exercise prescribing (counseling)
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Procedure
- assess current level of fitness
- history
- physical examination
- exercise testing
- 2 or more risk factors for coronary artery disease
- diabetes mellitus in good control is not a risk factor[4]
- hypertension in good control is not a risk factor[4]
- symptoms suggestive of coronary artery disease
- > 45 years & planning vigorous exercise
- for asymptomatic adults at low risk of cardiovascular events, USPSTF recommends against screening with resting ECG or exercise stress test[4][5]
- insufficient evidence to assess balance of benefits & harms of screening with resting or exercise ECG to prevent cardiovascular events in asymptomatic adults at intermediate or high risk of cardiovascular events (USPSTF)[5]
- 2 or more risk factors for coronary artery disease
- assess motivation
- assess barriers
- medical
- health conditions
- medications
- physical disabilities
- social or work-related
- psychologic
- medical
- exercise program
- start with low-intensity physical activity*
- incorporate warm-up & cool-down sessions*
- stretching exercises
- before & after exercise
- hamstrings, quadriceps, low back & calf muscles
- stretching exercises
- strength training (6-12 repetitions) twice weekly*
- aerobic exercise
- frequency 3-5 days/week
- intensity 50-85% of maximum predicted heart rate
- duration 15-60 minutes
- moderate intensity aerobic exercise at least 30 minutes 5 times/week or vigorous exercise at least 20 minutes 3 time/week[4]
- balance & functional training
- specific conditions
- low back pain
- type 2 diabetes
- structured program of aerobic exercise &/or resistance training
- COPD
- consider risk of falls in the elderly[4]
- osteoporosis
* reduces risk of musculoskeletal injury
Notes
- USPSTF concludes evidence insufficient to recommend for or against exercise prescribing
- exercise referral schemes increase physical activity & lower incidence of depression, but do not affect BMI, blood pressure, or lipid levels in sedentary primary care patients[2]
More general terms
Additional terms
References
- ↑ Journal Watch 22(17):137, 2002 US Preventive Services Task Force, Ann Intern Med 137:205, 2002 Eden KB et al, Ann Intern Med 137:208, 2002
- ↑ Jump up to: 2.0 2.1 Pavey TG et al. Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: Systematic review and meta-analysis. BMJ 2011 Nov 6; 343:d6462 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22058134
Williams NH. Promoting physical activity in primary care. BMJ 2011 Nov 6; 343:d6615 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22058135 - ↑ Jump up to: 3.0 3.1 Hoffmann TC, Maher CG, Briffa T et al Prescribing exercise interventions for patients with chronic conditions. CMAJ. March 14, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26976965 <Internet> http://www.cmaj.ca/content/early/2016/03/14/cmaj.150684
- ↑ Jump up to: 4.0 4.1 4.2 4.3 4.4 4.5 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ Jump up to: 5.0 5.1 5.2 US Preventive Services Task Force, Curry SJ, Krist AH et al. Screening for Cardiovascular Disease Risk with Electrocardiography: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(22):2308-2314 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29896632 https://jamanetwork.com/journals/jama/fullarticle/2684613
- ↑ Izquierdo M, Merchant RA, Morley JE et al International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging. 2021;25(7):824-853. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34409961 Free article. https://www.sciencedirect.com/science/article/pii/S1279770723007881
- ↑ Riebe D, Franklin BA, Thompson PD et al Updating ACSM's Recommendations for Exercise Preparticipation Health Screening. Med Sci Sports Exerc. 2015 Nov;47(11):2473-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26473759
- ↑ Jump up to: 8.0 8.1 Camacho PM, Petak SM, Binkley N, et al. American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26(Suppl 1):1-46. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32427503 https://www.endocrinepractice.org/article/S1530-891X(20)42827-7/fulltext