Professional Documents
Culture Documents
Physical Activity, Exercise, However, they are often confused with one another,
and the terms are sometimes used interchangeably.
and Physical Fitness: This paper proposes definitions to distinguish them.
Definitions and Distinctions Physical activity is defined as any bodily move-
for Health-Related Research ment produced by skeletal muscles that results in
energy expenditure. The energy expenditure can be
CARL J. CASPERSEN, PhD, MPH measured in kilocalories. Physical activity in daily
KENNETH E. POWELL, MD, MPH life can be categorized into occupational, sports,
GREGORY M. CHRISTENSON, PhD conditioning, household, or other activities. Exer-
cise is a subset of physical activity that is planned,
Dr. Caspersen and Dr. Powell are epidemiologists and Dr. structured, and repetitive and has as a final or an
Christenson is an evaluation researcher in the Behavioral Epi- intermediate objective the improvement or mainte-
demiology and Evaluation Branch, Division of Health Educa- nance ofphysicalfitness. Physicalfitness is a set of
tion, Center for Health Promotion and Education, Centers for
Disease Control, Atlanta, GA 30333. attributes that are either health- or skill-related.
Tearsheet requests to Dr. Caspersen. The degree to which people have these attributes
can be measured with specific tests.
Synopsis ..................................... These definitions are offered as an interpreta-
tional framework for comparing studies that relate
"Physical activity," "exercise," and "physical physical activity, exercise, and physical fitness to
fitness" are terms that describe different concepts. health.
Physical Fitness
In contrast with physical activity, which is related
sion and comparison of studies of physical activity to the movements that people perform, physical
will be facilitated if the data in the studies are dis- fitness is a set of attributes that people have or
cussed in terms of specific identifiable categories. achieve. Being physically fit has been defined as
"the ability to carry out daily tasks with vigor and
Exercise alertness, without undue fatigue and with ample
energy to enjoy leisure-time pursuits and to meet
The term "exercise" has been used interchange- unforeseen emergencies" (10). Although the defini-
ably with "physical activity" (9), and, in fact, both tion may be conceptually sound, things such as
have a number of common elements (see box p. vigor, alertness, fatigue, and enjoyment are not eas-
127). For example, both physical activity and exer- ily measured. On the other hand, a number of
cise involve any bodily movement produced by measurable components do contribute to physical
skeletal muscles that expends energy, are measured fitness (fig. 2). The most frequently cited compo-
by kilocalories ranging continuously from low to nents fall into two groups: one related to health and
high, and are positively correlated with physical the other related to skills that pertain more to ath-
fitness as the intensity, duration, and frequency of letic ability (11).
movements increase. Exercise, however, is not The health-related components of physical fitness
synonymous with physical activity: it is a subcate- are (a) cardiorespiratory endurance, (b) muscular
gory of physical activity. Exercise is physical activ- endurance, (c) muscular strength, (d) body compo-
ity that is planned, structured, repetitive, and pur- sition, and (e) flexibility. These components are
posive in the sense that improvement or mainte- defined in the glossary (p. 129). Just as the amount
nance of one or more components of physical of physical activity ranges from low to high, so does
fitness is an objective. The formula relating physical the level of physical fitness. Moreover, the levels of
activity and exercise is: the five health-related components need not vary in
concert; for example, a person may be strong but
kCalexerclse+ kCalnonexerctse` kcaltotal daily Physical activity lack flexibility. The five health-related components
of physical fitness are more important to public
Exercise, then, is a subset of physical activity and health than are the components related to athletic
may constitute all or part of each category of daily ability; therefore, we limit our discussion to these.
128 Public Health Reports
Operational definitions and methods of measuring moves from laboratory measures to self-assess-
components of physical fitness vary with the inter- ment. Within these three levels of evaluation, one
ests and needs of investigators and evaluators (12- may choose to employ a different measure of
14). The table below lists procedures commonly greater or lesser precision or accuracy, depending
employed to evaluate health-related physical fitness on the specific objectives of the investigation and
components for laboratory, epidemiologic, and cost constraints.
self-assessment techniques. Although the compara-
bility of these measures has not been addressed Discussion
formally, the cost, precision, and accuracy of the The definitions of physical activity and physical
measures are generally assumed to decline as one fitness we have proposed contain useful parallels.
Health-related physical fitness measures
Evaluation procedures
Fitness component Laboratory Epidemiologic Self-assessment
Cardiorespiratory .......... Maximum oxygen uptake on Canadian Home Fitness Test Canadian Home Fitness Test
treadmill (16) or cycle (17), cycle ergometer (18). (17), 12-minute run (19).
ergometer (15).
Body composition ......... Underwater weighing, Skinfold (209, body mass Skinfold pinch test (22).
potassium-40 (20). index (21).
Muscular strength ......... Cable tensiometer (23). Handgrip dynamometer Upper-lower trunk lift,
(24,25). hanging leg lift (26).
Muscular endurance ....... Isokinetic tests (24). ... Pull-ups, flexed arm hang,
situps (26).
Flexibility .................. Leighton flexometer (27). Sit-and-reach flexometer Sit-and-reach test (13).
(26).
A CRITICAL FACTOR FOR EPIDEMIOLOGIC RE- their potential for use in epidemiologic studies with
SEARCH is the accurate assessment of the variables respect to four important criteria:
under study. For the cardiovascular risk factors of
smoking, serum cholesterol, and blood pressure, * To be valid, the instrument must measure what it
there are standardized techniques for assessment of is intended to measure.
the factors that provide consistency of measure- * To be reliable, the instrument must consistently
ment and definition across studies. However, with give the same results under the same circum-
research on physical activity this has not been the stances. If the instrument is reliable and valid, it is
case. also accurate.
This review considers seven major categories of * To be practical, the instrument must have accept-
physical activity assessment procedures that have able costs to both the investigator and the partici-
been used in various settings (table 1) and evaluates pant.
March-April 1985, Vol. 100, No. 2 131