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You are the exercise specialist in a cardiac rehabilitation center. A patient (age 63 years, height 5″11″, BW 85 kg) will come to your facility to begin a training program. His chart indicates that his doctor wants him to lose 10 lbs of body weight, in order to better control the first signs of Type II diabetes. He must lose the weight in 6 months, when his next check-up will take place. Your job is to design a training program for your patient, so that he will achieve that goal.
In order to simplify the math for this example, we will assume that the patient’s weight is 85 kg throughout the training period
The weight should be lost from the body’s fat mass. Therefore, your patient must lose 10 lbs, or else, burn 35,000 kcal worth of energy.
The improvements in physical conditioning (e.g. increased RMR were not significant)
Your patient indicates that he would much prefer to exercise on the cycle ergometer, because his knees are bothering him a little when he walks.
Your patient said he can practice 4 days/week
Aside from the exercise session, nothing else (e.g. lifestyle, diet) has changed in his daily routine.
He will be in your facility for 6 months = 26 weeks. Since he will exercise 4 times per week, he will participate in 104 workout sessions. Therefore, he must burn 35,000 ÷ 104 = 336.5 kcal each time he shows up.
Since 5 kcal of energy require 1 liter O2 to be consumed, the patient’s total oxygen consumption for each workout must be 336.5 ÷ 5 = 67.3 L O2/day, or 67,300 ml/day.
Let us assume your patient can only work out for 60 minutes, so for each minute he must consume 67,300 ml ÷ 60 min = 1,121 ml O2/min (absolute VO2).
The next step is to find what pedaling frequency and resistance setting you should use, in order for our patient to achieve this oxygen consumption.
An average pedalling frequency that he feels comfortable with is 50 rpm, in which case the distance travelled by the wheel is 300 m (see your lab manual for more explanations).
The last piece of information needed is how much weight should we place on the tray?
In order to find the answer, we will use the cycle ergometer metabolic equation:
VO2 = (power × 2) + (3.5 × BW)
By substitution, we have 1,121 = (power × 2) + (3.5 × 85)
By solving for power (the unknown factor) we find that power = 411.75 kgm/min.
So, in 1 min he performed mechanical work equal to 411.75 kgm. Since kgm is the unit of Work, and Work = Force × Distance, and the distance traveled is 300 m, we can find that the load applied is 1.37 kg.
Your patient needs to exercise 4 times per week for 6 months, on a cycle ergometer, at a pedaling frequency of 50 rpm, against a resistance of 1.37 kg, in order to lose 10 lbs in 6 months.
Obviously, some of the assumptions we made at the beginning will be violated, so you will need to adjust the workload accordingly.
Let’s take the man from the walking running section and continue through to find and prescribe his energy expenditure..
A 58-YEAR OLD MAN IS WALKING ON THE TREADMILL AT 2.5 MPH, UP A 3% GRADE. WHAT IS HIS VO2 WORKRATE?
speed = 2.5 mph × 26.8 = 67 m/min
grade = 3% or 0.03
So, since all the units have been appropriately converted, I have:
VO = 3.5 + (speed × 0.1) + (speed × grade × 1.8)
by substituting: VO2 = 3.5 + (67 × 0.1) + (67 × 0.03 × 1.8) = 13.8 ml/kg/min.
LET’S CONTINUE HERE.. HOW MANY KCALS DID HE SPEND IF HE EXERCISED FOR 30 MINUTES AT THIS LEVEL?
What is his absolute VO2 if his BW is 50 kg?
Absolute VO2 = Relative VO2 × BW
So, VO2 = 13.8 ml/kg/min × 50 kg = 690 ml/min, or 0.69 l/min.
How many kcal of energy did he spend if he exercised for 30 min?
Total VO2 = absolute VO2 × duration = 0.69 l/min × 30 min = 20.7 l.min
We know that 1 liter O2 is equal to 5 kcal of energy, therefore he burned 103.5 kcal.
How much fat did he burn in this exercise bout?
1 lb fat = 3,500 kcal, so he burned 0.03 lbs of fat.
How many sessions to burn 1 lb of bodyfat?
3500 / 103 calories per session = 34 sessions!