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Exercise is physical activity that is planned, structured, and repetitive for the purpose of conditioning any part of the body. Exercise is used to improve health, maintain fitness and is important as a means of physical rehabilitation.
Exercise is useful in preventing or treating coronary heart disease, osteoporosis, weakness, diabetes, obesity, and depression. Range of motion is one aspect of exercise important for increasing or maintaining joint function. Strengthening exercises provide appropriate resistance to the muscles to increase endurance and strength. Cardiac rehabilitation exercises are developed and individualized to improve the cardiovascular system for prevention and rehabilitation of cardiac disorders and diseases. A well-balanced exercise program can improve general health, build endurance, and slow many of the effects of aging. The benefits of exercise not only improve physical health, but also enhance emotional well-being.
Studies have shown that a consistent, guided exercise program benefits almost everyone from Gulf War veterans coping with fatigue, distress, cognitive problems, and mental health functioning to patients awaiting heart transplants. Exercise in combination with a reduced-calorie diet is the safest and most effective method of weight loss. The United States Department of Agriculture (USDA) food pyramid, called MyPyramid, makes exercise as well as food recommendations to emphasize the interconnectedness between exercise, diet, and health.
Before beginning any exercise program, an evaluation by a physician is recommended to rule out potential health risks. Once health and fitness level are determined and any physical restrictions identified, the individual's exercise program should begin under the supervision of a health care or other trained professional. This is particularly true when exercise is used as a form of rehabilitation. If symptoms of dizziness, nausea, excessive shortness of breath, or chest pain are present during exercise, the individual should stop the activity and inform a physician about these symptoms before resuming activity. Exercise equipment must be checked to determine if it can bear the weight of people of all sizes and shapes. Individuals must be instructed in the proper use of exercise equipment in order to prevent injury.
Range of motion exercise
Range of motion exercise refers to activity aimed at improving movement of a specific joint. This motion is influenced by several structures: configuration of bone surfaces within the joint, joint capsule, ligaments, tendons, and muscles acting on the joint. There are three types of range of motion exercises: passive, active, and active assists. Passive range of motion is movement applied to a joint solely by another person or persons or a passive motion machine. When passive range of motion is applied, the joint of an individual receiving exercise is completely relaxed while the outside force moves the body part, such as a leg or arm, throughout the available range. Injury, surgery, or immobilization of a joint may affect the normal joint range of motion. Active range of motion is movement of a joint provided entirely by the individual performing the exercise. In this case, there is no outside force aiding in the movement. Active assist range of motion is described as a joint receiving partial assistance from an outside force. This range of motion may result from the majority of motion applied by an exerciser or by the person or persons assisting the individual. It also may be a half-and-half effort on the joint from each source.
Strengthening exercise increases muscle strength and mass, bone strength, and the body's metabolism. It can help attain and maintain proper weight and improve body image and self-esteem. A certain level of muscle strength is needed to perform daily activities such as walking, running, and climbing stairs. Strengthening exercises increase muscle strength by putting more strain on a muscle than it is normally accustomed to receiving. This increased load stimulates the growth of proteins inside each muscle cell that allow the muscle as a whole to contract. There is evidence indicating that strength training may be better than aerobic exercise alone for improving self-esteem and body image. Weight training allows one immediate feedback, through observation of progress in muscle growth and improved muscle tone. Strengthening exercise can take the form of isometric, isotonic and isokinetic strengthening.
During isometric exercises, muscles contract. However, there is no motion in the affected joints. The muscle fibers maintain a constant length throughout the entire contraction. The exercises usually are performed against an immovable surface or object such as pressing one's hand against a wall. The muscles of the arm are contracting but the wall is not reacting or moving in response to the physical effort. Isometric training is effective for developing total strength of a particular muscle or group of muscles. It often is used for rehabilitation since the exact area of muscle weakness can be isolated and strengthening can be administered at the proper joint angle. This kind of training can provide a relatively quick and convenient method for overloading and strengthening muscles without any special equipment and with little chance of injury.
Isotonic exercise differs from isometric exercise in that there is movement of a joint during the muscle contraction. A classic example of an isotonic exercise is weight training with dumbbells and barbells. As the weight is lifted throughout the range of motion, the muscle shortens and lengthens. Calisthenics are also an example of isotonic exercise. These would include chin-ups, push-ups, and sit-ups, all of which use body weight as the resistance force.
Isokinetic exercise utilizes machines that control the speed of contraction within the range of motion. Isokinetic exercise attempts to combine the best features of both isometrics and weight training. It provides muscular overload at a constant preset speed while a muscle mobilizes its force through the full range of motion. For example, an isokinetic stationary bicycle set at 90 revolutions per minute means that no matter how hard and fast the exerciser works, the isokinetic properties of the bicycle will allow the exerciser to pedal only as fast as 90 revolutions per minute. Machines known as Cybex and Biodex provide isokinetic results; they generally are used by physical therapists.
Exercise can be very helpful in prevention and rehabilitation of cardiac disorders and disease. With an exercise program designed at a level considered safe for the individual, people with symptoms of heart failure can substantially improve their fitness levels. The greatest benefit occurs as muscles improve the efficiency of their oxygen use, which reduces the need for the heart to pump as much blood. While such exercise does not necessarily improve the condition of the heart itself, the increased fitness level reduces the total workload of the heart. The related increase in endurance also should translate into a generally more active lifestyle. Endurance or aerobic routines, such as running, brisk walking, cycling, or swimming, increase the strength and efficiency of the muscles of the heart.
A physical examination by a physician is important to determine if strenuous exercise is appropriate or detrimental for an individual, especially when the exercise program is designed for rehabilitation. Before exercising, proper stretching is important to prevent the possibility of soft tissue injury resulting from tight muscles, tendons, ligaments, and other joint-related structures.
Proper cool down after exercise is important in reducing the occurrence of painful muscle spasms. Proper cool down stretching also may decrease frequency and intensity of muscle stiffness the day following any exercise program.
Improper warm up can lead to muscle strains. Overexertion without enough time between exercise sessions to recuperate also can lead to muscle strains, resulting in inactivity due to pain. Stress fractures also are a possibility if activities are strenuous over long periods without proper rest. Although exercise is safe for the majority of children and adults, there is still a need for further studies to identify potential risks.
Significant health benefits are obtained by including a moderate amount of physical exercise in the form of an exercise prescription. This is much like a drug prescription in that it also helps enhance the health of those who take it in the proper dosage. Physical activity plays a positive role in preventing disease and improving overall health status. People of all ages, both male and female, benefit from regular physical activity. Regular exercise also provides significant psychological benefits and improves quality of life.
Exercise burnout may occur if an exercise program is not varied and adequate rest periods are not taken between exercise sessions. Muscle, joint, and cardiac disorders have been noted among people who exercise. However, they often have had preexisting or underlying illnesses.
- Exercise training that is geared to provide a sufficient cardiovascular overload to stimulate increases in cardiac output.
- Exercise involving free movement without the aid of equipment.
- The time limit of a person's ability to maintain either a specific force or power involving muscular contractions.
- A disorder characterized by loss of calcium in the bone, leading to thinning of the bones. It occurs frequently in postmenopausal women.
For Your Information
- "Exercise and Physical Fitness." MedlinePlus. February 25, 2009 [cited February 26, 2009]. http://www.nlm.nih.gov/medlineplus/exerciseandphysicalfitness.html.
- "Exercise for Children." MedlinePlus. February 23, 2009 [cited February 26, 2009]. http://www.nlm.nih.gov/medlineplus/exerciseforchildren.html.
- "Exercise for Seniors." MedlinePlus. February 18, 2009 [cited February 26, 2009]. http://www.nlm.nih.gov/medlineplus/exerciseforseniors.html.
- American College of Sports Medicine. P. O. Box 1440, Indianapolis, IN 46206-1440. Telephone: (317) 637-9200. Fax: (317) 634-7817. http://www.acsm.org.
- American Medical Association. 515 N. State Street, Chicago, IL 60610. (800) 621-8335. http://www.ama-assn.org.
- American Physical Therapy Association. 1111 North Fairfax Street, Alexandria, VA 22314-1488. (800) 999-APTA (2782) or (703) 684-APTA (2782). TDD: (703) 683-6748. http://www.apta.org.
- National Athletic Trainers' Association. 2952 Stemmons Freeway, Dallas, TX 75247-6916. (800) 879-6282 or (214) 637-6282. Fax: (214) 637-2206. http://www.nata.org.
Range of motion
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.
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.
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.
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.
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.
ex·er·cise(ek'sĕr-sīz), Avoid the misspellings excercise, exersise, exercize, and other variants.
exercisePublic health The rhythmic contraction of muscles against a force Pros ↓ risk of cholecystectomy, ↓ risk of CAD, CHD, CA–colorectal, breast, prostate, DM–improved insulin utilization, obesity, stroke, osteoporosis, stress, anxiety; ↑ sexual pleasure, strength, flexibility, stamina, psychological well-being, general health; improved reaction time, memory, moods, immune resistance, sleep, self-confidence, control of arthritis, weight, quality of life. See Aerobic exercise, Anaerobic exercise, Breathing exercise, Cardiovascular exercise, Codman's pendulum exercise, Hoshino exercise, Isometric exercise, Isotonic exercise, Pritikin exercise, Vigorous exercise.
exercise(ek'ser-siz?) [L. exercitus, trained, drilled]
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.
Bates exerciseSee: Bates exercises
Buerger postural exerciseSee: Buerger, Leo
Codman exerciseSee: Codman exercise
dynamic stabilization exerciseStabilization exercise.
Kegel exerciseSee: Kegel exercise
kinetic chain exercise
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.
passive exercisePassive motion.
pelvic floor exerciseKegel exercise.
pendulum exerciseCodman exercise.
progressive resistive exerciseAbbreviation: PRE
regressive resistive exerciseAbbreviation: RRE
resistive exerciseResistance exercise.
static exerciseIsometric exercise.
|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|
|1020||Running 8 miles/hr (12.9 km/hr); climbing stairs with 30-lb (13.61-kg) load|
exerciseMuscular activity undertaken for the promotion of health and for the pleasure inherent in the use of the body. Modern sedentary life involves a dangerous degree of under-exertion and much of the bodily disorder suffered today can be attributed to the use of artificial energy sources to replace the use of one's own musculature.
Patient discussion about exercise
Q. Do you exercise at all? If so, what exercise do you perform and why? What are it's benefits? I am looking to incorporate different routines and exercises into my workouts and would like your assistance.
Q. How much exercise should I do. I am very fond of exercise. But I get tired soon and loosing my energy. How much exercise should I do?
Q. How do you motivate yourself to exercise? I have a problem- I can easily get myself to go to work and other strenuous things, but when I need to get myself out for some exercise, which is only for me, I don’t find the energy for that. Does anyone have any tips how to encourage myself?