This document outlines the principles of exercise prescription, including overload, specificity, reversibility, and maintenance, which guide the development of individualized exercise programs. It emphasizes the FITT-VP principle, detailing recommendations for frequency, intensity, time, type, volume, and progression of exercise to optimize health and physical fitness. Furthermore, it discusses aerobic exercise guidelines and strategies for safe progression in training to enhance adherence and minimize risks.

1. PRINCIPLES OF EXERCISE
PRESCRIPTION
- Apeksha J. Pahade
1st MPT Musculoskeletal sciences

2. OBJECTIVES
At the end of the seminar student should be clear with –
• Principles of exercise training
• FITT – VP principle of exercise prescription.

3. INTRODUCTION
• An exercise training program ideally is designed to meet
individual’s health and physical fitness goals.
• The principles of exercise prescription (Ex Rx) are intended
to guide health care professionals in the development of an
individually tailored Ex Rx

4. PRINCIPLES OF EXERCISE TRAINING
• Overload
• Specificity
• Reversibility
• Maintenance

5. OVERLOAD:
• A safe and effective training program is one that progressively overloads the body
and allows adequate time for adaptation to each level of stimulation
• The key is to find the upper limit and the lower limit.
SPECIFICITY:
• The effects of training are specific to those parts and systems of body that are
overloaded.
• Adaptation is specific to the muscle groups that are stimulated
• Adaptations are also specific to the energy producing systems that are stimulated.

6. REVERSIBILITY:
• The effects of training are transient and reversible .
MAITENANCE:
• If the individual is satisfied with their current level of fitness, they
may be able to maintain it by continuing the same amount of training
per week or even by slightly reducing their training for brief periods.

7. COMPONENTS OF EXERCISE TRAINING SESSION
A single exercise session should include the following phases:
• Warm-up.
• Conditioning and/or sports-related exercise.
• Cool-down.
• Stretching.

8. WHAT IS THE PRINCIPLE OF PRESCRIPTION?
According to the American College of Sports Medicine (ACSM)
recommendations, the FITT-VP is principle of Ex Rx
• The Frequency (how often),
• Intensity (how hard),
• Time (duration or how long),
• Type (mode or what kind),
• Total Volume (amount/ quantity)
• Progression (advancement)

9. • The optimal Ex Rx should address the health-related physical fitness
components of cardiorespiratory (aerobic) fitness (CRF), muscular
strength and endurance, flexibility, body composition, and
neuromotor fitness.

10. AEROBIC (CARDIOVASCULAR ENDURANCE) EXERCISE
EVIDENCE-BASED RECOMMENDATIONS
Frequency :
• ≥5 d /wk of moderate exercise, or ≥3 d /wk of vigorous
exercise, or a combination of moderate and vigorous exercise
on ≥3–5 d /wk is recommended.

11.  Intensity:
• Moderate and/or vigorous intensity is recommended for most
adults.
• Light -to-moderate intensity exercise may be beneficial in
deconditioned individuals.
• Highly trained athletes may need to exercise at “near maximal”
(i.e., 95%–100% VO2max) training intensities to improve
VO2max, whereas 70%–80% VO2max may provide a sufficient
stimulus in moderately trained athletes.

12. METHODS FOR PRESCRIBING EXERCISE INTENSITY

14. Time :
• 30–60 min / d of purposeful moderate exercise, or 20–60
min / d of vigorous exercise, or a combination of moderate
and vigorous exercise per day is recommended for most
adults.
• <20 min of exercise per day can be beneficial, especially in
previously sedentary individuals and this time is then
gradually increased to 40-60 mins.

15. Type:
• Rhythmic, aerobic exercise of at least moderate intensity that
involves large muscle groups and requires little skill to perform
is recommended for all adults to improve health and CRF.
• Other exercise and sports ,requiring skill to perform ,or higher
levels of fitness are recommended only for individuals
possessing adequate skill and fitness to perform the activity.

17.  Volume :
• Exercise volume is the product of Frequency, Intensity, and
Time (duration) or FIT of exercise.
• Exercise volume may be used to estimate the gross EE of an
individual’s Ex Rx.
• MET-min /wk and kcal /wk can be used to estimate exercise
volume in a standardized manner.

19. • A target volume of ≥500–1,000 MET-min / wk is recommended.
• Increasing pedometer step counts by≥ 2,000 steps / d to reach a
daily step count ≥7,000 steps / d steps is beneficial.
• Exercising below these volumes may still be beneficial for
individuals unable or unwilling to reach this amount of exercise.

20. • Lower exercise volumes can have health/fitness benefits for
deconditioned individuals, and greater volumes may be
needed for weight management

21. Rate of progression:
• The recommended rate of progression in an exercise
program depends on the individual’s health status, physical
fitness, training responses, and exercise program goals.
• Progression may consist of increasing any of the
components of the FITT principle of Ex Rx as tolerated by
the individual.

22. THE RECOMMENDED SEQUENCE OF PROGRESSION OF AEROBIC
EXERCISES
Increasing Duration: E.g. increase duration of exercise
session by 5 to 10 mins every 1 to 2 weeks over the first
4 to 6 weeks
Increasing Frequency and Intensity: E.g. increase
frequency and intensity of exercise session as tolerated
over the next 4 to 8 months
The individual should be monitored for any adverse
effects of the increased volume, and downward
adjustments should be made if the exercise is not well
tolerated

23. • This approach may enhance adherence.
• A gradual progression of exercise is reasonable until the desired
exercise goal (maintenance) is attained.
• Any progression in the FITT-VP principle of Ex Rx should be made
gradually avoiding large increases in any of the FITT-VP components
to minimize risks of muscular soreness, injury, undue fatigue, and the
long-term risk of overtraining.

24. REFERENCES
• ACSM’S Guidelines for Exercise Testing and Prescription NINTH
EDITION, chapter 7, pp: 162-179.
• James S. Skinner, Exercise testing and prescription in special cases,
chapter 2, pp: 23-36.
• Doctors Handbook, chapter 4, pp: 23-38

25. THANK YOU