It is widely understood that desirable progressive adaptation is made possible by means of progressive intensity and/or duration of activity. It is important for a personal trainer to know the options available to guide clients safely and effectively along this path. 

 The Safe option

As the name implies, this option involves prescribing an initial conservative and non-stressful intensity level for the sake of safety in dealing with extremely overweight populations. This approach is most often used when introducing an extremely "deconditioned", overweight, beginning client, to exercise.

The primary value in using this method of intensity determination is to prepare the extremely overweight client for future general fitness exercise prescriptions. In the case of the extremely overweight client, diet should be emphasized and exercise de-emphasized early in the fitness prescription.

This should be commonly practiced as aggressive dieting and moderate to intense exercise together, can add up to trouble manifesting itself in the form of a condition known as metabolic acidosis. This condition can be caused by the above mentioned combination of an aggressive diet and an aggressive exercise program.

If there is a choice between an aggressive diet or an aggressive exercise program with respect to the seriously overweight population, it is generally safest to focus first on the diet, since exercise alone may can lead contraindications. By reducing the body weight significantly before beginning a moderately stressful exercise program, joints, hard tissue, muscles, cardiorespiratory system, etc., will be spared the stresses that common among grossly overweight individuals who practice a moderate- to intense-exercise program.

If an exercise program is initially prescribed, then the exercise portion of an overweight client's fitness prescription should consist of low impact, low intensity, and very low level activity. Walking at a slow pace on soft surfaces and/or on treadmills are examples of appropriate exercises.

The Measurable Option

Prescribing exercise intensity using a percentage of the client's calculated maximum heart rate is generally the most popular of all currently used methods of intensity determination. In this case, the trainer consults with the exercise participant. Then, after gathering as much relevant information as possible, the trainer makes a judgement and establishes the initial exercise heart rate recommendation.

As effective as this method is in anticipating a safe and appropriate level of starting intensity, only the client knows the true amount of effort he or she is applying, regardless of any dictated exercise heart rate. Tolerance to various exercise heart rates varies from individual to individual. For example, a target exercise heart rate of 165 BPM may be more difficult for one individual to tolerate than for another, even when the two seem equally conditioned.

It is important to bear in mind when using this method that unless the trainer questions the client extensively throughout the performance of an exercise as to its difficulty, the trainer may not know whether the program is overexertive or less than optimal. Here, the performance of a submaximal pre-exercise test is suggested (The NFPT recognizes and recommends the application of Amercian College of Sport Medicine's submaximal pre-exercise test protocol in these cases).

The Optimal Option

The Rating of Perceived Exertion (RPE) option in most cases offers the best way to maximize beginning client progress, while at the same time paying the utmost attention to contraindications and signs of overexertion. The trainer accomplishes this by repeatedly verbalizing contraindications and early warning signs of overexertion to the client during exercise performance. Simply put, the client informs the trainer of how he or she feels at a specific instant based on a scale of discomfort. The trainer and client then work together in adjusting the workload/exercise intensity until the desired "optimal" amount of tolerable exertion is being practiced. 

When using this method, accurate communication between trainer and client is fundamental. Using RPE for aerobic exercise has long been practiced and allows the participant to "govern" his or her intensity level by ranking it as a degree of discomfort to a provided RPE number scale.

The client reaches an initial tolerable level of effort deemed appropriate by both the client and trainer based on the client's description of effort and the trainer's questions regarding to overexertion symptoms and contraindications. Often, an RPE chart assigns a number to different levels of described effort. The trainer's job here is straightforward: He or she can dictate a number on the scale and require the client to perform at the corresponding perceived exertion (i.e., 1=somewhat hard, 2=hard, 3=very hard, 4=very, very hard, etc.).

Applied properly, using RPE should allow deconditioned clients and their trainers the latitude to optimize progress more effectively than by using the above described methods of determining initial intensity. Generally speaking, the application of RPE could be effectively used to optimize the rate of client progress during all forms of exercise, not just aerobics.

It should be noted that contraindications are exactly the same regardless of the type of activity being performed. For this reason, it is important to memorize them and verbalize them -- perhaps to the point of annoying the client at first. In the long run, however, this practice will help reduce your clients' risks while helping to improve their results.

TrackBack URI for this entry

Comments (0)

Subscribe to this comment's feed