Aerobic Training/Endurance Training

Definition

Aerobic/endurance training consists of continuous exercise performed with the goal of improving and maintaining the fitness of the body's cardiovascular system (heart, lungs, circulation).

Purpose

The purpose of aerobic training is to engage the body's heart, lungs, and circulatory system via repeated and continuous exercise to improve overall health, maintain fitness, and help prevent the development of obesity, hypertension, and cardiovascular disease. Regular aerobic exercise improves the efficiency of the functioning of the heart, lungs, and circulatory system. Aerobic/endurance training may be prescribed by a physician as therapy following a cardiovascular event (e.g., myocardial infarction) or cardiovascular surgery (e.g., angioplasty, heart transplantation), or as a preventive intervention in patients at risk for developing cardiovascular disease due to hypertension, high blood cholesterol, or family history of cardiovascular disease. Aerobic/endurance training may also be recommended to help overweight and obese patients lose and maintain body weight, or to help combat depression, anxiety, and/or stress.

A sedentary lifestyle and excess caloric consumption are the primary causes of an increase in overweight and obesity; regular aerobic exercise is considered an important factor in controlling weight. Overweight and obese individuals are at higher risk of developing several medical conditions, including:

• asthma
• diabetes
• hypertension
• orthopedic complications, such as hip and knee pain and limited range of motion
• cardiovascular disease
• high cholesterol
• sleep apnea
• psychosocial disorders, such as depression, negative body image, and eating disorders

Clinical studies have shown that regular aerobic exercise has numerous benefits, including:

• controlling weight gain and maintaining healthy weight
• reducing blood pressure and cholesterol
• possibly improving coordination
• improving self-esteem and self-confidence
• decreasing the risk of developing diabetes, cardiovascular disease, and certain types of cancer
• increasing life expectancy

There have also been some recent reports linking aerobic exercise to a decrease in the risk of alzheimer's disease.

Precautions

Before beginning any exercise program, including strength training, an evaluation by a physician is recommended to rule out any potential health risks. Individuals with physical restrictions or certain medical conditions may require an exercise program supervised by a health care professional, such as a physical therapist or exercise physiologist. If dizziness, nausea, excessive shortness of breath, or chest pain occur during any exercise program, the activity should be stopped and a physician should be consulted before resuming activity. First-time users of any type of exercise equipment should be supervised by a knowledgeable fitness professional, such as a personal trainer.

Description

Aerobic/endurance training involves moderate to vigorous physical activity that results in an elevated heart rate for a sustained period of time. For adults, aerobic exercise within a target heart rate range calculated based on a maximum heart rate by age is recommended. For healthy children, cardiovascular exercise that elevates the heart rate to no greater than a maximum heart rate of 200 beats per minute is recommended.

Aerobic/endurance training can be performed with or without special equipment. Examples of aerobic exercise that elevates the heart rate include bicycle riding, group fitness aerobic classes, running, swimming, jumping rope, brisk walking, dancing, soccer, tennis, and basketball. Aerobic training equipment includes treadmills, stationary cycles, elliptical trainers, and stairclimbing machines. Aerobic/endurance training is appropriate and beneficial for individuals of all ages, although exercise modifications may be necessary for children or older adults. The amount and type of exercise, as well as the frequency of exercise, may vary depending on the specific goals of the individual and their physical condition.

Government guidelines recommend the following:

• Engaging in at least 30 minutes of moderate-intensity physical activity on most days of the week to reduce the risk of developing chronic disease. For most healthy individuals, greater health benefits are possible when the intensity and duration of activity is increased.

• Performing 60 minutes of moderate- to vigorous-intensity physical activity on most days of the week to help manage body weight and prevent gradual weight gain that occurs with aging.
• Performing 60 to 90 minutes of moderate-intensity activity every day to lose weight.

More specific recommendations for children, pregnant and lactating women, and older adults, as well as nutrition and caloric consumption information, are included in the Dietary Guidelines for Americans 2005.

Preparation

A physical examination by a physician is important to determine if aerobic/endurance training is appropriate or detrimental. Prior to beginning exercise, a proper warm-up is necessary to help prevent the possibility of injury resulting from tight muscles, tendons, ligaments, and joints. Appropriate warm-up exercises include walking, light calisthenics, and stretching.

Instruction on proper exercise form may be necessary for individuals inexperienced with aerobic exercise. Healthcare and fitness professionals, such as a certified personal trainer, or physical therapist, can provide instruction on the proper form and frequency to achieve maximum benefits. These professionals may also perform a pre-exercise assessment of the individual's fitness to assist in designing an appropriate program.

If individuals are deconditioned, injured or recuperating from an injury, or have physical limitations, certain types of aerobic exercise may not be appropriate or achievable during the first few sessions, or ever. It is necessary to gradually increase intensity and duration before progressing to more vigorous activity.

Aftercare

Proper cool-down after exercise is important and should include a gradual decrease in exercise intensity to slowly lower the heart rate back to the normal range, followed by stretches to increase flexibility and reduce the likelihood of muscle soreness. Following vigorous activities that involve sweating, lost fluids should be replaced by drinking water during and after the activity.

Complications

Improper warm-up can lead to muscle strains, soreness, and other injuries. Overexertion without enough time between exercise sessions to recuperate also can lead to muscle strains, resulting in inactivity due to pain. Some individuals may be susceptible to exercise-induced asthma. Dehydration is a risk during longer activities that involve sweating; water should be available and consumed during and after activities that cause prolonged sweating.

Results

Significant health benefits are obtained by including at least a moderate amount of physical exercise for 30 to 60 minutes daily. Regular physical activity plays a positive role in preventing disease and improving overall health status. For individuals just beginning an exercise program, results (including weight loss and increased endurance) will be noticeable in four to six weeks. For individuals with physical limitations or those recovering from surgery or injury, regular and appropriately prescribed and supervised aerobic training may help alleviate pain, improve range of motion, and increase physical endurance.

KEY TERMS

Aerobic— Exercise training that is geared to provide a sufficient cardiovascular overload to stimulate increases in cardiac output.

Angioplasty— A cardiovascular interventional procedure performed by threading a catheter through the arteries around the heart to relieve blockages resulting from cardiovascular disease.

Calisthenics— Exercise involving free movement without the aid of equipment.

Myocardial infarction— Heart attack.

Hypertension— High blood pressure.

Health care team roles

For individuals under a physician's care who are prescribed aerobic training as therapy, supervision by an exercise physiologist, physical therapist, sports medicine professional, physical therapist assistant, or other healthcare professional experienced in rehabilitation and therapeutic exercise may be required. Aerobic training under such supervision is usually performed in a hospital rehabilitation department, an outpatient physical therapy center, or other medical fitness facility. Exercise professionals can also assist in designing appropriate aerobic training programs based on an individual's needs by performing initial fitness assessment tests and prescribing specific exercises that may address limitations or injuries.

Resources

BOOKS

McArdle, William D., Frank I. Katch, and Victor L. Katch. Exercise Physiology: Energy, Nutrition, and Human Performance, 5th ed. Philadelphia: Lippincott, 2001.

PERIODICALS

Anderson, Ross E., Jakicic, John M. "Physical Activity and Weight Management: Building the Case of Exercise." The Physician and Sports Medicine. 31(2003 November):39-45.

Cornelissen, V.A., Fagard, R.H. "Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors." Hypertension. 46(2005 October): 667-675.

Huang, G., Gibson, C.A., Tran, Z.V., et al. "Controlled endurance exercise training and VO2max changes in older adults: a meta-analysis." Preventive Cardiology. 8(2005 Fall):217-225.

Pokan, R., Von Duvillard, S.P., Ludwig, J., et al. "Effect of high-volume and -intensity endurance training in heart transplant recipients." Medicine and Science in Sports and Exercise. 36 (December 2004):2011-2016.

Wilmore, Jack H. "Aerobic Exercise and Endurance: Improving Fitness for Health Benefits." The Physician and Sports Medicine. 31(2003 May):45-51.

ORGANIZATIONS

American College of Sports Medicine. 401 W. Michigan Street, Indianapolis, IN 46202-3233. (317) 637-9200. Fax: (317) 634-7817. 〈http://www.acsm.org/〉.

American Council on Exercise. 4851 Paramount Drive San Diego, California 92123. (800) 825-3636. 〈http://www.acefitness.org〉.

American Heart Association. 7272 Greenville Avenue. Dallas, TX 75231. 1-800-AHA-USA-1. 〈http://www.americanheart.org〉.

OTHER

Department of Health and Human Services (HHS) and the Department of Agriculture (USDA). Dietary Guidelines for Americans 2005. January 12, 2005. 〈http://www.healthierus.gov/dietaryguidelines〉