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Though the risks of being sedentary far outweigh the risks of exercise, one should be prudent when beginning an aerobic exercise program. Safety guidelines from the ACSM state that individuals at low or moderate health risk can begin a moderate-intensity exercise plan without a medical exam or exercise stress test, whereas people at high risk should be evaluated by their doctor. You are at high risk if you have:
Mitochondria inside the muscle increase in number and activity. Mitochondria are the powerhouses of your cells. They do all the heavy-duty work to keep you moving. They use the oxygen to burn the fat and carbohydrate that makes you go. The good news is that they increase in number and activity, by as much as 50%, in just a matter of days to weeks in response to regular aerobic exercise in adults of all ages.

To estimate the amount of energy—remember, energy equals calories—the body uses during physical activity (versus when you’re at rest), scientists use a unit that measures the metabolic equivalent for task (MET). One MET is what your body burns while lounging on the couch watching Netflix. Walking, a "moderate" exercise, uses 3 to 6 METs; running, which is typically classified as "vigorous," uses 6 METs or more. 

Aerobic exercise comprises innumerable forms. In general, it is performed at a moderate level of intensity over a relatively long period of time. For example, running a long distance at a moderate pace is an aerobic exercise, but sprinting is not. Playing singles tennis, with near-continuous motion, is generally considered aerobic activity, while golf or two person team tennis, with brief bursts of activity punctuated by more frequent breaks, may not be predominantly aerobic. Some sports are thus inherently "aerobic", while other aerobic exercises, such as fartlek training or aerobic dance classes, are designed specifically to improve aerobic capacity and fitness. It is most common for aerobic exercises to involve the leg muscles, primarily or exclusively. There are some exceptions. For example, rowing to distances of 2,000 meters or more is an aerobic sport that exercises several major muscle groups, including those of the legs, abdominals, chest, and arms.
In the end, vigorous running wins out for calorie burn, but remember that calories aren't everything. Obsessing over exactly how many calories you consume or burn is just as unhealthy as not exercising at all. So choose the activity you love most—whether it be walking or running—and focus less on the calories and more on how much better you feel after doing it. 

All that oxygen being pumped by the blood is important. You may be familiar with the term "oxygen consumption." In science, it's labeled VO2, or volume of oxygen consumed. It's the amount of oxygen the muscles extract, or consume from the blood, and it's expressed as ml/kg/minute (milliliters per kilogram of body weight). Muscles are like engines that run on fuel (just like an automobile that runs on fuel); only our muscles use fat and carbohydrates instead of gasoline. Oxygen is a key player because, once inside the muscle, it's used to burn fat and carbohydrate for fuel to keep our engines running. The more efficient our muscles are at consuming oxygen, the more fuel we can burn, the more fit we are, and the longer we can exercise.
A good way to begin is to write down a weekly exercise plan, including when you will exercise each day, and continue to do so every week for three months if you are serious about sticking with exercise but concerned about your motivation. Write down what day(s) of the week, what time of day, minutes of activity, and the activity that you'll do when setting your plan. Be as specific and realistic as possible, and remember that it's not how much you do when you start that counts but that you simply do something. Getting started is usually the hardest part. You can always add more later on.
Rowers, treadmills, bikes, and cross-country skiers are all effective if you use them. There is some suggestion that some individuals are more inclined to exercise at home with equipment than at the gym or a class. The activity you choose is a personal choice and it varies for everyone, and so you need to experiment until you find what works best for you. Some individuals prefer to go to the gym while others are perfectly content to work out at home on their own equipment in front of their TV. TV can make the time pass quickly, and so can your favorite movie, music, scholarly courses taught by professors, or books on tape (see resources for online vendors). Finding something that will distract you might just make that 30-minute workout bearable, and believe it or not you might even look forward to it! After all, it could be the only 30 minutes in your day that you have all to yourself. Indulge! Aerobic exercise videos and DVDs are also effective if you use them! They are convenient if you prefer to work out at home instead of taking a class at a studio or a gym, and there are hundreds to choose from. I suggest that you check out Collage Video (http://www.CollageVideo.com), or give them a call and ask for a recommendation. Also check if your local library rents exercise videos on tape or DVD. And by the way, there are videos for all types of activity; from weight training, to tai-chi, to stretching. Check out all the possibilities to add flexibility and strength-building to your cardio workout.

It is appropriate to do aerobic exercise every day. There is no need to rest in between sessions unless you are at an extreme level of training, such as preparing for a marathon, or if you experience reoccurring joint pain. If joint pain is a limiting factor, it would be appropriate to alternate less painful exercises with those that may cause joint pain or to discontinue the painful exercise altogether.

Impaired aerobic capacity, also known as impaired endurance, is a common patient impairment that can limit participation in functional, occupational, and recreational activities. Even functional tasks that require only a few minutes can be limited by aerobic capacity. Older adults are particularly vulnerable to impaired aerobic capacity due to anatomic and physiological changes that occur with aging, greater propensity for sedentary behaviors, and greater risk for disease processes that limit the oxygen transport system.1 In addition, aerobic capacity is directly influenced by the habitual activity pattern of an individual, which may vary across individuals from total inactivity to frequent and intense activity. Any factors that limit habitual physical activity, such as illness, injury, and or travel, will cause adaptations that diminish aerobic capacity. Conversely, any factors that promote habitual physical activity, such as intentional exercise, yard work, and occupation-related physical tasks, will result in adaptations that improve aerobic capacity. In older adults, many physiological, pathological, and psychosocial factors can contribute to restricted physical activity. Figure 12-1 depicts the persistent vicious cycle that can be created when sedentary behaviors, chronic disease, and functional dependency interact.2 This chapter will provide an overview of causes and factors contributing to impaired aerobic capacity in older adults and describes physical therapist patient management (examination, evaluation, diagnosis, and interventions) to address decreased endurance and its impact on function.


When the weather outside is frightful, many people turn to treadmills. Admittedly, treadmills are boring. Spice up a complete treadmill workout by using elevation to give the sense of a trail. You don't have to follow the preprogrammed courses. Create your own interval training with hills. Make it a mental game. Life isn't automated and your treadmill workout shouldn't be either. Ascend and descend by varying your elevations and speeds.
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‘Aerobic’ exercise refers to exercise that requires the consumption of substantially more oxygen than at rest. It is of a light to moderate intensity, and can be undertaken for a prolonged duration (many minutes to several hours) without excessive fatigue. Examples of aerobic exercise include walking, jogging, swimming or cycling at a steady pace. Another example would be dancing or ‘aerobics’ classes.Regular exercise causes your body to make adjustments that result in improved health and physical functioning. Continuing with regular exercise enables your body to maintain these benefits. Regularly doing the right types of exercise at the correct intensity, and for an appropriate duration, results in the most benefit.The benefits of aerobic exercise can be broadly categorised as either ‘fitness’ (physical capacity) or ‘health’. Fitness and health are linked, and most forms of aerobic exercise will help you achieve both.Fitness — including increased cardiorespiratory fitness and endurance (stamina)Regular aerobic exercise improves your cardiovascular fitness by increasing your capacity to use oxygen. It does this by increasing your heart’s capacity to send blood (and hence oxygen) to the muscles. This is mainly achieved through an increase in the size of the heart’s pumping chambers (ventricles), which means that your heart doesn’t have to beat as fast to deliver the same amount of blood. This is evident in a slower resting heart rate, and a slower heart rate for the same exercise intensity.As you get ‘fitter’, particular activities (such as walking or jogging at a specified speed) will become easier.You’ll also be able to undertake the activity for longer (known as endurance), and/or at a higher intensity (e.g. jogging at a faster speed). The same applies to activities such as cycling or swimming, but it should be noted that fitness tends to be specific. So jogging will provide only limited benefits to your swimming fitness and vice versa. However, a side-benefit you may notice is that you also have increased stamina for the everyday activities of life, not just for exercise.Other fitness improvements occur in the exercising muscles, and are specific to those muscles being used in the mode of exercise (e.g. walking, running, cycling, or swimming). These include an increased capacity for the muscles to take up and use the additional oxygen being delivered by the heart.Reduced risk of certain health problemsRegular aerobic exercise has been shown to reduce the risk of heart disease, high blood pressure, type 2 diabetes, colon cancer and breast cancer. It can lower blood pressure and improve your blood cholesterol by reducing the levels of LDL-cholesterol (so-called ‘bad’ cholesterol) and increasing the amount of HDL-cholesterol (so-called ‘good’ cholesterol). It can also reduce anxiety, stress and depression, as well as instilling a general sense of well-being. Regular aerobic exercise has even been shown to have the potential to increase your lifespan.Low-impact aerobic exercise such as swimming is valuable for improving general health and fitness in people who have arthritis or other conditions that limit their ability to do weight-bearing exercise.Importantly, whereas fitness tends to be quite specific, many health benefits can be gained from any form of aerobic exercise. Additionally, the health gains can be achieved from relatively moderate amounts of exercise — moving from a lifestyle involving no exercise to one that involves some exercise can lead to substantial improvements in health.Weight controlAerobic exercise burns up energy (calories). Regular sessions of 30 to 60 minutes of low to moderate intensity aerobic exercise (at around 55 to 70 per cent of maximum heart rate) can be an important part of a weight loss or weight management programme that is also mindful of the energy (calories) consumed as food.However, many of the health benefits associated with aerobic exercise occur independently of weight loss. Evidence from large studies has shown that active, overweight people do not have a greater risk of many diseases than inactive people who are not overweight. From a health perspective, it is of course best to be both active and a healthy weight, but if weight reduction is a problem, it doesn’t mean that the exercise is having no benefit.Improved bone and muscle healthYour risk of osteoporosis (excessive bone thinning as you age) can be reduced by regular weight-bearing aerobic exercise such as brisk walking.By stimulating the growth of tiny blood vessels in your muscle tissues, aerobic exercise has also been shown to lessen the pain experienced by people who have fibromyalgia or chronic low back pain, as the oxygen supply to the muscles is improved and waste products are removed more efficiently.Social benefitsRegular aerobic exercise can have social benefits too, whether you walk with a friend, play tennis with workmates, or form a social cycling team. Exercising with friends can also be the most effective way of ensuring that you do it regularly.Aerobic exercise precautionsAs with any form of exercise, be aware of over-exercising, either by doing aerobic exercise too hard, for too long or too often. This approach can lead to injury, and abandoning of your fitness programme. Remember to build up gradually from your current activity level, and not to progress too rapidly. If you are new to regular aerobic exercise, several weeks of low to moderate intensity aerobic exercise are usually advised before introducing more vigorous aerobic exercise sessions.If you have existing health problems, are at high risk of cardiovascular disease, or have muscle, bone or joint injuries, check with your doctor before undertaking an aerobic exercise programme. Also, men aged over 40 years and women aged over 50 years who have not exercised regularly in the recent past should check with a doctor before undertaking a programme of vigorous physical activity. Last Reviewed: 11 January 2010
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