How to Write an Exercise Prescription

How to Write an Exercise Prescription MAJ Robert L. Gauer, MD LTC Francis G. O’Connor, MD, FACSM Department of Family Medicine Uniformed Services University of the Health Sciences How to Write an Exercise Prescription MAJ Robert L. Gauer, MD LTC Francis G. O’Connor, MD, FACSM Department of Family Medicine Uniformed Services University of the Health Sciences CONTENTS Section Page INTRODUCTION............................................................................................................... 1 EPIDEMIOLOGY OF INACTIVITY .............................................................................. 3 REASONS FOR INACTIVITY......................................................................................... 5 ROLE OF THE HEALTH CARE PROVIDER............................................................... 7 BENEFITS OF EXERCISE............................................................................................... 9 I. All-Cause Mortality.............................................................................................. 9 II. Atherosclerotic Vascular Disease......................................................................... 9 III. Cancer................................................................................................................... 10 IV. Diabetes Mellitus.................................................................................................. 10 V. Hypertension......................................................................................................... 11 VI. Osteoporosis ......................................................................................................... 11 VII. Dyslipidemia......................................................................................................... 12 VIII. Obesity.................................................................................................................. 12 IX. Mental Health....................................................................................................... 13 X. Economic Benefits................................................................................................ 13 RISKS OF PHYSICAL ACTIVITY.................................................................................. 15 I. Exercise Related Sudden Death............................................................................ 15 II. Musculoskeletal.................................................................................................... 19 III. Miscellaneous Risks............................................................................................. 20 CURRENT RECOMMENDATIONS............................................................................... 21 I. Evolution of Physical Activity Recommendations............................................... 21 II. Current Recommendations ................................................................................... 22 A. ACSM recommendations................................................................................ 22 B. CDC/ACSM recommendations....................................................................... 23 C. AHA Scientific Statement............................................................................... 24 D. AMA Guidelines for Adolescent Preventive Services.................................... 24 E. Department of Health and Human Services.................................................... 25 F. United States Preventive Services Task Force................................................ 25 III. Summary of Recent Physical Activity Recommendations................................... 25 EXERCISE PRESCRIPTION........................................................................................... 27 I. Approach to Recommending Exercise ................................................................. 27 II. Pre-exercise Evaluation........................................................................................ 31 III. Graded Exercise Testing....................................................................................... 33 IV. Writing the Exercise Prescription......................................................................... 37 A. Activity Selection............................................................................................ 37 B. Frequency........................................................................................................ 40 C. Duration .......................................................................................................... 40 D. Intensity........................................................................................................... 41 E. The Exercise Session....................................................................................... 44 i ... - tailieumienphi.vn