Exercise Prescription and Program Implementation
The FITT-VP framework
Prescriptions are built from Frequency, Intensity, Time, Type, Volume and Progression. Aerobic: 3–5 days/week, 30–60 minutes of moderate work (150–300 min/week) or 20–60 minutes of vigorous work (75–150 min/week). Intensity anchors: 40–59% heart rate reserve (moderate) and 60–89% HRR (vigorous); roughly 64–76% and 77–93% of HRmax; RPE 11–13 and 14–17 on the 6–20 scale; or the talk test. Resistance: 2–3 days/week, 2–4 sets of 8–12 repetitions at about 60–70% 1RM for novices, with 48 hours between sessions for the same muscle groups. Flexibility: 2–3 days/week, holding 10–30 seconds for 2–4 repetitions to the point of tightness. Neuromotor training (balance, agility, coordination) 2–3 days/week benefits older adults.
Session design and progression
A session includes a 5–10 minute warm-up, the conditioning bout, a 5–10 minute cool-down, and stretching. Progress by increasing duration or frequency before intensity, and change only one variable at a time.
Traps
Percent HRmax and percent HRR produce very different target heart rates-do not substitute one for the other. The 220 − age estimate can be badly wrong for an individual. Clients on beta-blockers have blunted heart rate responses, so use RPE. Teach clients to exhale during exertion rather than performing a Valsalva maneuver.
Worked example (Karvonen)
HRmax 190, resting HR 60, target 60%: (190 − 60) × 0.60 + 60 = 138 bpm.