January 6, 2022 – There has been a push in recent years to encourage physicians exercise as medicinetelling their patients how often, how long and how hard to exercise to improve their health.
A new Brigham Young University study suggests that doctors can take this initiative to the next level, creating exercise programs that lead to specific health outcomes; for example, lower blood pressure or weight loss.
“The results of this study and others suggest that we should be able to prescribe exercise more consistently and accurately like we prescribe medicine,” said senior study author Dr. Jayson Gifford, professor of exercise science at Brigham Young University.
These exercise prescriptions will be tailored to the patient based on a largely overlooked metric of fitness known as critical power, or maximal steady state — the fastest speed you can go while maintaining a speed that can be sustained over extended periods of time.
By framing exercise programs around critical power rather than more frequent use of VO2max (maximum effort), we can more accurately predict health outcomes, just like we can predict medicine, researchers say inside Journal of Applied Physiology.
“We’ve known for centuries that exercise is part of a healthy and long life,” says Jordan Metzl, MD, a sports medicine physician at Hospital for Special Surgery in New York City. exercise therapy“But it wasn’t until the past 70 years that we realized the medical value of exercise.”
Metzl, who was not involved in the study, helps lead an annual seminar at Cornell Medical College to teach medical students how to prescribe exercise beyond the cookie-cutter “30 minutes a day” recommendation.Nonetheless, doctors and other healthcare professionals Difficulty regularly exercising to prevent or treat disease.there’s still one Recent research by the University of Oxford found that when doctors gave weight loss advice, It is often vague and difficult for patients to use.
“Exercise medicine is one of the safest and most effective forms of preventive health care,” Metzl said. “We need to fully engage the medical community in prescribing exercise to their patients.”
This study suggests that focusing on key powers may be key to achieving this goal.
what the research found
In the study, 22 adults completed 8 weeks of moderate-intensity training or high-intensity interval training, or HIIT. The intensity levels specified in both plans are based on VO2max. Therefore, the people in the study trained at a given percentage of their VO2max.
Both groups saw improvements in stamina, but results varied from person to person. These mixed results could be explained by individual differences in critical power.
“As exercise physiologists have believed for many years, improvements are more related to the key percentage of power an individual is working on than percentage of maximum oxygen uptake,” said lead study author Jessica Collins, a Brigham Young University researcher.
Not only that, but several subjects who did not increase their VO2max done See critical power and stamina increases.
“People tend to only focus on VO2 max,” Gifford said. “Many people may look at some individuals who do not see an increase in VO2max and conclude that training is not effective. Personally, I believe that by focusing almost exclusively on VO2max, many potentially useful therapies have been ruled out. “
It turns out that critical power varies from person to person, even among those with similar VO2 maxima.
“Assume you and Jessica have the same VO2max,” explains Gifford. “If we let you all do it at 70% [your VO2 max]it may be more than Your maximum steady state, which will make you really hard.it may be the following Her maximum steady state, which is easy for her. ”
This means that everyone puts different stresses on their bodies, and that stress triggers improvements in health and stamina.
“Below critical power, metabolic stressors are well managed and remain at elevated but steady levels,” Gifford said. “Above critical power, metabolic stressors are generated so rapidly that they cannot be controlled and continue to accumulate until reaching very high levels that lead to failure.”
Knowing your critical power means you can predict how these stressors will build up, and you can tailor an exercise program to give you just the right “dose” of stressors, says Gifford.
Such procedures, Gifford suggested, could be used in recovering patients recovering from heart attack or lung disease. Or they could help older adults improve endurance and physical performance, Collins noted.
But first, the researchers had to confirm these results by programming exercise routines based on people’s critical mass and looking at how different measures improved.
How to Find Your Critical Power
Critical power isn’t new, but it’s largely ignored by exercise physiologists and medical professionals because it’s not easy to measure.
“People usually train based on VO2 max or max heart rate, which is even less precise,” Gifford said.
Finding people’s critical power in this study involved multiple timed trials and calculating speed/power versus time, Gifford explained.
But for a rough measure of your critical power, you can use an app that measures functional threshold power (FTP), which Gifford calls the “Walmart version” of critical power. “Not exactly the same, but close,” he said. (the application Strava Has FTP and quite sophisticated power analysis. )
Or skip the technique and go by feel. If you’re below your critical power, “it’s going to be challenging, but you feel in control,” says Gifford. Beyond your critical power, “your breathing and heart rate will keep climbing until you fail in about 2 to 15 minutes, depending on how far you go.”
Collins points out, though, that you don’t need to know the key strengths to start exercising.
“The beauty of exercise is that it’s such a powerful drug that you don’t have to fine-tune your exercise in this way to see the benefits,” he said. “I don’t want that to be an obstacle to working out. It’s important to do something.”