Fitness professionals have many traditional and creative options for developing cutting-edge cardio programming. But, they must first assess clients correctly before designing a program.

Cardiovascular programming, if implemented properly, offers a wealth of health benefits, such as increased metabolism, reduced resting blood pressure, increased HDL cholesterol, improved sleep and many more. The implementation of appropriate cardio programs for clients is crucial to their health and achieving fitness goals. If the program is implemented improperly, your trainers might put their clients at more risk for injury than when they started to become active. Keeping this in mind, the updated American College of Sports Medicine (ACSM) guidelines are a good place to start when designing a program. Also, you should offer cardiovascular assessments, depending on a client's current health status, review traditional and non-traditional/creative forms of cardiovascular programming and use equipment to develop revenue-building programs within your facility. Note: Throughout this article, the terms aerobic, cardiovascular and cardiorespiratory will be considered synonymous with "cardio." They all refer to exercise that involves the heart, blood vessels and lungs.

ACSM guidelines for cardiovascular stimulus

Here are the newly revised ACSM recommendations for cardio stimulus.
  • Mode/type - Any activity that uses large muscle groups, is maintained continuously, and is rhythmical and aerobic in nature.
  • Frequency - Three to five days a week.
  • Intensity - 40 to 85 percent (40 to 50 percent for deconditioned) of Heart Rate Reserve (HRR), or 64 to 94 percent (64 to 70 percent for deconditioned) of maximum heart rate.
  • Duration/time - 20 to 60 minutes of continuous or intermittent (10 minute bouts) aerobic activity.
  • Progression (rate) - Three stages: initial, improvement and maintenance.
Note: 150 to 400 kcal per day, or a minimum of about 1,000 kcal per week; 2,000 kcal per week is recommended for optimal weight control. These updated guidelines are a bit more inclusive, and take into consideration multiple populations. They now include 40 to 50 percent of HRR for those who are deconditioned. Clients who are deconditioned should train at this level until they begin to improve; then, they can work their way into the 50 to 85 percent of HRR reserve, where they can develop cardiovascular fitness. The key word there is "fitness," as opposed to physically active. Remember that the ACSM guidelines for cardiovascular stimulus use heart rate methods, but that is not the only way to determine intensity of cardiovascular exercise. Keep in mind that Rate of Perceived Exertion is still the preferred method when dealing with some populations, especially clients who are pregnant, using heart-rate-altering medications and other special populations. The final method to determine intensity is Metabolic Equivalents, which is typically used by exercise physiologists in a clinical or laboratory setting.

Types of assessments

Depending on your setting, there are several ways to assess a client's initial level of cardio fitness, including diagnostic and functional assessments, and maximal and sub-maximal assessments. (Note: You will notice that I refer to these as "assessments" and not "tests." People commonly correlate the "test" term with a pass or fail scenario, whereas "assessment" refers more to gathering baseline data or information. When communicated in that fashion, the client typically is not as consumed with the results, and it helps the trainer drop preconceived expectations of clients.) Diagnostic assessments are typically used in a clinical or hospital-supervised program with a cardiologist. This type of assessment is used to diagnose potential cardiorespiratory types of diseases or abnormalities, like a Graded Exercise Test administered by a cardiologist. Functional assessments are typically performed on apparently healthy clients to assess their true functional capacity, like a VO2max assessment administered by an exercise physiologist. Both of these assessments yield much information, but take education, training and money to administer and interpret appropriately. Typical assessments performed in a fitness setting include the YMCA 3-Minute Step Assessment, several walking and running assessment protocols, and a few bike protocols. All of these are typically functional assessments yielding data that will help a trainer properly develop a client's program. These types of field assessments are only estimates, but, if performed correctly and in the proper environment, yield consistently accurate information. Depending on a client's ability and your equipment, you trainers might choose a maximal or sub-maximal assessment using one or multiple stages. Always err on the side of caution when administering an assessment. For example, the YMCA 3-Minute Step Test is a single stage assessment that is considered a sub-maximal assessment by most professional certification entities. There is a positive linear relationship of a client's ability for heart rate recovery and overall cardiovascular condition. The issue lies in that the YMCA 3-Minute Step Test may be a maximal assessment for a deconditioned individual who does not have the functional capacity to complete the assessment proficiently. Also remember that when an assessment has a client go a specified distance for time (for example, a 1.5-mile run/walk), that is a maximal assessment. You are giving clients a specified distance and basically telling them to complete it as fast as possible.

Traditional cardio training programs

After your trainers show professional prudence by assessing clients' cardiorespiratory baselines, they are ready to put together a program. Remember that trainers can be creative with the traditional programs, so long as they work within their client's abilities. Continuous training. This type of cardio training is also called long slow distance (LSD) training. It is typically a prolonged continuous cardio bout in the lower end of the cardio zone. For instance, an LSD day for an apparently healthy client could be a stationary bike training at 50 to 60 percent of HRR for 20 to 60 minutes. It's also been dubbed the "fat burning zone" by the cardio equipment industry, though health and fitness professionals should communicate to clients that their primary fuel may be fat, but their caloric expenditure is not that great - and that is what really counts toward weight loss. Discontinuous/interval training. Interval training consists of harder cardio exercise intermittently dispersed with lower intensity bouts. This type of training is used for all fitness levels. The typical work-to-rest ratio for a beginner is 1:5 or 1:4. The more a person becomes conditioned, the work-to-rest ratio sometimes decreases to 1:1, depending on the activity. A good example would be for a beginner walking on a treadmill at 2.5 to 3.5 mph. During the work cycle, the exerciser can increase the incline to about 5 degrees for about 30 seconds and then bring it back down to 0 degrees for two to three minutes. Fartlek training. Fartlek training takes the interval training technique and makes it completely random. Low, medium and high intensity cardio bouts are incorporated, and anaerobic bouts of exercise are thrown in, as well. For anyone who has ever played team sports, an example of Fartlek training is the whistle-blowing running drill coaches often use. This form of unstructured interval training has been proven to be the most beneficial to athletic performance for sports that incorporate quick, discontinuous bouts for aerobic/anaerobic exercise, like soccer and basketball. Circuit training. Circuit training is the combination of both cardio and resistance training. Clients perform a type of cardio training and then move to a type of resistance training. For instance, a client would perform a bike interval for three minutes, perform a body weight squat for 30 seconds, then move back to the bike. Cross training. Cross training uses two different types of cardio exercises. For instance, a client spends two minutes on the cycle and then two minutes on treadmill. For more experienced exercisers, this is sometimes called "brick" training.

Creative/nontraditional programs

New Leaf metabolic training. Through the specialized assessment protocol New Leaf offers, trainers are able to program specifically for their clients' needs. The New Leaf program evaluates a person's ability to use oxygen (VO2) and then has programs for almost any type of client, from beginner to elite athlete, depending on their specific goals (www.newleaffitness.com). Cross-fit training. Corss-fit training has its roots in the military, but it is a specific blend of cross training and interval training. Cross-fit blurs the line between cardio and resistance training for an intense, as well as scalable, training effect. Cross-fit's approach is through pushing the anaerobic system and, in return, the aerobic system will benefit, as well. Cross-fits training components consist of 1) metabolic conditioning, or "cardio"; 2) interval training; 3) gymnastics, weightlifting (snatch, clean and jerk); 4) throwing; and 5) nutrition (www.crossfit.com). Steel Bronco training. The Steel Bronco workout was developed at Cal Poly-Pomona University. This type of training takes into account multiple types of cardio training, and is very particular in the program design. It can be adapted to all levels of fitness. The program model looks like the following as a timed sequence/set: 1) cardio exercise: bike, treadmill, rowing (distance equivalent to about 1 to 1:30 minutes; 2) pushing exercise for 10 to 20 reps (such as modified push-ups, push-ups, BOSU push-ups); 3) plyometric/bodyweight/ agility/core exercise; 4) pulling exercise; 5) full-body exercise. All of the previous exercises are performed one after the other for time. Then the participant moves into a type of active rest for 2 to 3 minutes. The interval is performed again, and is repeated for four to six sets. There are many variations to this type of workout (www.asicampusrec.com).

Revenue-generating programs

All of these programs have the potential to generate revenue for your facility, depending on your financial scope and target market. Chances are, the majority of cardio training programs can use the existing equipment in your facility. However, there are also some specialized training and equipment available. Make sure you truly understand your market before investing in any of the creative approaches to cardio training. For instance, New Leaf Metabolic Training has quite a bit of specialized equipment that could be costly. Still, if your target market can support New Leaf, the return on investment could be tremendous. You may want to integrate these programs into your orientations, which may help in selling a personal training package. A facility could also develop specialized six-, eight- and 10-week programs in a group or one-on-one setting. Finally, a facility may want to incorporate heart rate monitors in almost all aspects of the facility. A facility can use them in personal training or small group training to help clients monitor their appropriate intensity levels. As clients begin to realize the importance of a heart rate monitor, your facility could offer them for sale. Polar offers a referral program through its website for fitness professionals (www.polarusa.com).

Help clients reach their goals

As cardio programming becomes more specialized depending on limitations and goals, fitness professionals must educate and train clients more efficiently. Adhere to the newly updated ACSM guidelines, found in ACSM's Guidelines for Exercise Testing and Prescription. By using the proper assessment and program methods, you can help clients obtain their health and fitness goals in a safe and effective environment.
Reference
American College of Sport Medicine. ACSM's Guidelines for Exercise Testing and Prescription, 7th Ed. Lippincott Williams & Wilkins: Baltimore, Md., 2006.