Skip Navigation LinksHome > September 2004 - Volume 36 - Issue 9 > Consistency of the Talk Test for Exercise Prescription
Medicine & Science in Sports & Exercise:
APPLIED SCIENCES: Physical Fitness and Performance

Consistency of the Talk Test for Exercise Prescription

PERSINGER, RACHEL; FOSTER, CARL; GIBSON, MARK; FATER, DENNIS C.W.; PORCARI, JOHN P.

Free Access
Article Outline
Collapse Box

Author Information

Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI

Address for correspondence: Carl Foster, Ph.D., Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601; E-mail: foster.carl@uwlax.edu.

Submitted for publication December 2003.

Accepted for publication March 2004.

Collapse Box

Abstract

PERSINGER, R., C. FOSTER, M. GIBSON, D. C. W. FATER, and J. P. PORCARI. Consistency of the Talk Test for Exercise Prescription. Med. Sci. Sports Exerc., Vol. 36, No. 9, pp. 1632–1636, 2004.

Introduction/Purpose: The Talk Test has been shown to be well correlated with the ventilatory threshold, with accepted guidelines for exercise prescription, and with the ischemic threshold. As such, it appears to be a valuable although quite simple method of exercise prescription. In this study, we evaluate the consistency of the Talk Test by comparing responses during different modes of exercise.

Methods: Healthy volunteers (N = 16) performed incremental exercise, on both treadmill and cycle ergometer. Trials were performed with respiratory gas exchange and while performing the Talk Test. Comparisons were made regarding the correspondence of the last positive, equivocal, and first negative stages of the Talk Test with ventilatory threshold.

Results: The %V̇O2peak, %V̇O2 reserve, %HRpeak, and %HR reserve at ventilatory threshold on treadmill versus cycle ergometer (77%, 75%. 89%, and 84% vs 67%, 64%, 82%, and 74%) were not significantly different than the equivocal stage of the Talk Test (83%, 82%, 86%, and 80% vs 73%, 70%, 87%, and 81%). The V̇O2 at ventilatory threshold and the last positive, equivocal and negative stages of the Talk Test were well correlated during treadmill and cycle ergometer exercise.

Conclusions: The results support the hypothesis that the Talk Test approximates ventilatory threshold on both treadmill and cycle. At the point where speech first became difficult, exercise intensity was almost exactly equivalent to ventilatory threshold. When speech was not comfortable, exercise intensity was consistently above ventilatory threshold. These results suggest that the Talk Test may be a highly consistent method of exercise prescription.

There are well-accepted guidelines for exercise prescription, both for healthy individuals and for patients with cardiovascular or other chronic diseases (1,11). These guidelines are generally related to achieving well-defined percentages of the peak heart rate (HR), peak oxygen consumption (V̇O2peak), or of the HR or V̇O2 reserve. Conformance with these guidelines maximizes the likelihood that the health and fitness goals of exercise training will be achieved while minimizing the risk of exertion related complications (8). However, prescription of exercise can be a difficult process requiring diagnostic exercise testing and/or skills outside the training of many physicians or other healthcare providers. Monitoring of training intensity can also become a barrier to compliance by many patients in that exercise is usually prescribed using objective criteria (e.g., target HR), but most exercisers prefer subjective methods of monitoring exercise training intensity.

Until now, the rating of perceived exertion has been the dominant tool for subjective monitoring of exercise training intensity (1,11). As a method of making the exercise prescription more simple, an informal guideline, widely referred to as the Talk Test, has arisen within the exercise community. This guideline suggests that if the exercise intensity is sufficient so that the patient can “just respond to conversation,” then the exercise intensity may be “just about right” (i.e., within accepted ranges of exercise training intensity). Within the last several years, the validity of this simple guideline has been systematically evaluated. The ability to converse during exercise (i.e., to pass the Talk Test) has been shown to produce exercise intensities consistently within the parameters suggested in clinical guidelines for exercise training in a variety of populations including university students (6), clinically stable patients with cardiovascular disease (13), and athletes (12). After studies that have demonstrated that the ventilatory threshold often precedes the ischemic threshold in patients with exertional ischemia (9), the Talk Test (which appears to be a surrogate of the ventilatory threshold) has been shown to effectively mark the ischemic threshold in patients with exertional ischemia (5). With this background, and considering that exertion related complications are often related to inappropriately severe exercise (8), the Talk Test appears to be a simple, practical, and yet fairly precise method of exercise prescription. That it does not require preliminary exercise testing or sophisticated monitoring strategies further adds to its appeal. However, before making broad recommendations regarding a new method, it is important to examine the consistency of the method. Will recommendations to exercise at an intensity that “just allows comfortable speech” be widely useable for individuals using different modes of exercise? Accordingly, the purpose of the present study was to evaluate the consistency of the Talk Test as a method of exercise prescription by comparing responses in subjects undertaking different modes of exercise. Specifically, we hypothesized that the last positive stage of the Talk Test represented an exercise intensity that was less than the ventilatory threshold (VT) and within accepted training intensity guidelines for both modes of exercise. We also hypothesized that the equivocal stage of the Talk Test represented an exercise intensity that was equivalent to VT and within accepted intensity guidelines for both modes of exercise. Lastly, we hypothesized that the negative stage of the Talk Test represented an exercise intensity beyond VT and outside accepted guidelines for exercise training intensity.

Back to Top | Article Outline

METHODS

Sixteen apparently healthy and moderately active individuals (10 males, 6 females) volunteered and participated in this study. All provided informed consent before participation, and the protocol had been approved by the Institutional Review Board for the Protection of Human Subjects of the University of Wisconsin-La Crosse. The subjects were prescreened for contraindications to exercise testing and training using a questionnaire developed by the American Heart Association and American College of Sports Medicine (2). Characteristics of the subjects are provided in Table 1. We included both male and female subjects on the basis that we wanted the results to be as generalizable as possible and because previous studies have not suggested a gender bias in the relationship between the ventilatory threshold and the Talk Test.

Table 1
Table 1
Image Tools

After habituation to the laboratory setting, equipment and exercise tests, each subject performed four, randomly ordered, exercise tests, each on a separate day, but at the same hour of the day. Each subject performed two incremental exercise tests on a treadmill and two on an electrically braked cycle ergometer. One of the exercise tests on each ergometer included measurement of respiratory metabolism using open circuit spirometry (Quinton Q-MC, Seattle, WA). The exercise protocol was individualized to each subjects’ exercise capacity, but all included stage durations of 2 min. The speed of the treadmill belt was fixed based on responses during habituation trials at a level where the subject was very comfortable and indicated that they could exercise virtually indefinitely. For some subjects, this represented walking, for others jogging. For most subjects, the initial cycle ergometer power output was 25 W, and stage increments were 25 W. For subjects who weighed < 60 kg, the initial power output and increments were 20 W. Exercise was continued to the maximal level of exertion sustainable, and all subjects received vigorous verbal support during the tests. Predetermined heart rate end points were not used for termination of the exercise tests. Heart rate was measured throughout the exercise tests using radio telemetry (Polar Electro-Oy, Finland). V̇O2peak was defined as the highest consecutive 30-s measurement of V̇O2 observed during the test. The VT was defined using the V-slope method, with confirmation by changes in the ventilatory equivalents for O2 and CO2 (7).

The other exercise test on each ergometer involved having the subject recite, aloud, a standard paragraph (The Pledge of Allegiance) during the last 30 s of each exercise stage. This 31-word passage is familiar to most people in the United States and can usually be recited without the need of cue cards, which were available if necessary. Immediately upon the completing the passage, the subject was asked “can you still speak comfortably?” One answer to this question was “yes,” which we refer to as “passing” or a “positive” Talk Test result. If the subject equivocated in any way, their Talk Test result was referred to as “equivocal.” At the first time that the subjects reported that they definitely could not speak comfortably, we took this result as “failing” or a “negative” Talk Test result. The exercise protocol was terminated at this time. In the case where the investigator thought that the subject was having difficulty speaking, we gently asked the subject if they were sure of their answer. However, at a fundamental level we tried to minimize the influence of the investigator and encouraged the subject to make the subjective determination of whether or not they could speak comfortably. This procedure is the same as we have used in other studies (5,6,12,13). We have previously shown that the HR response to the exercise protocol is unaffected by reciting the standard paragraph (6), which we have interpreted to mean that the necessity for performing two exercise tests (gas exchange and Talk Test) to link the ventilatory threshold to the Talk Test does not introduce systematic errors into the relationship.

The positive, equivocal, and negative stages of the Talk Test were then compared with VT and to widely accepted %HR and %V̇O2peak guidelines for exercise prescription (1,11). The results were analyzed using multiple comparison repeated measures ANOVA. Post hoc tests were accomplished using the Tukey test. Correlation coefficients between Talk Test related measures and VT, as well as between ergometer responses were computed using the Pearson product moment correlation.

Back to Top | Article Outline

RESULTS

On the treadmill, the mean V̇O2 at VT was not significantly (P ≤ 0.05) different than the V̇O2 at either the last positive or equivocal stages of the Talk Test (Table 2, Fig. 1). The V̇O2 at VT was significantly less than the V̇O2 at the first negative stage of the Talk Test. On the cycle, the V̇O2 at VT was not significantly different than the V̇O2 at either the last positive or equivocal stages of the Talk Test but was significantly less than the V̇O2 at the first negative stage of the Talk Test. The V̇O2 at the VT was well correlated with the V̇O2 at the positive, equivocal, and negative stages of the Talk Test, on both treadmill and cycle ergometer (Fig. 1). The absolute values of V̇O2 on treadmill vs cycle ergometer at VT, the positive, equivocal, and negative stages of the Talk Test were consistently larger on the treadmill. This reflected the difference in V̇O2peak between exercise modes (3.59 ± 0.94 vs 3.20 ± 0.84 L·min−1). The pattern of differences was highly consistent and well correlated for VT, and for positive, equivocal, and negative stages of the Talk Test (Table 2, Fig. 2).

Table 2
Table 2
Image Tools
FIGURE 1Relationship...
FIGURE 1Relationship...
Image Tools
FIGURE 2Relationship...
FIGURE 2Relationship...
Image Tools

When comparing responses on the treadmill versus cycle ergometer, the %V̇O2peak at the VT and at the positive and equivocal stages of the Talk Test were not significantly different, suggesting that the Talk Test represents a common, mode-independent metabolic intensity for both modes of exercise. The %V̇O2peak at the negative stage of the Talk Test was significantly greater than at VT. Similar results were observed relative to %V̇O2 reserve (Table 2).

On the cycle ergometer, %HRpeak and %HR reserve at the positive and equivocal stages of the Talk Test were not significantly different than at VT. At the negative stage of the Talk Test, %HRpeak and %HR reserve were significantly greater than at VT (Table 2). This general pattern was also observed during treadmill exercise, although in some cases the %HRpeak and %HR reserve observed at the positive and equivocal stages of the Talk Test were significantly greater than at VT. The mean values for %HRpeak and %HR reserve at VT and at the positive and equivocal stages of the Talk Test were at exercise intensities within generally accepted recommendations for exercise training intensity (1,11) (Table 2). The mean value of %HRpeak and %HR reserve at the negative stage of the Talk Test was greater than accepted recommendations for appropriate exercise training intensity.

Back to Top | Article Outline

DISCUSSION

The main finding of this study was the similarity of the correspondence to the ventilatory threshold during treadmill and cycle ergometer exercise when compared using a simple marker of exercise intensity, the Talk Test. Whereas the treadmill elicited higher absolute values for exercise intensity at all measured points, when the data were expressed in terms of the metabolic sustainability of the exercise (represented by VT), the results between ergometers were remarkable in their consistency. Similarly, it appears that the exercise intensity associated with either the last positive or equivocal stage of the Talk Test is comparable to the intensity suggested by widely accepted guidelines for exercise prescription (1,11). When comfortable speech was no longer possible (e.g., negative stage of the Talk Test), the exercise intensity consistently exceeded guidelines for exercise prescription (1,11). Accordingly, the results support all three of our hypotheses.

Previous studies have shown a close relationship between VT and both the last positive and equivocal stages of the Talk Test (6,12,13), a correspondence reflected in the current data. The absolute values of %V̇O2peak, %V̇O2 reserve, %HRpeak, and %HR reserve in the present data at the last positive stage of the Talk Test is substantially similar to that observed in previous studies (6,12,13). Although the present research and other studies (6,12,13) have used recitation of a standard paragraph as the challenge, other slightly different speech provoking strategies have proven equally effective in approximating exercise intensity (3,4,10). In any case, the Talk Test can reliably produce exercise intensities within accepted guidelines for exercise prescription. That this technique can also apparently help to avoid exertional ischemia (5) makes it very attractive for healthcare professionals counseling their patients regarding exercise. The similarity between the treadmill and cycle ergometer results suggests that the Talk Test is a consistent tool, applicable to a variety of exercise settings.

The present study was conducted using relatively young, healthy and physically active individuals. Previous results from our laboratory using clinically stable patients participating in a community-based cardiac rehabilitation program (13) and in patients undergoing diagnostic exercise testing (5) suggest the population generalizability of the technique. The one qualification that needs to be applied to the technique is that whatever provocative stimulus is used to define the Talk Test, it must be recited aloud. Many individuals will be able to exercise at a much higher intensity if the standard paragraph is recited silently or “under one’s breath.” We believe that this occurs because the striking increase in ventilatory frequency, which typically occurs at VT, interferes with the ventilatory control that is necessary for vocalized speech.

In summary, the results of this study demonstrate that the simple monitoring device of asking whether comfortable speech is possible results in exercise intensities that are within well-accepted guidelines for exercise prescription, without the necessity for preliminary exercise testing. Further, because the results are very similar between modes of exercise, it seems reasonable to suggest that the Talk Test technique is highly consistent. Accordingly, it may represent a clinically useful tool for clinicians faced with the need to provide exercise training guidelines for their patients.

Back to Top | Article Outline

REFERENCES

1. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription, 6th Ed. Philadelphia: Lippincott, Williams & Wilkins, 2000, pp. 137–234.

2. Balady, G. J., B. Chaitman, D. Driscoll, et al. Recommendations for cardiovascular screening, staffing and emergency policies at health/fitness facilities: a Joint Position Statement by the American College of Sports Medicine and the American Heart Association. Med. Sci. Sports Exerc. 30:1009–1018, 1998.

3. Brawner, C. A., S. J. Keteyian, and T. E. Czaplicki. A method of guiding exercise intensity: the talk test. Med. Sci. Sports Exerc. 27:S241, 1995.

4. Brawner, C. A., M. A. Vanzant, J. K. Ehrman, et al. Guiding exercise intensity using the talk test among persons with coronary artery disease. Med. Sci. Sports Exerc. 35:S173, 2003.

5. Cannon, C., C. Foster, J. P. Porcari, K. M. Skemp-Arlt, D. C. W. Fater, and R. Backes. Relationship between the talk test and the ischemic threshold. Am. J. Med. Sport (in press).

6. Dehart-Beverley M., C. Foster, J. P. Porcari, D. C. W. Fater, and R. P. Mikat. Relationship between the talk test and the ventilatory threshold. Clin. Exerc. Physiol. 2:34–38, 2000.

7. Foster, C., M. Schrager, and A. C. Snyder. Blood lactate and respiratory methods of evaluating the capacity for sustained exercise. In:Physiological Assessment of Human Fitness, P. J. Maud and C. Foster (Eds.). Champaign, IL: Human Kinetics Publishers, 1995, pp. 57–72.

8. Foster, C., and J. P. Porcari. The risks of exercise training. J. Cardiopulm. Rehabil. 21:347–352, 2001.

9. Meyer, K., L. Samek, A. Pinchas, P. Baier, P. Betz, and H. Roskamm. Relationship between the ventilatory threshold and the onset of ischemia in ECG during stress testing. Eur. Heart J. 16:623–630, 1995.

10. Norman, J. F., J. Kracl, D. Parker, and A. Richter. Comparison of the counting talk test and heart rate reserve methods for extimating exercise intensity in healthy young adults. J. Exerc. Physiol. Online (http://www.asep.org/jeponlinearchieves) 5:15–22, 2002.

11. Pollock, M. L., G. A. Gaesser, J. D. Butcher, J. P. Despres, R. K. Dishman, and B. A. Franklin. The recommended quantity and quality of exercise for maintaining cardiorespiratory and muscular fitness and flexibility in healthy adults. Med. Sci. Sports Exerc. 30:975–991, 1998.

12. Recalde, P. T., C. Foster, K. M. Skempt-Arlt, et al. The talk test as a simple marker of ventilatory threshold. S. Afr. J. Sports Med. 8:5–8, 2002.

13. Voelker, S. A., C. Foster, K. M. Skemp-Arlt, G. Brice, and R. Backes. Relationship between the talk test and ventilatory threshold in cardiac patients. Clin. Exerc. Physiol. 4:120–123, 2002.

Cited By:

This article has been cited 22 time(s).

European Journal of Preventive Cardiology
Validity of the Talk Test for exercise prescription after myocardial revascularization
Zanettini, R; Centeleghe, P; Franzelli, C; Mori, I; Benna, S; Penati, C; Sorlini, N
European Journal of Preventive Cardiology, 20(2): 376-382.
10.1177/2047487312438982
CrossRef
Plos One
An Economic Evaluation of Resistance Training and Aerobic Training versus Balance and Toning Exercises in Older Adults with Mild Cognitive Impairment
Davis, JC; Bryan, S; Marra, CA; Sharma, D; Chan, A; Beattie, BL; Graf, P; Liu-Ambrose, T
Plos One, 8(5): -.
ARTN e63031
CrossRef
Bmj Open
Promoting physical activity in sedentary elderly Malays with type 2 diabetes: a protocol for randomised controlled trial
Sazlina, SG; Browning, CJ; Yasin, S
Bmj Open, 2(6): -.
ARTN e002119
CrossRef
Circulation
Exercise Standards for Testing and Training: A Scientific Statement From the American Heart Association
Fletcher, GF; Ades, PA; Kligfield, P; Arena, R; Balady, GJ; Bittner, VA; Coke, LA; Fleg, JL; Forman, DE; Gerber, TC; Gulati, M; Madan, K; Rhodes, J; Thompson, PD; Williams, MA
Circulation, 128(8): 873-934.
10.1161/CIR.0b013e31829b5b44
CrossRef
International Journal of Behavioral Medicine
Ecological Momentary Assessment of the Relationship between Intention and Physical Activity Behavior in Bariatric Surgery Patients
Bond, DS; Thomas, JG; Ryder, BA; Vithiananthan, S; Pohl, D; Wing, RR
International Journal of Behavioral Medicine, 20(1): 82-87.
10.1007/s12529-011-9214-1
CrossRef
Clinics
Changes in body weight, C-reactive protein, and total adiponectin in non-obese women after 12 months of a small-volume, home-based exercise program
Mediano, MFF; Neves, FA; Cunha, ACDR; de Souza, EPG; Moura, AS; Sichieri, R
Clinics, 68(8): 1121-1127.
10.6061/clinics/2013(08)10
CrossRef
Acta Clinica Belgica
Medical management of obesity
Giri, M
Acta Clinica Belgica, 61(5): 286-294.

International Journal of Behavioral Nutrition and Physical Activity
The effect of duration of exercise at the ventilation threshold on subjective appetite and short-term food intake in 9 to 14 year old boys and girls
Bozinovski, NC; Bellissimo, N; Thomas, SG; Pencharz, PB; Goode, RC; Anderson, GH
International Journal of Behavioral Nutrition and Physical Activity, 6(): -.
ARTN 66
CrossRef
Acta Oncologica
Improved physical fitness of cancer survivors: A randomised controlled trial comparing physical training with physical and cognitive-behavioural training
May, AM; Van Weert, E; Korstjens, I; Hoekstra-Weebers, JEHM; Van Der Schans, CP; Zonderland, ML; Mesters, I; Van Den Borne, B; Ros, WJG
Acta Oncologica, 47(5): 825-834.
10.1080/02841860701666063
CrossRef
American Journal of Health-System Pharmacy
Interpreting current physical activity guidelines and incorporating them into practice for health promotion and disease prevention
Slack, MK
American Journal of Health-System Pharmacy, 63(): 1647-1653.
10.2146/ajhp050367
CrossRef
Journal of Aging and Physical Activity
The Phone-FITT: A brief physical activity interview for older adults
Gill, DP; Jones, GR; Zou, GY; Speechley, M
Journal of Aging and Physical Activity, 16(3): 292-315.

International Journal of Sports Medicine
Effects of a learning trial on self-regulation of exercise
Wegner, MS; Whaley, MH; Glass, SC; Kasper, MJ; Woodall, MT
International Journal of Sports Medicine, 28(8): 685-690.
10.1055/s-2007-964836
CrossRef
Bmc Public Health
Health enhancing strength training in nonagenarians (STRONG): rationale, design and methods
Rexach, JAS; Ruiz, JR; Bustamante-Ara, N; Villaran, MH; Gil, PG; Ibanez, MJS; Sanz, NB; Santamaria, VO; Sanz, NG; Prada, ABM; Gallardo, C; Romo, GR; Lucia, A
Bmc Public Health, 9(): -.
ARTN 152
CrossRef
Bmc Neurology
Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise training in older adults with vascular cognitive impairment
Liu-Ambrose, T; Eng, JJ; Boyd, LA; Jacova, C; Davis, JC; Bryan, S; Lee, P; Brasher, P; Hsiung, GYR
Bmc Neurology, 10(): -.
ARTN 14
CrossRef
Journal of Sports Sciences
The ABC of Physical Activity for Health: A consensus statement from the British Association of Sport and Exercise Sciences
O'Donovan, G; Blazevich, AJ; Boreham, C; Cooper, AR; Crank, H; Ekelund, U; Fox, KR; Gately, P; Giles-Corti, B; Gill, JMR; Hamer, M; McDermott, I; Murphy, M; Mutrie, N; Reilly, JJ; Saxton, JM; Stamatakis, E
Journal of Sports Sciences, 28(6): 573-591.
10.1080/02640411003671212
CrossRef
ACSM's Health & Fitness Journal
INTENSITY OF PHYSICAL ACTIVITY AND THE "TALK TEST": A Brief Review and Practical Application
Webster, AL; Aznar-Laín, S
ACSM's Health & Fitness Journal, 12(3): 13-17.
10.1249/FIT.0b013e31817047b4
PDF (1019) | CrossRef
Medicine & Science in Sports & Exercise
The Effect of Acute Exercise on Serum Brain-Derived Neurotrophic Factor Levels and Cognitive Function
FERRIS, LT; WILLIAMS, JS; SHEN, C
Medicine & Science in Sports & Exercise, 39(4): 728-734.
10.1249/mss.0b013e31802f04c7
PDF (185) | CrossRef
American Journal of Physical Medicine & Rehabilitation
Task-Oriented Intervention in Chronic Stroke: Changes in Clinical and Laboratory Measures of Balance and Mobility
Leroux, A; Pinet, H; Nadeau, S
American Journal of Physical Medicine & Rehabilitation, 85(10): 820-830.
10.1097/01.phm.0000233179.64769.8c
PDF (502) | CrossRef
The American Journal of the Medical Sciences
A Clinician's Approach to Medical Management of Obesity
Low, AK; Bouldin, MJ; Sumrall, CD; Loustalot, FV; Land, KK
The American Journal of the Medical Sciences, 331(4): 175-182.

PDF (331)
Journal of Cardiopulmonary Rehabilitation and Prevention
The Talk Test as a Marker of Exercise Training Intensity
Webber, H; Doberstein, ST; Udermann, B; Foster, C; Porcari, JP; Anderson, J; Paulson, M; Smaczny, D
Journal of Cardiopulmonary Rehabilitation and Prevention, 28(1): 24-30.
10.1097/01.HCR.0000311504.41775.78
PDF (347) | CrossRef
Journal of Cardiopulmonary Rehabilitation and Prevention
Validity of the Counting Talk Test in Comparison With Standard Methods of Estimating Exercise Intensity in Young Healthy Adults
Norman, JF; Hopkins, E; Crapo, E
Journal of Cardiopulmonary Rehabilitation and Prevention, 28(3): 199-202.
10.1097/01.HCR.0000320072.89093.0d
PDF (257) | CrossRef
Topics in Geriatric Rehabilitation
Effects of Aquatic Intervention on the Cardiopulmonary System in the Geriatric Population
Gulick, DT
Topics in Geriatric Rehabilitation, 26(2): 93-103.
10.1097/TGR.0b013e3181dfd8bf
PDF (218) | CrossRef
Back to Top | Article Outline
Keywords:

VENTILATORY THRESHOLD; EXERCISE GUIDELINES; HEART RATE; FITNESS

©2004The American College of Sports Medicine

Login

Article Tools

Images

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us