Exercise prescription and basic principles of therapeutic exercise (2022)

1. OVERVIEW AND DESCRIPTION

Exercise is one of the most underutilized treatment option in modern American healthcare which places an emphasis on medications and procedures. The benefits of exercise have been researched and documented by many groups and agencies over the past three decades. The American College of Sports Medicine (ACSM),1 U.S. Centers for Disease Control and Prevention2, the U.S. Surgeon General, and the National Institutes of Health3 have issued landmark publications on physical activity and health.1,3,4 An exercise program that includes aerobic, resistance, flexibility, and neuromotor training is indispensable to improve and maintain physical fitness and health.4 Despite this, physical inactivity has been cited as one of the greatest public health threats of the 21st century.5

Exercise has been shown to:

  • Benefit cardiovascular and respiratory function
  • Reduce cardiovascular and respiratory function
  • Decrease morbidity and mortality
  • Decrease anxiety and depression6
  • Reduce pain7,8,9
  • Improve cognitive function
  • Enhance physical function and independent living in older individuals
  • Enhance feelings of well-being
  • Reduce risk of falls in older individuals
  • Prevent or mitigate functional limitations in older adults
  • Enhance performance of work, recreational, and sport activities6

Exercise and physical activity are often overlooked as therapeutic treatment options. Additionally, prescribing exercise may be challenging as many patients are looking for an “easy fix.” When appropriately utilized, exercise can be an effective long-term treatment for many conditions.10 The U.S. Department of Health and Human Services published Physical Activity Guidelines in 1996 and more recently in 2018. Recommendations for adults include at least 150 minutes a week of moderate-intensity aerobic activity, or 75 minutes a week of vigorous-intensity aerobic activity, or an equivalent combination of the two. ACSM defines moderate intensity is defined as 3 to 5.9 metabolic equivalents (METs), 45-63% VO2 max, or 64-91% of maximum heart rate. They define vigorous intensity is defined as greater than 6.0 METs, 64-91% VO2 max, or 77-93% of maximum heart rate (please also refer to Table 1).4 Children and adolescents are encouraged to perform 60 minutes or more of physical activity daily, including aerobic, muscle-strengthening and bone-strengthening activities.4 While these recommendations provide a general target for much of the population, many people will need directions. Exercise prescription should be designed to meet the specific needs of an individual patient, geared to their co-morbidities and their age. Exercise prescription involves careful screening including history and physical examination to determine a patient’s capacity for physical activity, as well as a survey of goals and interests. The evidence in favor of regular physical activity outweighs any inherent risk for adverse events,11 and evaluating for issues such as cardiovascular, pulmonary, and metabolic health is an important part of an initial assessment.12

An effective home exercise program should be individualized and directed to help the person develop fitness, maintain health, and/or treat specific conditions.10 Special considerations need to be placed on pain, which can serve as a barrier and may lead to non-compliance.13 Patients should be counseled on appropriate advancement or potential reduction of the exercise program. The person performing the exercise should be focused on maintaining proper form and what that feels like physically. Insistence on perfecting technique will allow the person to challenge him or herself while increasing strength and endurance gains, with less risk of pain or injury. Lastly a home exercise program should prepare the patient for his or her normal activities: fitness needs/goals, occupation, sport, or recreational activities. Many well-intended practitioners prescribe exercises that are appropriate and fit the suggestions above, but do not assist the patient in returning to the desired job or activity. Other exercises can potentially put the area to be treated under too much strain, such as using resistance bands or weights to “strengthen” a still painful rotator cuff injury.

There are several methodologies to exercise prescription. One of the easier methods is the Frequency, Intensity, Time, and Type (FITT). The ACSM also recommends FITT-VP (Frequency, Intensity, Time, Type, Volume, and Progression). Utilizing these methodologies parallels writing a traditional medication prescription. Each component of the prescription provides a patient with specific information to incorporate aerobic, resistance, flexibility, and neuromotor exercise training into a fitness program.14,6

Greenman’s idea of exercise discusses restoring length, strength and control of muscle function as the process of treating muscular imbalances. A successful exercise program restores nervous system control of muscle function as much as possible. To achieve this, he prescribes the following sequence:

  • Sensory motor balance training
  • Stretching of short, tight, hypertonic muscle to symmetry
  • Strengthening of inhibited weak muscles
  • Restoration of symmetrical movement patterns
  • Aerobic conditioning15

Yet another method of exercise prescription, outlined by McGill, takes on a five stage progression of training.

  • Stage 1 involves detection and remedy of incorrect motor patterns.
  • Stage 2 establishes stability of joints throughout the whole body via exercise and education, with a focus on spine stability.
  • Stage 3 develops endurance and applying prior skills to daily activities.
  • Stages 4 and 5 are for athletes and includes training strength, speed, power, and agility.16

An additional consideration towards stages or progressions of the exercise can be made from the foundation laid by the initial prescribed regimen. While the recommendation of “some is good, more is better” is certainly well-supported, we should keep in mind that small and well-spaced increments will reduce the incidence of adverse events and improve adherence.11 Progression of exercise allows the body to adapt to the stresses of it, from a musculoskeletal level. When the exercise is progressed too quickly, they are at risk of injury. A patient must also understand how to recognize the difference between signs of exercise stress, such as increased heart rate and muscle soreness, and symptoms of overexertion or injury.10 If a patient cannot perform the exercise due to pain, muscle tension or fatigue, various tools should be made available to the patient, such as medications – or other modalities such as massage therapy, TENS, manual therapy, etc. to facilitate the exercises.17 Informing the patient that these symptoms generally improve after the first few days of starting or increasing a program can be helpful.

(Video) Exercise Prescription - Principles of Exercise Prescription

2. RELEVANCE TO CLINICAL PRACTICE

Current recommendations advise accumulation of moderate-intensity aerobic physical activity to attain a daily goal of around 30 minutes. Additional data is available to show that bouts of approximately 10 minutes each can be effective in attaining this goal and suggest that the volume of energy expended is more important than the duration of the exercise.14 Large prospective studies of diverse populations show that an energy expenditure of approximately 1000kcal/week of moderate intensity physical activity is associated with lower rates of cardiovascular disease and premature mortality.14 Significant risk reductions for these have been shown to begin at volumes below the recommended targets, and as low as half the recommended volume. While measured kcal’s is useful, perhaps a more practical measure for aerobic activity is the MET. MET’s measure the absolute intensity of aerobic activity with 1 MET equivalent to the resting metabolic oxygen consumption rate of approximately 3.5mL/kg/minute.18 It is known that significant health benefits emerge with a volume of 500 to 1000 MET minutes/week and this volume can be met by walking at 3.0 mph on three days a week for 50 minutes.18

Despite recommendations and guidelines, most people present with a variety of reasons why they do not exercise. Patients will note lack of time, lack of motivation, and poor ability to maintain adherence, thus it is crucial to take these aspects into account when formulating an exercise prescription in order to increase compliance.19 There are tools to measure a person’s readiness to exercise more. The Physical Activity Readiness Questionnaire (PAR-Q) is a self-guided, seven question tool that can be used as a screening instrument. Engagement and finding activities that the person will enjoy doing also helps improve compliance with exercise.20 For example, a person who enjoys socializing with others may be more successful when enrolled in group classes or participating in team sports rather than running on a treadmill alone. If a person is motivated and engaged, he or she may be more willing to find the time to exercise. Other barriers include pain (both pre-morbid as well as new onset due to too rapid progression) or another medical condition that limits activity or the amount of activity done. Addressing these medical conditions, or finding an alternative exercise to accommodate can be very successful. For instance, a person with knee osteoarthritis that limits running may do well with swimming or water aerobics in which the buoyancy of the water decreases the knee pain.10,19 Another potential barrier is for those who are exercise novices or who have various physical impairments where more energy is required to perform what is typically thought of as low-intensity exercise. The ACSM uses walking at 3-4 mph as an example of moderate-intensity exercise.4 However, for instance people who are physically deconditioned, morbidly obese, or with various other physical impairments, walking at 3-4 mph may actually be vigorous exercise. These persons can be taught to use tools such as heart rate, or perceived exertion indices (e.g. Borg Perceived Exertion Scale) to monitor their activity. They can also be taught how to slowly increase the activity, starting with duration, frequency, or intensity. They should be taught not to increase all three at once. Close communication with the person is ideal and will help ensure compliance and safety. People in these situations can benefit from the close and frequent communication and instruction that a personal trainer, or potentially a physical therapist, can provide. For individuals who cite time as a barrier, a physician can recommend utilizing high-intensity interval training (HIIT). As defined by the ACSM, HIIT is episodic, short bouts of high intensity exercise. For each high intensity bout, the lowest VO2 max should be 65% and the high is maximal possible effort.4 HIIT is opposed to the more typical moderate-intensity continuous training where there is no fluctuation in aerobic energy expenditure. A recent meta-analysis on HIIT training for cardiometabolic health cited that compared to moderate intensity continuous aerobic training, HIIT may be more effective at increasing aerobic capacity and reducing risk factors associated with metabolic syndrome. Authors of one study encourage clinicians to incorporate HIIT, performed three times a week for at least 12 weeks, into exercise programs for obese patients.19 Another recent review looking at HIIT in patients with coronary heart disease found that the optimal protocol involved short interval duration (15 seconds) and maintaining close work/recovery ratios.20

A meta-analysis in 2016 quantified the dose-response association between physical activity and five chronic diseases (Diabetes, Ischemic Heart Disease, Ischemic stroke, Breast and Colon Cancer) and found that higher levels of total physical activity, compared to current minimums recommended by the WHO and ACSM, were associated with lower risk for all outcomes.3 However, it should be noted that the dose-response relationship between volume and health benefits is curvilinear with the greatest return on investment at lower levels of activity and decreasing return of health benefits at higher levels of activity.11

3. CUTTING EDGE/UNIQUE CONCEPTS/EMERGING ISSUES

While the majority of the recommendations for exercise are targeted at a general, healthy adult or youth population, evidence suggest that specified exercise therapy is beneficial for patient populations with certain co-morbidities. Guidelines and recommendations are available for chronic diseases such as diabetes, obesity, arthritis, peripheral arterial disease, COPD, coronary artery disease, multiple sclerosis, and cancer. Some of these disease and others will be discussed.

Cardiovascular Diseases

Physical activity’s benefits on cardiorespiratory health is extensively well documented.4 Heart disease and stroke risks can be dramatically decreased with exercise. Regular aerobic exercise decreases arterial stiffness, reduces blood pressure, increases HDL, decreases LDL, and decreases resting heart rate. Exercise is known to decrease all-cause mortality in those with coronary artery disease.4,21 But what is often overlooked are the benefits of the addition of resistance training to aerobic exercise. Increasing skeletal muscle mass has similar effects as aerobic exercise and can complement the effects. Historically several studies identified concerns that resistance training and strengthening exercises alone may increase arterial stiffness. However, some more recent studies have been inconclusive or contradictory demonstrating actual improvement in arterial stiffness.22

(Video) Exercise Prescription For Strength Training In Physical Therapy 10-6-20

Results from the HF-ACTION trial (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) suggest that exercise therapy reduces cardiac mortality and hospitalizations in patients with coronary heart disease and that exercise therapy may be safely conducted in certain heart failure populations.23 A recent meta-analysis supports this evidence. It found reduction in the risk of re-hospitalization due to heart failure and improvements in health-related quality of life following exercise interventions.24,25

Stroke

The American Heart Association and the American Stroke Association have provided a detailed report on guidelines for prescribing exercise for stroke survivors across all stages of recovery. Points of emphasis include low- to moderate-intensity aerobic activity, muscle-strengthening activity, and reduction of sedentary behavior.25 In terms of specific types of exercise for this patient population, community cycling exercise programs have been shown to significantly improve sit-to-stand capacity, activities of daily living, psychosocial functioning, energy, and depression.26 Additionally, forced, rather than voluntary, aerobic exercise can lead to enhanced motor skill acquisition when done prior to upper-extremity repetitive task practices.27 Other specific exercise prescriptions being evaluated for stroke survivors include HIIT and physical exercise in real and virtual environments.28,29

Multiple Sclerosis and Neuromuscular Diseases

A review on exercise therapy for patients with MS found that combining aerobic training, strength training, and yoga yielded improvements in balance, dynamic gait, and symptoms of fatigue.30 Another review of exercise in neuromuscular disease (NMD) summarizes studies and information about a variety of neuromuscular conditions. Some basic recommendations for patients in this population include exercising carefully and under the supervision of their physician, and also targeting certain muscles and breathing exercises rather than whole body aerobic conditioning. These recommendations include non-ambulatory individuals with NMD.31,15 All in all, the current literature continues to confirm the benefits of exercise in MS patients,32,33 but the absence of a conceptual framework and toolkit for translating this into practice remains a limiting factor in its implementation.34

Cancer

The ACSM published guidelines for physical activity in cancer survivors in 2010 with general recommendations. They instruct to avoid inactivity, and to continue exercise as soon and as often as possible.35 Physical inactivity and obesity has been shown to increase a person’s risk of development and of recurrence of certain cancers such as colon, breast, and endometrial.36,37 For both aerobic and resistance exercises, the ACSM provided tumor-specific recommendations taking into account the pathophysiology and unique effects of specific cancer types (e.g. risk of pathologic fractures from bone metastasis or the risk of lymphedema status post mastectomy). The ACSM recommends a “low and slow” approach, and no upper limit on the amount of resistance an individual is capable of progressing towards.35 In general, a Cochrane Systematic review found that there is evidence supporting exercise for helping in fatigue related to chemotherapy either during or after adjuvant treatment. Aerobic exercise has been demonstrated to help in cancer-related fatigue in breast and prostate cancer patients specifically. Unfortunately, resistance training was not found to be as beneficial for improving fatigue.38 One randomized controlled trial noted that the combination of both moderate intensity aerobic exercise and resistance training reduces the symptoms of chemo-induced peripheral neuropathy when used during treatment.39 Caution must be taken with overtraining in individuals with hematologic malignancies who received hematopoietic stem cell transplantation, due to concern for adverse immune effects.35

Pregnancy

(Video) Exercise Prescription - Principles of Strength Training

The traditional advice to rest during pregnancy has changed toward a more healthy and active pregnancy.40 Regular exercise during pregnancy promotes overall wellness and may reduce hypertensive disorders of pregnancy and gestational diabetes.41 The American College of Obstetricians and Gynecologists recommends an exercise program of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week with those women with medical obstetric complications being monitored closely by their obstetrician.41,42 The PARmed-X for Pregnancy is a tool that may be utilized by the healthcare provider to medically screen pregnant women for exercise therapy, track their progress with exercise, and monitor for indications to stop exercise.43

Dementia/Cognitive Impairment

In recent years, there has been excitement about exercise’s effect on cognition and potentially decreasing a person’s risk of dementia. Some research shows that immediate results of exercise include improved anxiety and sleep. With long-term exercise, there can be improvement in executive functioning including the ability to plan and organize, attention, processing, and emotional control.4 Unfortunately, many studies have shown mixed results. Two recent randomized control trials found that a 3 to 4 month high-intensity functional exercise program can slow decline in ADL independence and improve balance in those with dementia,44,45 but a separate paper derived from one of those same studies showed no superior effects on global cognition or executive function.46 A 2015 Cochrane review reported that there is promising evidence that exercise programs may improve the ability to perform ADLs but that there is a lack of evidence on their benefit on cognition.47 Meanwhile, a meta-analysis performed in 2017 looked at the combined effects of cognitive and physical exercise training in people with mild cognitive impairment and found a small-to-medium positive effect on global cognitive function and a moderate-to-large positive effect for ADLs.48 Interestingly, in the few studies that do show benefit, it appears that Tai Chi improves attention and processing when compared to no exercise.49 (Overall, there needs to be more randomized control trials regarding this topic to verify the utility of exercise in people with cognitive impairment/dementia.

Other

Use of performance enhancing substances has become quite controversial. This is sometimes referred to as “doping.” Doping refers to the use of prohibited performance-enhancing drugs (PEDs), hormones and growth factors, or methods (e.g., gene doping, blood doping, etc) specifically to enhance athletic performance beyond normal physiologic levels and not for the purposes of treating a legitimate medical condition.50 Our role as physicians should be to direct our patients away from these substances and provide education on the harmful effects that can arise from their use.

Low-intensity resistance training combined with blood flow restriction (BFR) is gaining favor as an alternative means to increase muscular strength and hypertrophy. External pressure is applied to the area of interest and maintains arterial inflow while occluding venous outflow to the area.51 Compared with low-load training, low-load BFR is more effective and tolerable and thus may be a good musculoskeletal rehabilitation tool in patients who would otherwise be unable to perform heavy-load training to increase muscular strength.52 Potential safety issues of BFR include muscle necrosis and thrombus formation, so participants must be monitored closely by a qualified provider. BFR resistance exercise may be performed 2 to 3 times weekly for the same muscles, but higher frequencies may be implemented depending on individual training status and goals. “Time under occlusion” should be closely monitored, and release of pressure between sets is important to allow for reperfusion.51

4. GAPS IN KNOWLEDGE/EVIDENCE BASE

Most exercise research is focused on outcomes for healthy adults. While we have guidelines on volume, intensity, and frequency of exercise for healthy individuals, further investigation is needed into which exercises and what intensity and volumes are more beneficial for certain populations. Further investigation into these disease processes will better emphasize the preventative and curative effects of exercise. Additionally, longitudinal studies to investigate how exercise impacts a person over a lifetime will also be helpful in further defining exercise’s role in maintaining health. Other directions include research and guidelines for those with physical disabilities, both congenital and acquired. The focus on acquired disability and aging will become more important in our nation as the American population becomes older and face new health challenges. With time, as research and the literature becomes more robust, it will become more evident that therapeutic exercise can be used in addition to medication and surgeries in the treatment of our patients.

Table 1 Exercise Intensity

Adapted from ACSM 2018 guidelines4

METs%HRmax%VO2max
Low1.6-2.950-63<45
Moderate3.0-5.964-7645-63
Vigorous≥6.077-9364-91
(Video) PET Lecture 7 Exercise Prescription

REFERENCES

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  10. Hoffman MD, Kraemer WJ, Judelson DA. Therapeutic exercise. IN: Frontera W, Delisa J, Gans J, and Robinson B Delisa’s Physical Medicine and Rehabilitation. 5th Ed. Philadelphia, PA. Wolters Kluwer; 2010;1634-1662.
  11. Powell KE, Paluch AE, and Blair SN: Physical activity for health: what kind? how much? how intense? on top of what? Annu Rev Public Health 2011; 32: pp. 349-365
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  13. McGill SM, Grenier S, Kavcic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyography and Kinesiology. 2003;13:353-359.
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  15. Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine Position Stand: The quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334-1359.
  16. Greenman PE. Principles of Manual Medicine. 2nd ed., Baltimore, MD: Williams & Wilkins, 1996:456.
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  20. Ribeiro PAB, et al. High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives. Ann Phys Rehabil Med (2016), http://dx.doi.org/10.1016/j.rehab.2016.04.004
  21. Kodama S, et al. Cardiorespiratory fitness as a quantitative-predictor of all-cause mortality and cardiovascular events in healthy men and women; a meta-analysis. JAMA 2009;301(19):2024.
  22. Phillips EM, Kennedy MA. The exercise prescription: a tool to improve physical activity. PM&R. 2012;4:818-825.
  23. Braith R and Stewart K. Resistance Exercise Training: Its Role in the Prevention of Cardiovascular Disease. Circulation 2006;113:2642-2650.
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  25. Sagar VA, Davies EJ,Briscoe S,etal. Exercise-based rehabilitation for heart failure: systematic review and meta-analysis.OpenHeart. 2015;2:e000163.doi:10.1136/openhrt-2014-000163
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  30. Mazzini NA, Almeida MGR, Pompeu JE, et al. A combination of multimodal physical exercises in real and virtual environments for individuals after chronic stroke: study protocol for a randomized controlled trial. 2019;20(1):436.
  31. Sa M. Exercise therapy and multiple sclerosis: a systematic review. Journal of Neurology. 2014;261(9):1651-1661.
  32. Anziska Y, Sternberg A. Exercise in neuromuscular disease. Muscle Nerve. 2013;48:3-20.
  33. Halabchi F, Alizadeh Z, Sahralan MA, et al. Exercise prescription for patient with multiple sclerosis; potential benefits and practical recommendations. 2017;17(1):185.
  34. Edwards T and Pilutti LA. The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systemic review and future research directions. Mult Scler Relat Disord. 2017;16:31-39.
  35. Motl RW, Sandroff BM, Kwakkel G, et al. Exercise in patient with multiple sclerosis. Lancet Neurol. 2017;16(10):848-856.
  36. Schmitz KH. American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Med Sci Sports Exerc 2010; 42(7):1409-1426.
  37. Eickmeyer s, et al. The role and efficacy of exercise in persons with cancer. PMR. 2012;4(11):874-81.
  38. Cramp F and Byron-Daniel J. Exercise for management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews. 2012(11):1465-1658.
  39. Klickner I, et al. Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multi-center randomized controlled trial. Support Care Cancer. 2018:26(40:1019-1028.
  40. Barakat R and Perales M. Resistance Exercise in Pregnancy and Outcome. Clinical Obstetrics and Gynecology. 2016;59(3):591-599.
  41. Gregg VH and Ferguson JE. Exercise in Pregnancy. Clin Sports Med. 2017;36(4):741-752.
  42. ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol. 2015;126(6)e135-142.
  43. Mottola M. Components of Exercise Prescription and Pregnancy. Clinical Obstetrics and Gynecology. 2016;59(3):552-558.
  44. Toots A, Littbrand H, Lindelof N, et al. Effects of High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia. J Am Geriatr Soc. 2016;64(1):55-64.
  45. Telenius EW, Engedal K, and Bergland A. Long-term effects of a 12 weeks high-intensity functional exercise program on physical function and mental health in nursing home residents with dementia: a single blinded randomized controlled trial. BMC Geriatr. 2015;15:158.
  46. Toots A, Littbrand H, Bostrom G, et al. Effects of Exercise on Cognitive Function in Older People with Dementia: A Randomized Controlled Trial. J Alzherimers Dis. 2017;60(1):323-332.
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Original Version of the Topic

Adam P. Cugalj, DO.Exercise prescription and basic principles of therapeutic exercise.10/22/2013.

Previous Revision(s) of the Topic

Kim Barker, MD. Austin Johnson, DO. Exercise prescription and basic principles of therapeutic exercise. 3/23/2017

(Video) Write an Exercise Prescription - Scott Larsen, DC

Author Disclosure

Kim Dan Do Barker, MD
Nothing to Disclose

Donald Kasitinon, MD
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FAQs

What are the principles of exercise prescription? ›

Exercise prescription is based on 5 principles: type, duration, frequency, intensity, and volume. Each measure has guidelines for what parameters denote vigorous, moderate, and low intensity exercise.

What is meant by exercise prescription? ›

Exercise prescription commonly refers to the specific plan of fitness-related activities that are designed for a specified purpose, which is often developed by a fitness or rehabilitation specialist for the client or patient.

What are the 3 basic factors in an exercise prescription? ›

The total dose or amount is determined by the three components of activity: frequency, duration, and intensity. Frequency is commonly expressed in sessions, episodes, or bouts per day or per week.

What are the 4 components of an exercise prescription? ›

Exercise prescription includes the type, intensity, duration, frequency and progression of physical activity.

What is the importance of exercise prescription? ›

Providing individualized exercise prescriptions can greatly improve patients' cardiovascular fitness and protect them from the development of and progression to chronic disease. The goal of an exercise prescription is to change patient behavior from sedentary to active.

What are exercise principles? ›

The principles of specificity, progression, overload, adaptation, and reversibility are why practicing frequently and consistently are so important if you want to improve your performance.

What is prescription? ›

1 : a written direction or order for the preparing and use of a medicine. 2 : a medicine that is ordered by a doctor as a remedy. prescription. noun.

What six factors must be considered in the exercise prescription? ›

The six factors of exercise prescription are the mode or type of exercise, frequency of participation, duration of each exercise bout, intensity of the exercise bout, weekly volume of the exercise prescription and breaks in prolonged sitting.

What are the three stages of an exercise prescription quizlet? ›

Terms in this set (3)
  • Initial conditioning. 1-6wk. Familiarize the client with exercise training. ...
  • Improvement stage. 4-8months. Frequency, intensity, and duration are systematically & slowly advanced 1 at a time until fitness goal reached.
  • Maintenance stage. Preserve level of fitness after improvement stage.

What are the 4 modes of exercise testing? ›

Maximal test (exercise stress test; EST) Cardiopulmonary exercise test (CPET) Submaximal test (six-minute walk test; 6MWT) Submaximal treadmill test.

How do you prescribe exercise intensity? ›

The traditional approach has been to prescribe exercise intensity as a percentage of maximal oxygen uptake (VO2max) or maximum heart rate (HRmax) and these methods remain common in the literature.

What are the 4 types of exercise defined by the ACSM? ›

ACSM Revises Guidelines for Exercise to Maintain Fitness
  • Cardiorespiratory Fitness and Weight Control.
  • Muscular Strength.
  • Flexibility Training.
15 Jan 1999

Should exercise be prescribed as medicine? ›

Exercise and physical activity are preventative. No physician would prescribe a medicine to a patient who is currently healthy. However, we do need to encourage all people to be physically active on a regular basis. It is more than preventing disease or rehabilitating from disease, but staying healthy.

What I is stand for in Fitt principle? ›

FITT (frequency, intensity, time, and type) is one way to remember the general guidelines for what should be included in a fitness plan.

How does the principle of progression apply to the exercise prescription? ›

The principle of progression states that as your body adapts to your exercise routine, you have to change it up. This can mean gradually increasing the weight, duration, or intensity of your weight training in order to see growth.

What are the benefits of physical exercise? ›

Being physically active can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.

What vo2max means? ›

VO2 max, or maximal oxygen consumption, refers to the maximum amount of oxygen that an individual can utilize during intense or maximal exercise. This measurement is generally considered the best indicator of cardiovascular fitness and aerobic endurance.

What are the 5 principles of exercise? ›

In order to get the most out of your training, you need to apply these key principles of training – overload, specificity, reversibility and variation.

What are the 7 principles of physical exercise? ›

JERRY Diaz, a certified National Academy of Sports Medicine personal trainer, said there are seven principles of exercise: individuality, specificity, progression, overload, adaptation, recovery, and reversibility.

What are the 8 principles of physical activity? ›

  • 1 – Principle of PROGRESSIVE OVERLOAD.
  • 2 – Principle of INDIVIDUALIZATION.
  • 3 – Principle of REGULARITY.
  • 4 – Principle of SPECIFICITY.
  • 5 – Principle of REVERSIBILITY.
  • 6 – Principle of VARIATION & ADAPTATION.
  • 7 – Principle of REST & RECOVERY.
  • 8 – Principle of PERIODIZATION.
24 Dec 2016

What is prescription and its types? ›

1- Simple prescription: Those written for a single component or prefabricated product and not requiring compounding or admixture by the pharmacist. 2- Compound or complex prescription: Those written for more than a single component and requiring compounding.

What is prescription and example? ›

A prescription is the piece of paper on which your doctor writes an order for medicine and which you give to a chemist or pharmacist to get the medicine. You will have to take your prescription to a chemist. 2. countable noun. A prescription is a medicine which a doctor has told you to take.

What is prescription and its parts? ›

Predating modern legal definitions of a prescription, a prescription traditionally is composed of four parts: a superscription, inscription, subscription, and signature. The superscription section contains the date of the prescription and patient information (name, address, age, etc.).

How does principles of exercise is very important to individual training? ›

Understanding exercise principles allows trainers to monitor the stress (exercise load) placed upon their client in order to make the training safe and effective, helping the client to achieve their goals.

What is exercise prescription for cardiorespiratory fitness? ›

principle of exercise prescription and the ACSM's estimates of cardiorespiratory and resistance exercise intensity. Vigorous aerobic exercise intensity was defined as >65% VO2max or >65% HRR or >75% HRmax and moderate as 45–65% VO2max or 50–65% HRR or >65–75% HRmax.

What factors you need to consider before performing an exercise? ›

Fitness isn't just about working hard, it's about working smart. So when you're endeavoring to get in shape, make sure you consider the four fitness factors, or FITT: Frequency, Intensity, Type and Time. Ideally, exercise is something you should do every day.

What is the correct order and time period for the stages of progression in an exercise program? ›

Three key phases to exercise are the warmup, training, and the cool down. During the warmup you ready the body for what's to come. In the middle phase, you perform the strenuous work. And in the cool down period, you bring your body back to a resting state.

What are 5 benefits of therapeutic exercise? ›

Overview
  • Enable ambulation.
  • Release contracted muscles, tendons, and fascia.
  • Mobilize joints.
  • Improve circulation.
  • Improve respiratory capacity.
  • Improve coordination.
  • Reduce rigidity.
  • Improve balance.
29 Nov 2018

What are therapeutic activities? ›

Therapeutic activities cover a wide range of functional tasks like bending, lifting, catching, pushing, pulling, throwing, squatting etc. An example of a therapeutic activity could be lifting a weighted object and placing it on the top shelf, which is mainly to strengthen overhead shoulder .

What is the difference between therapeutic activity and therapeutic exercise? ›

When a patient is expected to reach multiple outcomes by performing their therapeutic movements, they are engaging in an therapeutic activity. When only one outcome is expected, they are performing a therapeutic exercise.

What is a functional exercise test? ›

A Functional Fitness Assessment looks at how your body moves while performing different exercises. We examine your strengths, weaknesses, imbalances, flexibility and stamina to provide personalized exercise recommendations.

What is exercise capacity? ›

MEASUREMENT OF EXERCISE CAPACITY. Peak exercise capacity is defined as "the maximum ability of the cardiovascular system to deliver oxygen to exercising skeletal muscle and of the exercising muscle to extract oxygen from the blood" [5].

What is functional exercise capacity? ›

Functional capacity, exercise capacity, and exercise tolerance are generally considered synonymous and imply that a maximal exercise test has been performed and maximal effort has been given by the individual.

What methods are used to prescribe and monitor exercise intensity? ›

Several practical approaches to prescribing and monitoring exercise intensity exist including: heart rate monitoring, the Borg rating of perceived exertion scale, the Talk Test, and, motion sensors.

What is VO2max formula? ›

The simplest formula to calculate VO2 max is VO2 max = 15 x (HRmax/HRrest). This method is considered to compare well with other common formulas. The units for VO2 max are milliliters of oxygen per kilogram of body weight per minute (mL/kg/min).

How is VO2max calculated? ›

The most accurate way to test your VO2max is in a laboratory. Intensity will be varied (usually on a treadmill) while your respiratory rate and heart rate are measured during a 20-minute test. Depending on your concentration of oxygen and carbon dioxide being inhaled and exhaled, your VO2max will be scored.

What does ACSM stand for? ›

| The American College of Sports Medicine.

What is the purpose of ACSM? ›

ACSM advances and integrates scientific research to provide educational and practical applications of exercise science and sports medicine.

What are the components of the FITT principle that apply to all types of exercise? ›

What are the components of the FITT principle that apply to all types of exercise? D. Fitness, involvement, time, and type.

What is the importance of exercise prescription? ›

Providing individualized exercise prescriptions can greatly improve patients' cardiovascular fitness and protect them from the development of and progression to chronic disease. The goal of an exercise prescription is to change patient behavior from sedentary to active.

What are the 3 basic factors in an exercise prescription? ›

The total dose or amount is determined by the three components of activity: frequency, duration, and intensity. Frequency is commonly expressed in sessions, episodes, or bouts per day or per week.

What are the three stages of an exercise prescription? ›

The rates of progression for new exercisers are generally broken into three separate 6-week phases: (1) initial conditioning, (2) fitness improvement, and (3) fitness maintenance. This is how your physician or trainer keeps you on track and reaching your fitness goal.

What is the FITT principle examples? ›

FITT example for weight loss

Frequency: Get your heart rate up during 3 to 6 days of the week. Intensity: This will depend on your current fitness level. For a high-intensity workout, aim to reach 70 to 80 percent of your maximum heart rate. Time: Aim for around 20 to 30 minutes per workout.

Why is Fitt Principle important? ›

When properly applied, FITT actually enables you to push your limits just enough to make progress without harming your body. It also decreases your likelihood of developing conditions like hypertension, obesity, or diabetes. Furthermore, exercise encourages your body to release endorphins, which offer pain relief.

What is frequency in Fitt Principle? ›

Frequency: refers to the frequency of exercise undertaken or how often you exercise.

How does the principle of progression apply to the exercise prescription? ›

The principle of progression states that as your body adapts to your exercise routine, you have to change it up. This can mean gradually increasing the weight, duration, or intensity of your weight training in order to see growth.

Should exercise be prescribed as medicine? ›

Exercise and physical activity are preventative. No physician would prescribe a medicine to a patient who is currently healthy. However, we do need to encourage all people to be physically active on a regular basis. It is more than preventing disease or rehabilitating from disease, but staying healthy.

Which of the FITT principles discuss the effort level of the exercise? ›

INTENSITY. The second rule in the FITT principle relates to intensity. It defines the amount of effort that should be invested in a training program or any one session.

How does principles of exercise is very important to individual training? ›

Understanding exercise principles allows trainers to monitor the stress (exercise load) placed upon their client in order to make the training safe and effective, helping the client to achieve their goals.

What is volume in exercise prescription? ›

Volume. The volume refers to the sum work performed in a given training phase. It includes the duration of the activity, the distance, and the number of times a bout was performed within a training period (E.g.: 40 km per week).

What is the meaning of principle of progression? ›

Principle of progression is the idea that the value of a house increases when more valuable houses are built in the area. This contrasts with principle of regression, which is based on the concept that larger, more expensive houses lose value when they are near smaller, less valuable homes.

What is progression exercise? ›

Progressing your exercise means changing it to make it more challenging. A change in your exercise prescription could mean changing the: intensity of your exercise (making it more vigorous) duration of your exercise (making it longer) type (trying a different exercise)

Why is exercise called medicine? ›

Exercise is a powerful stimulus that can reduce and prevent the occurrence of cardiovascular and metabolic dysfunction. Therefore, exercise indeed is medicine that can improve the quality of life. Both regular aerobic exercise and HIIT are beneficial for health.

Who started exercise medicine? ›

Exercise is Medicine (EIM) is a nonprofit initiative co-launched on November 5, 2007 by the American College of Sports Medicine and the American Medical Association, with support from the Office of the Surgeon General and the 18th Surgeon General Regina Benjamin.

What are the benefits of physical exercise? ›

Being physically active can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.

What is the importance of Fitt Principle? ›

The F.I.T.T. Principle is important because it outlines how to manipulate your program to get in shape and get better results. It also helps you figure out how to change your workouts to avoid boredom, overuse injuries and weight loss plateaus.

What is the most important principle of Fitt? ›

Intensity. This is an extremely important aspect of the FITT Principle and is probably the hardest factor to monitor. The best way to gauge the intensity of your exercise is to monitor your heart rate.

What is frequency in Fitt Principle? ›

FITT stands for frequency, which is how often you exercise, intensity, which is how hard you exercise, time, which is how long each session lasts and what time of day you exercise, and type, which is what activities you do.

What are the 5 principles of exercise training? ›

In order to get the most out of your training, you need to apply these key principles of training – overload, specificity, reversibility and variation.

What are the 7 principles of physical exercise? ›

JERRY Diaz, a certified National Academy of Sports Medicine personal trainer, said there are seven principles of exercise: individuality, specificity, progression, overload, adaptation, recovery, and reversibility.

What are the 4 main principles of training? ›

In order to get the most out of your training, you must follow some basic simple training principles which are overload, specificity, reversibility, and variance. Overload means we must put our bodies under more stress than normal in order for adaptive changes to be made.

Videos

1. Introduction to Exercise Assessment and Prescription
(Vivo Phys - Evan Matthews)
2. Ch 7 Aerobic Exercise
(Nicole Patterson)
3. Why there is more to Exercise Prescription than doing 3x10
(Physiotutors)
4. Exercise Prescription
(Body Dynamics Inc)
5. Study Topics: Exercise Prescription – How to Provide Proper Feedback on Performance
(PT Exam Prep)
6. Exercise Prescription 201
(Edmonton O-day'min Primary Care Network)

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