Skip to main content

Advertisement

SpringerLink
Log in

Exercise Testing and Prescription

Practical Recommendations for the Sedentary

  • Leading Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Summary

A sedentary lifestyle is prevalent in most industrialised societies. Persuasive evidence allows us to demonstrate that a physically active lifestyle protects against the development and progression of many chronic diseases. The assessment of sedentary individuals for the purpose of exercise testing and or exercise prescription should always culminate in the determination of the relative risk of the individual for traumatic events which may be precipitated by participation in moderate physical activity. Sedentary individuals may be categorised in a low to high risk stratification as apparently healthy (Class I), higher risk (Class II), or known coronary heart disease and/or symptomatic of chronic disease (Class III). An expanded role for allied health professionals, such as a clinical exercise physiologist, may enhance and extend the services of physicians and nurses as they relate to exercise testing, exercise prescription and preventative healthcare in general. Risk stratification will determine the type of exercise test, the exercise prescription and the exercise environment (low to high levels of supervision). The exercise prescription may include a determination of mode, duration, frequency, intensity, and progression of activity. Although target heart rate remains one of the most effective instruments for monitoring exercise intensity, the rate of perceived exertion should be incorporated especially in the titration of exercise prescriptions for those on β-blockade therapy. Finally the benefits of an exercise programme, derived from a foundation of proper assessment, are numerous and include improvements in cardiovascular fitness, body composition, blood lipid profile and retention of essential muscle mass during the course of the life-cycle. A considerable public health benefit will result if sedentary individuals become regularly more physically active.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. AHA Medical/Scientific Statement. Statement on exercise: benefits and recommendations for physical activity programs for all Americans. Dallas (TX): American Heart Association, 1992

    Google Scholar 

  2. Fletcher GF, Blair SN, Blumethal J, et al. Statement on exercise: benefits and recommendations for physically active programs for all Americans. Circulation 1992; 86: (340–4)

    Article  PubMed  CAS  Google Scholar 

  3. Powell KE, Thompson PD, Caspersen CJ, et al. Physical activity and the incidence of coronary heart disease. Annu Rev Public Health 1987; 8: (253–87)

    Article  PubMed  CAS  Google Scholar 

  4. Paffenbarger Jr RS, Hyde RT, Wing AL, et al. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 1986; 314: (605–13)

    Article  PubMed  Google Scholar 

  5. Leon AS, Connett J, Jacobs Jr DR, et al. Leisure-time physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial. JAMA 1987; 258: (2388–95)

    CAS  Google Scholar 

  6. Eklund, LG, Haskel WL, Johnson JL, et al. Physical fitness as a predictor of cardiovascular mortality in asymptomatic north American men. The lipid research clinic’s mortality followup study. N Engl J Med 1988; 319: (1379–84)

    Article  Google Scholar 

  7. Blair SN, Kohl HW, Paffenbarger RS, et al. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 1989; 262: (2395–401)

    Article  PubMed  CAS  Google Scholar 

  8. Mittleman MA, Maclure M, Tafler GH, et al. Triggering of acute myocardial infarction by heavy physical exertion. N Engl J Med 1993; 329: (1677–83)

    Article  PubMed  CAS  Google Scholar 

  9. American College of Sports Medicine. Guidelines for exercise testing and prescription. 4th ed. Philadelphia: Lea & Febiger, 1991

    Google Scholar 

  10. Caspersen, CJ, Christenson GM, Pollard RA. Status of the 1990 physical fitness and exercise objectives: evidence from NHIS 1985. Public Health Rep 1986; 101: (587–92)

    PubMed  CAS  Google Scholar 

  11. Kohl HW, Gibbons LW, Gordon NF, et al. An empirical evaluation of the ACSM guidelines for exercise testing. Med Sci Sports Exerc 1990; 22: (533–9)

    PubMed  CAS  Google Scholar 

  12. Shepard RJ. PAR-Q, Canadian home fitness test and exercise screening alternatives. Sports Med 1988; 5: (188–95)

    Google Scholar 

  13. Kline GM, Porcari JP, Hintermeister R, et al. Estimation of V̇O2max from a one-mile track walk, gender, age, and body weight. Med Sci Sports Exerc 1987; 19: (253–9)

    PubMed  CAS  Google Scholar 

  14. Cooper KH. The aerobics program for total well-being. New York: M. Evans & Company Inc., 1982: 139–40

    Google Scholar 

  15. Froelicher VE. Exercise testing and training. New York: Le Jacq Publisher Inc., 1983: 12–3, 95

    Google Scholar 

  16. Nagle FJ, Balke B, Naughton JP. Traditional step tests for assessing work capacity. J Appl Physiol 1965; 20: (145–8)

    Google Scholar 

  17. Sheffield LT, Reeves TJ. Graded exercise in the diagnosis of angina pectoris. med Concepts Cardiovasc Dis 1965; 34: (1)

    CAS  Google Scholar 

  18. Bruce RA. Myocardial infarction after normal response to exercise. Circulation 1968; 38: (552)

    Article  PubMed  CAS  Google Scholar 

  19. Pollock ML. Prescribing exercise for fitness and adherence. In: Dishman RK, editor. Exercise adherence: its impact on public health. Champaign (II): Human Kinetics, 1988: 259–77

    Google Scholar 

  20. Painter P, Haskell WL. Decision making in programming exercise. In: Blair SN, Painter P, Pate RP, et al., editors. Resource manual for guidelines for exercise testing and prescription. Philadelphia (PA): Lea & Febiger, 1988: 256–62

    Google Scholar 

  21. Porter GH. Case study evaluation for exercise prescription. In: Blair SN, Painter P, Pate RP, et al., editors. Resource manual for guidelines for exercise testing and prescription. Philadelphia (PA): Lea & Febiger, 1988: 248–55

    Google Scholar 

  22. Hall LK, Meyer GC, Hellerstein HK. Cardiac rehabilitation: exercise testing and prescription. New York (NY): SP Medical and Scientific Books, 1984: 81–107

    Google Scholar 

  23. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 1970; 2: (92–8)

    PubMed  CAS  Google Scholar 

  24. Goldberg AL, Etlinger JD, Goldspink DF, et al. Mechanism of work-induced hypertrophy of skeletal muscle. Med Sci Sports Exerc 1975; 7: (248–61)

    CAS  Google Scholar 

  25. Poehlman ET, Gardner AW, Ades PA, et al. Resting energy metabolism and cardiovascular disease risk in resistance-trained and aerobically trained males. Metabolism 1992; 41: (1351–60)

    Article  PubMed  CAS  Google Scholar 

  26. Hopp JF. Effects of age and resistance training on skeletal muscle: a review. Phys Ther 1993; 73: (361–73)

    PubMed  CAS  Google Scholar 

  27. Sauvage Jr RL, Myklebust BM, Crow-Pan J, et al. A clinical trial of strengthening and aerobic exercise to improve gait and balance in elderly male nursing home residents. Am J Phys Med Rehabil 1992; 71: (333–42)

    Article  PubMed  Google Scholar 

  28. Braith RW, Graves JC, Pollock ML, et al. Comparison of two versus three days per week of variable resistance training during 10 and 18 week programs. Int J Sports Med 1989; 10: (450–4)

    Article  PubMed  CAS  Google Scholar 

  29. Starkey DB, Welsh MA, Pollock ML, et al. Equipment improvements in strength following high intensity, low and high volume training [abstract]. Med Sci Sports Exerc 1994; 26 (5): S116

    Google Scholar 

  30. Westcott WL. Strength fitness. 4th ed. Dubuque (IA): William C. Brown Publishers, 1995

    Google Scholar 

  31. Walberg JL. Aerobic exercise and resistance weight-training during weight reduction sports medicine 1989; 47: 343–56

    Google Scholar 

  32. Wilmore JH. Body composition in sport and exercise: Directions for future research. Med Sci Sport Exerc 1983; 15: (21–31)

    CAS  Google Scholar 

  33. Grundy SM. Release of the second report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel II, or ATPII), and of Data from the Third National Health and Nutrition Examination Survey. NIH publication no. 93.3095. Bethesda (MD): National Institute of Health, 1993

    Google Scholar 

  34. Haskell WL, Taylor HL, Wood PD, et al., Strenuous physical activity, treadmill exercise test performance and plasma highdensity lipoprotein cholesterol. The Lipid Research Clinic’s Program Prevalence Study. Circulation 1980; 62 Pt IV: 53–61

    CAS  Google Scholar 

  35. Farrell PA, Barboriak J. The time course alterations in plasma lipid and lipoprotein training. Atherosclerosis 1980; 37: (231–8)

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Moses H. Cone Memorial Hospital, 1200 North Elm Street, Greensboro, North Carolina, 27401-1020, USA

    Carl N. King

  2. South Carolina Heart Center, Columbia, South Carolina, USA

    Mark D. Senn

Authors
  1. Carl N. King
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark D. Senn
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

King, C.N., Senn, M.D. Exercise Testing and Prescription. Sports Med. 21, 326–336 (1996). https://doi.org/10.2165/00007256-199621050-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199621050-00002

Keywords

Search

Navigation