1. Optimizing heart rate during exericise Dr. Aashish Contractor HOD: Preventive Cardiology and Rehab, Asian Heart Inst. Medical Director, Standard Chartered Mumbai Marathon

2. What is Exercise Physiology?

3. Definitions Physiology: is a branch of biological science concerned with the function of organisms and their parts. Exercise physiology is a branch of physiology that deals with the functioning of the body during exercise.

4. Heart Anatomy

6. Cardiac Output The amount of blood pumped by the heart each minute Product of heart rate and stroke volume Q = HR x SV Heart rate = number of beats per minute Stroke volume = amount of blood ejected in each beat 75 bpm x 70 mls/ beat = 5000 mls or 5 liters/min

10. Transition From Rest  Exercise and Exercise  Recovery Rapid increase in HR, SV, cardiac output Plateau in submaximal (below lactate threshold) exercise Recovery depends on: Duration and intensity of exercise Training state of subject

11. Cardiovascular Response to Endurance Training Maximum cardiac output increases Maximum stroke volume increases Maximum heart rate does not change

16. Lactate Threshold

17. Cardiovascular Conditioning n Frequency n Intensity n Type n Time F I T T

18. Exercise Programming Components Cardiovascular Frequency- 3-5 days/week Intensity- 55/65% - 90% HR max 40/50% - 85% VO2R or HRR Duration- 20-60 min of continuous or intermittent (minimum 10 min bouts) Mode- uses large muscle groups, maintained continuously, and rhythmical in nature

19. Intensity Intensity refers to how hard the body is working during exercise. Needs to be sufficient to overload the body in order to achieve a training effect. Common ways for deciding the intensity would be by using Age predicted formula Karvonen formula Functional capacity (MET system)

20. Age predicted formula : HRmax = 220 – Age Karvonen method : Using Heart Rate Reserve (HRR) to calculate intensity HRR = MHR – RHR Target HR intensity = Target % HRR + RHR

21. Guidelines for choosing intensity To experience benefits of cardiovascular exercise one must work at an intensity of 50 % - 85 % of VO2max (MET system) 50 % - 85 % of HRR method 60 % - 90 % of HRmax

22. Monitoring Intensity Heart rate method RPE scale Talk test method

23. Heart Rate Depending on the person’s level of fitness, calculate the Target heart rate intensity range by using the Age predicted formula or the Karvonen method and accordingly ask the client to maintain his exercise intensity in that range.

24. Rate of Perceived Exertion (RPE) Indicates a quantitative feeling of fatigue Used to regulate exercise intensity

25. Borg RPE Scale 6 7very, very light 8 9very light 10 11fairly light 12 13somewhat hard 14 14hard 16 17very hard 18 19very, very hard 20

26. Talk Test This simple test indicates if an individual is working at an appropriate intensity by whether or not he or she can converse while exercising. Breathing should be rhythmical and comfortable. If the person is gasping for breath between words then exercise intensity is too high.