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How to Write an Exercise Prescription

How to Write anExercise PrescriptionMAJ Robert L. Gauer, MDLTC Francis G. O Connor, MD, FACSMD epartment of Family MedicineUniformed Services University of the Health SciencesHow to Write an ExercisePrescriptionMAJ Robert L. Gauer, MDLTC Francis G. O Connor, MD, FACSMD epartment of Family MedicineUniformed Services Universityof the Health OF FOR OF THE HEALTH CARE OF Mortality .. Vascular Disease .. Mellitus ..12 VIII. Health .. OF PHYSICAL Related Sudden .. of Physical Activity Recommendations .. Recommendations.

intensity and duration of exercise. This is most readily achieved through a written exercise prescription program. The products of an effective exercise program are disease prevention, healthy living and a general sense of well being. This monograph is designed to assist HCPs in appropriately prescribing exercise to their patients. This

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Transcription of How to Write an Exercise Prescription

1 How to Write anExercise PrescriptionMAJ Robert L. Gauer, MDLTC Francis G. O Connor, MD, FACSMD epartment of Family MedicineUniformed Services University of the Health SciencesHow to Write an ExercisePrescriptionMAJ Robert L. Gauer, MDLTC Francis G. O Connor, MD, FACSMD epartment of Family MedicineUniformed Services Universityof the Health OF FOR OF THE HEALTH CARE OF Mortality .. Vascular Disease .. Mellitus ..12 VIII. Health .. OF PHYSICAL Related Sudden .. of Physical Activity Recommendations .. Recommendations.

2 22A. ACSM CDC/ACSM AHA Scientific AMA Guidelines for Adolescent Preventive Department of Health and Human Services ..25F. United States Preventive Services Task Force .. of Recent Physical Activity Recommendations ..25 Exercise to Recommending Exercise .. Evaluation .. Exercise the Exercise Prescription ..37A. Activity Frequency ..40C. Duration ..40D. The Exercise Rate of Muscle Principles of Exercise Prescription in Secondary Prevention ..53A. Prescription in the Absence of Ischemia or Significant Prescription in the Presence of Ischemia or Arrhythmias.

3 54C. Summary .. Mellitus ..57A. Exercise in Type 1 Diabetes Mellitus ..57B. Exercise in Type 2 Diabetes Mellitus ..59C. Complications .. Disease ..75 VIII. Exercise in the Personnel .. - Exercise ASSESSMENT - NATIONAL CHOLESTEROL EDUCATION PROGRAM: EXPERT PANEL GUIDELINES FOR DIAGNOSIS AND TREATMENT OF HIGH - EFFECTS OF MEDICATIONS ON HEART RATE, BLOOD PRESSURE, AND Exercise CAPACITY ..C-1D - CARDIOVASCULAR Prescription - BEGINNER S PROGRAM TRAINING LOG ..E-1F - INTERMEDIATE PROGRAM TRAINING - BODY MASS INDEX TABLE.

4 G-1 RESOURCES/REFERENCESI ndividual Guidelines for Cardiovascular Guidelines for patients with Diabetes Mellitus ..REF-5 Exercise Guidelines for Pregnancy and Post-partum ..REF-7 Weight Training Guidelines for Healthy Adults and Low-Risk Cardiac patients ..REF-9iiiRESOURCES/REFERENCES (continued)PageAquatic Exercise Workout .. REF-11 Training for the Army Physical Fitness Test (APFT) .. REF-13 Getting Out of Your Chair .. REF-15 How to Start a Walking Program .. REF-17 Exercising in Cold Weather .. REF-19 Sensible REF-21 Fitness injury prevention.

5 REF-23 Conditioning Exercises .. REF-25 Bend and Stretch .. REF-27 National REF-31 Figures1. Exercise Assessment and Prescription Flow Cardiovascular Risk Assessment ..353. Management of Exercise Induced 1. PROPORTION OF ADULTS REPORTING NO LEISURE-TIME ACTIVITY WITHIN THE LAST MONTH, 1991 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM ..4 TABLE 2. BARRIERS AND MOTIVATORS ASSOCIATED WITH PHYSICAL 3. PHYSICAL ACTIVITY AND THE REDUCED RISK OF SPECIFIC CANCERS ..10 TABLE 4. PRETEST PROBABILITY OF CORONARY ARTERY DISEASE BY AGE, GENDER, AND SYMPTOMS.

6 17 TABLE 5. CATEGORIES OF ACTIVITY BY MUSCULOSKELETAL IMPACT ..19 TABLE 6. EXAMPLES OF COMMON PHYSICAL ACTIVITIES FOR HEALTHY US ADULTS BY INTENSITY OF EFFORT REQUIRED ..24 TABLE 7. HOW TO APPROACH ROADBLOCKS ..29 TABLE 8. MODEL FOR PHYSICAL ACTIVITY 9. PRE- Exercise EVALUATION HISTORY ..31 TABLE 10. CONTRAINDICATIONS TO 11. INDICATIONS FOR Exercise STRESS TESTING ..33 TABLE 12. COMPONENTS OF AN Exercise Prescription ..37 TABLE 13. ACTIVITY SELECTION GUIDE ..38 TABLE 14. ENERGY EXPENDITURES FOR VARIOUS ACTIVITIES ..39 TABLE 15.

7 BORG SCALE FOR RATING PERCEIVED EXERTION ..43ivTABLES (continued)PageTABLE 16. CLASSIFICATION OF PHYSICAL ACTIVITY INTENSITY, BASED ON ACTIVITY LASTING UP TO 60 17. PROGNOSTIC FACTORS FOR patients WITH CORONARY ARTERY DISEASE ..49 TABLE 18. NEW YORK HEART ASSOCIATION FUNCTIONAL CLASSIFICATION FOR CONGESTIVE HEART FAILURE ..50 TABLE 19. PREVENTION OF HYPOGLYCEMIA OR 20. Exercise AND THE STRESS ACROSS SELECTED 21. Exercise GUIDELINES FOR PREGNANCY AND THE POSTPARTUM PERIOD ..64 TABLE 22. FACTORS THAT SUGGEST Exercise -INDUCED ASTHMA.

8 68 TABLE 23. COMPONENTS OF THE COPD Exercise 24. CLASSIFICATION OF OVERWEIGHT AND OBESITY BY BMI AND ASSOCIATED DISEASE RISK ..75 TABLE 25. FUNCTIONAL CHANGES ASSOCIATED WITH 26. GENERAL GUIDELINES FOR THE Exercise Prescription IN CHRONICALLY ILL patients ..821 INTRODUCTION All parts of the body if used in moderation and exercised in labors towhich each is accustomed, become thereby healthy and well developed,and age slowly; but if unused and left idle, they become liable to disease,defective in growth, and age quickly.

9 HippocratesRegular physical activity has been regarded as an important component of a healthy lifestyle and hasbeen proven to increase longevity and the overall quality of Recently, this stand has been reinforcedby scientific data linking physical activity to a wide array of physical and mental health ,3 Despite this evidence and the apparent heightened public awareness, millions of Americans continue topractice sedentary lifestyles. In order to effect change, it is very important that health care providers(HCPs) include Exercise counseling as a part of routine health maintenance.

10 HCPs in this paper refers tophysicians, physicians assistants, nurse practitioners and those directly involved in primary health need to emphasize the benefits of Exercise and encourage all children and adults to engage in atleast 20 to 60 minutes of formal physical activity at a minimum of 3 days per week. Most patients canbegin a formal Exercise Prescription program after consultation with a HCP. Selected high-risk patients ,specifically those with pre-existing coronary artery disease (CAD), may require further evaluation priorto initiation of Exercise .


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