Prescription of Exercise for Health and Fitness

Prescription of Exercise for Health and FitnessPhysiology DepartmentMedical FacultyUniversitas Sumatera Utara

How to start exercise programs?Active lifestyle is important for optimal health.Maintain a regular regimen of activity, that is of longer duration or of more vigorous intensity are likely to derive greater benefit.Appropriate exercise type and intensity varies, depending on individual characteristics, current fitness level, and specific health concerns.

Medical clearance/evaluation Medical evaluation necessary before starting an exercise program.Some people either should not be exercising at all or are considered at high risk and should be restricted to exercising only under close medical supervision, for example:men over 40 years ageWomen over 50 years agePeople of any age who are considered to be high risk

Exercise prescriptionInvolves four basic factors:Mode or type of exerciseFrequency of participationDuration of each exercise boutIntensity of the exercise boutThe goal of exercise program is to improve aerobic capacity in people who have not been exercising.

How much exercise is effective ?A minimum threshold for frequency, duration, and intensity of exercise must be reached before any aerobic benefits are obtained.American College of Sports Medicine (ACSM) recommendation for developing and maintaining aerobic capacity: training intensity of 60%-90% of ones maximum heart rate (Hrmax) or 50%-80% of VO2max

Exercise modeShould focus on one or more modes, types, of cardiovascular endurance activities.Select activities that enjoying and continuing throughout life.Fun, provides challenge.Consider: geographic location, climate, availability of equipment and facilities, home exercise.

Exercise frequencyOptimal: 3 to 5 days per week.Simply for the health-related benefits.Additional days above are beneficial for weight loss but this level should not be encouraged until the exercise habit is firmly established and the injury risk is reduced.

Exercise durationRecent research: 20 to 30 min per day is an optimal amount.Exercise duration can not be discussed appropriately without also discussing exercise intensity.Improvements in aerobic capacity are gained with either a short duration, high intensity or a long duration, low intensity, if the minimal threshold is exceeded for both duration and intensity.

Exercise intensityHow hard must you push yourself to gain benefits?For most people, intensity should be at least 60% VO2 max.Health benefits occur at intensities lower than those needed for aerobic conditioning.

Monitoring exercise intensityCan be monitored on the basis of : training heart rate (THR), metabolic equivalent (MET), or rating of perceived exertion (RPE).THR: linear relationship between HR and VO2.MET: activities classified by intensity according to their oxygen requirements.RPE: individuals subjectively rate how hard they feel that they are working.

Exercise programWarm-up and stretchingEndurance trainingCool-down and stretchingFlexibility trainingResistance trainingRecreational activities

Exercise and Rehabilitation of People With DiseasesExercise training has become an extremely important part of rehabilitation programs for a number of diseases.Although the specific physiological mechanisms explaining the benefits of exercise training for some diseases have not been clearly defined, there are many general health benefits that appear to improve the patients prognosis.

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