NORTHWESTERN UNIVERSITY,INC

Laoag City, Ilocos Norte

Additional patient populations

Therapeutic exercise can also be used in many diagnoses other than those specified above. See
Table 1 (below) for more diagnoses and pertinent exercise recommendations.
Table 1. Some Therapeutic Exercise Routines for Specific Patient Populations 

Department Disease Therapeutic Exercise

Cardiac   Ischemic heart disease  AROM; endurance training (eg, after
(CAD) a 5min warm-up, exercise until the
 Post-MI heart rate reaches that attained at 50%
 Stable angina of VO2 max)
 Stable chronic heart  Training muscle strength by
failure (CHF) with sinus resistance training, which must be
rhythm and ejection carried out with great caution and
fraction of £ 40% adjusted to each patient's physical
fitness level
Pulmonary  Pneumonia  Postural drainage exercises
 Chronic bronchitis
 Bronchiectasis
 Asthma  Breathing techniques
 Emphysema  Relaxation techniques
 Respiratory  Stretching exercises to mobilize
insufficiency respiratory muscles
 Restrictive lung disease Note: The level of physical effort should be
limited because exercise may provoke
bronchospasm
Orthopedics  Fractures  Preoperative and postoperative
 Amputations exercises
 Isometric exercises for joints with
minimal ROM
 ROM exercises to prevent
contractures and heterotopic
ossification
Burns    Passive and active exercises assisted
by therapists to prevent contractures
Rehabilitation  Cervical, thoracic, and  Training of the Swedish Back
lumbar problems School*

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 NORTHWESTERN UNIVERSITY,INC
Laoag City, Ilocos Norte

 Treatment of muscle contractures

 Myofascial release
 Flexibility training (stretching) to
mobilize joints
 Resistance (which may include
isometric exercises) and PNF training
of muscle strength in muscles that
have become weakened, as well as in
the back extensors and abdominal
muscles
 Graded fitness training
 Ankylosing spondylitis  Mobilization of spinal vertebrae
 Extension exercises
Rheumatoid    Flexibility training
arthritis  Gentle fitness training
Gynecology  Pregnancy and  Prenatal and postnatal exercises
and obstetrics postdelivery  Relaxation techniques
 After mastectomy  Training to reduce lymphedema
 Urinary incontinence  Isometric exercises to pelvic muscles
*The Swedish Back School derived from pioneering Swedish studies in the 1970s that measured
intradiscal pressure in normal nuclei pulposi at the L3 level. The pressure at L3, measured with a
subject standing erect, was found to be 100kp/cm2 in a male weighing 75kg. The pressure
increased to 250kp/cm2 when an individual was sitting bent forward and diminished to
50kp/cm2 when he was lying prone.

The Swedish Back School, mentioned in the above table, is a systematic training regimen aimed
at teaching patients with back problems to use movement patterns that diminish the load on the
low back. For example, among persons studied it was found that when an individual lifted a load
of 20kg with bent knees, his measured intradiscal pressure was 250kp/cm2, whereas when he
lifted the same load with the knees straight, the pressure rose to 380kp/cm2. Consequently, the
Swedish Back School trains patients in the use of the former technique, allowing for keeping the
back straight, thereby diminishing the load by 130 kp/cm2.
Mechanical aids in physical fitness
Examples of mechanical aids used in physical fitness maintenance and training include the
following:
 Electrically braked cycle ergometers
 Treadmills

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 NORTHWESTERN UNIVERSITY,INC
Laoag City, Ilocos Norte

 Rowing apparatuses
 Bed bicycles
 Arm cycles
 Pulleys
 Free weights
 Weight-training machines
 Indoor stair steppers
 Medicine balls
 Pools

Guidelines
The guidelines on physical activity were released in November 2018 by the Physical Activity
Guidelines Advisory Committee of the US Dept of Health and Human Services. [79, 80]
Age- and condition-related recommendations
Age-related recommendations are as follows:
 Children aged 3-5 years: Should be physically active throughout the day to enhance
growth and development.
 Children aged 6-17 years: Sixty minutes or more of moderate-to-vigorous physical
activity per day.
 Adults: At least 150-300 minutes per week of moderate-intensity aerobic physical
activity, OR  75-150 minutes per week of vigorous-intensity aerobic physical
activity, OR an equivalent combination of moderate- and vigorous-intensity aerobic
activity; muscle-strengthening activities should be performed on two or more days per
week.
 Older adults: Multicomponent physical activity to include balance training, aerobic
activity, and muscle-strengthening activity.
Condition-related recommendations are as follows:
 Pregnant and postpartum women: At least 150 minutes of moderate-intensity aerobic
activity weekly.
 Adults with chronic conditions or disabilities who are able: Follow key guidelines and
perform both aerobic and muscle-strengthening activities.
Sleep, daily functioning, and mental Health
Strong evidence demonstrates that moderate-to-vigorous physical activity improves sleep quality
by decreasing the time is takes to fall asleep; it can also increase deep-sleep time and decrease
daytime sleepiness.

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Laoag City, Ilocos Norte

Single episodes of physical activity promote improvements in executive function, to include

organization of daily activities and future planning. Cognition (ie, memory, processing speed,
attention, academic performance) also can be improved with physical exercise.
Regular physical activity reduces the risk of clinical depression, as well as reducing depressive
symptoms and symptoms of anxiety.
Strong evidence demonstrates regular physical activity improves perceived quality of life.
Risk of diseases and conditions
Regular physical activity minimizes excessive weight gain, helps maintain weight within a
healthy range, improves bone health, and prevents obesity, even in children as young as 3-5
years.
In pregnant women, physical activity helps reduce excessive weight gain in pregnancy and helps
reduce the risk of developing gestational diabetes and postpartum depression.
Regular physical activity has been shown to improve cognitive function and to reduce the risk of
dementia; falls and fall-related injuries; and cancers of the breast, esophagus, colon, bladder,
lung, endometrium, kidney, and stomach. It also helps retard the progression of osteoarthritis,
type 2 diabetes, and hypertension.
Promotion of physical activity
School- and community-based programs can be effective.
Environmental and policy changes should improve access to physical activity and support of
physical activity behavior.
Information and technology should be used to promote physical activity, to include activity
monitors (eg, wearable devices), smartphone apps, computer-tailored printed material, and
Internet-based programs for self-monitoring, message delivery, and support.

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