Exercise and Fitness

Exercise and Fitness 

• Regular exercise as part of a fitness program helps achieve optimal weight, control blood pressure, increase high-density lipoprotein, lower risk of CAD, increase endurance, and improve the sense of well-being.
• Long-term goals of regular exercise include decreased absenteeism from work, improved balance and reduced disability among the elderly, decreased osteoporosis and fracture risk, and reduced health care costs.
• Studies have shown that both high-intensity exercise and low- to moderate-intensity exercise performed at least three times per week have positive effects.
  • High-intensity exercise achieving 70% to 90% of maximum heart rate produces lactic acid in the muscles, which inhibits fat burning; however, calories will be burned at a higher rate because carbohydrates are used for energy.
  • Low- to moderate-intensity exercise achieving 50% to 70% of maximum heart rate begins to access fat stores for fuel after 30 minutes of exercise; with longer duration of exercise fewer calories but more fat will be burned.
• Individual tolerance, time allotment, interests, and physical impairment must be figured into exercise planning.
• Suggest walking, jogging, bicycling, swimming, water aerobics, and low-impact aerobic dancing as good low- to moderate-intensity exercise, performed three to five times per week for 45 minutes. Walking can be done safely and comfortably by most patients if the pace is adjusted to the individual's physical condition. Use of weights is important for muscle strengthening throughout the lifespan.
  • Exercise programs should include 5- to 10-minute warm-up and cool-down periods with stretching activities to prevent injuries.
  • Full intensity and duration of exercise should be worked up to gradually over a period of several weeks to months.
• Advise patients to stop if pain, shortness of breath, dizziness, palpitations, or excessive sweating is experienced.
• Advise patients with cardiovascular, respiratory, and musculoskeletal disorders to check with their health care provider about specific guidelines or limitations for exercise.

GERONTOLOGIC ALERT

Due to physiologic limitations of old age, maximum effective exercise for the elderly is 20 to 40 minutes at 50% to 60% of maximum heart rate.

NURSING ALERT

Severe cases of COPD, osteoarthritis, and coronary disease are contraindications for unsupervised exercise; check with the patient's health care provider to see if a physical therapy or occupational therapy referral would be helpful.