Sports Medicine: Just the Facts

CHAPTER 15 • EXERCISE PRESCRIPTION 91

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15 EXERCISE PRESCRIPTION

Mark B Stephens, MD, MS, FAAFP,

CAQAM

INTRODUCTION

• Three of every four Americans do not engage in suffi-
  cient physical activity on a regular basis (US
  Department of Health and Human Services, 2000).
  One of every four Americans is considered to be
  sedentary.


• Sixty percent of all Americans are either overweight or
  obese (US Public Health Service, 2001). Physical inac-
  tivity and obesity are correlated with increases in heart
  disease, diabetes, certain cancers and all-cause mortal-
  ity (Stephens, O’Connor, and Deuster, 2002). Sufficient
  physical activity protects against these conditions.
  •Physical activity has been listed as a leading health
  indicator for the national public health initiative
  Healthy People 2010 (US Public Health Service, 2001).


• Healthcare providers generally do a poor job of coun-
  seling patients regarding the benefits of physical
  activity. Only 20–40% of preventive health care visits
  document physical activity counseling (Walsh et al,
  1999). During these visits, providers include a written
  physical activity plan (exercise prescription) only
  25% of the time.
  
  
  • While the U.S. Preventive Services Task Force has
    stated that there is insufficient evidence to recommend
    for or against routine physical activity counseling (US
    Preventive Services Task Force, 2002), patients consider
    such counseling to be an important part of their medical
    visit and expect physicians to provide them with infor-
    mation regarding physical activity and nutrition.
  
  
  
  

BENEFITS OF PHYSICAL ACTIVITY

• The benefits of physical activity are well described.
  Regular physical activity prevents hypertension,
  hyperlipidemia, osteoporosis, cardiovascular disease,
  certain cancers and type-2 diabetes (US Department
  of Health and Human Services, 1996).

THE EXERCISE PRESCRIPTION:

COMPONENTS OF PHYSICAL FITNESS

•Physical fitness can be defined as the ability to carry

out functional and recreational activities of daily

living without undue stress or fatigue.

• There are five primary components included in the
  definition of physical fitness:
  1.Cardiorespiratory endurancerepresents the ability
  of the cardiovascular and respiratory systems to
  take in and transport oxygen to metabolically
  active tissue.
  2.Muscular strengthrepresents the maximal force
  generated by a muscle group against a fixed resist-
  ance.
  3.Muscular endurancerepresents the ability to repet-
  itively move a muscle group against a set resist-
  ance before the onset of muscular fatigue.
  4.Body compositionrepresents the distribution of fat
  and lean tissue (bone and muscle) mass within a
  given individual.
  5.Flexibilityrepresents the ability to move a particu-
  lar joint or series of joints through an entire range
  of motion.
  •To be thorough, an exercise prescription should
  include specific recommendations targeted toward
  each component of physical fitness within the context
  of an individual’s preexisting state of health and per-
  sonal goals.

THE EXERCISE PRESCRIPTION: WHAT

TO INCLUDE

• An exercise prescription (also referred to as an activ-
  ity prescription) should include clear written instruc-
  tions about the frequency, intensity, type, and duration
  (time) of activities that they should engage in.