Heart-Rate Training

A Non-Invasive Window Into Your Body

One of the most frequently asked questions is "Why can't I just take my pulse on my neck or wrist". According to studies done by Dr. James Rippe and published in the New England Journal of Medicine; taking your pulse during exercise is not only intermittent but also inaccurate by as much as +/- 15 beats per minute.

This discrepancy is significant with a healthy population -- consider the potential consequences with a decconditioned or diseased population. Also, consider that other muscle movements and heavy breathing can make it hard to find, let alone count, your pulse. And if you stop or slow your activity to count, it's not really an accurate measure of your exercising heart rate.

Integrating "At Risk" Members

Intermittent vs. Continuous Heart Rate Monitoring

Safety Tips For Cardiovascular Exercise Obtain your doctor's approval and good supervision and instruction when starting an exercise program Warm up before and cool down after exercise. Avoid sudden strenuous exertion and abrupt cessation of vigorous exercise. Start gradually. If you plan to start jogging, begin with a brisk walking program and gradually progress to slow jogging over weeks or months. Exercise regularly. Don't try to cram all your exercise into one day per week. Heed warning signs and symptoms. Angina Breathlessness Clammy perspiration Dizziness Edema Fluttering Gastric upset Avoid high-intensity activity. The exercise should feel "fairly light" to "somewhat hard". The "talk test" is another way to determine if you are overdoing it: if you are unable to comfortably carry on a conversation during exercise, you are probably working too hard. Heart rate monitoring can be especially helpful in this regard. Undergo exercise testing periodically to assess your progress and screen for abnormal signs and symptoms. Wear appropriate, comfortable clothing and shoes for optimal comfort and performance. Try to exercise before meals; if you can't, wait until at least one hour after you've eaten. Don't exercise if you are ill. Don't exercise outdoors on extremely hot or cold days, or when the humidity is high or it's very windy, use your health club.

Intermittent vs. continuous heart rate monitoring is another issue worth discussing. Intermittent usually means taking the pulse manually at the wrist or neck. Another example of this is the contact method employed by cardiovascular equipment manufacturers. This requires the participant to manually grasp the appropriate handles on the device to get a heart rate reading. These can be inaccurate and awkward to utilize. These contacts are affected by sweat, hand lotion and contact pressure to name a few. Some heart rate monitor manufacturers also employ the contact/intermittent method. They either pick up the radial pulse at the wrist or require the participant to apply digital pressure on the monitor to take a pulse. A heart rate monitor that provides continuous heart rate is not a pulse monitor. They are true heart rate monitors that incorporate the same technology as expensive hospital ECG machines found in the hospital, physician's office and physiology laboratories. The monitor has two components; the transmitter worn around the chest that picks up electrical signals directly from the heart with every beat and the receiver, which picks up the signal (radio telemetry) from the transmitter and displays it in watch-like fashion. The other side of the coin is the high intensity exercise addicted individual. There is a growing body of scientific evidence demonstrating myocardial (heart muscle) damage from frequent high intensity cardiovascular activity. Leading the investigation currently is Dr. Timothy Noakes from South Africa and well-known author of informational texts such as The Lore of Running. Dr. Jamie Ducet and interventional cardiologist in Boulder, Colorado has seen 6 such incidents in the past year. Two of these required surgery to repair the damage done by frequent high intensity cardiovascular exercise. The need for well educated, appropriately credentialed personnel in the health club setting is imperative to assist members in product selection, exercise intensity, appropriate program design, realistic goal setting for optimal results and reduced risk potential. The scientific evidence is there; we just need to review it and promote practical application. Every health and fitness professional that uses "evidence based" knowledge to validate his or her programs does so with the temperament of experience and keen observation. This in turn promotes credibility within our profession and the industry at large. Frequent Vigorous Exercise Is Better Than Intermittent Vigorous Exercise According to Paul D. Thompson, M.D. in his book, Exercise and Sports Cardiology, exercise can provide adults with multiple cardiovascular benefits, but it also carries risks. Sudden cardiac death (kills an estimated 225,000 Americans each year) and acute myocardial infarction are the most important cardiovascular complications of exercise based on both frequency and seriousness.

Researchers at Boston's Brigham and Women's Hospital have found that frequent vigorous exercise is better than intermittent vigorous exercise in the reduction of cardiovascular disease and sudden cardiac death. The doctors go on to say that besides protecting the heart, regular, vigorous exercise strengthens bones and muscles, increased flexibility, and reduces blood pressure, cholesterol, body fat, stress and risk of stroke.

Keep in mind this is not a problem exclusive to adults. Doctors from the Centers for Disease Control and Prevention conducted the first-ever survey of cardiac arrest in people ages 14-34. Across the United Stated, the number of fatal cardiac arrests in this age group rose from 2,710 in 1989 to 3,000 in 1996. In all, 23,320 young adults died, almost three-quarters of them men.

According to federal figures, 17 percent of U.S. high school students say they smoke cigarettes regularly, compared with 12 percent a decade ago. Twelve percent of people in there 20s are now considered obese, compared with 7 percent 10 years ago.

Among people in there 30s, obesity has risen from 11 percent to 19 percent. Too much weight causes an array of ill effects that might increase the risk of cardiac arrest, including heightened cholesterol levels, high blood pressure and diabetes.

If childrens' health is your interest and passion look at the research and publication by Thomas Rowland, M.D.. Among the highlights are "Developmental Exercise Physiology" and "Exercise and Children's Health". Remember the national statistic that states; one in four children are obese and children as young as 12 have abnormal cholesterol values.

Heart Rate Appropriate Exercise

• Lowers blood pressure, especially in people who have high blood pressure
• May reduce triglyceride and total cholesterol levels, increase HDL-cholesterol levels, and lower LDL-cholesterol levels.
• Helps control body weight and reduce body fat
• Relieves stress
• Helps regulate blood sugar levels in people with diabetes

• Cholesterol less than 200 mg/dl
• LDL-cholesterol less than 100 mg/dl
• HDL-cholesterol greater than 35 mg/dl
• Triglyceride less than 200 mg/dl

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"So as the fitness level increases, the heart can pump more oxygenated blood with each beat. "

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Each individual has their own personal heart rate and responds to exercise in different ways. This is one of the fundamental reasons to determine ones individual heart rate and not use tables and charts, which are erroneous and antiquated. Under a constant workload, the heart rate of a very fit person increases more slowly than that of an unfit person. Differences in skill and technique during exercise also affect the heart rate.

A person's heart rate can vary from day to day. Individual heart rates are based on maximal heart rate. Factors affecting max heart rate include age, gender, stress, disease and fitness level along with other genetic factors. A simple effective method is for males to take 220 (theoretical maximal heart rate) - age = personal age adjusted maximum heart rate. For females take 226 - age = personal age adjusted maximal heart rate.

The higher theoretical maximal heart rate is to accommodate for the smaller female heart, decreased stroke volume and smaller blood volume as a whole. Recently as published in the New York Times the theoretical max heart rate theory has been challenged. However, until the body of evidence-based data grows, it is still a good estimate of theoretical maximal heart rate.

Experienced individuals and athletes may use a different formula, which accounts for resting or morning heart rate. This allows for training adjustments on a daily or weekly basis. In this formula you need to know your actual maximal heart rate. The author recommends that those considering engaging in an exercise regiment, increasing the intensity or their program or presenting with risk factors or history appropriate of further testing have a "graded exercise test" (GXT) under the supervision of a cardiologist.

Not only will you determine your appropriate maximal heart rate you will also gain valuable information regarding cardiovascular response to increased workload (exercise). The test, under the supervision of a cardiologist, will determine three very important variables.

• The electrical response of the heart under stress
• Blood pressure response to increased demand
• Heart rate response to increased demand

Do not confuse this evaluation with a sub-maximal test or a VO2 assessment. These tests may not be appropriate for the average exercise enthusiast. The health and fitness professional should search the literature for a review of testing methods and draw their own conclusions.

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"More frequent, shorter duration bouts of cardiovascular activity are more beneficial and less dangerous"

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Once the maximal heart rate has been determined an appropriate cardiovascular program can be developed. Additional factors to consider when developing and implementing a heart rate monitor program include;

• Intensity-during aerobic exercise, the intensity level is determined by the speed and type of movement as well as the muscle mass involved. A fast tempo makes the exercise more strenuous. Adding active muscle mass (for example, adding arm movements to leg movements and adding hand-held weights) during exercise increases the intensity.
• Mode -- what type of exercise will be determined by the current condition of the individual, goals of the program and equipment available.
• Duration/Frequency-studies show that more frequent, shorter duration bouts of cardiovascular activity are more beneficial and less dangerous. Minimal levels might include 30-40 minutes of aerobic activity 5-6 times a week.
• The position of the body-the heart rate is lowest when lying down and highest when standing, because of the work required to return the blood through the veins to the heart.
• Environmental factors-high temperatures and or humidity increase heart rate; low temperatures may alter the heart rate as well. A one percent decrease in hydration may vary the heart rate by as many as 5 beats per minute.
• Psychological and physiological stress levels-the heart rate, both at rest and during exercise, is generally elevated in the overworked body. Excessive exercise may cause excess fatigue and stress. Lack of sleep and the demands of family, study, and job may also influence the heart rate.
• Drugs-a number of drugs, used to treat heart disease, hypertension, asthma, coughs, and stress or anxiety can accelerate or decelerate the heart rate depending on the pharmacological action of the drug. Refer to the ACSM's drug guide for specifics.

Most forms of aerobic training use the legs, not the arms. Exceptions include rowing, swimming, and Nordic skiing. Research suggests that exercise should condition the arms as well as the legs. In many of the activities of daily living, the need for upper body strength and endurance is tremendous. Because of the SAID principle (specific adaptation for imposed demands) the upper body will not be conditioned in the same manner as the lower extremities. Typically the heart rates for upper body activity are 10-15 beats lower than for lower extremity activity.

Typical Heart Rate Training Zones (based on a percentage of maximal heart rate:

• Anaerobic or interval work: 85 - 95% max heart rate
• Lactate threshold or Anaerobic threshold work: 75-85% max heart rate
• Tempo work: 65-75% max heart rate
• Recovery work 55-65% max heart rate

Examples of potential weekly cardio-appropriate activity utilizing a heart rate monitor:

Consider 100% of cardiovascular activity occurs on a weekly basis

• 75% is done in the recovery heart rate zone
• 15% is done in the tempo heart rate zone
• 5% is done in the LT/AT heart rate zone
• 5% is done in the anaerobic (red) heart rate zone

Example of appropriate walking/running program:

Walking for performance requires that you work hard enough to get your heart rate into the 80-90% of maximum zone one to three times per week. The idea is to force your body into taking in and circulating a large volume of oxygen while walking and to teach your muscles to utilize that oxygen efficiently so that you can walk faster without building up lactic acid in your blood and muscles. In doing so you are raising your lactate threshold.

SAMPLE WORKOUTS

Here are some sample workouts used by recreational walkers. Try them as is or modify to meet your schedule and level of fitness.

TEMPO WALKS

After a 10-minute warm-up at 60-70% max heart rate, walk for 20-30 minutes at approximately 85% of max heart rate or 10 beats below your anaerobic threshold. Cool down easily for 10 minutes afterwards.

LACTATE THRESHOLD INTERVALS

After sufficient warm-up, walk 3x8 minutes, or 3x2 minutes at 90% max heart rate or at your anaerobic threshold. Repeat this routine 4-10 times allowing your heart rate to drop 20 beats between intervals.

RECOVERY WALKS

Walk 60-minutes or longer at 55-60% max heart rate or 20-30 beats below your anaerobic threshold. Remember, this is recovery and you should not exceed the recommended heart rate.

SAMPLE WEEK: FOR PERFORMANCE

Exercise times per day

Sun	Mon	Tues	Wed	Thurs	Fri	Sat
60+	:30	:45	60+	:30	off	:45
RW	LTIW	TW	RW	LTIW		TW

KEY
RW = Recovery Walk
TW = Tempo Walk
LTIW = Lactate Threshold Interval Walk

Example of appropriate group cycling workout:

SAMPLE 1

3 minutes at 30 beats below anaerobic threshold

Being mindful of the conservative nature in which these examples were created will optimize enjoyment, cardiovascular health, compliance, and adherence and minimize the risk of injury, undue stress and program decay.

The current trend in today's health club programming is towards group exercise. To make every group exercise safer and more effective for the individuals, to avoid a group exercise culture that drives unknowing participants to intensities beyond their capabilities incorporate heart rate monitoring into the program. Providing monitors for participants to utilize during the class will encourage safe (heart rate appropriate) conditioning for maximum fun and fitness. Appropriate instruction and teacher utilization will encourage all participants to purchase a monitor for use in class as well as in their outside activities of choice. Remember, the limitations of the future are the limitations of the mind. You are limited only by your creativity and willingness to explore new fitness frontiers following the evidence-based path of those before you.

About the Author

Stephen Black is internationally recognized as a leader in the Sports Medicine/Wellness industries. Mr. Black has published extensively in this area and writes regularly for trade publications. He has twenty-two years experience in the development, implementation and operation of health related facilities. He currently works with hospitals, health clubs and organizations world wide providing expertise and education.

Mr. Black is a clinical instructor at Boulder College of Massage and serves as an advisor and board member to several nationally recognized leaders in Wellness. He also conducts research and provides clinical expertise to a variety of equipment manufacturers and Internet companies. Said expertise relates to product development, testing and market strategies. As a nationally recognized leader in sports medicine, Mr. Black provides expert testimony for legal and legislative matters. www.rockymountainhpc.com.

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