LESSON 4:

CARDIORESPIRATORY AND MUSCULOSKELETAL FITNESS:

TRAINING PRINCIPLES AND EXERCISE PRESCRIPTIONS
OBJECTIVES

 To explain the principles that govern cardiorespiratory and

resistance training exercise prescriptions.

 To critique a peer's exercise program based on training

principles and exercise prescriptions.

 To implement an individualized exercise program on

cardiorespiratory endurance and musculoskeletal fitness.
Fitness
 Physical fitness refers to a set of attributes that an individual has
or can achieve in order to perform physical activities.
 It represents a complex assortment of components (health-
related, skill-related, and physiological) that affect our ability to
function and be physically active.
 Cardiorespiratory endurance, which refers to our capacity to
sustain a physical activity such as exercise or sports, depends on
the ability of our cardiorespiratory system to supply blood and
oxygen to the working muscles.
 It has been shown that children with lower levels of physical
activity have higher levels of percent body fat and poor
cardiorespiratory fitness (ACSM, 2011; Kyrolainen et al., 2010;
Pate et al., 2005).
 While cardiovascular diseases present themselves at later
stages in life, precursors of this may be found at childhood and
adolescence (Ortega et al., 2008).

 Aerobic (remember aerobic glycolysis?) physical activities, in

which the body's large muscle groups (e.g. arms and legs) move
rhythmically and continuously for a prolonged period of time, are
the best exercises to enhance our cardiorespiratory endurance.

 As we grow older, we lose muscle mass (a condition known as

sarcopenia).

 This loss in muscle mass and muscle function translates into

difficulty in lifting, pushing, pulling, and performing our daily
activities.
 The loss of muscle tissue, which is the main reason for a decrease
in metabolism, impacts on our body weight. The loss of muscle
function also results in a decline in our ability to move about and in
our capacity for independent living.

 Muscle strength and endurance are, therefore, important to maintain

and improve our balance and mobility; it makes lifting and reaching
easier; it decreases the risk for injuries and falls, and it stresses the
bones and preserves bone density, thus decreasing the risk for
osteoporosis.

 Resistance training, which involves a variety of exercises ranging

from the use of one's body weight to the use of apparatuses,
develops our musculoskeletal fitness.
Physical Fitness

 A set of attributes that an individual has or can achieve in

order to perform physical activities.

 It is represented as a complex assortment of components

(health-related, skill-related, and physiological fitness) that
affect our ability to function and be physically active.
Cardiorespiratory Endurance
 Another health-related fitness component that relates to the
capacity to sustain a physical activity such as exercise or
sports, which depends on the ability of our cardiorespiratory
system to supply blood and oxygen to the working muscles.
Musculoskeletal Fitness

 Another health-related fitness component that relates to the

ability of the muscles to exert maximum force (strength) or
persist without fatigue (endurance) when overcoming a
resistance.

 It depends on the functional capacity of the bones,

muscles and connective tissues, and is influenced by
flexibility, which is key to balance, postural stability, and
mobility.
Response versus Adaptation
 A response is a short-term change in the body system
during exercise (e.g. increased heart rate for greater blood
supply to working muscles), while adaptation refers to a
long-term change resulting from exercise (e.g. slower
resting heart rate resulting from greater stroke volume).
Bone Remodelling

 Process of breaking down tissues resulting from exercise

overload and its subsequent build-up as a result of recovery
and adaptation, provided that the exercise principles are
properly observed.
Response and Adaptation to Exercise
 Changes in our body system occur as the body responds, adjusts, and
adapts to exercise.
 A short-term change is termed a response. For example, once you start
exercising you will notice your breathing and heart rate increase. These
changes are the responses of the cardiorespiratory system to the increased
demand for blood flow (e.g. oxygen supply and elimination of carbon
dioxide and lactic acid).
 If the body is regularly exposed to this exercise stimulus, an adaptation or
long-term change occurs. For example, the resting heart rate decreases
because the heart contracts more forcefully to pump a greater amount of
blood.
 Tie cardiorespiratory system has, therefore, become more efficient in terms
of an increase in stroke volume, or the amount of blood pumped by the
heart per beat, which explains why it does not have to beat as often.
 What about changes to the muscular system? When muscles are
exposed to a resistance greater than what they normally
encounter at rest, they increase in size or hypertrophy.
 Transient hypertrophy, or the feeling of 'pump' which occurs
during a workout, is due to fluid accumulation (edema) in the
muscle.
 Tie long-term increase in muscle mass or chronic hypertrophy,
however, is attributed to an increase in the size Of the protein
filaments (action and myosin).
 Another example of a neuromuscular adaptation resulting from
resistance training would be the increased ability to recruit
muscle fibers into action. This enables you to perform with
increasing levels of resistance, that is, lift heavier weights
(because you have grown stronger!) or perform more repetitions
of an exercise (because of greater endurance).
 Generally, our. body has a tremendous capacity to adapt to exercise—
our bones, muscles, tendons, and ligaments become stronger and
more functional. Results from the remodelling process which involves
both the break down and build-up of tissues. However, when the break
down occurs more rapidly than the build-up, injury occurs.
 For example, if a joint is forced beyond its normal range of motion (e.g.
sprain), the responses are pain and swelling to prevent further activity
and greater potential damage to the joint. If you try to take on too much
too soon, you are susceptible to an overuse injury, which is a type of
injury caused by repetitive micro-trauma to the d tendons, bones, and
joints.
 Training errors in terms of too rapid acceleration of the intensity,
duration, or frequency of your activity; improper technique which is
common among beginners, weak anatomical links, and muscle
imbalances due to old injuries and lack of fitness, and improper
equipment (e.g. type of shoe) are among the factors that contribute to
overuse injury
 This is why it is important for you to know the basic scientific principles
that govern how the body responds, adjusts, and adapts to exercise
and physical activity.

 Exercise and physical activities are aimed at improving one's fitness, so

getting injured as a result of your participation is certainly
counterproductive to health.

 Remember, the oft-repeated phrase of "no pain, no gain" does not

apply here because injuries can be prevented with proper information,
training, and common sense.
Training Principles

 Basic training principles govern how our body responds,

adjusts, and adapts to exercise.

 These principles which include overload, progression

(mode, frequency, intensity, and time), specificity,
reversibility, use and disuse, variety, and individual
differences can be used in designing a safe and effective
exercise program.
Overload
 Overload principle states that a greater than normal load or intensity of
the body is needed for adaptation or improved function and fitness to
occur.
 The initial response of the body to an overload is discomfort and fatigue.
When the loading stops, the body undergoes recovery and eventually
adapts to this overload.
 The body must then be challenged by a new training load in order to
elicit positive responses and greater adaptation (e.g, higher level of
fitness). If the training load is excessive, injury or illness is a likely
consequence.
 The following variables may be altered or manipulated to overload the
body: mode, frequency, intensity, and time or MFIT (which also sounds
like what you are going to be—'Am fit!').
 It is important to understand and properly apply the principle of overload
if you want to see improvement
Progression

 This principle is also referred to as progressive overload

and indicates that overload should not be increased too
slowly or rapidly if fitness is to result.

 In other words, overload must be applied gradually and

steadily over an extended period of time.
It is initially based on your current activity status, which could
be any of the following:

1. deconditioned or inactive with no or minimal physical activity;

2. intermediate or moderately deconditioned because you are
sporadically active but without an optimal exercise plan; or
3. established because you are regularly engaging in moderate to
vigorous exercise.

 Using the MFIT formula, you can determine how much exercise
is enough for you to build fitness safely and effectively. The
MFIT formula is a basic set of rules about what is necessary to
gain a training effect from an exercise program.
 As the body begins to adapt to the exercise routine, the MFIT
may be gradually increased, preferably one at a time.
 This is important as too rapid a progression results in extreme
fatigue, pain during the workout, and discouragement from such
a difficult or stressful experience.
 This may contribute to attrition, or dropping out of your program
altogether.
 If too much overload is applied too soon, the body does not have
enough time to adapt properly and injury may occur. Thus, the
overload must be increased systematically.
 Mode or type of activity refers to one's choice of physical
activity or exercise based on:

1. your personal needs or goals. Is it improving your

cardiorespiratory endurance, muscle strength, increasing bone
density, decrease body fat by increasing muscle mass, to name
a few?;

2. level of skill. Choose an activity in which you are quite skillful

or confident in so that you will enjoy. your participation; and
3. availability and accessibility of facilities and equipment.
 Aerobic physical activities, in which the body's large muscle
groups (e.g. arms and legs) move rhythmically and
continuously for a prolonged period of time, are the best
exercises to enhance cardiorespiratory endurance.

 Since the muscles of the legs compose a good portion of

the total body musculature, aerobic activities such as
walking, jogging or running, stair climbing, bicycling, and
soccer are among the activities that have a high potential
for developing cardiorespiratory endurance.
 The major muscles of the chest and back involved in most arm
movements are relatively large and predominantly used in exercises
such as swimming, badminton, tennis, volleyball, and basketball.
These activities also use the legs vigorously.

 Resistance training, on the other hand, involves loading the bone

through muscular contractions. This stimulates bone growth and
results in increased bone mass and mineral density.

 Increase in muscle mass (hypertrophy) which results in increased

ability to generate more force (e.g, become stronger), and increase in
resting metabolic rate while contributing to loss of body fat (Young &
Steinhard, 1995) are also adaptations of the body to resistance
training.
 Frequency refers to the number of times (e.g. days) you
exercise in a given week.

 This depends on the intensity and duration of the exercise, such

that a lower intensity exercise bout requires more frequent
sessions than a high-intensity bout to afford the body longer
recovery time.

 The number also varies based on your fitness goal. For

example, aerobic activities for cardiorespiratory endurance are
recommended on most days Of the week, while resistance
training and stretching activities are recommended two to three
times a week.
 Intensity refers to the level of difficulty of an exercise or workout as well
as the amount exerted during performance. Intensity can be monitored
through heart rate when you palpate your pulse, your perceived level of
physical effort (e.g. rating or exertion) and your ability to talk comfortably
while exercising (e.g. talk test).

 You will know more about monitoring exercise intensity in Lesson 6. What
is important for now is that you should be able to breathe comfortably and
rhythmically throughout the workout to ensure a safe and comfortable
level of exercise, especially if you are just starting with their program.

 Cardiorespiratory endurance is best improved by increasing the heart rate

above the resting state; muscular strength and endurance by increasing
the resistance or the number of repetitions, and flexibility is best
increased by stretching the muscles to a point of slight tension or mild
discomfort.
 Time refers to the length of an exercise session. Individuals who are inactive
(no prior activity) can start with light-to-moderate activities that last between 20
to 30 minutes, or accumulate 10 minute bouts for a total of 30 minutes a day.

 Overall, the target is to accumulate 60 minutes to 1 1/2 hours per week. Those
who have minimal activity, or once you have met the earlier target, you can
workout for 30-60 minutes a day for a total of 2 h to 3 1/3 hours per week.

 If your activity status is intermediate (fair to average fitness), engage in

moderate activity for 30 minutes to 1 h hours per day for a total of 3 1/3 to 5
hours per week. Finally, a habitual exerciser can spend the same amount of
time but pursuing moderate-to-vigorous activities instead (ACSM, 2011). For
resistance training, time is expressed in terms of repetitions and sets.
Specificity
 This principle indicates that one must identify and train or overload a
specific fitness component in order to develop it. In other words,
cardiorespiratory fitness can be achieved through aerobic physical
activities; muscle strength and endurance can be improved through
resistance training; and flexibility through stretching exercises.
 Furthermore, there are specific exercises that activate and develop a
particular muscle group in resistance training.
 This principle also implies that if you want to become better at a
particular activity or improve your skill in it, you must engage in that
activity.
 For example, one training via a running program and another via a
swimming program will reap gains in cardiorespiratory fitness. But the
swimmer will perform better in a swimming test, while the runner will do
better in a running test. This means that specific neuromuscular
involvement is extremely important if one is training for increased
performance in a given activity.
Reversibility, Use and Disuse
 The adaptations from exercise or training are reversible, that is, a
fitness component deteriorates to a level that is equivalent to one's
level of physical activity.
 Use it or lose it, which means, in order to maintain a desired level of
fitness, an exercise overload must be imposed on the body
systematically and continuously.
 This principle is, therefore, closely related to the principle of use and
disuse. After an overload, rest periods are necessary to allow the body
to recover.
 During recovery, the body restores the energy stores that were
depleted during exercise to allow the body to exercise once more.
 This is also when adaptations occur.
 Long rest intervals such as more than a week or two lead to a
gradual loss of fitness.

 In fact, you can lose 50% of your fitness gains within two months
after completely refraining from exercise or physical activity. How
long should a recovery period be?

 Generally, it is recommended that you rest 48-72 hours between

exhaustive sessions. This does not mean though that you should
not be active at all for this period of time.

 Rather, you can vary your activities so that one system is allowed
to recover. If you are an athlete and in the off-season, you can
continue training through a modified program (e.g. cross-training)
to maintain your fitness.
Variety
 Training, because it is a long-term process, can potentially become
boring or monotonous. Hence, there is a need for variety to maintain
your interest or motivation and sustain your participation.
 Variety may be incorporated in an exercise program through changes in
exercise mode (e.g. alternate aerobic and resistance training; switch
from running to cycling, circuit training that employ different modalities
such as machines, suspension cord, stability, and balance balls) and
intensity (e.g. alternate heavy and light workouts).
 It is also important to keep written records that document what you
have accomplished in any given exercise session. This helps you
monitor your progress as well as impact on your motivation when you
reflect on the gains that you have achieved over time.
Individual Differences

 This principle states that we all have varying abilities in terms of

developing each of the fitness component. These differences are
grounded on genetics, age, sex, body composition and size, medical
conditions and injuries, among others. means that each of us is unique
in the way our body responds, adjusts, and adapts to exercise.
 For example, some of us respond well to resistance training, while
others respond better to cardiorespiratory endurance training.
Moreover, there is a variation of 3 to 10 times in the responses of those
who do not show much change (low responders) and those who show
a good deal of change (high responders) given a standard and similar
exercise regimen that is carried out over 15-20 weeks (Lakka &
Bouchard, 2004).
 This is why there is no one-size-fits-all program. Rather, exercise
programs must be individualized to suit the individual's needs,
interests, and other unique characteristics.

 Despite these individual differences, scientific evidence supports the

association between regular physical activity and health. It is not
accurate to say that one cannot benefit from physical activity because
your genes do not allow you to obtain the maximum level of fitness.

 While some individuals have a higher natural capacity to develop

various components of fitness, sedentary individuals differ from them
because of physical inactivity, not their genetic abilities. Although our
genes are beyond our control, we can choose how we live our lives.
Program Design
Assessment
 Creating your own exercise program seems like a daunting task. Yes, it requires
careful thought and planning but the first step is the hardest —realizing the need
to be active.
 The previous chapter underscored the association between physical activity and
health so you may know the benefits of being active. It has also provided you
with assessments on your current physical activity patterns and the stage of
change that you are at.
 You may now undertake fitness assessments (refer to Lesson 6 for a more
thorough discussion on assessing cardiorespiratory endurance, muscle strength,
and endurance) to help you determine where you stand in terms of your
cardiorespiratory and musculoskeletal fitness, and flexibility.
 This baseline information can help you identify areas for improvement and serve
as basis for goal setting. Remember, no matter what your current level of fitness
is, and whether you are inactive or already active, you can always improve.
 A fitness test battery consists of a variety of performance tests
designed to assess health-related fitness components. With the
exception of body composition, wherein only measurements are made
(e.g. height, weight, waist circumference) all the tests require the
exertion of submaximal effort. Each test protocol carefully explains the
purpose of the test, what to do during the test and how you can
interpret your test score.

 It is important to relate the criterion-referenced standards to health,

particularly risks for disease (e.g. cardiovascular diseases, diabetes,
hypertension, obesity). Since these diseases only manifest over a
period of time (usually when one is older), it is important to remember
that diseases have their origins in one's present lifestyle.
 Prior to the fitness assessment, it is important to ascertain your readiness
for physical activity. You can use the Physical Activity Readiness
Questionnaire or PAR-Q (Assessment 2.1 in Lesson 2) to determine if you
might have a medical problem or need a doctor's consent prior to fitness
testing and starting an exercise program.

 If you answered "yes" to any of the questions in the PAR-Q talk to your
doctor before you start becoming much more physically active or before
you have your fitness test. Although physical activity is perfectly safe for
apparently healthy individuals, it is important to obtain your doctor's
approval, particularly if you are planning to engage in vigorous intensity
activity. The risks for such activity are higher than the risks for moderate
intensity activity. Most of all, certain medical conditions may require
modifications in exercise programming.

 If you answered "no" to all questions in the PAR-Q then you can be
reasonably sure that you can participate in the fitness test and start
becoming more physically active.
 Before you begin your training, take time in setting SMART
goals for yourself.

 Although the results of your fitness assessments can help

you monitor your progress, your desire to start an exercise
program is related to how you function on a daily basis.

 Your wake-up call to be active could have been based on

any of the following:
1. You struggle with your normal activities: going up a flight of stairs, reaching over your
shoulder to fasten a zipper, reaching for an object above your head or down on the
ground, carrying a bag full of groceries;

2. You want to improve your overall fitness: you are not able to keep up with peers when
playing sports or recreational activities, you are limited in your recreational pursuits
because you are not strong enough;

3. You are interested in looking and feeling better: you no longer fit into your clothes, you
feel unhappy with your appearance because of weight gain, the added body fat limits
your enjoyment of recreational activities; and/or

4. You want to obtain the health benefits of physical activity and exercise.

 This means that your exercise program needs to become a regular part of your life. If
you are ready to commit yourself to this, we can now develop your action plan.
Recognizing these signs and acknowledging that you need to regularly engage in
physical activities are important steps toward improving your health and wellness.
Cardiorespiratory Endurance or Aerobic Training

 Cardiorespiratory fitness should be the mainstay of any exercise

program.

 Such a program is guided by the MFIT principles, that is, they help you
determine how much exercise is enough for you to get fit safely and
effectively.
1. Mode: Choose any activity that increases breathing, elevates
your heart rate and maintains this for an extended period, and
requires the large muscle groups to move repetitively,
rhythmically and continuously.

 Aerobic physical activities are classified into four groups

based on the skill and fitness demands (see Table 4.2). But
these groupings are not progressive, meaning, group C
activities are not better than group B.
2. Frequency: This depends on the intensity and duration (time) of your
exercise, such that a lower intensity exercise bout requires more frequent
sessions, and a higher intensity exercise bout requires a longer period of
recovery.
For example, if you enjoy running which is quite a vigorous activity, three
times per week will be enough for health and fitness gains. But if you can
only manage a brisk walking program which is a moderate intensity
activity, five days per week is better. You can also mix these two activities
for a weekly combination of three to five days, for example, two days of
brisk walking and two days of running.

 Start by exercising at least three times per week with no more than two
days between sessions. Allow yourself adequate recovery from the
overload. When the body has adapted to this, you can work it up to five
days per week, but no more than this because it can lead to injury.
3. Intensity: There are a variety of ways to quantify the intensity of your
exercise bout. This will be discussed more thoroughly in Lesson 6. For now,
you must know that the recommended intensity for developing
cardiorespiratory fitness depends on your fitness classification:

 As a beginner, lower intensity and short-duration activity is recommended

to reduce risk of injury and to enhance your adherence to the program.

 The same recommendation holds true for those with previous injury or
those who train for competitive reasons.

 For those with higher fitness levels, enjoy being challenged, and/or who
are athletes perform higher intensity activities. Remember the overload
principle—the more fit you are, the higher the intensity needed to
stimulate further improvement.
4. Time: depends on the amount of time you can commit to exercise and
your fitness status. If you are a beginner, perform any activity that you can
sustain for 10 minutes. Increase the duration by adding a couple of
minutes as the exercise becomes easier, until you have reached about 30
minutes per day. This may take weeks, a month, or even more but do not
be discouraged. Keep on going and you will make progress.

 If you already feel comfortable with moderate-intensity activity for about

30 minutes, you may exercise longer while staying at this intensity.
Another option would be to increase the intensity but decrease the
length of the session. A general rule of the thumb is that one minute of
vigorous-intensity activity is equivalent to two minutes of moderate-
intensity activity (USDHHS, 2008). For example, a 15-minute run
provides the same health benefit as a 30-minute walk.
Activity