Selection of proper exercise program is very crucial.  Assuming “As my friend is doing so and so exercise I can also do the same” is not advisable. Your Fitness Trainer will plan your exercise routine after assessing your health condition, fitness level, body composition and discussing about your family medical history, goals and how much time you are willing to dedicate for each session. Improvement in overall fitness, increasing functional capacity and minimizing risk of injury should be the primary considerations while starting any fitness program. This can be achieved by emphasizing on training of all the components of physical fitness within the program design.

Components of Physical Fitness
• Cardiovascular Endurance. Also referred to as aerobic fitness describes the ability of cardiorespiratory system i.e. heart, lungs and blood vessels to deliver an adequate supply of oxygen to exercising muscles.
• Muscular Strength.  Is the maximum amount of force a muscle or muscle group can develop during single contraction.
• Muscular Endurance.  Is the number of repeated contractions a muscle or muscle group can perform against a resistance without fatiguing.
• Flexibility.  Describes the amount of movement (range of motion) that can be accomplished at a joint.
• Body Composition.  An individual’s weight on a scale consists of two dimensions : Body fat and Fat free weight (water, muscles, bones, blood, organs etc.)  In general, the body-fat percentage of a fit individual falls in the range of 21 to 24%for women and 14 to 17%for men.  Achieving and maintaining a healthy body composition is an important part of health and fitness.

A balance in the physical fitness components is crucial. One should achieve a balance between muscular strength/endurance and flexibility. The fitness components cardiovascular endurance and body composition relate directly to the primary risk factors for heart disease.  Proper strength training minimizes risk of osteoporosis, arthritis and also helps in maintaining Ideal Body Weight. Flexibility Exercises reduces risk of Injury. Thus addressing all components of fitness will help to achieve the best overall benefits of fitness.

Principles of Exercise physiology

Specificity
Physiological Adaptations to exercise are specific to the system Worked during the stress  of exercise . It means if you do an aerobic exercise like cycling, it will increase your cardiovascular endurance and not muscle strength.

Overload
It means to train the body’s systems (musculoskeletal or cardiovascular) such that these systems must be made to work harder than it is accustomed to working.

Adaptation
The body becomes accustomed to a particular workload and is no longer stimulated to make further gains. A plateau arises after some time of continuous training and no more further benefits are achieved.

Progression
Steadily increasing the workload in proportion to the gains made by the individual in order to continue making improvements.  For e.g. Increasing the duration or speed of walking

Frequency
The number of times per week an exercise routine is performed

Intensity
The amount of work accomplished in a given period of time. In strength training exercise, the load of the weight being lifted determines the intensity.

Duration
The period of time spent on the actual workout. For e.g. 30 mins walk

Cardiorespiratory Fitness
Cardiorespiratory (CR) fitness, sometimes called CR endurance, aerobic fitness, or aerobic capacity, is one of the five basic components of physical fitness. CR fitness is a condition in which the body’s cardiovascular (circulatory) and respiratory systems function together, especially during exercise or work, to ensure that adequate oxygen is supplied to the working muscles to produce energy. CR fitness is needed for prolonged, rhythmic use of the body’s large muscle groups. A high level of CR fitness permits continuous physical activity without a decline in performance and allows for rapid recovery following fatiguing physical activity.
Activities such as running, bicycling, swimming, cross-country skiing, rowing, stair climbing, and jumping rope place an extra demand on the cardiovascular and respiratory systems. During exercise, these systems attempt to supply oxygen to the working muscles. Most of this oxygen is used to produce energy for muscular contraction. Any activity that continuously uses large muscle groups for 20 minutes or longer taxes these systems. Because of this, a wide variety of training methods is used to improve cardiorespiratory endurance.
Benefits of Aerobic Exercises
• Decrease in Heart disease risk factors by reducing resting blood pressure, increasing HDL Cholesterol, decreasing total cholesterol, reduction in body fat stores, increased heart function
• Prevention of type 2 diabetes
• Helps in control of diabetes by reducing blood glucose levels and increasing insulin sensitivity
• Increased aerobic work capacity
• Increased lactate threshold
• Decreasing resting heart rate, Increasing total blood volume, increasing heart volume, increasing resting and maximum stroke volume, increasing maximum oxygen consumption
• Increasing capillary density and blood flow to active muscles
• Increasing maximal ventilation
• Reduction in anxiety, tension and depression.

Any type of fitness training, whether it is aerobic training, strength training, or flexibility training is based on the overload principle. Overload means to train one of the body’s systems (Skeletal system or cardiopulmonary system) such that, that system must be made to work harder than it is accustomed to working. The exercise must cause a sustained increase in the amount of blood returning to the heart. To maintain overload, aerobic training should follow four rules.  The exercise should
(1) Be the correct type, (2) be done at the proper intensity, (3) be of sufficient duration, and (4) occur with adequate frequency.

Exercise Mode

Selection of the exercise mode is made on the basis of your functional capacity, interests, time availability, equipment and facilities, and personal goals. Any activity that uses large muscle groups, is rhythmical and cadiorespiratory in nature, and is maintained continuously can be used. Walking, jogging cycling, group aerobic class, cardio kickboxing, stair climbing, cross country skiing, rowing and swimming are examples of aerobic exercises.

Exercise Intensity
Intensity refers to speed or level of exercise workload. Working out at proper intensity is very crucial. Your level of fitness determines at which intensity you should exercise. For beginners even low intensity can give maximum benefits of exercise and as your functional capacity increases you need to increase your intensity to achieve same benefits.
Research shows that optimum exercise intensity for fitness improvement is in the range of about 50 to 85% of maximum oxygen consumption.  The higher a client’s level of fitness, the higher should be the appropriate exercise intensity.

Monitoring Exercise Intensity

Heart rate 
(a) Percentage of Maximal Heart Rate
(b) Percentage of Heart Rate Reserve

(a) Percentage of Maximal Heart Rate
Maximal Heart Rate (MHR) can be determined accurately by a maximal functional capacity test (Graded Exercise Test) by using a treadmill or bicycle ergometer preferably in presence of a physician. MHR can also be calculated by Age -predicted formula

MHR = 220-age
Target Heart Rate (THR) × Percentage of MHR

For e.g. If a 40 year old women desires to workout at the intensity of 70% of her maximal heart rate :
MHR = 220-40 = 180 (predicted max HR)
180 × 0.70 (70% exercise intensity)
THR = 126 (target exercise HR)

You need to use caution while using this method and individuals older than 65 may have significantly higher MHR than predicted by this formula.

(b) Percentage of Heart Rate Reserve (Karvonen Formula)
It is the more accurate method to determine intensity. In this you need to take out your heart rate reserve.

Training Heart Rate (THR) = Maximum Heart Rate (MHR) – Resting Heart Rate(RHR) × desired intensity (50 to 85 %) + Resting Heart Rate.

For e.g. If the above mentioned women has RHR of 80 bpm (pulse rate of beats per min) her training heart rate will be :
MHR = 220-40 = 180
HRR = 180  – 80 (RHR) = 100 (RHR = Resting Heart Rate; HRR = Heart-rate reserve)
100 × 0.70 (desired intensity) = 70
THR = 70 + 80 (RHR) = 150 (target HR at 70% of heart-rate reserve)

Rate of Perceived Exertion
Exercise intensity can also be measured by assigning a numerical value to subjective feeling of exercise exertion. RPE takes into account all that the exercising individual perceives in terms of exercise fatigue including psychological, musculoskeletal and environmental factors. It correlates with cardiorespiratory and metabolic factors like heart rate, breathing rate, oxygen consumption, and overall fatigue.
It is best to workout by measuring Heart Rate determined by percentage of maximal heart rate or percentage of heart-rate reserve and correlate it with RPE scale.

Ratings of Perceived Exertion

Revised RPE Scal

0    Nothing at all
0.5    Very, very weak
1    Very weak
2    Weak
3    Moderate
4    Somewhat strong
5    Strong
6
7    Very strong
8
9
10 Very, Very strong
*   Maximal

You can use this scale as a subjective way of measuring how hard you are exercising.  For most people, exercising at a “Somewhat strong to hard” level (3 to 5 on the 0 to 10 scale) correlates well with an appropriate training heart rate

Talk Test
it utilizes the hyperventilation response to monitor intensity. You should be able to carry on a comfortable conversation while exercising, if breathing is labored and difficult, the intensity is too high. Hyperventilation during exercise is normally accompanied by a burning, sometimes painful sensation in the active muscles because of lactic acid accumulation. This method is usually used for beginners or low fitness level

Exercise Duration
The third rule is that an aerobic exercise bout should last for a minimum of 10 minutes per session with a goal of at least 20 minutes of aerobic activity accumulated over the course of a day to lead to substantial fitness improvements over time.  Once a client reaches the proper intensity, the activity must be sustained for the minimum time to cause adequate aerobic overload. There is an inverse relation with the intensity and duration.  If the intensity is increased, the dyration can be decreased and a similar training effect will be achieved. Conversely, if the intensity is decreased, the duration must be increased to elicit the same training effect

Exercise Frequency
The fourth rule for cardiovascular training is that the proper type of activity, done at the correct intensity and continued for a sufficient length of time, must be performed at least three days per week. While training three days per week may be sufficient, especially for those just beginning an exercise program, more frequent exercise, such as a brisk, daily walk is certainly acceptable. It is important to allow adequate rest and recovery to minimize the risk associated with overtraining.  You can modify criteria such as the mode, frequency, duration and intensity of exercise to suit your level of fitness,  program goals ,and schedule.  It is important to build a foundation of endurance at a relatively low-to-moderate intensity prior to performing higher intensity workouts or competitions for safety and comfort.  Thus, in the beginning, you can gradually increase the duration, while holding intensity nearly constant until acceptable level of endurance such as 20 to 30 minutes, has been achieved then increase intensity to achieve further goals.

Progression

Initial Conditioning Stage
This stage usually lasts four to six weeks or longer.  It may include low level aerobic activities at an intensity of 40 – 60% of Heart rate reserve for the duration of 10 to 20 mins for 3/5 sessions per week. Duration of Exercise must be gradually increased depending upon the client’s response to exercise and initial fitness level.

Improvement Conditioning Stage
It may lasts from 8 – 20 Weeks. The rate of progression is very rapid.  The intensity can be increased with 60 to 85% of HRR depending on fitness level and age.  Duration should be increased every 2-3 weeks according to the client’s response and goals.  For achieving safe progression duration of exercise should be increased first before increasing intensity.  Monitoring every 2 to 4 week intervals (RPE, Heart rate, symptoms, risk factors, caloric expenditure) is important.

Maintenance Stage
When client achieve their primary goals and target functional capacity, the maintenance stage begins.  This stage may be reached within 6 to 12 months.  Maintaining their fitness level becomes crucial in this stage.  Clients must be encouraged to engage in variety of different activities or sports having similar energy requirements which are of their likings, fun and enjoyable.

Warm-up and Cool-down
Warm-up and cool-down periods are essential parts of any exercise session. The length of these sessions is proportional to the intensity and length of the conditioning phase.  A typical 30 to 40 minute conditioning phase at 70% of maximum heart rate would warrant a 5 to 10 minutes of warm-up and cool-down.  The aerobic component of warm-up and cool-down phase should be followed by stretching those muscle groups active in the conditioning phase.

Warm-up
Graduated low-level aerobic exercise is essential for maximizing safety and economy of movement during the aerobic conditioning phase of an exercise session. The warm-up should gradually increase the heart rate, blood pressure, oxygen consumption, dilation of the blood vessels, elasticity of the active muscles, and the heat produced by the active muscle.

Benefits of warm up
• Gradually increases the heart rate
• Gradually increases the body temperature
• Prepare the body for rigorous demand of exercise
• Gradually increases cardiac output, blood pressure and oxygen consumption
• Increases elasticity of connective tissues and muscles
• Prepares the body psychologically for exercise

Cool-down
Purpose of the cool down is to slowly decrease the heart rate and overall metabolism, both of which have been elevated during the conditioning phase.  Cool down helps prevent the sudden pooling of blood in the veins and ensures adequate circulation to the skeletal muscles, heart and brain. Cool-down may aid in preventing delayed muscle stiffness and reduces any tendency toward post exercise fainting and dizziness. Low level of aerobic exercise, similar to that of the conditioning exercise is recommended.

Benefits of cool down
• Gradually lowers heart rate to normal
• Avoids blood pooling in lower extremities
• Avoids rapid drop in blood pressure thus avoiding occurrence of light headedness and dizziness
• Decreases overall metabolism and concentration of exercise hormones
• Reduces the tendency for muscle cramping and spasm

Training Methods

Continuous Training
This method involves training for a specified duration at a particular intensity throughout, without taking breaks. Exercise mode can be walking, cycling, swimming or aerobic dance. Intensity is maintained continuously between 50-80% of HRR depending upon fitness level.

Interval Training
It involves alternating high intensity bouts of exercise with relatively low intensity bouts. This is specifically beneficial to clients who wish to train at higher intensity but cannot sustain it for longer periods. It enables the client to recover during low intensity session and thus can perform another high intensity session.

Fartlek Training
Its similar to internal training but high low intensity workout are not systematically measured.

Circuit Training
It involves going through a series of exercise stations with relatively brief rest between each station. It mainly helps to enhance muscular endurance and incorporates low weight high repetition exercises. It may also be aerobic circuit training including stationary cycling, trade mill, Stair climber, elliptical trainer and rowing. It can also be the combination of both aerobic and anaerobic training.

Aerobic Cross Training
It comprises of all aerobic training methods with variety of exercise intensities and modes. It make the session enjoyable and interesting.

Recommented Exercise Program for beginners
1^st Month :
Warm up pf 5 to 10 mins slow walking /cycling – increasing the speed gradually along with some stretching exercises like cross toe touch or side bends (detail flexibility exercises will be discussed later)
Brisk walking / cycling for 15 to 20 mins at the intensity of  3 or 4 , 2 days per week.
Gradually slowing down speed to cool don for 5 to 10 mins and static stretching of major muscle groups.

After a month gradually increase the duration of brisk walking / cycling to 30 to 40 mins per session. The intensity can be increased to 5 or 6 on RPE scale.

Safety Guidelines
Following listed are some precautions to be taken while undergoing exercise program

• Avoid exercise for atleast 90 mins after meals
• Ask your client to stop immediately if there is chest discomfort, lightheadedness or dizziness
• Lower exercise intensity in very hot or humid environment and to altitudes above 5000 feet
• Take rest if there is tenderness in joint.  Ask them to consult doctor if there is any joint injury.
• Discontinue exercise during illness like viral infections.
• Obtain clearance from medical practitioner in cases of hypertension, diabetes, cardiovascular disease.
• Wear proper exercise apparel like proper shoes and clothes which facilitate full range of motion, absorbs sweat and are comfortable.
• Provide proper ventilation for indoor exercise
• Use safe equipments and are tested at regular intervals
• Include proper warm up and cool down sessions in exercise program
• Drink water before, during and after exercise.

Manasi Joshi