Hierarchical framework to improve individualised exercise prescription in adults : a critical review

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Lehtonen , E , Gagnon , D , Eklund , D , Kaseva , K & Peltonen , J E 2022 , ' Hierarchical framework to improve individualised exercise prescription in adults : a critical review ' , Bmj open sport & exercise medicine , vol. 8 , no. 2 , 001339 . https://doi.org/10.1136/bmjsem-2022-001339

Title: Hierarchical framework to improve individualised exercise prescription in adults : a critical review
Author: Lehtonen, Elias; Gagnon, Dominique; Eklund, Daniela; Kaseva, Kaisa; Peltonen, Juha Evert
Contributor organization: Department of Diagnostics and Therapeutics
University of Helsinki
Clinicum
Date: 2022-06
Language: eng
Number of pages: 10
Belongs to series: Bmj open sport & exercise medicine
ISSN: 2398-9459
DOI: https://doi.org/10.1136/bmjsem-2022-001339
URI: http://hdl.handle.net/10138/346333
Abstract: Physical activity (PA) guidelines for the general population are designed to mitigate the rise of chronic and debilitating diseases brought by inactivity and sedentariness. Although essential, they are insufficient as rates of cardiovascular, pulmonary, renal, metabolic and other devastating and life-long diseases remain on the rise. This systemic failure supports the need for an improved exercise prescription approach that targets the individual. Significant interindividual variability of cardiorespiratory fitness (CRF) responses to exercise are partly explained by biological and methodological factors, and the modulation of exercise volume and intensity seem to be key in improving prescription guidelines. The use of physiological thresholds, such as lactate, ventilation, as well as critical power, have demonstrated excellent results to improve CRF in those struggling to respond to the current homogenous prescription of exercise. However, assessing physiological thresholds requires laboratory resources and expertise and is incompatible for a general population approach. A case must be made that balances the effectiveness of an exercise programme to improve CRF and accessibility of resources. A population-wide approach of exercise prescription guidelines should include free and accessible self-assessed threshold tools, such as rate of perceived exertion, where the homeostatic perturbation induced by exercise reflects physiological thresholds. The present critical review outlines factors for individuals exercise prescription and proposes a new theoretical hierarchal framework to help shape PA guidelines based on accessibility and effectiveness as part of a personalised exercise prescription that targets the individual.
Subject: Physical fitness
Cardiovascular
Aerobic fitness
Exercise physiology
TALK TEST
VENTILATORY THRESHOLD
PERCEIVED EXERTION
PHYSICAL-ACTIVITY
HIGH-INTENSITY
FAMILIAL AGGREGATION
CARDIORESPIRATORY FITNESS
AUTONOMIC FUNCTION
UPTAKE RESPONSE
HEART-RATE
315 Sport and fitness sciences
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion


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