FUNCTIONAL EVALUATION FOR A "TAILORED" EXERCISE PRESCRIPTION IN OLDER ADULTS

The functional evaluation is the process that provides assessment of the integrative responses involving the pulmonary cardiovascular and skeletal muscle system; it is useful to determine the health status and the individual fitness level, to prescribe correct exercise intensity and to monitor the possible changes over time. The most important physiological parameters for the functional evaluation and a correct exercise prescription are the maximum oxygen uptake (VO2max) and the anaerobic threshold (AT). The aim of my PhD project was to develop and validate some indirect methods for the maximum oxygen uptake and the anaerobic threshold determination in groups of young and older adults. The main goal is the feasibility and accuracy of these new "field" methods. The main results of my research are: 1) It is developed and validated a “tailored” version of the Åstrand-Rhyming step test and a new equation for VO2max prediction in older adults; they appear suitable for a rapid (5-min), safe (submaximal), accurate and precise VO2max prediction in healthy older adults. 2) It is verified that the AT can be accurately determined in healthy subjects based on measures of deoxygenated hemoglobin, index of oxygen extraction measured non-invasively by near infrared spectroscopy (NIRS). The main advantages of NIRS-based measures of AT over lactate-based techniques are the non invasiveness and the time/cost efficiency. 3) It is compared NIRS-based measures of AT to the most commonly used surrogate of AT i.e. the ventilatory thresholds of Wasserman (VT1 and VT2); NIRS-based measures of AT was highly correlated and substantially coincident with VT1. On the contrary NIRS-based measures of AT underestimated VT2. Compared to other methods, NIRS-based measures of AT offers the advantage of the independence from irregularity of breathing pattern that can heavily affect ventilatory based techniques.