Hansen Dominique, Junior Gerson Cipriano, Milani Juliana Goulart Prata Oliveira, Milani Mauricio, Gojevic Tin, Machado Felipe V C, Kambic Tim, Eijsvogels Thijs M H, Bonifazi Marco, Dendale Paul, D'Ascenzi Flavio
Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL), Hasselt University, Wetenschapspark 7, 3590, Diepenbeek, Belgium.
Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.
Sports Med. 2025 Jul 4. doi: 10.1007/s40279-025-02272-9.
Guidelines for aerobic exercise training (AET) often recommend training intensities on the basis of a percentage of peak effort (e.g. %peak heart rate [%HR], %peak oxygen uptake [%VO]). However, such an approach could be associated with a higher inter-individual variability in acutely induced physiological responses (e.g. blood lactate, HR, VO) when compared with threshold-based prescription (i.e. ventilatory threshold [VT] or lactate threshold [LT]). Therefore, we performed a literature review to compare the acute physiological impact of AET prescription based on fraction of the peak effort versus threshold-based exercise prescription (VTs and LTs), and how these prescription options may influence the efficacy of exercise intervention in healthy subjects and patients with cardiovascular risk or disease. Data from cross-sectional studies (15 studies; 5312 participants) indeed reveal a greater inter-individual variance in acute physiological responses to a single exercise (e.g. HR, VO, blood lactate) when exercising at the same %HR or % VO compared with exercising at (a fraction of) VT or LT. Data from randomised exercise intervention studies (3 studies; 135 participants) and a meta-analysis (1544 individuals from 42 studies) show that aerobic exercise prescription based on the percentage of peak effort leads to smaller improvements in VO and metabolic health when compared with aerobic exercise prescription based on the VTs or LT. These collective findings suggest that threshold-based AET intensity prescription elicit more homogeneous acute physiological responses, and greater VO improvements. Hence, it is time to move past standard recommendations and implement a threshold-based approach when prescribing the AET intensity.
有氧运动训练（AET）指南通常根据峰值运动强度的百分比来推荐训练强度（例如，峰值心率百分比[%HR]、峰值摄氧量百分比[%VO₂]）。然而，与基于阈值的处方（即通气阈值[VT]或乳酸阈值[LT]）相比，这种方法可能会导致急性诱发的生理反应（如血乳酸、心率、摄氧量）在个体间存在更高的变异性。因此，我们进行了一项文献综述，以比较基于峰值运动强度百分比的AET处方与基于阈值的运动处方（VT和LT）对急性生理的影响，以及这些处方选项如何影响健康受试者和有心血管风险或疾病的患者的运动干预效果。横断面研究（15项研究；5312名参与者）的数据确实显示，与在VT或LT（的某个分数）下运动相比，在相同的%HR或%VO₂下运动时，单次运动的急性生理反应（如心率、摄氧量、血乳酸）在个体间存在更大的差异。随机运动干预研究（3项研究；135名参与者）和一项荟萃分析（来自42项研究的1544名个体）的数据表明，与基于VT或LT的有氧运动处方相比，基于峰值运动强度百分比的有氧运动处方在摄氧量和代谢健康方面的改善较小。这些综合研究结果表明，基于阈值的AET强度处方能引发更均匀的急性生理反应，并能带来更大的摄氧量改善。因此，在开具AET强度处方时，是时候摒弃标准建议并采用基于阈值的方法了。
