Basic Concepts in Exercise Physiology

M. Arslan Aslam (DPT)

 Learning Objectives
 What is Exercise Physiology?
 What do we study in Exercise Physiology?
 What are the basic concepts in Exercise Physiology
 A basic concept of Exercise Prescription for health, fitness and among special populations
 Energy Systems in Exercise
 From where do you study Exercise Physiology
 Careers in Exercise Physiology
 What is Exercise Physiology?
 Exercise physiology is the study of the body’s responses to physical activity. These responses
include changes in metabolism and in physiology of different areas of the body like the heart,
lungs, and muscles, and structural changes in cells. 
 What do we study in Exercise Physiology?
 Control of Internal Environment
 Common measurements in Exercise Physiology
 Exercise and the Immune System
 Cardiovascular Responses to Exercise
 Respiration During exercise
 Temperature Regulation during Exercise
 Hormonal Responses to Exercise
 Physiology of Training: Effect on VO2 Max, Performance, and Strength
 Exercise Tests to Evaluate Cardiorespiratory Fitness
 Exercise Prescriptions for Health, Fitness, and Special Populations
 Factors affecting Performance
 Laboratory Assessment of Human Performance
 Training for Performance
 Training for Female Athlete, Children, and Special Populations
 What are the Basic Concepts in Exercise Physiology?
 What is VO2 max?
 Recognize the basic principles of exercise physiology
 Identify fundamental transient or permanent adaptations of different
systems in response to exercise
 Principles of training
 Apply the principles of exercise physiology to prescribe exercises that
prevent or decrease certain chronic conditions and attain maximum results
in their goal.
 What are the basic principles of training? What type of energy systems are
involved in different sports?
 VO2 Max
  VO2 max is the maximum capacity of an individual's body (cardiovascular system) to transport and use
oxygenated blood to large muscle mass during incremental exercise.
It is also called maximal aerobic power or maximal oxygen uptake.
It is closely linked to the functional capacity of cardiovascular system to deliver blood to the muscle
during maximum and supra-maximum exercise, while maintaining mean arterial pressure.
VO2 max can be calculated by Fick Equation: -


Whereas
It is expressed as: -
 Absolute value (L/min).
 Relative rate (ml/kg/min).
 Percentage.
 Testing Procedures
 Field Tests
• Maximum Run Test
• Walk Test
• Canadian Home Fitness Test

 Graded Exercise Test

• Treadmill
• Cycle Ergometer
• Stepping bench
 Principles of Training
 Overload
 Training must be raised to a higher level than normal to create the extra demands to
which the body will adapt.
 This can be done in three ways:
1. Increase the intensity
2. Increase the frequency
3. Increase the duration
 Specifity
• Training must be geared towards the needs of the specific sporting activity in order
to improves fitness of the body parts that the sport uses.
 Reversibility
• Gains are lost when overload is removed
Cardiovascular Changes
with Exercise
 Cardiac Hypertrophy with Long-term Exercise
 Athlete’s heart
 Physiological, Eccentric Hypertrophy
 Occurs in response to healthy exercise or pregnancy
 Occurs in response to volume-overload
Normal Heart Left Ventricular
Hypertrophy
Changes in Respiration due to Exercise
 Exercise Prescription
 Exercise prescription commonly refers to the specific plan of fitness-related activities that are designed for a
specified purpose, which is often developed by a fitness or rehabilitation specialist for the client or patient.
 The concern about the proper dose of exercise needed to bring about a desired effect (response) is similar to the
physician’s need to know the type, quantity, and duration of the taken to cure a disease.
 An exercise dose reflects the interaction of intensity, frequency, type, and duration to yield the volume of exercise.
 Exercise dose is characterized by: -
• Frequency of exercise
• Intensity of exercise
• Time (duration) of exercise
• Type of exercise
 It is usually characterized by FITT principle, where F = Frequency, I = Intensity, T = Time (duration) and T =
Type of exercise.
 Exercise Prescription for Cardiorespiratory Fitness
The
 exercise program includes dynamic, large-muscle activities such as walking, jogging, running, swimming, cycling, rowing and dancing.
 
Frequency

 The frequency of exercise is higher for moderate-intensity exercise ( 5 days/week).

 The frequency of vigorous-intensity exercise is less ( 3 days/week).
 2–4 sessions per week minimum for moderate-intensity exercise.
 2 sessions per week with higher-intensity exercise.
Intensity

 Intensity is the overload on cardiovascular system needed to bring about a training effect.
 Intensity threshold for a CRF training effect is lower for less fit (sedentary people) and higher for more fit persons.
 About 60-80% of VO­2 max is the range sufficient for most people to achieve CRF goals.
 Range of heart rate values associated with exercise intensity needed to have CRF training exercise intensity needed to have CRF training effect is
known as target heart rate (THR) range.
Time (Duration)
 Duration is associated with intensity of exercise. Improvements in cardiorespiratory fitness is when minimal threshold of intensity is achieved.
 Greater duration of work is required with low intensity exercise and low duration of exercise is required with high intensity.
 Sedentary persons can more easily accomplish an exercise session of low intensity and long duration than the reverse and achieve the health-related
benefits of physical activity with minimal risk.
 Total work per session should be about 200-300 kCal.
 Duration must be considered with intensity.
Type of Exercise
 Usually aerobic exercises are considered which involves large muscles. Example cycling, swimming, and running.
Type II Diabetes Mellitus
 Exercise Prescription for Type II Diabetes Mellitus
Aerobic Exercise Training
 Exercise 3-7 days/week.
 Work at 40-85% heart rate reserve or 12-16 on the 6-20 rating of perceived exertion scale.
 20-60 minutes per session. Total workout duration of one week must be 150 minutes of moderate-intensity or 75 minutes of vigorous-
intensity.
 Use nonweight-bearing, low-impact activities (bicycle or stationary cycle, swimming, water exercise), if weight-bearing activities are
contraindicated.
Resistance Exercise Training
 Exercise 2-3 days/week.
 Work at 60-80% 1-RM; approximately 11-15 on 6-20 rating of perceived exertion scale.
 Do 1-3 sets of 8-12 repetitions for major muscle groups.
 Avoid the Valsalva maneuver.

Recommendations
 Follow a schedule for both aerobic and resistance training program.
 Drink more fluid and have carbohydrates available.
 Exercise in supervision with someone who can help in an emergency.
 Exercise Prescription for Asthmatics
The aerobic exercise program recommendations for those with asthma include;
Frequency
At least 2-3 days/week.
Intensity
60% of VO2 peak or the work rate at the ventilatory threshold.
Time
At least 20-30 minutes/day.
Type
Usuallyaerobic exercises but swimming is considered better than other types of exercise, given that air
above the water contains more moisture.
 Effect of Exercise on Hypertension
 Exercise is recommended for all because it reduces the risk of coronary artery disease,
even if blood pressure is not reduced.
 Both fitness and physical activity are inversely related to the development of
hypertension.
 Endurance exercise is associated with a 5-7 mmHg reduction in resting blood pressure
in people with hypertension.
 The standard American College of Sports Medicine exercise prescription of
improving VO2 max is effective in reducing blood pressure in people with
hypertension.
 Exercise in the moderate-intensity range (40-59% of heart rate reserve) is effective.
 Frequency of exercise is do it most days per week.
 Duration of activity is to do at least 30 minutes per session.
 This should be supplemented by resistance training at 60-80% 1-RM.
In addition to exercise, following are the
recommendations to help lower the blood pressure;
 Lose weight, if overweight.
 Limit alcohol intake. Stop smoking.
 Reduce sodium (salt) intake.
 Maintain adequate dietary potassium. Eat a diet rich in fruits, vegetables, low-fat dairy
products.
 Reduce dietary fat, saturated fat and cholesterol intake.
 For recreational athletes who are hypertensive and need medication to control blood
pressure, the preferred drugs are the angiotensin-converting enzyme inhibitors and calcium
channel blockers. Blood pressure should be checked frequently so that dosage can be altered
by the physician.
 Cardiac Rehabilitation
 Exercise training is now accepted a part of therapy for patients with cardiac disease.
 Cardiac rehabilitation is different for different patients depending upon type and severity of illness.
The persons served by cardiac rehabilitation programs include: -

 Angina Pectoris

 Myocardial Infarction
 Angioplasty
 Coronary Artery Bypass Graft Surgery (CABGS)
 Angina Pectoris
 Angina pectoris is the chest pain related to ischemia of the ventricle due to
occlusion of one or more of the coronary arteries.
 The symptoms occur when the work of the heart exceeds a certain value.
 The work on heart is estimated by the double product (mentioned earlier on
page).
 Medical treatment includes nitroglycerin and β-blockers.
 Exercise training supports this drug effect. As the person becomes trained, the
heart rate response at any work rate is reduced.
 This allows the individual to take on more tasks without experiencing the chest
pain.
 Myocardial infarction (MI)
 These patients have actual heart damage (loss of ventricular muscle) due to a prolonged occlusion of one
or more of the coronary arteries.
 These patients are on medications to reduce the work of heart and control arrhythmias.
 These patients experience a training effect similar to those who do not have a myocardial infarction.
 Coronary artery bypass graft surgery (CABGS)
 These patients have had surgery to bypass one or more blocked coronary arteries.
 The success of the surgery is dependent on the amount of heart damage that existed prior to
surgery, as well as the success of the revascularization itself.
 These patients benefit from exercise training because most are deconditioned prior to surgery
as a result of activity restrictions related to chest pain.
 Exercise also improves the chance that grafted vessels will remain open.
 Cardiac rehabilitation program helps the patient to differentiate angina pain from chest wall
pain related to the surgery.
 Percutaneous Transluminal Coronary Angioplasty (PTCA)

 In this procedure, the chest is not opened; instead, a balloon-tipped catheter (a long, slender tube) is
inserted into the coronary artery.
 In the coronary artery, the balloon is inflated to push the plaque back toward arterial wall.
 Stents may be used in the PTCA procedure to help keep the artery open.
 Exercise Programs in Cardiac Rehabilitation
Exercise Programs
Cardiac rehabilitation includes a Phase 1, Phase 11 and Phase 3 program.

Phase 1 Program
 Phase 1 includes inpatient exercise program that is used to help the patients make transition from the
cardiovascular event to the time of discharge from the hospital.
 Specific signs and symptoms exhibited by the patient are used to determine whether the patient should
do exercise program and when to terminate the exercise session.
 Patients engage in monitored low level exercise and receive patient education.
Phase 2 Program
 After the patient is discharged from hospital, a phase II program of exercise can be started at home.
 Includes warm up with stretching, endurance and strength exercises and cool down activities as for
healthy individuals.
 CHD patients who are very deconditioned require only light exercise to achieve their target heart rate.
 Target heart rate is determined from GXT results (220 –age cannot be used).

Phase 3 Program
 Phase 3 program begins away from the hospital where there is less supervision, except for the ability to
respond to an emergency. It is usually home-based.
 Effects and Benefits of Cardiac Rehabilitation
 Improves VO2 max, higher work rates and increased capacity to perform prolonged sub-maximum work,
improved lipid profile (lower total cholesterol and higher HDL cholesterol).
 Should be combined with diet, medication and counseling.
 Exercise during Pregnancy
 Pregnancy places special demands on a woman due to developing fetus’s needs for calories, protein,
minerals, vitamins and physiologically stable environment needed to process these nutrients.
 Pregnant woman should begin with thorough physical examination.
 A pregnant woman should consult with her physician before starting a physical activity program.
Relative contraindications for Exercise during Pregnancy Absolute contraindication for Exercise during Pregnancy
 Severe anemia  Hemodynamically significant heart disease
 Unevaluated maternal cardiac arrhythmia  Restrictive lung disease
 Chronic bronchitis  Cervical incompetence
 Uncontrolled diabetes mellitus type I  Multiple gestation at risk for premature labor
 Extreme obesity or underweight  Persistent 2nd and 3rd trimester bleeding
 Extremely sedentary life style  Premature labor in current pregnancy
 Intrauterine growth retardation in current pregnancy  Ruptured membranes
 Poorly controlled hypertension  Placenta previa after 26th weeks of pregnancy
 Seizure disorders  Pre-eclampsia
 Poorly controlled hyperthyroidism
 Heavy smoking
 Exercise Recommended for Pregnant Woman
In the absence of medical or obstetric complications a woman can follow;
 150 minutes/week of moderate-intensity physical activity.
 Exercise in supine position should be avoided because of risk of reduced venous return and orthostatic
hypotension.
 Weight supported activities are encouraged.
 For women doing structured exercise programs, Canadian guide lines suggest a talk test to set exercise intensity.
 Talk test is reduce intensity when speech cannot be continued without pause to catch one’s breath.
 The rating of perceived exertion (12-14 on the original Borg scale) is also used to set exercise intensity.
 Following heart rate changes are for further guidance;
 140-155b/min---less than 20 years old.
 135-150b/min---20-29 years old.
 130-145b/min---30-39 years old.
 125-140b/min---40 years or older.
Characteristics of Energy Systems
Energy System of Human Body
 Energy Systems in Soccer
Socceris a form of football game played by two teams of eleven players with a sphere ball which may not be handled during play except by
the goalkeepers and by players during throw-in.
Training to Improve ATP-PC system for Soccer
 Soccer game play is made up of many short bursts of high intensity exercise.
 Training to improve mainly the ATP-PC system is utilized because it maximizes the ATP production. To improve anaerobic capacity,
extremely high-intensity exercise needs to be conducted.
Anaerobic Training to Improve Soccer
The most popular form of anaerobic training among soccer players is interval training of high-speed/high-intensity exercise followed by
periods of rest or low activity.
Aerobic Training to Improve Soccer
An effective way to gain better aerobic levels as a soccer player is to perform tempo runs. When running, always try to keep in mind to be
relax, bend the upper body forward and move fast with the arms.
Soccer specific exercise using ball dribbling or small group play may be performed as aerobic interval training. Heart rate monitoring during

soccer specific exercise is a valid indicator of actual exercise intensity.

Strength Training to Improve Soccer Skills
Strength training induces greater performance improvements in jump actions than in running-based activities, and these achievements
varied according to the motor task.  
Weight training exercises focusing on the back and abdomen will develop the core, stabilizing the body and allowing the quick cuts
essential to soccer moves.
Arm exercises help not only goalkeepers and field players with throw-ins but balance the body when changing directions. And all soccer
players need powerful quadriceps and hamstrings for speed and power.
 Energy Systems in Cricket
Cricket is
a bat-and-ball game played between two teams of eleven players on a field at the centre of which is a 20-metre
(22-yard) pitch with a wicket at each end, each comprising two bails balanced on three stumps.
Cricket is predominantly a throwing sport; the shoulder joint must be both flexible and strong.
Aerobic System
 The aerobic system is relied upon by bowlers and batsmen in cricket. The batsmen rely on it if they are playing a long
innings and are constantly running between the wickets. This constant running would use up the ATP-PC and anaerobic
system and start to use the aerobic system after a short time in to a batsman innings. A bowler would require the aerobic
system if they were bowling a long spell of overs and were constantly running on to bowl.
ATP-PC System
 Bowlers use the ATP-PC system when they sprint in for their run up. As the run up is usually done in a few seconds and is
high intensity it uses up the energy provided by the ATP-PC system. But as the system runs out quickly the bowler can
generally use it once per over as an ‘effort ball’.
 Batsmen use the ATP-PC system in running between the wickets as it usually a short, high intensity burst of energy lasting
a few seconds.
 A fielder would use this system when chasing down the ball in the outfield as it would be a high intensity short burst of
sprinting to reach the ball again lasting a few seconds.
Anaerobic System
 Bowler, batsmen and fielders all need the lactic acid system (anaerobic glycolytic system). when the ATP-PC system has
been used to is full extent.
 Energy Systems in Marathon Runners and Sprinters
 The aerobic system is the predominant energy system used for races lasting longer than three minutes.
 Its estimated that during sprint events approximately 95% of energy production comes via
the anaerobic system (85% phosphate, 10% anaerobic glycolysis), and only 5% from aerobic oxygen. Thus,
the 100m sprint is an anaerobic event relying heavily on energy supply from the ATP-PC system.
 Careers in Exercise Physiology
 Exercise Physiologist
 Personal fitness training
 Exercise Specialist
 Kinesiotheraptist
 Athletic Trainer
 Cardiac Rehabilitation
 Strength and conditioning in commercial, rehabilitative, and sport-related environment
 Where to study Exercise Physiology?
(References)
1. Exercise Physiology: Theory and Application to Fitness and Performance 10th Edition by Scott Powers and
Edward Howley
2. Exercise Physiology: A Thematic Approach by Tudor Hale
3. Physiology of Sport and Exercise by W. Larry Kenney, Jack H. Wilmore, and David L. Costill
4. Youth Soccer: From Science to Performance by Thomas Reilly
5. Cutting Edge Cricket Book by Frank S Pyke and Ken Davis
6. Exercise and the Heart book by Victor F. Froelicher and Jonathan Myers, 5th Ed.-Saunders (2006)
My book of Exercise Physiology
 Last Thing About Exercise
 If we put the health benefits from exercise into a pill where we say that this pill
decreases heart attack and cancer risks, increases longevity, boosts mood and
cognitive performance; people would pay billions of dollars for this. If I create
it I’d win the Nobel Prize. Yet it’s very difficult to convince my patients to
begin an exercise program.
-Dr. Mikhail Varshavski