1. NVFC Health and Wellness Resource Modules
FITNESS BASICS: Cardiorespiratory

2. Cardiorespiratory Fitness
Cardiorespiratory Endurance
The ability of the heart and lungs to deliver oxygen to the working muscles and for the muscles to extract the oxygen
Cardiorespiratory Fitness
Improves the function and efficiency of the cardiovascular and respiratory systems, increases metabolism, and burns calories
Cardiorespiratory Endurance
The cardiovascular and respiratory systems work together to make-up our cardiorespiratory endurance. The heart must pump blood through the body, including the lungs. When the blood passes through the lungs following an inhalation it picks up oxygen and drops off carbon dioxide for expiration – this process is known as gas exchange. The reverse exchange happens at the muscles – the blood delivers oxygen to the working muscles and takes away carbon dioxide allowing the muscle to maintain working aerobically (with oxygen).
Cardiorespiratory Fitness
In order for the cardiovascular and respiratory systems to become stronger and work together as cohesively as possible they must be forced to work under more strenuous conditions then the everyday basics of living. Through cardio-respiratory endurance training each system is called upon to work harder, and they must work as a team in order to meet the supply and demand of the muscle systems that are working during the activity.

3. Health Benefits of Cardiorespiratory Fitness
Reduces risk of coronary artery disease
(ie. heart disease)
Lowers Cholesterol
Improves TC/HDL ratio
Decreases Heart Rate and Blood Pressure
Lowers Cholesterol and Improves Total Cholesterol (TC)/HDL Ratio
Cardiorespiratory exercise increases the production of HDL (high density lipoproteins or “good cholesterol”) in the liver. This increased production of HDL helps clear LDL (low density lipoproteins or “bad cholesterol”) and other plaque contributing factors that are present in the arteries that can increase the risk of forming a clot – which may stop blood flow to areas below its formation. When a clot happens in the coronary (heart) arteries we call it a heart attack, and when it occurs in the cerebral (brain) arteries we call it a stroke.
Through the increase in HDL levels and the lowering of the LDL levels, we will see the relationship between the Total Cholesterol (TC) and the HDL get better. This relationship is expressed as a ratio – which is derived by dividing the TC by the HDL. The ratio is considered healthy when it is below 4.5.
Decreases Heart Rate and Blood Pressure
The cardiovascular system must be able to pump enough blood efficiently throughout the body in order to deliver oxygen and remove carbon dioxide from the working muscles. The respiratory system must be able to take in oxygen at an adequate enough rate to meet the working muscles demand. The more a person taxes their systems to perform these basic systems at a higher intensity, the stronger and more efficient the systems become at all times – including at rest.
This is why we see decreases in blood pressure and heart rate at rest – the body responds to the increase in demand during exercise and is able to train itself to work smarter and not harder at rest. This decreased workload on the heart allows it more relaxation and recovery time, therefore decreasing the risk of heart attack.
The slower and less forceful contractions decreases the amount of pressure that is placed on the arterial walls, which decreases blood pressure, therefore lowering the risk of heart attack and stroke.

4. Cardiorespiratory Fitness Program Components
Frequency
Intensity
Time
Type
Frequency
Recommendation is minimum of 3 days/week at appropriate exercise intensity. If possible, physical activity should be done every day.
Goal is to increase daily energy expenditure kcal. Can be achieved by increasing activities of daily living (ie. walking at moderate intensity every day).
Add recovery time
1 day off between workouts helps reduces overtraining
Intensity
64-94% of maximum heart rate
40/50-85% maximum oxygen consumption (depending on medical concerns- refer to the ACSM 7 Major Risk Factor section of the HWA manual)
12-16 Rate of Perceived Exertion
Time
20-60 continuous minutes; or 3 sessions of 10 minutes has same effect as 30 continuous minutes in untrained individuals
Relationship between intensity and duration is inverse
30 10 kcals/minute = 300 kcals
kcals/minute = 300 kcals
The goals is to use time and intensity together in away that allows maximal caloric burn for the individual:
Fitter individuals can work at higher intensity for less time
The beginning exerciser will need to work at lower intensity for longer durations in order to burn maximal calories
Type
Rhythmic movements of the large muscle groups – swimming, walking, cardiovascular exercise machines such as the Elliptical and Cross Trainer
Activities should be low impact for the beginning exerciser in order to prevent injuries.

5. Cardiorespiratory Fitness
Monitoring intensity
Target heart rate (THR)
Rate of perceived exertion (RPE)
Talk test
Target Heart Rate:
AGE PREDICTED MAX HEART RATE (APMHR)
Used for Healthy Adults under 50 years with one (1) or no (0) ASCM coronary artery disease risk factors; uses a range between 64/70% - 90% of APMHR
220 – Age = Age Predicted Max Heart Rate (APMHR)
Example: 28-year old individual
220 – 28 = 192 BPM
192 BPM * 64% = 123 BPM
192 BPM * 90% = 173 BPM
HEART RATE RESERVE (HRR)
More individualized, used for individuals with known cardiac risk factors; uses resting heart rate in addition to age; uses a range between 40/50% - 85% of HRR
220 – 28 = 192 BPM
APMHR – Resting Heart Rate (RHR) = Heart Rate Reserve (HRR)
192 BPM – 62 BPM = 130 BPM
(HRR * % of Intensity) + RHR = Target Heart Rate Reserve
130 * 40% = 52 BPM + 62 BPM = 114 BPM
130 * 85% = 110 BPM + 62 BPM = 172 BPM
Rate of Perceived Exertion (RPE):
RPE is a scale that allows an individual to judge their intensity based on how they feel like they are working. Often the RPE is used as a scale, in which 0 reflects a minimal work load while 10 would reflect maximal workload – almost to the point of system failure.
Examples:
Quietly sitting in a chair would have a rating of 0
Walking at a pace that you feel is moderate might be given a rating of 3 or 4.
The recommended RPE range for most people is usually between 3 (moderate) and 7 (very strong) which correlates to % max HR for all ages.
Talk Test
This method can easily be used to determine if the workload is too high. The test is simply reciting the Pledge of Allegiance during exercise and then determining whether it was easy to do without feeling winded or if it was hard to do without feeling winded. The test can also use intermittent conversation as a guide. If a brief conversation (30 sec or less) can be carried out without feeling winded then intensity is at an appropriate level.

6. Guidelines and Considerations
Physician’s clearance
Extended warm-up and cool-down
Low or non-impact
Longer duration and lower intensity
May be accumulated in shorter bouts throughout the day
Modify as needed
Physicians Clearance: Physicians clearance will be needed for anyone that has a known history of heart disease, or that has 2 or more of the ACSM 7 Major risk factors covered in the HWA course. It is good to request exercise guidelines and limitations from client’s physician, and to maintain close contact with client’s physician.
Extended Warm Up & Cool Down: Many people with cardiovascular disease have a compromised metabolic and or cardiorespiratory system and it takes longer for their bodies to adjust to changes in intensity. Warm-up and cool down should be extended to allow the individual enough time to safely perform and recover from the exercise session. The warm-up and cool-down session might be longer than 10 minutes each in order to produce a safe exercise environment.
Low or Non-Impact: Low or non-impact with longer duration and lower intensity exercises will benefit the beginner exercise greater as it allows them to exercise more comfortably for longer durations. The less intense longer duration will allow for greater caloric burn, faster recovery, and confidence in their program versus a high intensity program that can yield high risk of injury and discourage and intimidate the beginning exercise from continuing.
Shorter Bouts of Exercise: If need be, split up the cardio-respiratory sessions into 3 – 10 minute bouts of exercise. This will yield the same results as 30 continuous minutes, and can make the program seem more manageable to the beginning exerciser.
Modify As Needed: If after following all of these steps the program still seems too difficult for the beginning exerciser look for more ways to modify the program. Add more rest between machines – try different types of training (interval, circuit, long slow distance). Change the mode of exercise (walking, elliptical, swimming, cross trainers, stationary bikes).

7. Additional Resources American Council on Exercise
ACE Personal Trainer Manual (3rd Edition) (ISBN 13: ; ISBN 10: )
National Volunteer Fire Council
Heart Healthy Firefighter Program