Aerobiccardiorespiratory Exercise

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Aerobic exercise consists of rhythmic, large-muscle movements at moderate to high intensity. Activities such as walking, bicycling, swimming, cross country skiing, and stair stepping are considered aerobic exercise. Regular aerobic exercise reduces the risk of myocardial infarction, high blood pressure, excess body fat, resting heart rate, and lung function. In addition, aerobic exercise has been positively correlated with improvements in emotion and mood.

A cardiorespiratory exercise "prescription" generally consists of four areas: frequency, Intensity, Time or Duration, and Mode or Type of Activity, often referred to as the FITT principle. Recommendations in these different areas are dependent upon the goals of your exercise program. The following recommendations, suggested by the American College of Sports Medicine, are geared toward: 1) enhancing physical fitness, 2) reducing risk for future development or recurrence of cardiovascular disease, and 3) ensuring safety during participation in exercise.

• Intensity—55 to 90 percent of maximal heart rate

• Type—Any activity that uses large muscle groups, can be maintained for prolonged periods, and is rhythmic

These are good guidelines to keep in mind when beginning an exercise program; however, sometimes they are merely guidelines. Multiple sclerosis can add some different challenges when recommending aerobic exercise. For instance, some people with MS demonstrate blunted heart rate responses to exercise—a condition in which the heart rate does not increase with exercise intensi-ty—and may find it hard to achieve the "tar-

Table 13.1 Rate of perceived exertion (RPE) scale


Nothing at all Extremely light Very light Light Moderate Somewhat heavy




Very heavy

9 10

Extremely heavy Maximal

get" heart rate. Therefore, it may be more effective to think about the FITT principle in the following manner.

• Frequency—Don't miss more than 2 days in a row. Try to move every day, but don't worry if you miss a day. Be kind to yourself as you slowly develop this "therapeutic ritual."

• Intensity—Utilize a rate of perceived exertion (RPE) scale (see Table 13.1). The RPE scale is a numerical scale that will help you define the proper level of exertion for an exercise session. The most effective way to determine the proper RPE is through a graded exercise test with your healthcare specialist. This will be particularly helpful to those with the blunted heart rate response described earlier.

• Time—Start a time that is comfortable for you and progress from there. Progression should be approximately 10 percent per week. Don't try to increase the time too much or too quickly.

• Type—Pick something you enjoy and that is available. You may need to look at ways to modify the activity (e.g., specialized bike pedals), but if you enjoy something, you are more likely to stick with it.

Starting an aerobic exercise program takes commitment! It is important to set realistic goals and utilize your healthcare team in identifying an appropriate exercise prescription. Some tips to keep in mind when beginning your program include:

• Approach your exercise as a "therapeutic ritual." Schedule your exercise on certain days and do your best to stick with it. There will be times when it is not possible, but to "build the habit," it is important to incorporate it into your life.

• Five-minute rule—Because exercise is a therapeutic ritual, begin your activity on the days you have set. If after 5 minutes of the activity you feel "increased fatigue," then stop the activity and schedule it on another day. If you feel better, which is often the case, then complete your activity for that day.

• Two-hour rule—If 2 hours after you have finished exercising, you don't feel as well as you did before you started, then you probably exercised too hard. (This usually manifests as an increase in fatigue.)

• It is OK to break up your exercise throughout the day. If you experience increased fatigue with 20 minutes of continuous exercise, try two separate 10-minute sessions. Think in terms of cumulative increases in exercise, not necessarily what you do in one session. It is what you do every day that counts, not what you do on a single day.

• Drink plenty of fluids to stay hydrated and cool.

• Pick an appropriate time of day to exercise to avoid overheating and increased fatigue.

• Consider exercising with a group of people. This will increase socialization and commitment to the exercise program.

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Aerobics For Fitness

Aerobics For Fitness

Getting in shape and staying fit is not always easy but some ways are easier than others such as aerobics when you do it right. Aerobics For Fitness Provides You With Everything You Need to Know to Make Aerobics Work Right And Produce Real Fitness Results.

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