* Intensity - the on a level of di...

* Intensity - the on a level of difficulty of each exercise composing (includes the number of repetitions for musculoskeletal power endurance and flexibility training activities);

* Duration - the longitudinal dimensions of time a single exercise or exercise session will be performed as well as the long-term timeframe for the total program;

* common occurrence - the number of times the exercise program will be performed within a specific timeframe.

* Progression - the manner and pace with which the program will be advanced through the whole extent of time to provide an increased physiologic demand.

Intensity, duration and commonness combine to establish the dose of exercise or bulk of energy expended. These ultimate parts may be measured by a variety of parameters (Table 1) the selection of which is pendent upon the: (1) patient's initial exercise tolerance; (2) acuity of clinical signs and symptoms; (3) port of risk factors for injury or death; (4) desired of the same height of fitness at the conclusion of the program; and (5) logistical considerations for program implementation and adherence. Logistical requirements include a safe, environmentally supportive place to exercise, the availability of appropriate equipment and of appropriately qualified personnel to administer and supervise the program as well as the patient's motivation flat and schedule limitations.

Determination of the appropriate workload at which to start an exercise or activity is essential to optimize patient results as well as safety. Graded exercise experiments using a treadmill or round of years ergometer provide a standardized arrangement by which to measure or calculate a patient's peak or submaximal aerobic capacity and endurance as well as associated clinical signs and symptoms. Field ordeals such as the 6-minute walk do not require exercise equipment beyond a stopwatch and may be applied in any setting.25 In the absence of a formal ordeal estimations of workload are possible using various metabolic calculations (Figure 3) and/or vigor expenditure tables.20,26 Similarly, maximal heart rate may be estimated via a variety of equations, the most numerous common of which is 220-age. Tanaka et al27 produc different equations for healthy individuals [208 - 0.7(age)] and sedentary individuals [211 - 0.8(age)] based onward analysis of data from 351 studies (total sample = 18 712) None of these equations were derived based upon individuals with disease or disability. Estimations have the advantage of being useful in any setting further may be associated with large standard errors (standard deviation for 220-age = ?±10-12 beats/minute)20 appropriate to an inability to account for diagnosis and medication-related changes, the carriage of risk factors for injury or death, and the general intent of environmental conditions on exercise tolerance. In an effort to address these limitations, Jurca et al28 cause to growed an equation that includes sex age, body mass index, resting heart rate, and self-reported physical activity score; however, it remains to be validated in clinical practice. Finally, ratings of perceived exertion (RPE) may be used as gros estimates of effort in conjunction with the heart rate achieved at a given workload.20 sum of two units scales are available (Figure 4) as well-as; not only-but also; not only-but; not alone-but of which require the patient to rate their total amount of exertion and fatigue. A primary advantage of these scales is their usefulness for evaluating effort during any physical activity or exercise. The disadvantage is the high inter-individual variability with refer to to the heart and work rate horizontals per unit on the scale.