ~75 MET hours per week [9,10,11]. This is paralleled by a progressive reduction in the probability of cardiovascular events with increases in the number of steps accumulated per day [12,13,14]

Objectives

Findings

Discussion

Conclusion