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CONCEPTS OF
CHAPTER 11

CARDIOVASCULAR
EXERCISE
LEARNING OBJECTIVES
1 | Describe the benefits of cardiovascular exercise.

2 | Identify and explain the acute variables for cardiovascular exercise.

3 | Identify common modes of cardiovascular training.

4 | Explain the common environmental influence on physical activity.

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CHAPTER 11 | Concepts of Cardiovascular Exercise

From getting out of bed to participating in sports, human movement is an essential component

of survival. While the nervous system determines the task and sends the appropriate signals

to muscles, which in turn move a person, the cardiovascular system is responsible for

supplying nutrients to and transporting waste from tissues. Modern society requires little

physical effort from most people; therefore, to stave off various diseases such as cancer,

diabetes, and heart disease, cardiovascular exercise is crucial.

Cardiorespiratory specifically refers to the heart, blood vessels, and lungs, while cardiovascular

specifically refers to the heart and blood vessels.

Note: Cardiorespiratory exercise and cardiovascular exercise are used interchangeably in

this text.

BENEFITS OF CARDIOVASCULAR EXERCISE

Cardiovascular exercise is an important contributor to overall health and wellness. Performing

aerobic exercise and stimulating the cardiovascular system helps keep the heart, blood
AEROBIC EXERCISE: vessels, and lungs healthy. However, there are many other proven benefits to a regular cardio
Exercise that improves or
is intended to improve the routine, including the following:
efficiency of the body’s
cardiorespiratory system in
• Reduces fatigue
absorbing and transporting
oxygen.
• Improves energy levels

• Reduces depression

• Reduces stress and anxiety

• Prevents some types of cancer

• Enhances self-image

• Slows the effects of aging

• Improves sleep

• Improves mental acuity (sharpness of the mind, determined in memory, focus,

concentration, and understanding)

REDUCES FATIGUE
Research shows that sedentary people who begin a regular exercise program reported a

reduction in fatigue. This includes symptoms of fatigue such as drowsiness, sore muscles,

slowed reflexes, and irritability. This effect occurs in diverse populations, including healthy

adults, cancer patients, and people with diabetes and heart disease. In these studies, the

average effect of exercise was greater than the effect of stimulant drugs such as caffeine.

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IMPROVES ENERGY LEVELS
A more robust cardiovascular system allows the heart to pump more blood per beat, supply

more blood to itself between beats, and therefore increase efficiency. Less resistance to blood

flow, increased volume of blood filling the heart for transport, and stronger heart contraction

produce the efficiency. Research also suggests that improving blood flow simultaneously

increases the amount of oxygen being delivered to the brain. Optimal cognitive function (brain

function) is supported by sufficient oxygen supply to the brain and can improve alertness and

energy levels in people of all ages.

REDUCES DEPRESSION
In the US, 1 in 10 adults struggles with depression and many turn to antidepressant drugs

for relief. However, Harvard Health suggests that exercise may work as well as medications to

relieve depression. Clients suffering from severe depression should consult their physicians

before stopping any form of treatment or before starting physical activity.

High-intensity exercise stimulates the production of endorphins, hormones that promote

ENDORPHINS:
feelings of well-being. This results in acute feelings of happiness. Low-intensity exercise Hormones that promote
feelings of well-being.
sustained over time releases neurotrophic proteins or growth factors. These proteins

stimulate nerve cell growth and the creation of new neural pathways and connections. The

resulting increases in brain function make people feel better.

GROWTH FACTORS:
Proteins that stimulate
nerve cell growth and the
creation of new neural
REDUCES STRESS AND ANXIETY pathways and connections.
Many of the same mechanisms that help improve depression also help relieve stress and anxiety.

When stress affects the brain, the effects are felt throughout the body. The opposite is also true.

Exercise can immediately elevate a person’s mood for hours after cessation. In addition, research

suggests that regular exercise has a protective effect against stress, anxiety, and depression.

One study showed that those who engaged in regular vigorous exercise were 25 percent less

likely to develop depression or an anxiety disorder within the next five years.

PREVENTS SOME TYPES OF CANCER

New research from the American Cancer Society and the National Cancer Institute links

exercise with a lower risk of thirteen different cancers. The findings linked leisure-time

physical activity, such as gardening, walking, bowling, and horseback riding, with reduced risk

of breast, colon, esophageal, and endometrial cancers as well as kidney cancer, liver cancer,

myeloid leukemia, and stomach cancer.

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CHAPTER 11 | Concepts of Cardiovascular Exercise

Regular intentional physical activity was strongly associated with a reduced risk of multiple

myeloma (a blood cancer) and cancers of the bladder, head and neck, lungs, and rectum.

ENHANCES SELF-IMAGE
People who participate in regular exercise develop strength, muscle density, flexibility,

coordination, and balance and in turn, can make positive changes to the look and function

of their bodies. Multiple studies suggest that improving physical fitness helps people feel

more competent and confident, positively influencing the way they feel about their bodies

and boosting self-esteem. When a person perceives an improvement in their physical fitness

through physical activity—based on weight loss, muscle tone, strength, endurance, and so

forth—it triggers an improvement in body image, which can reinforce exercise as a part of a

healthy lifestyle.

SLOWS THE EFFECTS OF AGING

Studies following sedentary and active aging populations have shown that aging is not the

same for all people. Older, active people had health markers similar to those 20 or 30 years
HEALTH MARKERS: their junior. For example, older adults who engaged in regular cardiovascular activity:
Tools at the service of
health professionals that
objectively measure and • experienced decreased loss of muscle mass or strength,
evaluate indicators of
normal biological processes • did not increase body fat or cholesterol levels,
or pathogenic processes
(i.e., blood pressure). • did not experience a reduction in testosterone levels (males), and

• had stronger immune systems with T cell (a type of white blood cell that helps

protect the body) counts as high as those of a young person.

IMPROVES SLEEP
The Centers for Disease Control and Prevention (CDC) estimates nearly one-third of adults

get the recommended seven to nine hours of sleep per night and two-thirds of teens are not

getting the recommended eight hours per night needed to maintain good health. Chronic
SLEEP DEPRIVATION:
Achieving a less than ideal sleep deprivation leads to an increased risk for physical and mental illness and costs
sleep duration.
businesses and the health care system billions of dollars each year.

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Table 11.1 Sleep Recommendations

THE NATIONAL SLEEP FOUNDATION’S SLEEP RECOMMENDATIONS

BY AGE GROUP

Group Age Sleep Recommendation

Newborns 0–3 months 14–17 hours

Infants 4–11 months 12–15 hours

Toddlers 1–2 years 11–14 hours

Preschoolers 3–5 years 10–13 hours

School-age children 6–13 years 9–11 hours

Teenagers 14–17 years 8–10 hours

Younger adults 18–25 years 7–9 hours

Adults 26–64 years 7–9 hours

Older adults 65+ years 7–8 hours

As little as 10 minutes of aerobic exercise can improve the quality of sleep and increase

the overall duration of sleep through all sleep stages. Early morning and afternoon exercise

have been found to have the most beneficial effects for people looking for improved sleep

quality. Exercising at night may negatively affect sleep quality, but the data is not conclusive.

The theory is that increased blood flow, exposure to bright light, and brain oxygenation have

an energizing effect on the brain and may impair the body’s natural production of melatonin.

Better sleep allows people to improve their recovery, allowing them to exercise more regularly.

IMPROVES MENTAL ACUITY

Exercise directly benefits memory and cognition by reducing insulin resistance, reducing

inflammation, and stimulating the release of growth factors. The sum benefits of these

actions affect the health of brain cells and the creation of new blood vessels in the brain and

can enhance the growth and longevity of new brain cells.

Many studies have shown that the prefrontal cortex and medial temporal cortex—the parts of

the brain responsible for thinking and memory—are larger in active people than in sedentary

people. In addition, engaging in a regular fitness program for as little as six months is

associated with an increase in the size of certain areas of the brain.

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CHAPTER 11 | Concepts of Cardiovascular Exercise

CARDIOVASCULAR TRAINING PRINCIPLES

The principles and components of program design are a common thread through all areas

of physical fitness, from warm-up to flexibility, strength training, and cardiovascular work.

Each principle and component helps explain how to best program cardiovascular training

for each client. How long, how hard, and how often clients train are determined by the

underlying principles.

PRINCIPLE OF SPECIFICITY
The type of cardiovascular exercise and the associated acute training variables chosen for

each client must be specific to benefit the client’s desires. A marathon runner and a sprinter

do not follow the same training program. The more specific the cardiovascular training is to

the sport or activity, the greater the improvement in performance the client can expect.

PRINCIPLE OF INDIVIDUAL DIFFERENCES

Fitness assessments provide information about a client’s current fitness level and

potential challenges. The data collected should be used to determine the appropriate

training loads and progression. Periodic reassessments give a fitness trainer insights

into how clients have adapted to the prescribed program and what manipulations need

to occur to drive success. A program that works for one client should not be assumed to

work for another.

PRINCIPLE OF PROGRESSIVE OVERLOAD

As the body adapts to training, systematic and progressive stresses are placed on the

body to facilitate its adaptive response. Much like resistance training, changes to volume,

intensity, and frequency should all be progressively increased to initiate adaptations to

cardiovascular training. Depending on the client’s goals, shorter rest periods, longer bouts of

exercise, faster bouts of exercise, or more frequent bouts of cardiovascular exercise can be

applied to overload the cardiovascular system and elicit change. However, the progression

of all variables should be gradual—frequency, intensity, or duration should not be increased

by more than 10 percent each week. Furthermore, only one to two variables should be

manipulated at a time to prevent overreaching or overtraining.

PRINCIPLE OF REVERSIBILITY

The effects of aerobic exercise are not permanent. Research shows that cardiorespiratory

fitness declines sharply within two weeks of stopping intense endurance training. Fitness

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returns to pretraining levels after 10–32 weeks of detraining. However, systematically

decreasing the frequency and duration of exercise while maintaining intensity is beneficial to

avoid overtraining and will not significantly decrease VO2 max.

VO2 MAX:
The maximum amount of
GENERAL ADAPTATION SYNDROME oxygen an individual can
The body goes through three stages in response to adequately intense exercise—alarm, utilize during exercise.

resistance, and exhaustion. During the alarm stage, the body experiences symptoms

of fatigue, weakness, or soreness. This stage lasts from two to three weeks. During the

resistance stage, the body experiences biochemical, mechanical, and structural adaptations

to improve efficiency in response to the stress applied during training. Finally, during the

exhaustion stage, the body again suffers symptoms of fatigue, weakness, or soreness,

though with greater intensity. If training is maintained at the same level, instead of adapting

positively, the client may experience burnout, overtraining, injury, or illness.

A properly periodized cardiovascular training program allows adequate and timely recovery to

avoid the stage of exhaustion. This includes manipulating acute training variables as well as

programming rest and recovery. ACUTE TRAINING

VARIABLES:
Fitness-Fatigue Paradigm The components that
specify how an exercise is
performed.
Higher-intensity cardiovascular training leads to greater fitness adaptation but also generates

greater fatigue. Clients will likely require more rest and time for recovery after intense training

bouts or cycles. If training stays at a consistent high intensity, fatigue will increase and result

in reduced performance.

If training intensities are low, so reduced are fitness adaptations, fatigue, and performance.

However, research has shown that fatigue dissipates at a faster rate than fitness. If

appropriate training strategies and periodization are used, then fitness and performance
levels will increase while fatigue levels decrease.

Tapering

During a taper period, the volume or frequency of training decreases to allow the body

adequate rest and recovery. During this recovery time, there must be a focus on low-intensity TAPER PERIOD:
A training period where
technique work and nutritional interventions for optimized physical recovery and performance. the volume or frequency of
training decreases to allow
Tapering is commonly used in conjunction with a periodized program to help athletes and the body adequate rest and
recovery.
bodybuilders peak and fully recover for competition.

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CHAPTER 11 | Concepts of Cardiovascular Exercise

MODIFYING ACUTE TRAINING VARIABLES

Commonly manipulated acute training variables for cardiorespiratory training are as follows:

• Frequency

• Intensity

• Time/duration

• Type

• Resistance

• Rest

• Recovery

With any programming periodization, only one to two variables are manipulated at a time to
allow for adaptation. This also allows a trainer to determine which variables are the most

effective at eliciting a desired training response for each client.

FREQUENCY
For aerobic endurance performance, three to six training sessions per week is typical. The

“ideal” training frequency depends on the intensity and duration of each training bout, the

training goal(s), the training status of the client, and the specific sport season for athletes.

For cardiovascular health, the American Heart Association recommends the following:

Table 11.2 Cardiovascular Frequency Recommendations

RECOMMENDATIONS RECOMMENDATIONS
FOR ADULTS FOR YOUTH

150 minutes or 2.5 hours Should be physically

Fat loss or
per week or more of active with opportunities
endurance 3–5 years
moderate-intensity aerobic to move throughout the
goal
activity day

Strength or 60 minutes per day of

75 minutes per week of
hypertrophy moderate to vigorous-
vigorous aerobic activity
goal intensity physical activity
6–17
years
Any combination of At least 3 days per week
General
moderate to vigorous- of vigorous intensity
fitness goal
intensity aerobic activity activity

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Volume

Volume is easily manipulated during each session by increasing the amount of work completed,

specifically the amount of time spent performing cardiovascular activity. Increasing frequency

or duration or both increases volume.

• Cardiovascular intensity can be measured using several different methods:

• VO2 Max: the maximum rate of oxygen consumption measured during exercise

• Target heart rate (THR): the goal heart rate to reach a specific level of physical TARGET HEART RATE
exertion for cardiovascular fitness improvement (THR):
The estimated beats per
• Rate of perceived exertion (RPE): measured by the Borg rating scale (6–20) or the minute that need to be
reached to achieve a
modified exertion scale (0–10), a quantitative and subjective measure of exertion specific exercise intensity.

during physical activity

• Talk test: the use of the ability to speak during exercise as a gauge of the relative RATES OF PERCEIVED
intensity EXERTION (RPE):
A subjective sliding scale of
• Metabolic equivalent (MET): the measure of the ratio of a person’s expended a client’s perception of their
exercise intensity.
energy to their mass while performing physical activity

Table 11.3 Rating of Perceived Exertion: Borg and Modified Borg Scales TALK TEST:
The ability to speak during
THR exercise as a gauge of the
BORG MODIFIED BREATHING, EXERCISE relative intensity.
(PERCENT
RPE RPE TALK TEST TYPE
OF MAX HR)
METABOLIC
6 No exertion EQUIVALENT (MET):
0 The measure of the ratio
7 of a person’s expended
Very light breathing. 50–60 percent Warm-up energy to their mass while
8 Can sing “Happy performing physical activity.
1 Birthday” easily.
9

10
2 Deeper breathing but
11 comfortable. Able to 60–70 percent Recovery
hold a conversation.
12
3
13
Able to talk but difficult
70–80 percent Aerobic
to hold a conversation
14 4

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Table 11.3 Rating of Perceived Exertion: Borg and Modified Borg Scales
(CONT)

THR
BORG MODIFIED BREATHING, EXERCISE
(PERCENT
RPE RPE TALK TEST TYPE
OF MAX HR)

15 5 Starting to breathe
hard and getting
80–90 percent Anaerobic
uncomfortable to carry
16 6
a conversation

17 7 Deep and forceful

breathing.
Uncomfortable and
18 8
High intensity,
unable to talk. 90–100 percent
VO2 max
19 9 Extremely hard

20 10 Maximum exertion

INTENSITY
Cardiorespiratory training intensity can be measured using the Borg RPE or modified RPE

scales, METs, the talk test, THR, or a personal heart rate monitor. Some of the acute variables

that can be manipulated to affect intensity are the following:

• Rest: decrease rest time to increase intensity

• Resistance: increase resistance to increase intensity

• Speed: increase speed to increase intensity

There are six standardized types of cardiovascular training. Each is a slight modification of

the acute variables as well:

1. Low intensity, long duration or low-intensity steady state (LISS): cardiorespiratory

MAXIMUM HEART exercise between 60 and 75 percent of maximum heart rate that remains within
RATE: the aerobic threshold
The estimated maximum
number of times the heart 2. Moderate intensity, medium duration: 70 to 85 percent of maximum heart rate
should beat per minute
during exercise. Calculated effort that aims to remain aerobic. For untrained clients, the percent of maximum
by subtracting a person’s
age from 220. heart rate may be lower.

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 3. High intensity, short duration or high-intensity interval training (HIIT): 80 percent

of maximum effort or greater during work periods, with lower-intensity rest periods

that are long enough to allow the heart rate to recover

4. Aerobic intervals: sub-maximum effort during work periods to remain within the

aerobic threshold

5. Anaerobic intervals (Tabata): maximum effort during 20-second work periods with

short 10-second complete rest for eight rounds or four minutes total. RPE 10 effort.

Fartlek (“speed play” in Swedish) is an outdoor running style that uses landmarks and terrain

to increase or decrease running speed. Fartlek training is a way to modify several variables FARTLEK:
A training system for
at once. There are two common types of Fartlek workouts: time-based and random. distance runners that
continually varies terrain
and pace to enhance
Time-based intervals include the following:
conditioning and eliminate
boredom.
• Fixed time: exercise for a set period for each interval

• Varying time: each interval will be a different length of time

• Varying pace: each interval will have a different speed

Random intervals are completely dependent on the runner. For example, a client may

mark intervals using trees or signs—run from this tree to that tree, recover as necessary,

and then repeat. Intervals may be based on terrain—walk up hills and run down them. Or

a client may change pace whenever a new song comes on the radio. Distance can also

be used to mark intervals.

The intensity of a physical activity can be classified based on oxygen requirements. The
amount of oxygen the body uses is directly proportional to the energy used during the

activity (in the form of adenosine triphosphate [ATP]). METs are used to estimate the

energy expenditure for many common physical activities. At rest, the body uses about 3.5

milliliters (mL) of oxygen per kilogram (kg) of body weight per minute. The resting level

of oxygen consumption is referred to as 1.0 MET. An 8.0 MET level would equal eight

times the amount of oxygen used at rest. Using METs as a reference with clients, grading

intensity by multiples of resting levels can assist clients in understanding their intensity.

Many modern cardiovascular machines use METs, and METs can be converted to other

work measurements such as kilocalories per minute or watts.

Although the MET method can be used for prescribing exercise intensity, it has two limitations.

First, environmental factors—heat, humidity, cold, wind, altitude, pollution, differences in terrain,

and so forth—can change the way the cardiovascular system responds to a given MET level.

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As a result, the cardiovascular system may be working harder at the “same” MET level. If a

task gets harder because of, say, heat or altitude, the body requires more oxygen, burning more

kilocalories; therefore, the task would not be at the same MET level. For example, brisk walking

(3.5–4 miles per hour [mph]) equals 5 METs, but in a hot environment, it may require more

work or a higher MET level to accomplish the same task. In another scenario, brisk walking at

3.5 mph while wearing a weighted vest would require more oxygen, increasing the MET level.

The more oxygen the body uses during physical activity, the more Calories it will burn. METs are

used to estimate the energy expenditure for many common physical activities.

Second, as fitness improves, a client needs to exercise at higher MET levels to continue to

advance fitness per the principle of progressive overload. For these reasons, THR and RPE

are more commonly used to indicate exercise intensity than the MET because of ease of use.
Using the same example of brisk walking (3.5–4 mph) equaling 5 METs, as fitness levels

increase, THR and RPE may decrease.

A fitness professional can use the following equation to determine the Calories expended for

a client’s favorite activity:

METS × 3.5 × Bodyweight (KG) / 200 = Calories per Minute

TEST TIP!
The acronym for the most common cardiorespiratory training variables is FITT.

F: Frequency

I: Intensity

T: Time

T: Type

TIME/DURATION
The duration of a training session is inversely related to exercise intensity. The longer the exercise

session, the lower the intensity. The higher the intensity, the shorter the exercise session.

Calorie burn for individuals will vary based on physical size and fitness level. Here are some

examples that can equal approximately a 250-Calorie expenditure:

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Table 11.4 Duration of Cardiovascular Activity Equaling 250 Calories

MODERATE HIGH
LOW INTENSITY, INTENSITY, INTENSITY,
DESCRIPTION
LONG DURATION MODERATE SHORT
DURATION DURATION

Activity and Slow walking Brisk walking Moderate jogging

duration for 60 minutes for 45 minutes for 20 minutes

Speed 3.0 mph 4.0 mph 6.0 mph

Liters of oxygen
per minute 0.9 L O2 /min 1.1 L O2 /min 2.7 L O2 /min
consumed

Approx. Calories
250 Cal burned 250 Cal burned 250 Cal burned
burned

TYPE
Walking, running, swimming, cycling, rowing, circuit training, and many sports are variations

of exercise that affect the cardiovascular and respiratory systems. There is no ideal type of

cardiovascular training. Activities that a client enjoys and align with their goals should be the

primary training type to ensure exercise satisfaction and commitment to training.

RESISTANCE
Incline and speed can be modified on most cardiovascular machines. Cardiovascular training

machines such as treadmills, step mills, cycles, and rowing machines also include resistance

settings to increase or decrease training intensity. In addition, training intensity can be

increased by adding resistance via equipment or by modifying the training environment.

Equipment such as ropes, sleds, parachutes, resistance bands, and weights—weighted vests

or kettlebells—can be added to aerobic exercises to increase intensity and variability.

Choosing different training environments also changes the intensity and variability of a

workout. For example, hills or stadium stairs increase intensity by manipulating the incline or

decline of the activity. Training on sand, grass, artificial turf, or rocky trails changes the level of

impact to joints (less impact) and increases intensity because the surface shifts underfoot.

Training on solid surfaces, such as concrete, increases the impact to joints but decreases

the overall level of intensity.

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CHAPTER 11 | Concepts of Cardiovascular Exercise

Water can also be used as resistance. Aerobic training in the water can be effective but also
gentle on joints. Training intensity can be increased or decreased by adding paddles for more
resistance or floatation devices for varied buoyancy.

Though a change in resistance (load), tool, and environment can vary intensity and variability,
these changes can also alter movement mechanics. Pushing or pulling a light load on a
sled will change the intensity, and a heavier load can enhance or compromise movement
mechanics and should be considered with the desired outcome in mind.

RECOVERY
Intense exercise must be followed by adequate rest and recovery to allow positive adaptations
and avoid overtraining. If training is the stimulus and nutrition the building blocks, recovery
is what allows for and fosters adaptations such as tissue repair. Recovery can be active or
passive. For example, foam rolling or stretching is “active,” while and sleep and hydration
are “passive.” Recovery is as important a component as training and nutrition, though often
overlooked. Many seasoned marathon runners, for example, follow a three- to four-week taper
plan to conclude a training cycle or prepare for an event. This means that training volume
is reduced during the final two to four weeks before the race. Common practice is to reduce
weekly volume (mileage) by 20 to 30 percent each week.

For example, if a client’s highest mileage week is 42 miles, the first taper week mileage would
be reduced by 8.5–12.5 miles. Training intensity (speed) will remain at race pace, but the
overall training volume will decrease.

Table 11.5 Aerobic Endurance Training Types

FREQUENCY DURATION (ACTIVITY
TRAINING TYPE INTENSITY
PER WEEK PER SESSION)
Low-intensity Race distance or longer Approx. 70 percent
1–2
steady-state (LISS) (Approx. 30–120 minutes) of VO2 max
At lactate threshold;
Pace/tempo 1–2 Approx. 20–30 minutes at or slightly above
race pace
3–5 minutes
Intervals 1–2 Close to VO2 max
(1:1 work-to-rest ratio)
30–90 seconds Greater than
Repetition 1
(1:5 work-to-rest ratio) VO2 max
Varies Between
distance and pace/
Fartlek 1 Approx. 20–60 minutes
tempo training
intensities

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Range of Motion
Range of motion can be manipulated to meet many objectives. For example, if a new client
wants to train for a marathon but was previously sedentary, they may complain of low back
pain or other issues. Tight hip flexors caused by prolonged sitting or repetitive activities such
as jogging or cycling can shift the pelvis, resulting in anterior pelvic tilt. This specific postural
deviation causes imbalances throughout the musculature of the lumbopelvic hip complex but
specifically contributes to inactivity and weakness in the gluteus maximus. Range of motion
training interspersed with cardiovascular training can fix muscle imbalances, improve running
efficiency, and reduce low back pain.

MEASURES OF CARDIORESPIRATORY FITNESS

The overall health of a person’s cardiorespiratory system is critical to their ability to engage
in physical activity and exercise and can be assessed through a process called spirometry.
Spirometry uses a spirometer to measure the airflow into and out of the lungs, including
measurements of the following: SPIROMETER:
An apparatus for measuring
the volume of air inspired
• Maximum voluntary ventilation: the volume of air breathed out in a specified time
and expired by the lungs.
with maximum effort

• Vital capacity: the greatest volume of air that can be expelled from the lungs after
VITAL CAPACITY:
taking the deepest possible breath The greatest volume of air
that can be expelled from
• Tidal volume: the lung volume representing the normal volume of air displaced the lungs after taking the
deepest possible breath.
between normal inhalation and exhalation when extra effort is not applied

• Total lung capacity: the volume of the lungs when fully inflated
TIDAL VOLUME:
• Residual volume: the volume of air remaining in the lungs after maximum exhalation The lung volume
representing the normal
volume of air displaced
between normal inhalation
and exhalation when extra
effort is not applied.

Figure 11.1 Spirometer

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VITAL CAPACITY
The vital capacity of the lungs is the greatest volume of air that can be expelled from

the lungs after taking the deepest possible breath. Using a spirometer, vital capacity is

measured by how much air is exhaled after a person breathes in as much air as possible.

Vital capacity measures the functional portion of a person’s lungs and, for healthy adults,

typically measures around 3,000 to 5,000 mL, depending on age, sex, height, and mass. Low

vital capacity (generally below 3 liters [L] or 3,000 mL) is generally a symptom or a sign of a

respiratory problem or disease.

The average adult has a normal breathing rate of 12 breaths per minute. A conditioned athlete

may breathe as much as 20 times their vital capacity over one minute, while a deconditioned

person may not even reach 10 times their vital capacity in one minute. However, aerobic

exercise can improve vital capacity by strengthening the muscles involved in respiration and

increasing the efficiency of the lungs.

TIDAL VOLUME
The tidal volume is the lung volume representing the normal volume of air displaced between

normal inhalation and exhalation when extra effort is not applied. This means it is a measure

of how much air moves into and out of someone’s lungs while at rest. On average, tidal

volume is about 10 percent of a person’s vital capacity.

People with larger bodies have larger lungs than those of smaller stature, which also means

they may have a higher natural tidal volume. Although this value will be different among
people of varying body size, an average adult tidal volume is about one-half of a liter (500 mL)

per breath in healthy males and slightly less (approximately 400 mL) per breath in healthy

females.

The following factors influence tidal volume and vital capacity:

• Age: Lungs are at their maximum capacity during early adulthood and decline with

age.

• Sex: Female reproductive hormones lower aerobic power and pulmonary function.

• Body size: Smaller bodies naturally have smaller lung capacity.

• Physical conditioning: Lung capacity improves (up to about 15 percent) with frequent
aerobic exercise.

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During exercise, tidal volume typically increases as breathing becomes deeper. This allows the

lungs to take in more oxygen and expel more carbon dioxide. However, tidal volume does reach

a plateau based on exercise intensity. During low- to moderate-intensity exercise, research

has shown that the increase in tidal volume and breathing rate is roughly proportionate to the

exercise intensity. However, at higher intensity efforts, a plateau in tidal volume is reached,

and the only way to increase respiration is to increase the number of breaths per minute.

MINUTE VENTILATION
The total amount of air entering the lungs over the course of one minute is called the minute

ventilation. This cardiorespiratory measurement is directly related to a person’s tidal volume MINUTE VENTILATION:
The total amount of air
and is calculated as: entering the lungs over the
course of one minute.
Minute ventilation (MV) = respiratory rate × tidal volume (TD)

where the respiratory rate describes how many breaths the person takes per minute.

The average adult has a minute ventilation of about 6 L per minute. During exercise, tidal volume

and breathing rate increase to supply working cells more effectively with oxygen for metabolism

and to remove waste products. Thus, minute ventilation also increases. The average healthy

adult’s breathing rate increases to 35 to 45 breaths per minute based on intensity during exercise

as their tidal volume also increases. Research has shown that healthy adults typically have a

minute ventilation of approximately 100 L during heavy exercise. Well-conditioned clients can have

a minute ventilation of up to 160 L during maximum-effort exercise.

Unconditioned people, those with chronic health conditions that affect the lungs directly

or the surrounding structures, and people with neuromuscular diseases that progressively

weaken the muscles involved in respiration may have reduced minute ventilation. These

physical conditions can also cause the body to become reliant on muscles outside those

typically used for respiration (e.g., the abdominals), and these people may have shallow,

rapid, or labored breathing. For a fitness professional, this is important to recognize because

it can affect a client’s ability to breathe adequately during physical activity, and the intensity

or effort may need to be adjusted.

VO2 MAX
A person’s VO2 max is a calculation of how much oxygen the body can use during intense exercise

(V, volume; O2, oxygen). The more oxygen the body can use during exercise, the more cellular

energy can be produced to fuel that exercise. Recent research has shown that although VO2 max

is partially predetermined by genetics, it may also be increased with appropriate training.

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VO2 max is measured as the volume of milliliters of oxygen consumed per kilogram of body

weight per minute (mL/kg/min) and is most accurately calculated in a laboratory setting. The

Astrand-Rhyming Cycle Ergometer Test uses a bicycle to measure all-out efforts under a strict

protocol. While this is not conducted in most fitness settings (some facilities do have the

proper equipment and trained staff), the Rockport Walk Test (RWT) is often executed more

easily. This assessment requires a one-mile walk on a treadmill as fast as possible and has

been found to be relatively accurate for the estimation of VO2 max in adults aged 20 to 69.

With the Rockport Walk Test, VO2 max is calculated as:

Estimated VO2 max (mL/kg/min) = 132.853 – (0.0769 × body weight [lb]) – (0.3877 × age)
+ (6.3150 × sex) – (3.2649 × RWT time in minutes and hundredths) – (0.1565 × 1 – HR)

where age is in full years (no fractions), the sex variable is zero (0) for females and one (1)

for males, and the HR is the beats per minute taken at the end of the mile assessment. The

mile walk time is written in minutes and hundredths. For example, a time of 10:30 is 10.5

minutes, or a time of 11:15 is 11.25 minutes.

This estimation has been found to have an error margin of +/– 5, so the result should

account for this margin of error. For example, a VO2 max calculation of 35 mL/kg/min would
estimate between 30 and 40 mL/kg/min.

Some research has shown a link between heart rate and a person’s subjective RPE and VO2
max. Specifically, heart rate during activity can be used to estimate the VO2 max in many

clients. A general, though less accurate, calculation of VO2 max considers estimated
maximum heart rate and resting heart rate (RHR).
RESTING HEART RATE
(RHR): VO2 max = 15.3 × (max heart rate / resting heart rate)
The measure of heart rate
when completely at rest. where maximum heart rate is calculated as 220 minus age and resting heart rate is beats

per minute at rest (or the number of heartbeats at rest for 30 seconds multiplied by 2).

The norms for VO2 max also consider sex. It is important to understand that these calculations
are merely estimations unless completed under laboratory supervision, but the overall results

can be improved with cardiorespiratory training. For consistency, whichever method is used to

estimate VO2 max initially should be repeated for future evaluations.

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Table 11.6 VO2 Max Norms by Sex

VALUE FOR VO2 MAX

VO2 Max Norms for Men as Measured in ml/kg/min

Age Very Poor Poor Fair Good Excellent Superior

35.0- 38.4- 45.2- 51.0-

13-19 <35.0 >55.9
38.3 45.1 50.9 55.9

33.0- 36.5- 42.5- 46.5-

20-29 <33.0 >52.4
36.4 42.4 46.4 52.4

31.5- 35.5- 41.0- 45.0-

30-39 <31.5 >49.4
35.4 40.9 44.9 49.4

30.2- 33.6- 39.0- 43.8-

40-49 <30.2 >48.0
33.5 38.9 43.7 48.0

26.1- 31.0- 35.8- 41.0-

50-59 <26.1 >45.3
30.9 35.7 40.9 45.3

20.5- 26.1- 32.3- 36.5-

60+ <20.5 >44.2
26.0 32.2 36.4 44.2

VO2 Max Norms for Women as Measured in ml/kg/min

25.0- 31.0- 35.0- 39.0-

13-19 <25.0 >41.9
30.9 34.9 38.9 41.9

23.6- 29.0- 33.0- 37.0-

20-29 <23.6 >41.0
28.9 32.9 36.9 41.0

22.8- 27.0- 31.5- 35.7-

30-39 <22.8 >40.0
26.9 31.4 35.6 40.0

21.0- 24.5- 29.0- 32.9-

40-49 <21.0 >36.9
24.4 28.9 32.8 36.9

20.2- 22.8- 27.0- 31.5-

50-59 <20.2 >35.7
22.7 26.9 31.4 35.7

17.5- 20.2- 24.5- 30.3-

60+ <17.5 >31.4
20.1 24.4 30.2 31.4

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METABOLIC EQUIVALENT (MET)

The MET is the measure of the ratio of expended energy to the person’s mass while performing

physical activity. This measure considers the metabolic rate at rest and the metabolic rate

required to support an activity. One (1) MET is equal to a person’s metabolic rate when at

rest. One (1) MET is approximately 3.5 mL of oxygen consumed per kilogram of body weight

and is calculated as:

1 MET = weight (kg) × 3.5 mL

For example, a 150-pound person (68.04 kg) would have a 1 MET of 68.04 kg × 3.5 mL =

238.14 mL of oxygen per minute.

A MET value of four would mean this person is using four times the amount of oxygen and

has a metabolic rate four times that of their metabolic rate at rest. Energy expenditure can

vary by age and fitness level, but for most healthy adults, MET values can be helpful in

exercise planning and as a gauge for the effort being put forth during activity.

Several activities have been calculated in METs for the average adult. The approximation of METs

can be used to estimate the number of Calories burned during each activity for an individual.

Table 11.7 Estimated MET Values for Specific Activities

LIGHT MODERATE VIGOROUS

< 3.0 METS 3.0–6.0 METS > 6.0 METS

Housework Walking at very brisk pace

Sitting at a desk: 1.3
(cleaning, sweeping): 3.5 (4.5 mph): 6.3

Sitting, playing cards: Weight training Bicycling 12–14 mph

1.5 (lighter weights): 3.5 (flat terrain): 8

Standing at a desk: Golf Circuit training

1.8 (walking, pulling clubs): 4.3 (minimal rest): 8

Strolling at a slow Brisk walking

Singles tennis: 8
pace: 2.0 (3.5–4 mph): 5

Weight training
Washing dishes: 2.2 Shoveling, digging ditches: 8.5
(heavier weights): 5

Yard work
Hatha yoga: 2.5 Competitive soccer: 10
(mowing, moderate effort): 5

Swimming laps Running

Fishing (sitting): 2.5
(leisurely pace): 6 (7 mph): 11.5

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The Caloric value of an activity can be estimated using the MET value for the activity, body

weight in kilograms, and the following formula:

Calories burned per minute = (activity METs × 3.5 × bodyweight [kg]) / 200

For example, consider the 150-pound person again. Their weight in kilograms is 68.04 kg,

and they are walking at a very brisk pace with a MET value of 6.3.

Calories per minute = (6.3 × 3.5 × 68.04kg) / 200

= (1500.282) / 200

= 7.5 Calories per minute

7.5 Calories per minute × 60 minutes = approximately 450 Calories burned per hour

during this activity.

LACTATE THRESHOLD
Another means for calculating the efficiency of the cardiorespiratory system is the lactate

threshold. Lactate is a by-product of metabolism that is produced by blood cells, the brain, LACTATE THRESHOLD:
The maximum effort or
and muscle tissue. It is used to supply the cells with energy when there is a lack of oxygen intensity an individual can
maintain for an extended
or when normal cellular metabolism is disrupted. Lactate is a fuel, not a waste product. time with minimal effect on
blood lactate levels.
However, the threshold where lactate builds up in the tissues faster than it can be cleared is

an important indicator of cardiorespiratory endurance performance and can be improved with

cardiorespiratory training.

The measure of the lactate threshold measures the maximum effort or intensity a person

can maintain for an extended time with minimal effect on blood lactate levels. This requires

a blood draw to measure blood lactate levels, which makes it accurate but not necessarily

practical in a fitness setting. Lactate threshold is often expressed as approximately 75

percent of VO2 max or 85 percent of the maximum heart rate for the average person and can
vary based on fitness level.

VENTILATORY THRESHOLD
Closely related to the lactate threshold is the ventilatory threshold (VT). This measure tracks
VENTILATORY
changes in carbon dioxide extraction, oxygen consumption, and breathing rate and volume.
THRESHOLD (VT):
Ventilatory threshold represents the lactate threshold—the level of intensity where blood The threshold where
ventilation increases faster
lactate accumulates faster than it can be cleared from the body—and it causes a person to than the volume of oxygen.
breathe faster (increase their breathing rate) to consume more oxygen and expel more carbon

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dioxide. It is measured with a breathing mask or based on observable breathing rates as

opposed to the blood draw needed to accurately measure lactate thresholds.

For the average adult, the ventilatory threshold is at exercise intensities between 50 and 75

percent of maximum. An unconditioned client will reach their ventilatory thresholds at lower

physical intensities than a trained one. For example, walking may elevate an unconditioned

client’s breathing rate, while someone who has been training for a while may need to be

running at a seven-mile-per-hour pace to elevate their breathing rate.

It is also related to VO2 max in that ventilatory thresholds occur before maximum oxygen
uptake. Ventilatory threshold 1 (VT1) occurs when the breathing rate begins to increase

during activity, and ventilatory threshold 2 (VT2) is at a relatively high-intensity effort when the
person is out of breath. When someone achieves their VO2 max, they will no longer be able

to continue their exercise or activity.

VO2 Max
exercise needs to
VT2 conclude due to
exhaustion

breathing increased to
point where person is
out of breath

VT1
breathing begins to
increase

rest Maxiumum

Figure 11.2 Ventilatory Thresholds and VO2 Max

MAXIMUM HEART RATE

Maximum heart rate is the maximum beats per minute someone’s heart can achieve during

activity, and it is a measure that is estimated to help determine exercise intensity for

cardiorespiratory training. Testing to determine a client’s actual maximum heart rate requires

the client to work at maximum capacity, which is not practical for a fitness setting. However,

an estimation of maximum heart rate is commonly found using the following formula:

Maximum heart rate (HRmax) = 220 – age

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where age is in whole years. While commonly used to estimate maximum heart rate, this

formula has a margin of error of +/– 10 to 15 beats.

There is great variability by client and age on actual heart rate maximums. For example,

a well-conditioned client will likely have a higher maximum heart rate and a lower resting

heart rate because their cardiorespiratory system is more conditioned and efficient and can

handle more work than an unconditioned client. With that in mind, a fitness professional can

estimate a client’s heart rate and corresponding heart rate zones, but this formula should

not be used as an absolute.

HEART RATE ZONES

The heart rate is a key indicator for exercise intensity and is used by fitness professionals to

prescribe intensity and evaluate fitness levels. There are five heart rate zones that generally

correspond with exercise intensities. Each zone represents a range of the percentage of

maximum heart rate and an RPE. As with the maximum heart rate estimation, heart rate

zones are also estimations and can vary based on the training status, health condition, age,

and body size of the client.

Zone 1 is a very light intensity and equates to 50 to 60 percent of maximum heart rate and

an RPE of 1 to 2. Examples of zone 1 activities include a warm-up, a cooldown, and a slow

walking pace. This zone can be used to slightly elevate the heart rate, promote physical

recovery, and promote optimal metabolism. Activities in zone 1 can be sustained for extended

periods.

Zone 2 is a light intensity and equates to 61 to 70 percent of maximum heart rate and an

RPE of 3 to 4 (easy). Lightweight resistance training, a light jog, or walking up a flight of

stairs would fall into zone 2 cardiorespiratory intensity. Breathing at this intensity is light,

and the client may begin to sweat. Training in this zone can improve both muscular and

cardiorespiratory endurance and can be sustained for extended periods.

Zone 3 is a moderate training intensity and equates to 71 to 80 percent of maximum heart rate

and an RPE of 5 to 6 (moderate). Breathing may begin to deepen with moderate sweating in this

zone. Based on the percentage of maximum heart rate, training in zone 3 is generally still aerobic,

and aerobic fitness can be improved. Hiking, a moderate jog, and moderate-paced resistance

training are generally zone 3 activities that can elicit this level of heart rate response.

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Zone 4 is generally moving into anaerobic exercise and is a challenging intensity. Training in
ANAEROBIC EXERCISE: this zone equates to 81 to 90 percent of maximum heart rate and an RPE of 7 to 8 (hard).
Short-duration muscle
contractions that break Training in zone 4 can only persist for moderate amounts of time and elicits feelings of
down glucose without using
oxygen. physical fatigue and heavy breathing to the point that the client cannot carry on a conversation.

For example, running at a five-kilometer run pace, cardiorespiratory interval training, or

resistance training intervals would fall into zone 4. Training in this heart rate zone can promote

anaerobic fitness improvements and improve performance capacity.

The final heart rate zone is zone 5. Zone 5 is maximum effort and equates to 91 to 100

percent of maximum heart rate with an RPE of 9 to 10 (very hard). This intensity can only be

maintained for short durations, and it will feel like an all-out effort. Training in this zone can

improve athletic performance, fast-twitch muscle fiber development, and sprint speeds. Not
all clients will need to reach this heart rate zone. However, unconditioned clients may reach

this zone and RPE at lower heart rates than estimated, while more conditioned clients will

see the opposite effect.

ZONE 1 • 50-60% Max HR

Very light activity, such as warm-up/cooldown

ZONE 2 • 61--70% Max HR

Light activity, such as slow-paced jogging, walking
up a flight of stairs, lightweight low resistance

ZONE 3 • 71--80% Max HR

Moderate activity that increases aerobic endurance,
such as moderate jogging, cycling, or rowing

ZONE 4 • 81--90% Max HR

Hard anaerobic activity, such as high rep ball slams,
boxing, or heavy weight lifting

ZONE 5 • 91--100% Max HR

Extreme hard maximum exertion activity, such as
sprinting. All out effort!

Figure 11.3 Heart Rate Zones

To calculate the beats per minute that equate to each heart rate zone during cardiorespiratory

fitness prescription, a client’s maximum heart rate will be multiplied by the high and low

ranges of each zone. For example, consider a 35-year-old client.

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 HRmax = 220 – 35 = 185 beats per minute

Zone 1: 185 bpm × 0.50 = 92 bpm

185 bpm × 0.60 = 111 bpm

Zone 1 = 92 to 111 beats per minute

Zone 2: 185 bpm × 0.61 = 113 bpm

185 bpm × 0.70 = 129 bpm

Zone 2 = 113 to 129 beats per minute

Zone 3: 185 bpm × 0.71 = 131 bpm

185 bpm × 0.80 = 148 bpm

Zone 3 = 131 to 148 beats per minute

Zone 4: 185 bpm × 0.81 = 149 bpm

185 bpm × 0.90 = 166 bpm

Zone 4 = 149 to 166 beats per minute

Zone 5: 185 bpm × 0.91 = 168 bpm

185 bpm × 1.0 = 185 bpm

Zone 5 = 168 to 185 beats per minute

Again, these heart rate beats per minute are not absolute but can provide general guidance

as to where the client’s heart rate needs to be to achieve the desired cardiorespiratory
training effect.

HEART RATE RESERVE AND TARGET HEART RATE (THR)

Heart rate reserve (HRR) calculates the difference between a person’s estimated maximum

heart rate and their resting heart rate. It is a metric that can be tracked and improved as the HEART RATE RESERVE
resting heart rate decreases with cardiorespiratory conditioning. A fitness professional can
(HRR):
Maximum heart rate minus
use this formula to calculate HRR: resting heart rate.

HRR = HRmax – HRrest

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HRR can also be used to calculate a client’s THR. THR is the desired heart rate to be

achieved based on the desired exercise intensity, and this measure also considers the

person’s maximum and resting heart rates. THR can be calculated with the Karvonen formula
KARVONEN FORMULA: as follows:
The formula to estimate
a target heart rate with
consideration of heart rate THR = ([HRmax – HRrest] × desired intensity) + HRrest
reserve and resting heart
rate. Consider the 35-year-old client again with a resting heart rate of 55 beats per minute. If the

trainer would like them to work at 80 percent training intensity, their THR would be calculated

as follows:

HRmax = 220 – 35 (age) = 185 bpm

HRR = 185 bpm – 55 bpm (resting) = 130

THR = ([HRR] × 0.80 [intensity]) + 55 (resting)

= (130 × 0.80) + 55

= 104 + 55

THR = 159 bpm for 80 percent exercise intensity

WEARABLE FITNESS TECHNOLOGIES

Wearable fitness technologies track physical activity, such as heart rate, steps taken, and

Calories burned. Most come with a three-axis accelerometer to track movement in every

direction. Physical activity has numerous benefits to health, wellness, and fitness. Tracking

physical activity is an effective way to monitor activity. Most people tend to overestimate time

spent in vigorous intensities and underestimate sitting and low-intensity activities unless they

have objective data. Wearables are a great way for clients to get a feel for how hard or long
they are working and how active they are. Objective data can help a fitness professional set

and monitor realistic goals for clients.

WARM-UP AND COOLDOWN

A general warm-up should be conducted before a cardiorespiratory training bout to increase

heart rate, breathing, and body temperature and to psychologically prepare the client for

exercise. A general warm-up should include 5–10 minutes of low- to moderate-intensity

activity. Examples of general warm-up exercises include walking, jogging in place, walking

lunges, jumping jacks, or a few slow laps in the pool.

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Self-myofascial release and targeted stretching for movement preparation should also be

conducted during the warm-up period. This is especially true for clients with a history of injury,

muscle imbalance, or tightness in certain muscles.

Specific warm-ups are done to further enhance performance of the exercise activity to follow and

should come after the general warm-up. A specific warm-up should include dynamic movements

that mimic the exercises that follow. Warm-up exercises should target the joints and muscles that

will be used in the workout. This may include lower-intensity intervals of the activity such as leg

swings before running stadium stairs or high-knee marching before sprint intervals.

A fitness professional should allow at least 30 seconds to 3 minutes of rest before beginning

the training session.

After the exercise bout, a client should perform a cooldown. A proper cooldown routine will

allow the heart rate and body temperature to return to normal. The cooldown period may last

from 5 to 10 minutes but should ideally last until the heart rate is back to normal. Elements

of flexibility may be added to the cooldown after heart rate has returned to resting.

During exercise, the heart must pump a greater volume of blood to support working muscles.

The muscles aid in this process by contracting with more force against the blood vessels. With

this force helping the blood resist gravity, it quickly returns to the heart to be reoxygenated and

sent back out to the body. If intense exercise is stopped abruptly without allowing the body to

cool down, blood may pool in the lower extremities and cause dizziness or loss of consciousness.

PHYSIOLOGICAL ADAPTATIONS TO AEROBIC EXERCISE

Aerobic exercise burns stored fat from adipose tissue, improves cardiovascular health and

fitness, and improves the body’s ability to recover after intense exercise. Aerobic exercise is

typically longer duration and relies on slow-twitch muscle fibers, which contract slower and

at a lower intensity. One major training adaptation of aerobic exercises is the increase in the

size and number of type I muscle fibers to improve endurance performance.

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Aerobic exercise cannot change type II muscle fibers into type I fibers contrary to popular

belief. These fiber types are too inherently different. However, some muscle fibers can begin

to favor and take on similar characteristics as another type of fiber based on the activity of

the person. This can occur, for example, if a sedentary person becomes more active and

begins to train for an athletic event such as powerlifting. While the adaptations surely do not

come overnight, this person, with proper training, will start to generate larger type II muscle

fibers and train a relatively low number of type I fibers to support their activity.
ATROPHY:
The wasting away or loss of In the same respect, type II fibers are more prone to atrophy with nonuse. This means there
muscle tissue.
are physiological mechanisms in the fast-twitch fibers that make them more likely to

degenerate than the more readily activated type I fibers.

ANGIOGENESIS:
The development of new Aerobic training also increases the number and size of blood vessels because of the need
blood vessels.
for higher levels of oxygen. Capillary networks surround the muscle fibers in a process called

angiogenesis. Increased amounts of nutrients and oxygen supply the muscles with fuel, and
MYOGLOBIN:
A protein in muscle cells waste is removed faster. This, in turn, supports muscular endurance, resistance to fatigue,
that carries and stores
and recovery.
oxygen.

Aerobic exercise also triggers important metabolic changes in muscle tissue, including an
AEROBIC CAPACITY: increase in mitochondria and myoglobin. Mitochondria are necessary for energy production,
A measure of the ability of
the heart and lungs to get and myoglobin stores the oxygen needed for that process. These changes improve aerobic
oxygen to the muscles.
capacity, a measure of the ability of the heart and lungs to get oxygen to the muscles. Many

of these adaptations contribute to the body’s increased ability to store muscle glycogen and

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use fat for energy with aerobic training as well. Since fatty acids are a more efficient source

of ATP, assuming adequate nutrition, the body will increase its ability to release fatty acids into

the bloodstream during aerobic exercise.

CARDIAC MUSCLE ADAPTATIONS

Aerobic exercise is ideal for strengthening the heart muscle, lungs, and blood vessels.

A strong, healthy heart efficiently supplies working muscles, organs, and tissues with

oxygenated, nutrient-rich blood and removes metabolic waste.

As the body is conditioned through aerobic exercise, the cardiac muscle strengthens, delivery

of blood and oxygen to the heart itself is improved, and the heart chambers empty and fill

more efficiently. All these adaptations improve the pumping capacity of the heart. The heart

can then pump more blood with fewer heartbeats, reducing the resting and maximum heart

rates of trained people.

MODES OF CARDIOVASCULAR EXERCISE

Along with the various cardiovascular machines available, there are several basic modes of

cardiovascular exercise. Walking and running serve as the foundation for most cardiovascular

training sessions. Proper form, movement mechanics, and ranges of motion contribute to

the efficacy of any cardiovascular activity and will prevent overuse injuries. Choosing an

appropriate mode of exercise for clients involves client goals, convenience, preference, and

client ability. The mode a client will consistently use may be the best option, at least initially.

WALKING
Walking is a low-impact workout suitable for most clients. A fitness professional should coach

clients on posture, foot motion, stride, and arm swing to get the most from this exercise.

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Posture

• Stand straight with feet about hip width apart, toes pointed forward, shoulders

relaxed and pulled back, and chin parallel to the ground.

• Engage the core muscles by pulling the belly button back toward the spine.

• Do not lean forward or arch the back.

Foot Motion

• Follow a heel-toe motion with the heel striking the ground first.

• Roll through the step from heel to toes, and push off with the toes.

Stride

• Keep a natural stride distance; do not overextend the front leg. The heel should
strike the ground close to the front of the body.

• The back leg is what propels the body forward. Keep the rear foot on the ground for as

long as possible, then push off with the toes as the hip and knee reach full extension.

• Hips should move front to back, not side to side.

Arm Swing

• Close the hands into loose fists, but do not clench the fists because this can raise

blood pressure.

• The arms should swing naturally from relaxed shoulders. The forward hand should

not cross the midline of the body.

• Keep the elbows close to the body.

RUNNING
The basic mechanics of running are similar to those of walking. However, the foot strike differs.

Here are some additional tips a fitness professional should share to cue proper running form:

• Shoulders should trace an “X” pattern. As the right foot comes forward, the left

shoulder moves forward. While the left foot is back, the right shoulder should be

forward. Shoulders should stay relaxed and over the hips.

• Lean slightly into the run by hinging at the hips and bracing the core. This helps engage

the gluteus maximus for more power through the stride as the hip and knee extend.

• Knees should fall in line with hips and midfoot. Measure by imagining a line from

the front of the hip joint through the knee joint and through roughly the second and

third toe.

• The most efficient running stride is one in which the shin is perpendicular to the

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 ground, directly underneath the hips, torso, and head when the foot strikes the

ground and is bearing the weight of the body. However, for running fast, an anterior

or positive shin angle means increased force application in the direction desired.

• The ideal foot strike when running occurs at the forefoot versus the heel (when

walking).

TREADMILL
Treadmills are commonly used for walking or running, as part of a warm-up or cooldown, or

for cardiovascular endurance assessments. Here is how a client can safely use a treadmill:

• With the treadmill off, grab the handrails and place feet on the sides of the belt.

Attach the safety clip to the clothing, and press the “Start” button.

• The belt will move slowly. Place one foot at a time onto the moving belt. Start

walking.

• Remove hands from the handrails.

• Walk or run with proper form without holding on to the handrails.

• To get off the treadmill, allow the belt to stop completely. Place feet on the sides of

the belt. Hold on to the handrails. Remove the safety clip. Step off, one foot at a time.

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STAIR-CLIMBER AND STEP MILL

A stair-climber has pedals that move up and down to mimic walking up steps. A step mill is a

revolving staircase that simulates walking or running up a flight of stairs. Here is how a client

can safely mount and dismount these machines:

• With the machine off, grasp the handrails. Step up, one foot at a time, and place

feet on the pedals or step. If on a step mill, climb to the highest step.

• Attach the safety clip to the clothing. Press the “Start” button.

• To dismount, make sure the pedals are immobile or the steps have come to a

complete stop. Grasp the handrails. Unclip the safety clip from the clothing. Step

off, one foot at a time.

Form and Posture on a Stair-Climber

The handrails on the stair-climber should only be used for getting onto and off the machine

or for balance as necessary.

• Stand upright. Hinge slightly forward from the hips.

• Keep the entire foot on the pedal.

• Steps should be moderately deep, not short or choppy.

Form and Posture on a Step Mill

• Use the handrails for getting onto and off the step mill or for balance as necessary.

• Stand upright. Keep a neutral spine. Relax the shoulders and look straight ahead.

• Do not hunch over or lean on the handrails.

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SWIMMING
Swimming is a very low-impact aerobic activity and is often used as a recovery technique

because of its minimal impact on the body. In addition to the benefits realized by aerobic

exercise, swimming offers the following:

• Reduced exercise-induced asthma symptoms from exercise in moist air

• Increased lung volume, which helps further reduce asthma symptoms

• Improved bone strength, especially in postmenopausal women

• Relief from arthritis symptoms such as joint stiffness and pain

To safely coach clients in the pool, it is best for a fitness professional to become a certified

swim instructor or water safety instructor through the Red Cross or to refer a client to one.

CYCLING
Cycling is a versatile, low-impact sport that can be done outdoors or indoors, in urban or rural
areas. Variables in cycling that affect intensity include the following:

• Tires: Road bikes have thinner tires that reduce resistance on the street, while

mountain bikes have thicker, rugged tires to grip the terrain for better traction.

• Cycle frame: In outdoor cycling, the lighter the frame, the lower the resistance.

• Cadence: The rhythm at which pedals affect muscle activation. One study showed

that higher speeds increased hamstring activation, while slower speeds engaged

the quadriceps.

• Environment: Weather affects cycling performance in outdoor cycling.

• Terrain: The condition of streets or trails affects overall performance as do incline

and decline (hills).

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The muscles engaged in cycling include the gluteus maximus, semitendinosus,

semimembranosus, biceps femoris, adductor magnus, vastus lateralis (externus), vastus

intermedius, vastus medialis (internus), gastrocnemius, soleus, plantaris, tibialis posterior,

flexor hallucis, and flexor digitorum longus.

Here’s how a fitness professional can properly adjust a cycle for comfort, ergonomics, and

performance:

Table 11.8 Upright and Recumbent Bike Setup Procedures

UPRIGHT CYCLES RECUMBENT CYCLES

Adjust the saddle (seat) to hip height. Lift the

Adjust the seat so that the extended leg has a slight
knee to a 90-degree angle from the hip, and
bend in the knee.
adjust the saddle to the height of the thigh.

Clients with lower back issues may benefit from

When seated, the extended leg—with the riding a recumbent rather than an upright cycle.
pedal at the bottom of its rotation—should However, clients with knee pain or injury may benefit
have a slight bend in the knee. more from upright cycles because recumbent cycles
put much more strain on the legs and knees.

With the pedals parallel to the floor, the knee

of the forward leg should be over the ball of
the foot.

Handlebars should be far enough away to

allow a slight bend in the elbows. For clients
with lower back issues, raise the handlebars
until they are comfortable.

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ROWING
Rowing is a low-impact aerobic activity that engages the legs, core, back, and arms. It is ideal for

including in cross-training. To mount the rowing machine, a client should sit on the seat and bring

the seat to the front of the machine, nearest the flywheel. Then the client should place feet into

the stirrups and secure the straps across the toes at the base of the great toe joint. Grasping the

oar with the thumbs under the handle, the client should maintain a light grip.

Each rowing movement has four parts:

• The catch: This is the starting position. The shins should be vertical, lats engaged,

shoulders relaxed, and core engaged. The client should lean slightly forward with
shoulders just in front of hips. A fitness professional should coach the client to

not allow the shoulders to round forward. Some of the muscles engaged in this

position are the deltoids, triceps, trapezius, serratus anterior, erector spinae, rectus

abdominus, hamstrings, tibialis anterior, and gastrocnemius.

• The drive: With back straight, core tight, and feet secured, the client should push

back with the lower body. Some of the muscles engaged in this position are the

biceps, brachialis, brachioradialis, erector spinae, hamstrings, gastrocnemius,

soleus, quadriceps, and gluteus maximus.

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• The finish: When the legs are almost fully extended, the client should hinge

backward at the hips and use the upper back to pull the oar toward the chest. The

oar should touch just below the chest. A fitness professional should cue the client

to engage the lats, not the shoulders or biceps. The drive and finish should be

one continuous movement. Some of the muscles engaged in this position are the

biceps, brachialis, brachioradialis, forearm extensors, latissimus dorsi, trapezius,

quadriceps, posterior deltoid, and gluteus maximus.

• The recovery: This is the return to the catch. The client should extend the arms

before leaning forward at the hips. Once the hands pass over the knees, the client

should allow the knees to bend. Then the client should slide the seat forward and

assume the catch position. Some of the muscles engaged in this position are the

trapezius, rectus abdominus, hamstrings, anterior deltoid, triceps, wrist extensors,

and gastrocnemius.

Figure 11.1 Rowing Movement Pattern

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JUMP ROPE
Skipping rope offers an intense aerobic workout and may improve balance, coordination, and

motor control. In addition, studies have shown that regular rope skipping can increase bone

density for young females.

Beginners and novices may find it easier to jump with a beaded rope rather than a cloth or

vinyl rope. To find the right length rope, a client should grasp the handles and step on the

middle of the rope. The handles should reach the armpits.

A fitness professional should find an area at least four-by-six feet large with enough overhead

clearance for the rope to pass. The jumping surface should be a wood floor, a plywood floor,

or an impact mat. Fitness professionals should be cautious of having clients jumping on hard

or uneven surfaces such as concrete or grass. If a client is not conditioned for jumping, a

high volume of jumping is not warranted and does not follow the principles of progression.

A client should practice upper and lower body movements separately. Fitness professionals

should coach clients to stay on the forefoot to better absorb impact.

BATTLE ROPES
A battle rope is a heavy rope used for intense metabolic conditioning. Some research

suggests that a 10-minute workout with battle ropes meets heart rate and energy expenditure

thresholds to increase cardiorespiratory fitness. HIIT with battle ropes may improve aerobic

and anaerobic capacity after just one month.

Battle ropes vary by length, thickness, and material.

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Table 11.9 Battle Rope Variants

LENGTH THICKNESS MATERIAL

Natural fibers: manila

From 30 feet to 100 feet 1.0 inches to 2.0 inches Synthetic fibers: polypropylene,
Dacron, or nylon

A large space with a solid anchor on which to affix the rope is needed for battle rope

workouts. The most popular use of battle ropes is wave exercises. Pulling exercises are done

by wrapping the rope around the anchor.

Here are some guidelines for varying muscle activation and intensity:

• Thickness: Thicker ropes increase intensity by activating the forearm and hand

muscles to challenge (and develop) grip strength. They also add resistance to the

workout because they are heavier.

• Length: Longer ropes require more space than shorter ropes but provide more

challenge while doing wave exercises.

• Distance from the anchor: Waves should reach all the way to the anchor. The

further a client stands from the anchor, the more challenging the workout.

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 • Wave size/pace: Wave size is subjective, but the larger the upper body motion,

the larger the wave and the greater the intensity. Likewise, pace can increase or

decrease intensity. The faster the pace (the smaller the wave), the more intense

the workout.

• Body position: To vary muscle activation, vary body position. A client should try
kneeling, squatting, lunging, sitting, and doing a plank position to target different

muscle groups.

• Wraps: To perform pulling exercises, a fitness professional can wrap the rope

around an anchor, and the client can pull the rope through the anchor, hand over

hand, and repeat. Intensity can be added by increasing the number of wraps around

the anchor.

KETTLEBELLS
Kettlebells were originally used for recreation and competitive strength athletics. They

continue to be used as such and have added functionality in circuit training as a cardiovascular

challenge. The benefits of kettlebell training include reduced pain in the neck, shoulders,

and low back and stronger overall musculature. Some studies report increased aerobic

conditioning for intercollegiate athletes, while other studies report no change in aerobic

capacity for sedentary adults. Kettlebell swings are complex movements that should be

progressively trained using first no or little weight and then increasing weight as form and

fitness improve.

Common kettlebell exercises include the following:

• Deadlift

• Halo

• Lunge

• Overhead press

• Row

• Goblet squat

• Swing

• Turkish getup

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HALO

OVERHEAD
PRESS

GOBLET
SQUAT

Figure 11.2 Kettlebell Exercises: Halo, Overhead Press, and Goblet Squat

CIRCUIT TRAINING
Circuit training includes strength training and cardiovascular training. A circuit is a group of
CIRCUIT TRAINING: exercises performed in succession. Each exercise is done for a predetermined number of
Body training that combines
endurance, resistance, repetitions or amount of time before moving on to the next exercise with little to no rest
high-intensity interval, and
aerobic training. between exercises.

The benefits of circuit training are constant among many populations, including healthy

adults, youth, seniors, obese adults, and adults with cardiometabolic syndrome and risk

factors for cardiovascular disease. Some proven benefits are as follows:

• Improved body composition

• Increased strength

• Improved cardiovascular performance

• High adherence rate to training

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Even the following greater results are realized when circuit training is manipulated to create HIIT:

• Improved peak oxygen uptake

• Increased perception of general health

• Decreased RPEs

• Improved quality of life

• Decreased systolic and diastolic blood pressures

• Increased stroke volume

• Improved emotional well-being

To implement circuit training, a fitness professional should measure the one-repetition

maximum (1RM) for each exercise to be performed and determine the training intensity for

each. Between 40 and 70 percent of 1RM is recommended. Since measuring 1RM can

be problematic, the use of a time frame, such as “should reach fatigue in 30 seconds” or

“completes 15 to 20 reps in 30 seconds,” is recommended. This will at least provide the

fitness professional with a rough guideline concerning what weight to use depending on what

the circuit training is targeting.

CROSS-TRAINING
Cross-training is a method of training outside one’s chosen sport. For athletes, it helps avoid

overuse injuries and can help maintain training adaptations during seasonal training cycles. CROSS-TRAINING:
The action of training or
For general fitness clients, it is a way to improve and maintain overall fitness while increasing practice in two or more
sports or types of exercise
engagement and exercise compliance. to improve fitness or
performance in one’s main
Research has shown that cross-training: sport.

• improves muscular endurance better than weight training alone,

• produces similar cardiovascular endurance benefits to running alone, and

• reduces the risk of injury from lifting heavy objects compared with weight training alone.

For strength-based athletes, cross-training should include cardiovascular endurance training.

For aerobic endurance athletes, cross-training should include lower-impact aerobic activities and

resistance training. Flexibility training is also a sound addition to any cross-training program.

Too much cross-training violates the fitness principle of specificity. Therefore, if a client has

sport-specific goals, a fitness professional should include cross-training in the off-season or

during a taper.

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OTHER SPORTS APPLICATIONS

Sports that require constant movement are considered aerobic. These include basketball,

cross-country skiing, dancing, fencing, gymnastics, hiking, hockey, ice-skating, kayaking,

lacrosse, martial arts, racquetball, in-line skating, skateboarding, snowboarding, soccer, and

tennis—to name a few. Many of these are cyclic activities in which the same movement is
CYCLIC ACTIVITIES: repeated, but some are considered acyclic activities in which different movements are
Activities that use the same
movement in repetition. involved. Nearly every sport’s performance can be improved with the use of intervals, but the

dominating energy system should be the focus of an effective cardiovascular training program.
ACYCLIC ACTIVITIES:
Activities that incorporate Table 11.10 Energy System Guidelines
different movement
patterns throughout. WHEN TIME REQUIRED
ENERGY TYPICAL
SYSTEM IS FOR FULL
SYSTEM ACTIVITIES
DOMINANT RECOVERY

Resistance training

<200 Msprints
ATP/CP 0-10 seconds 3–5 min.
Plyometrics and
ballistics

Badminton

Soccer
10-120
Glycolytic Gymnastics 20–60 min.
seconds
Hockey

100–400 M sprints

Long-distance running

2 min. and Swimming

Aerobic 24–72 hr.
longer
Rowing

Cycling

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ENVIRONMENTAL INFLUENCES ON ACTIVITY
Many sports have seasons that endure extreme weather conditions. Exercise in extreme heat

or extreme cold places additional stress on the body beyond exercise-induced stress. A fitness

professional is responsible for making choices about training variables, and environment,

including how long and how often a client can train in a given location safely and effectively,

is one of those variables.

EXTREME HEAT
Each person’s acclimatization state, fitness level, and hydration status affect the body’s

ability to dissipate heat to the environment. When temperatures are high, the body depends

on evaporative heat loss—perspiration or sweating—to maintain body temperature.

EVAPORATIVE HEAT
Scientific studies regarding skeletal muscle metabolism during exercise in the heat versus LOSS:
cold have shown the following in heated conditions: Cooling the body and
releasing heat via
evaporation of water and
• Increased plasma lactate levels electrolytes from the skin.

► Lactic acid levels rise when oxygen levels decrease.

• Increased muscle glycogen use

► Depletion of glycogen will reduce muscle endurance.

• Increased serum glucose concentration

► Body’s response to energy demand. Depletion of liver glycogen storage will

lead to the onset of fatigue.

• Decreased serum triglyceride concentration

► There is less fat in the bloodstream, likely due to both less triglyceride

manufacture and more muscle use during exercise.

• Increased anaerobic metabolism during submaximal exercise

► The body expends energy faster than blood can supply the muscles with

oxygen. To keep muscles fueled in this oxygen-deprived state, the body

increases anaerobic metabolism using glucose.

The causes of these conditions may include reduced muscle blood flow and a redistribution

of blood flow away from internal organs in favor of skeletal muscle.

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When body temperature rises, the body produces sweat to release excess heat. Sweating

rates of one liter per hour may result in dehydration, increasing the thickness of blood and

decreasing total blood volume. Both conditions can reduce the amount of heat lost and result

in an elevated core temperature, which can be detrimental to health.

EXTREME COLD
During cold exposure, the body reduces heat loss with peripheral vasoconstriction and
PERIPHERAL shivering. Peripheral vasoconstriction during exercise constricts smaller arterioles near the
VASOCONSTRICTION: skin to keep blood closer to the core of the body. This protective response also limits blood
Constriction of smaller
arterioles near the skin flow to the muscles and has been found to contribute to a decrease in muscle function and
to keep blood closer to
the core of the body and exercise capacity. Shivering is a generally involuntary contraction or twitching of muscle
preserve heat.
tissue as a physiological means of heat production, and it is only observed in humans and

other mammals. Vasoconstriction occurs first, then shivering if body temperature continues
SHIVERING:
Involuntary contraction or to drop below a set point.
twitching of muscle tissue
as a physiological means of Temperature balance within the body in extreme cold and the necessity for shivering are
heat production.
dependent on a few factors:

• Severity of environmental stress

• Effectiveness of peripheral vasoconstriction

• Intensity and mode of exercise

A person’s sex, age, and acclimatization state affect the body’s thermoregulatory responses

to cold. However, the most important factor affecting thermoregulatory tolerance in cold
ALTITUDE TRAINING:
Training at altitudes greater environments is body composition. Bodyfat provides insulation for the body, so those with
than 2,500 meters above
higher body fat mass will have a less severe reaction to extreme cold than those with less
sea level with the goal
of increasing the blood’s body fat mass.
oxygen carrying capacity.

ALTITUDE
ERYTHROPOIETIN
Altitude training includes training at altitudes greater than 2,500 meters above sea level
(EPO):
A hormone with a role in with the goal of increasing the blood’s oxygen-carrying capacity. Specifically, there is an
the proliferation of red
blood cells. increase in erythropoietin (EPO) in the event of chronic hypoxia or lack of oxygen, over a

period of weeks. EPO is a hormone produced by the kidneys and liver that plays a large role

HYPOXIA: in the production of red blood cells. The resulting training adaptation subsequently improves
Lack of oxygen.
sea level endurance performance by increasing lung capacity, increasing the lactic acid

threshold, and positively influencing red blood cell volume and hemoglobin mass.

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Acclimatization to altitude occurs between 12 and 14 days at moderate altitudes, up to

2,300 meters, but can take up to several months.

AIR QUALITY AND POLLUTION

Acute exposure to air pollution, including car emissions, ozone, dust, pollen, and mold, has

been found to significantly reduce exercise performance. However, the benefits of habitual

exercise, even in polluted conditions, seem to win out. In a large-scale study, the Danish Diet,

Cancer, and Health study, researchers found that long-term exposure to air pollution while

exercising did not reduce the benefits of physical activity on overall health. Furthermore,

evidence suggested that exercise reduced the risk of overall mortality by 25 percent.

Even though habitual exercise in polluted areas still has positive effects on health, scientists
suggest finding areas with less pollution in which to exercise. There is no sense in taking two

steps forward and one step back. Thinking through the best options possible in a creative way

will only enhance a fitness professional’s value to their clients.

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