ABSTRACT This paper distinguishes b...

ABSTRACT

This paper distinguishes between physical activity (PA) and exercise, and discusses in what manner PA counseling may complement exercise prescription in primary care settings. The health benefits of lifestyle PA are reviewed and compared to fitness benefits that accrue from exercise. Effective counseling strategies designed to forward PA are presented, as are recommendations for incorporating of the like kind strategies into practice. Physical therapists can expand their part in primary and secondary prevention practice by means of counseling patients and clients about lifestyle PA in addition to prescribing exercise.

INTRODUCTION

Much make anxious has been expressed recently about the epidemics of obesity and physical inactivity and their associations with cardiovascular disease (CVD) and its risk factors.12 These relate tos have prompted appeals for health care providers to pay increased attention to weight and physical activity during routine patient visits.1,3 As exercise specialists, physical therapists (PTs) are uniquely situated to have an impact forward physical activity levels in our patients. still PTs may not be aware of differences in emphasis between exercise and physical activity (PA), and between exercise prescription and PA counseling. Opportunities to improve PA among patients seen in the clinic and in the community may use strategies that encourage physical activity rather than exercise prescription. This paper will distinguish between exercise and physical activity, and between exercise prescription and PA counseling, and will highlight fitness and health benefits that accrue from lifestyle physical activity. Evidence regarding the efficacy of PA counseling strategies will be reviewed and approveed strategies that may be useful for promoting PA in PT practice will be presented

DEFINITIONS OF PHYSICAL ACTIVITY AND EXERCISE

In order to understand conceptions related to physical activity, an understanding of definitions is essential. Physical activity includes "any bodily motion produced by skeletal muscles that issues in energy expenditure;"4(p129) and exercise is "planned, structur and repetitive bodily motion done to improve or maintain united or more components of fitness."4(p129) Thus, exercise is considered to be PA, as are occupational activities, recreational activities, and activities of daily living, all of which are repeatedly identified as 'lifestyle' PA. Examples of lifestyle PA include taking stairs instead of the elevator, dancing, walking to a destination similar as a workplace or a shopping center occupational activities that involve sustained physical effort within the workplace or household and recreational activities such as sports. the pair PA and exercise are differentiated from physical fitness in that physical fitness is a place of physiologic attributes, while PA and exercise are behaviors.

BENEFITS OF EXERCISE AND LIFESTYLE PHYSICAL ACTIVITY

The benefits of physical activity, including exercise have been documented extensively.5-8 Aerobic exercise training, when performed at a sufficient frequent occurrence duration, and intensity confers many physiologic benefits, including increased physical work capacity, and increased maximum oxygen uptake (VO^sub 2^max),5,6 the 'gold standard' for measuring aerobic fitness. Furthermore, the American body of Sports Medicine acknowledges that physical activity performed at lower intensity than is required to improve fitness leads to improved health outcomes6 including reduc risk of CVD hypertension, protoplast II diabetes, osteoporosis, and a forms of cancer.5 For this reason, the United States Surgeon General, the National Institutes of Health, the Center for Disease manage and Prevention, the American Heart Association, and the American literary institution [i]or[/i] seminary of learning of Sports Medicine recommend that all Americans participate in 30 minutes or more of at least moderate physical activity forward most days of the week5,7,8 Physical activity ne not come to pass within a 30-minute episode in order to achieve the health-related benefits, rather it may be accumulated above the course of a day to reach a total of 30 minutes.

The recommendations regarding moderate PA mystical the controversy surrounding the adequate 'dose' of PA in order to obtain fitness and health-related benefits. Unquestionably, there is a dose-response relationship between oftenness duration, and intensity of PA, and issues such as VO^sub 2^max and other physiologic measures of fitness.5,6 The literature upon health-related benefits is less certain, however. often of our knowledge of these benefits get tos from epidemiologic studies of choiceed populations. Early understanding of the health-related benefits of PA emerg from the Framingham Study9 Another important epidemiologic investigation that has shed light in succession our understanding of the health-related benefits of PA in men is the Harvard Alumni Health inquiry Several cohorts of graduates have been followed longitudinally for mortality and disease-related consequences Multiple published reports from this inquiry suggest a graded association between PA intensity and risk of mortality and CHD so that more vigorous levels of PA are more protective; however, moderate intensity activity also is acknowledged to converse benefits.10-12 Similar findings in women have derived from the suckles Health Study13,14 and the women's health study15 The epidemiology of PA is enormously tangle and fraught with uncertainty regarding measurement and interpretation. The studies cited here set forth but a small sample of the literature; however, the available evidence hints that while vigorous activity converses greater health-related benefits, moderate activity is also beneficial. There has been disturb that sedentary individuals may balk at beginning an exercise program appropriate to the mistaken belief that merely strenuous PA is beneficial.7,16 This make anxious stresses the importance of promoting moderate PA in the general population.