Introduction to Exercise

For my second post, I want to give you a basic introduction to exercise, including defining some terms that you will probably see me use in future posts. If you are new to exercising or have not done it in a while, hopefully this will be helpful for you!

Before starting an exercise program, it is really important to determine if you need an exercise test and physician clearance. A great form is "Par-Q and You", a simple questionnaire from the Canadian Society for Exercise Physiology that you can fill out to help determine if you should see a physician before exercising. Another good guide is the "Health/Fitness Facility Preparticipation Screening Questionnaire" by the AHA and ACSM. Please note that, for all diabetic patients, it is best to see a physician before starting an exercise program (but more information on exercise testing and diabetes in the next post!).

The reason for pre-participation physician screenings is to ensure there are not any contraindications of exercise present. According to the ACSM's Guidelines for Exercise Testing and Prescription (9th ed., pg. 21-22), major signs and symptoms of cardiovascular, pulmonary, and metabolic disorders include: pain or discomfort in the chest, neck, jaws, or arms; shortness of breath at rest or with mild exertion; dizziness or loss of consciousness; dyspnea (abnormally uncomfortable awareness of breathing) at night that is relieved by sitting up or standing; swelling in the ankles; heart palpitations or fast resting heart rate (>100 bpm); intermittent claudication (pain in a muscle that is stressed by exercise, more information on this in the next post); heart murmur; and unusual fatigue or shortness of breath with normal activities.

Below are two important tables from the ACSM's Guidelines. The first table are the risk factors and defining characteristics of each for Atherosclerotic Cardiovascular Disease (CVD). The second table is a flow chart of need for exercise testing based on risk classification for CVD. Having only one risk factor puts you at low risk for CVD, having two or more puts you at moderate risk, and having a known cardiovascular, pulmonary, renal, or metabolic (diabetes!) disease puts you at high risk.

Atherosclerotic CVD Risk Factors and Defining Criteria

Exercise Testing Based on Risk Classification for CVD

Proper exercise programs should include cardiovascular training, resistance/strength training, and flexibility exercises. Exercise intensity is very important and can be defined by a variety of terms. One commonly used by professionals is MET level, with increasing METs being equivalent to increasing intensity. For example, walking at 3 mph is 3.0 METs, while jogging at 6 mph is 10.0 METs. An easy way to measure intensity while working out is by using heart rate (HR). Depending on the desired goal of exercise, exercisers should stay within a specific HR range (for instance, an unfit individual trying to lose weight should aim for HR = {[(220-age)*(0.40)] + 10 bpm}, with the target HR being 40% (0.40) of the maximum (220-age)). Trainers may use slightly more complicated (and accurate) equations to find the maximum HR, including the Karvonen Method. There are a number of charts available that measure RPE, or the Rate of Perceived Exertion. Popular in exercise science is a chart that ranges from 6-20, but modified ones are also available. As intensity increases, so does RPE (research also shows that, for the most part, HR also increases with RPE). Lastly, and very popular among older populations, is the "Talk Test". Using this test, an exerciser should be able to talk while exercising without getting too winded.

Light intensity exercise is <3.0 METs, HR not much above resting, and 6-9 on the RPE scale. Moderate intensity is 3-<6 METs, HR 40-60% maximum predicted HR, and 11-13 on RPE. Vigorous intensity exercise is 6+ METs, HR 60-100% max HR, and 15+ on RPE.

This concludes my short introduction to starting exercise. Look for my next post, which will be about exercise testing for diabetic individuals! Please post any comments or questions, if you have any!

Peace,

Emalee


Information for this blog came from the ACSM's Guidelines for Exercise Testing and Prescription, 9th edition (2014).