Functional Translation of Exercise Responses from Exercise Testing to Exercise Training: The Test of a Model.

Exercise prescription based on exercise test results is complicated by the need to downregulate the absolute training intensity to account for cardiovascular drift in order to achieve a desired internal training load. We tested a recently developed generalized model to perform this downregulation using metabolic equivalents (METs) during exercise testing and training. A total of 20 healthy volunteers performed an exercise test to define the METs at 60, 70, and 80% of the heart rate (HR) reserve and then performed randomly ordered 30 min training bouts at absolute intensities predicted by the model to achieve these levels of training intensity. The training HR at 60 and 70% HR reserve, but not 80%, was significantly less than predicted from the exercise test, although the differences were small. None of the ratings of perceived exertion (RPE) values during training were significantly different than predicted. There was a strong overall correlation between predicted and observed HR (r = 0.88) and RPE (r = 0.52), with 92% of HR values within ±10 bpm and 74% of RPE values within ±1 au. We conclude that the generalized functional translation model is generally adequate to allow the generation of early absolute training loads that lead to desired internal training loads.

Workload Accomplished in Phase III Cardiac Rehabilitation.

Exercise training is an important component of clinical exercise programs. Although there are recognized guidelines for the amount of exercise to be accomplished (≥70,000 steps per week or ≥150 min per week at moderate intensity), there is virtually no documentation of how much exercise is actually accomplished in contemporary exercise programs. Having guidelines without evidence of whether they are being met is of limited value. We analyzed both the weekly step count and the session rating of perceived exertion (sRPE) of patients (n = 26) enrolled in a community clinical exercise (e.g., Phase III) program over a 3-week reference period. Step counts averaged 39,818 ± 18,612 per week, with 18% of the steps accomplished in the program and 82% of steps accomplished outside the program. Using the sRPE method, inside the program, the patients averaged 162.4 ± 93.1 min per week, at a sRPE of 12.5 ± 1.9 and a frequency of 1.8 ± 0.7 times per week, for a calculated exercise load of 2042.5 ± 1244.9 AU. Outside the program, the patients averaged 144.9 ± 126.4 min, at a sRPE of 11.8 ± 5.8 and a frequency of 2.4 ± 1.5 times per week, for a calculated exercise load of 1723.9 ± 1526.2 AU. The total exercise load using sRPE was 266.4 ± 170.8 min per week, at a sRPE of 12.6 ± 3.8, and frequency of 4.2 ± 1.1 times per week, for a calculated exercise load of 3359.8 ± 2145.9 AU. There was a non-linear relationship between steps per week and the sRPE derived training load, apparently attributable to the amount of non-walking exercise accomplished in the program. The results suggest that patients in a community clinical exercise program are achieving American College of Sports Medicine guidelines, based on the sRPE method, but are accomplishing less steps than recommended by guidelines.