Exercise prescription.

Exercise can increase longevity and improve overall health and quality of life. Since a large proportion of Americans have a sedentary lifestyle, exercise counseling should be a part of routine health maintenance. Physicians need to provide patients with information about the specific benefits of exercise and motivate them to increase their physical activity. Physicians should encourage all adults, including those who elect not to participate in a formal exercise program, to accumulate 30 minutes or more of moderate-intensity physical activity on most days of the week. Before beginning an exercise program, selected higher risk patients may need to be evaluated with a physical examination and a treadmill test. Many patients benefit from a preexercise determination of fitness and specific instructions for monitoring their heart rate to maintain exercise within appropriate target ranges. A formal exercise prescription should include specific advice about the type, frequency, intensity, duration and progression of physical activity. Once an exercise regimen has begun, injury prevention and adherence to the program become important.