I. INTRODUCTION
Today,
technological advances promote sedentary lifestyles and approximately 66.3% of
American adults are either obese or overweight (Donnelly, Blair, Jakicic, Manore, Rankin, &
Smith, 2009; Fletcher, et al., 1992) . This trend has created various
challenges that have impacted the health care system, economy, and the
population nationwide. Obesity is
a disease of energy imbalance and one of the most useful weight management
tools is physical activity. Research
has shown a dose-response relationship of the higher of caloric expenditure due
to physical activity (>1,000 kcal/wk) results in an array of health
and fitness benefits. Physical
activity is associated with lower chronic disease risks including: coronary
heart disease, stroke, diabetes, and cancer
(Donnelly et al., 2009; Haskell, et al., 2007).
In
addition to activities of daily living, it is imperative that all adults
implement an exercise regimen to improve overall health and delay mortality (Garber, et al., 2011) . The purpose of this Position Stand is
to provide insight for healthy adults of all ages on individualized exercise
prescriptions and its evolving health benefits that far surpass other
treatment. This lifestyle intervention
will improve or maintain cardiorespiratory and muscular fitness and it is
beneficial to identify factors that promote adherence.
II.
EXERCISE PERSCRIPTION BARRIERS
The terms
exercise, physical activity, and physical fitness have different definitions
but are commonly misinterpreted and used interchangeably (Garber, et al., 2011) . Physical activity involves any type of
skeletal muscle contraction that results in caloric expenditure. This includes exercise, recreational
activities, competitive sports, and even activities of daily living, like
gardening (Donnelly et al., 2009). In contrary, exercise is a form of
physical activity that is planned and repetitive. Exercise is designed to improve physical fitness, a crucial
component of health (Garber, et al., 2011) . Physical fitness is known as the
ability to sustain the tasks of daily living without excessive fatigue. It can be measured through health related fitness components such as:
cardiorespiratory, muscular fitness (muscular strength and endurance),
flexibility, and body composition.
Incorporating these skills into an
exercise regimen is recommended to enhance quality of life, wellbeing, and
improve cognitive and physical functioning (Garber, et al., 2011) .
Advocating
physical activity should be incorporated through various components of life including:
national administration, community leaders, and health care providers. Unfortunately, physicians commonly
overlook their duty to encourage physical activity and educate individuals on
the health risks associated with inactivity (Fletcher, et al., 1992) . Healthcare providers treat the disease
instead of preventing the onset with exercise (Nelson, et al., 2007) . Neglecting
one of the crucial components of health creates a domino effect of chronic
health conditions. In order
to improve the adherence to physical activity, it should be incorporated in social
and personal factors of life.
Additionally, introducing self-monitoring techniques, various support
systems, and relapse prevention skills, would enhance the adoption of this
behavior change (Donnelly et al., 2009; Haskell,
et al., 2007).
III.
EXERCISE RECOMMENDATIONS
In
order to alleviate confusion, the exercise recommendation for healthy adults
has been updated to make concepts more concise quantitatively and qualitatively (Garber, et al., 2011; Haskell, et al., 2007) . A comprehensive exercise regimen is an
ongoing process that includes cardiorespiratory fitness, resistance training,
flexibility, and neuromotor skill.
Exercise should be tailored to the individual depending on their chronic
disease risk, goals, health status, current fitness levels, and exercise
response (Garber, et al., 2011) . Since the risk of activity related
falls, injuries, and deaths are potential threats to adults it is advised to
have a medical evaluation before adhering to any type program. In addition, gradual progression of
volume and intensity and consistent reevaluation is recommended to accomplish
goals (Fletcher, et al., 1992) .
The recommended
aerobic prescription should incorporate exercises that engage large muscle
groups at least 5 d/wk at a moderate (40-60% VO2R) to vigorous (> 60% VO2R) intensity. The daily duration of the
cardiovascular exercise training is 30 minutes and can be attained either
continuous or through 10-minute intermittent bouts; both duration methods show
similar health benefits (Haskell, et al., 2007) . After getting the muscles warmed up,
flexibility exercises should be incorporated. The goal of flexibility should be to develop range of
movement with exercises that should be practiced more than 2-3 days
weekly. Flexibility is the ability to move a joint through a range
of motion and exercises should target all tendons of major muscles. Without
flexibility, tissue damage and pain may occur and that affects the overall
ability to carry out every day activities (Haskell, et al., 2007) .
Another fundamental
recommendation is muscle-strengthening exercises that target all major muscle
groups (Haskell, et al., 2007) . Resistance training is recommended to
be performed 2 d/wk by 8-10 exercises total at 8-12 repetitions. To optimize the efficacy of resistance
training, the program variables of intensity, rest interval durations, and
frequency should be tailored to the goals of the individuals. Resistance training for the elderly
population should emphasize the development of power. Neuromotor exercises of balance,
agility, and coordination are beneficial (Garber, et al., 2011; Nelson, et al., 2007) . Muscular strength may improve or maintain: bone
mass, insulin sensitivity, fat-free mass and resting metabolic rate. During resistance training, the
metabolism is revved up and the breakdown of fat occurs. Overtime, body
composition improves due to gains in muscle mass and reductions in percent body
fat may, less than 2-3%, have shown improvements in risk factors of chronic
disease (Donnelly et al., 2009).
Exceeding
the recommended exercise requirements has shown greater benefits in physical
fitness, reductions in mortality, and management of chronic health conditions
and diseases (Garber, et al., 2011) . However, the dose-response relationship
between exercise and health is affected by other factors like baseline data. When prescribing exercise, intensity is
an important determinant and commonly moderate intensity is recommended to
maintain exercise consistency.
However, intensity may vary depending on fitness level and other factors
such as gender, age, and duration of time sitting daily. Metabolic equivalent (MET) is a value
of activity intensity and a MET is equivalent to resting energy
expenditure. The recommended
intensity is >500-1000
MET min/wk (Haskell, et al., 2007) . A relative measure of intensity is a more
appropriate method for older and deconditioned individuals (Garber,
et al., 2011) .
IV.
CONCLUSION
Overall,
a comprehensive exercise regimen that meets the recommendations for cardiorespiratory
fitness, resistance training, flexibility, and neuromotor skill is imperative
for all adults. Individualized and
tailored behavioral programs can enhance the adoption and short-term adherence
to exercise. Physical activity is an important treatment for various chronic
health conditions and should be encouraged for all adults.
Works Cited
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S., Jakicic, J., Manore, M., Rankin, J., & Smith, B. (2009). Appropriate
Physical
Activity Intervention Strategies for Weight Loss and Prevention of Weight
Regain
for Adults. Medicine and Science in
Sports and Exercise , 459-469.
Fletcher, G., Blair,
S., Blumenthal, J., Caspersen, C., Chaitman, B., Epstein, S., et al. (1992).
Statement
on Exercise Benefits and Recommendations for Physical Activity Programs for
All
Americans. Circulation Journal of the
American Heart Association , 86,
360-344.
Garber, C., Blissmer,
B., Deschenes, M., Franklin, B., Lamonte, M., Lee, I.-M., et al. (2011).
Quantity
and Quality of Exercise for Developing and Maintaining Cardiorespiratory,
Musculoskeletal,
and Neuromotor Fitness in Apparently Healthy Adults: Guidance for
Prescribing
Exercise. Medicine & Science in
Sports & Exercise , 43 (7),
1334-1359.
Haskell, W., Lee, I.,
Pate, R., Powell, K., Blair, S., Franklin, B., et al. (2007). Physical
Activitiy
and
Public Health: Updated Recommendations for Adults from the ACSM and AHA.
Medicine and Science in Sport Exercise , 39, 1423-1434.
Nelson, M., Rejeski,
W., Blair, S., Duncan, P., Judge, J., King, A., et al. (2007). Physical
Activity
and Public Health in Older Adults: Recommendations from the American
College
of Sports Medicine and the American Heart Association. Medicine & Science in
Sports & Exercise ,
1435-1443.
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