Chapter 1: Introduction to Physical Activity and Exercise for the Medically Compromised Patient

Benefits of Physical Activity and Exercise

Exercise is the most powerful "wonder" drug in the United States. In fact, the American College of Sports Medicine (ACSM) has launched a program called "Exercise is Medicine," with the sole purpose of getting Americans to incorporate physical activity and exercise into their daily routine, especially those with health problems.¹

ACSM has called on physicians to prescribe exercise to their clients and then assess and review every client's physical activity program at every visit. "Exercise is Medicine" aims to make physical activity and exercise a standard part of disease prevention and treatment in the United States. Physicians are encouraged to record physical activity and exercise as a vital sign. One of the goals of the program is to increase collaborations among physicians and exercise professionals, including physical therapists, to benefit people for whom exercise and increased physical activity can prevent, treat, or manage chronic diseases.

Exercise has proved effective in the primary and secondary prevention and treatment of more than 25 diseases and chronic conditions. Decades of science confirm that exercise improves health and can extend life expectancy. Type 2 diabetes, breast and colon cancer, hypertension, heart disease, obesity, depression, osteoporosis, chronic obstructive pulmonary disease, and arthritis comprise a partial list of the conditions and illnesses that can be affected by exercise. Regular activity can improve the quality of life and general well-being and mood, reduce stress, improve sleep, sharpen cognitive function, and improve sexual function.

Studies consistently show a benefit in general health and aerobic fitness via exercise training. Randomized controlled trials examining the effects of different intensities and amounts of exercise on peak oxygen consumption (Vo₂ max) make it clear that fitness levels are improved even with low amounts of exercise. Although the effect of exercise alone is substantial, it is significantly magnified when accompanied by other lifestyle changes, such as good nutrition and weight loss. Just burning calories through exercise is a beneficial side effect.²

It is appropriate to recommend mild exercise to improve fitness and reduce cardiovascular risk while also encouraging higher intensities and amounts for additional benefit.^3,4 Even a single weekly bout of high-intensity exercise has been shown effective in reducing the risk of death in groups of adults with known cardiovascular disease compared with those who reported no activity.⁵

Light to moderate exercise has been shown to limit the damaging effects of excess free radical formation now linked to a wide range of diseases. Regular physical activity and exercise have been linked to a reduction in mortality from all causes; just one exercise session weekly can make a difference.^6,7 Even knowing this, the majority of adults in the United States are not physically active at levels that can promote health.⁸

The acute effects of exercise have been proved: levels of serum ...