performance of physical exertion for improvement of health or correction of physical deformity.
active exercise motion imparted to a part by voluntary contraction and relaxation of its controlling muscles.
active assistive exercise voluntary contraction of muscles controlling a part, assisted by a therapist or by some other means.
aerobic exercise a type of physical activity that increases the heart rate and promotes increased use of oxygen in order to improve the overall body condition.
ballistic stretching e's rapid, jerky movements employed in exercises to stretch muscles and connective tissue.
cardiovascular exercise exercises to promote improved capacity of the cardiovascular system. They must be administered at least twice weekly, with most programs conducted three to five or more times weekly. The contraction of major muscle groups must be repeated often enough to elevate the heart rate to a target level determined during testing. Used in the treatment of compromised cardiovascular systems, as in cardiac rehabilitation, or as a preventive measure.
endurance exercise any exercise that involves the use of several large groups of muscles and is thus dependent on the delivery of oxygen to the muscles by the cardiovascular system; used in both physical fitness programs and testing of cardiovascular and pulmonary function.
isokinetic exercise dynamic muscle activity performed at a constant angular velocity.
isometric exercise active exercise performed against stable resistance, without change in the length of the muscle.
isotonic exercise active exercise without appreciable change in the force of muscular contraction, with shortening of the muscle.
McKenzie exercise an exercise regimen used in the treatment of low back pain and sciatica, prescribed according to findings during mechanical examination of the lumbar spine and using a combination of lumbar motions, including flexion, rotation, side gliding, and extension. It is sometimes referred to as McKenzie extension exercises, but this is a misnomer because the regimen involves movements other than extension.
voluntary contraction and relaxation of skeletal muscles without changing the muscle length or moving the associated part of the body. Called also static exercise
passive exercise motion imparted to a segment of the body by another individual, machine, or other outside force, or produced by voluntary effort of another segment of the patient's own body.
pelvic floor e's
1. a combination of endurance and strength exercises of the pelvic floor (circumvaginal or perianal) muscles, used in the management of stress urinary incontinence; the patient is taught to isolate and contract muscles once or twice a day.
in the nursing interventions classification
, a nursing intervention
defined as pelvic muscle exercise strengthening and training of the levator ani and urogenital muscles through voluntary, repetitive contraction to decrease stress
or mixed types of urinary incontinence
quadriceps setting exercise an isometric exercise to strengthen muscles needed for ambulation. The patient is instructed to contract the quadriceps muscle while at the same time elevating the heel and pushing the knee toward the mat.
range of motion (ROM) e's
exercises that move each joint through its full range of motion
, that is, to the highest degree of motion of which each joint normally is capable; they may be either active or passive.
Examples of range of motion exercises. A, Flexion: The bending of a joint. B, Extension: A movement opposite to flexion in which a joint is in a straight position. C, Rotation: Pivoting a body part around its axis, as in shaking the head. D, Abduction: A movement of a limb away from the median plane of the body; the fingers are abducted by spreading them apart. E, Adduction: Moving toward the midline of the body or to the central axis of a limb. F, Circumduction: A combination of movements that cause a body part to move in a circular fashion. G, Supination: Extension of the forearm to bring the palm of the hand upward. H, Pronation: Movement of the forearm in the extended position that brings the palm of the hand to a downward position. I, Inversion: Movement of the ankle to turn the sole of the foot medially. J, Eversion: Movement of the sole of the foot laterally. From Lammon et al., 1995.
See accompanying figure.
resistance e's (resistive e's) activities designed to increase muscle strength, performed against an opposing force; the resistance may be either isometric, isotonic, or isokinetic.
static stretching e's the placement of muscles and connective tissues at their greatest length by steady force in the direction of lengthening. Short duration forces can be obtained manually, but special traction devices, splints, and casts are generally used to apply low-intensity forces for prolonged periods (30 minutes or longer). Warming the soft tissue before or during stretching will generally facilitate lengthening.
a technique for evaluating circulatory response to physical stress; it involves continuous electrocardiographic monitoring during physical exercise, the objective being to increase the intensity of physical exertion until a target heart rate is reached or signs and symptoms of cardiac ischemia appear. Called also stress testing
Clinical exercise testing has become an important tool in screening for and diagnosing early ischemic heart disease that cannot be detected by a standard resting EKG, and in predicting the probability of the development of the condition in later years. The technique cannot determine the location of the lesion causing cardiac ischemia and therefore must be supplemented with angiocardiography when coronary occlusion is detected.
Common forms of exercise used include the treadmill and the bicycle ergometer
. These procedures must be performed in a clinical setting where health care personnel are available in the event symptoms develop during exercise, such as dyspnea, vertigo, extreme fatigue, severe arrhythmias, or other abnormal EKG readings.
Exercise testing also may be used to assess the pulmonary status of a patient with a respiratory disease. As the patient performs specific exercises, blood samples are drawn for blood gas analysis
, and ventilatory function tests such as tidal volume, total lung capacity, and vital capacity are conducted.
the scientific use of bodily movement to restore normal function in diseased or injured tissues or to maintain a state of well-being; called also corrective exercise
. As with any type of therapy, a therapeutic exercise program is designed to correct specific disabilities of the individual patient. The program is evaluated periodically and modified as indicated by the patient's progress and response to the prescribed regimen. Exercises affect the body locally and systemically and bring about changes in the nervous, circulatory, and endocrine systems as well as the musculoskeletal system.
Among the types of therapeutic exercise are those that (1) increase or maintain mobility of the joints and surrounding soft tissues, (2) develop coordination through control of individual muscles, (3) increase muscular strength and endurance, and (4) promote relaxation and relief of tension.
Joint Mobility. In the absence of a disability that prohibits mobility, the regular day-to-day activities of living maintain the normal movements of the joints. If, however, motion is restricted for any reason, the soft tissues become dense and hard and adaptive shortening of the connective tissues takes place. These changes begin to develop within four days after a joint has been immobilized and are evident even in a normal joint that has been rendered immobile. It is for this reason that therapeutic exercises to prevent loss of joint motion are so important and should be begun as soon as possible after an injury has occurred or a disease process has begun.
Prevention of the loss of joint motion is much less costly and time-consuming than correction of tissue changes that seriously impair joint mobility. It is recommended that each joint should be put through its full range of motion three times at least twice daily. If the patient is not able to carry out these exercises, he is assisted by a therapist or member of the family who has been instructed in the exercises. Inflammation of the joint, as in arthritis, may cause some pain on motion, and so passive exercises are done slowly and gently with the joint as relaxed as possible. Procedures that stretch tight muscles to increase joint motion should be done only by a skilled therapist who understands the hazards of fracture and bleeding within the joint, which can occur if the exercises are done improperly or too strenuously.
Muscle Training. Exercises of this type are taught to the patient who has lost some control over a major skeletal muscle. By learning precise and conscious control over a specific muscle, the patient is able to strengthen and coordinate its movement with normal motor patterns and thus enhance mobility. Muscle training or neuromuscular re-education demands full cooperation of the patient, who must be capable of understanding the purpose of the exercises, following directions, and giving full attention to the muscle isolated for retraining. The sessions are held in a quiet, comfortable atmosphere to facilitate concentration by the patient.
The development of conscious control over individual muscles is useful in the rehabilitation of patients with a variety of disorders, including physical trauma, diseases such as poliomyelitis that affect the motor neurons, and congenital disorders such as cerebral palsy. It involves a systematic program of sequential activities under the direction of a therapist knowledgeable in the technique. Although it requires much effort on the part of the patient and the therapist, the attainment of muscle control and coordination is a satisfying reward.
Muscle Strength and Endurance
. Improvement of muscle strength and endurance is particularly important in the rehabilitation of patients whose goal is to return to an active and productive life after a debilitating illness or disabling injury. The exercises are prescribed according to the individual needs of the patient and usually involve more than one group of muscles.Strengthening (force increasing) exercises
are prescribed after an examination has shown weakness in individual muscles or muscle groups. These exercises are usually administered with relatively high resistance and few (3 to 10) repetitions. A group of exercises, called a set,
is followed by a few minutes of rest. Three to 5 sets for a muscle or group constitute one bout of exercises. Strengthening exercises are often performed daily in early stages of rehabilitation, but less often later in treatment.Endurance exercises
stimulate changes in the involved muscle or muscles, resulting in improved capacity for repeated contraction (e.g., increased ability to use metabolites). When conducted over a sufficient length of time and with several muscle groups, they may also produce central effects of the cardiovascular system (see cardiovascular exercise
). Endurance exercises employ relatively low resistance and numerous (15 or more) repetitions. Endurance exercises are generally administered daily.
Relief of Tension. Exercises that promote relaxation of the muscles and provide relief from the effects of tension are useful in a wide variety of disorders ranging from mild tension headache to insomnia. Patients who are especially tense may require several sessions of instruction in relaxation before they can learn the technique.
Williams' e's (Williams' flexion e's) a therapeutic exercise regimen used in the treatment of low back pain; it seeks to reduce lumbar lordosis through flexion of the lumbar spine and strengthening of the abdominal musculature.
exercise (ek'ser-siz?) [L. exercitus, trained, drilled]
A physical or mental activity performed to maintain, restore, or increase normal capacity. Physical exercise involves activities that maintain or increase muscle tone and strength, esp. to improve physical fitness or to manage a handicap or disability. See: table; physical fitness
; risk factor
; sedentary lifestyle
Daily physical activity for a minimum of 35 min will increase exercise capacity and the ability to use oxygen to derive energy for work, decrease myocardial oxygen demands for the same level of work, favorably alter lipid and carbohydrate metabolism, prevent cardiovascular disease, and help to control body weight and body composition. An exercise program should include developing joint flexibility and muscle strength, esp. in the trunk and limbs. This is of particular importance as people age. Exercise can have a beneficial effect in patients with depression or anxiety. It is thought to have a positive effect on balance, endurance, attitude, and outlook.
An exercise program should be neither begun nor continued if the individual or the person prescribing the exercise program has evidence that the activity is painful or harmful. Persons have died while exercising, and heavy physical exertion may precede acute myocardial infarction, particularly in people who are habitually sedentary. See: exercise prescription
Mental exercise involves activities that maintain or increase cognitive faculties. Daily intellectual stimulation improves concentration, integration, and application of concepts and principles; enhances problem-solving abilities; promotes self-esteem; facilitates self-actualization; counteracts depression associated with social isolation and boredom; and enhances the quality of one's life. This is particularly important during aging. See: reminiscence therapy
Most of the negative aspects of aging can be either altered or diminished by a lifelong healthy lifestyle. For example, the loss of physical fitness and strength, an inevitable consequence of aging, can be altered by an individualized fitness and strength program. Progressive loss of bone mass due to osteoporosis may be either prevented or slowed by a program of regular exercise. Loss of cardiac fitness can be forestalled by an ongoing aerobic fitness program. Many cases of type 2 diabetes can be controlled by exercise and an appropriate diet. Arthritic stiffness and loss of flexibility can be influenced favorably by exercise, e.g., by walking and jogging; for patients who experience joint pain with impact exercise, swimming is an alternative. Obesity and loss of muscle mass can be prevented or minimized.
Exercise stimulates release of endorphins, and people who participate in regular exercise programs express positive feelings toward living. Exercise programs can be adapted for patients who are confined to wheelchairs. An important consideration for any exercise program is that it be enjoyable. No matter how beneficial the program may be, if it is not enjoyable or rewarding, it will not be continued.
A type of bodily movement performed by voluntary contraction and relaxation of muscles.
Exercise during which oxygen is metabolized to produce energy. Aerobic exercise is required for sustained periods of physical exertion and vigorous athletic activity. See: anaerobic exercise
High-intensity exercise, such as sprinting or weight lifting, that places more demand on muscles than oxygen delivery can match. When this occurs, glucose is metabolized for its stored energy without using oxygen as a reactant. Adenosine triphosphate (ATP) is produced rapidly, as well as the byproduct, lactic acid. See: aerobic exercise.
The use of a pool or an immersion tank filled with water for exercise. Such exercises may be used to improve balance and gait, enhance physical endurance, mobilize joints, and/or strengthen or stretch muscles. See: hydrotherapy
A type of bodily movement performed by voluntary muscle contractions that are augmented by an extrinsic force such as a clinician or mechanical device.
Bates exercise See: Bates exercises
Exercise that enhances the respiratory system by improving ventilation, strengthening respiratory muscles, and increasing endurance. It is used in pulmonary rehabilitation
Buerger postural exercise See: Buerger, Leo
Codman exercise See: Codman exercise
A form of isotonic exercise in which the muscle fibers shorten as tension develops. See: concentric muscle contraction; eccentric muscle contraction
Use of specific exercises to correct deficiencies caused by trauma, inactivity, muscular imbalances, poor flexibility, or biomechanical inadequacies.
dynamic stabilization exerciseStabilization exercise.
An exercise in which there is overall lengthening of the muscle in response to an external resistance. See: concentric muscle contraction; eccentric muscle contraction
An activity, e.g., stretching, designed to increase joint range of motion and extensibility of muscle.
An exercise carried through with no external assistance.
An exercise with equipment that uses variable resistance to maintain a constant velocity of joint motion during muscle contraction, so that the force generated by the muscle is maximal through the full range of motion.
ISOMETRIC EXERCISE: Isometric exercise of the upper extremities
Contraction and relaxation of a skeletal muscle or group of muscles in which the force generated by the muscle is equal to the resistance. There is no change in muscle length, and no movement results. See: illustration Synonym: muscle-setting exercise; static exercise
An active muscle contraction in which the force exerted remains constant and muscle length changes.
Kegel exercise See: Kegel exercise
kinetic chain exercise
An exercise that requires the foot (or hand) to apply pressure against a plate, pedal, or ground. This rehabilitation concept was determined by the anatomical functional relationship in the lower extremities. It also applies to the upper extremities. Kinetic chain describes how forces occur during human motion and how segments of the body are linked together. Kinetic chain exercises can either be open or closed. Open kinetic chain exercises are unrestricted movements in space of a peripheral segment of the body. Closed kinetic chain exercises are movements in which the distal segment meets with external resistance and remains fixed. Closed kinetic chain exercises are more functionally based than open chain exercises.
Kinetic chain exercises can either be open or closed. Kinetic chain describes how forces occur during human motion and how segments of the body are linked together. Open kinetic chain applies to unrestricted movement in space of a peripheral segment of the body. In closed kinetic chain exercises, the distal segment meets with external resistance, and remains fixed.
muscle-setting exerciseIsometric exercise.
Brainteasers, association tasks, calculations, puzzles, and other mental and physical exercises designed to stimulate thinking, problem solving, and other cerebral functions.
passive exercisePassive motion.
pelvic floor exerciseKegel exercise.
pendulum exerciseCodman exercise.
progressive resistive exercise Abbreviation: PRE
A form of active resistive exercise based on a principle of gradual increase in the amount of resistance in order to achieve maximum strength.
Movement of a joint through its available range of motion. It can be used to prevent loss of motion. See: illustration
regressive resistive exercise Abbreviation: RRE
A form of active resistive exercise that advocates gradual reduction in the amount of resistance as muscles fatigue.
An exercise (such as yoga, tai chi, dance, prayer, or meditation) that induces a relaxation response.
Exercise in which a muscle contraction is opposed by force to increase strength or endurance. If the resistance is applied by using weights, it is mechanical resistance; if applied by a clinician, it is manual resistance. Synonym: resistive exercise
resistive exerciseResistance exercise.
The application of fluctuating resistance loads while the patient stabilizes the part being trained in a symptom-free position. Exercises begin easily so that control is maintained, and progress in duration, intensity, speed, and variety. Synonym: dynamic stabilization exercise
static exerciseIsometric exercise.
A therapeutic exercise maneuver, using physiological principles, designed to increase joint range of motion or extensibility of pathologically shortened connective tissue structures.
The use of physical activity or training as a means of improving flexibility, health, strength, or well being; fostering recovery from injury or surgery; preventing complications of injury or illness; or improving or maintaining functional performance. Therapeutic exercise interventions may include techniques to improve motion, strength, motor control, muscle and cardiopulmonary endurance, and efficiency, posture, balance, and coordination.
|Calories Required per Hour of Exercise||Activity†|
| 80||Sitting quietly, reading|
| 200||Golf with use of powered cart|
| 250||Walking 3 miles/hr (4.83 km/hr); housework; light industry; cycling 6 miles/hr (9.7 km/hr)|
| 330||Heavy housework; walking 3.5 miles/hr (5.6 km/hr); golf, carrying own bag; tennis, doubles; ballet exercises|
| 400||Walking 5 miles/hr (8 km/hr); cycling 10 miles/hr (16.1 km/hr); tennis, singles; water skiing|
| 500||Manual labor; gardening; shoveling|
| 660||Running 5.5 miles/hr (8.9 km/hr); cycling 13 miles/hr (20.9 km/hr); climbing stairs; heavy manual labor|
* These estimates are approximate and can serve only as a general guide. They are based on an average person who weighs 160 lb (72.58 kg). † Energy requirements for swimming are not provided because of variables such as water temperature, whether the water is fresh or salt, buoyancy of the individual, and whether the water is calm or not.
|1020||Running 8 miles/hr (12.9 km/hr); climbing stairs with 30-lb (13.61-kg) load|