EXERCISE PRESCRIPTION

Table 3: The Keele Lifestyle nomogram for predicting VO2 submaximal ergometer cycling

RPE VO2max 9

10 11 12 13 14 15

max (l/min) from RPE during Cycle workrate (watts)

30 40 50 55 60 65 70 75 80 85 90 100 105 110 120 0.5 1.01 1.3 1.62 1.76 1.91 2.08 2.23 2.37 2.54 2.69 2.83 3.15 3.3 3.44 3.76 0.55 0.92 1.2 1.48 1.62 1.75 1.89 2.03 2.17 2.31 2.45 2.59 2.87 3.01 3.15 3.42 0.6 0.84 1.1 1.36 1.49 1.62 1.74 1.87 2 2.13 2.25 2.37 2.63 2.76 2.89 3.15 0.65 0.79 1.03 1.26 1.38 1.5 1.62 1.73 1.85 1.97 2.09 2.2 2.44 2.56 2.67 2.91 0.7 0.74 0.96 1.18 1.28 1.39 1.51 1.62 1.72 1.83 1.95 2.05 2.27 2.37 2.49 2.71 0.75 0.69 0.9 1.1 1.21 1.3 1.41 1.51 1.62 1.71 1.81 2 2.1 2.18 2.37 2.57 0.8 0.66 0.84 1.04 1.13 1.23 1.33 1.42 1.52 1.62 1.71 1.81 2

2.18 2.37 2.57

do they need to wear their glasses etc? Ask them to read it from the position of exercise

3

4 5

Explanation of the scale – make it clear that the scale is a measure of

how hard they are finding the activity now. If at any time they feel a change in how they are feeling they should inform you of their new rating

Acknowledging that the rating is made up of an integrated response

(eg.combined feeling in legs, arms, breathing etc.)

Anchor the top and bottom of the scale by creating an association with

the lowest and highest exertion levels. This can be done by explaining that level 6 equates to ‘sitting comfortably in a chair sipping their favourite drink’. To imagine the highest rating they should think of struggling to catch their breath and their whole body feeling completely exhausted and weakened by physical effort.

For the best results a cycle test should be performed for people wishing to exercise on a bike and a treadmill/walking test for those preferring to walk/jog/run.

The Keele Lifestyle nomogram protocol The test is performed for six minutes on a standard cycle ergometer on which workrate, in watts, can accurately be measured.

The aim is to raise the subject’s RPE to at least 9 and preferrably 11-13 within the first two minutes of cycling. If this is not achieved the workload should be increased by 50% for untrained and 100% for trained or young subjects, respectively. Table 2 pro- vides a guide to choosing appropriate start- ing pedal speeds and workrates.

If the workload has to be increased during the test, at least three minutes should be allowed for the heart rate to plateau in rela- tion to the workrate. The RPE at the 6th minute is required for the calculation of VO2

max.

Simply read down the left-hand column of table 3 to the RPE given by the exerciser in the 6th minute and then read across to the column of the workrate in watts. The value at this intersection is the predicted VO2

What to do with VO2 max Table 4 can be used to prescribe exercise

Table 4: Prescribed exercise cycle ergometer work rates in relation to VO2

max (l/min) Sedentary

VO2max (l/min)

0.9-1.1 1.2-1.4 1.5-1.7 1.8-2.0 2.1-2.3 2.4-2.7 2.8-3.0 3.1-3.3

26 SportEX

Pace at 55-65% VO2max (Watts)

36 43 65 84 97

111 129 143

Moderate/regularly active Pace at 65-75% VO2max (Watts) 41

50 75 96

112 127 149 165

intensity on a cycle ergometer where VO2 max has been predicted. Locate the indi- vidual’s VO2

max on the chart and read

across from this score to the training sta- tus column which best describes the con- dition of the subject. The value at the intersection should then act as a guide to the level of exercise to recommend.

This feature is a summary of two chapters taken from the recently published Butterworth Heinemann book Exercise on Prescription. The book is an excellent and essential guide for anyone working in health promotion. It is packed with numerous tables, charts and dia- grams accompanied by comprehen- sive and practical explanations and advice. Copies can be ordered from the BH’s customer service depart- ment on 01865 314301 (ISBN 0 7506 3288 7) at a cost of £16.99.

COMPETITION max.

SportEX Medicine has ten copies of Exercise on Prescription to give away which have been kindly donated by Butterworth Heinemann. All you have to do is tell us about your health pro- motion project. Fill in the one page form, the link for which can be found on the home page of the Sportex Medicine website, or if you are without internet access, telephone us on 0181 287 3312 to request a faxable form. The first ten projects received will win a free copy and be entered into a draw to win £100 along with all additional project entries received.

TIP