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By studying this chapter, you should be able to do the following:

  1. Contrast exercise with physical activity; explain how both relate to a lower risk of CHD and improvement in cardiorespiratory fitness (CRF).

  2. Describe the current public health physical activity recommendation from the U.S. Physical Activity Guidelines to improve the health status of sedentary U.S. adults.

  3. Explain what screening and progression mean for a person wanting to initiate an exercise program.

  4. Identify the optimal range of frequency, intensity, time (duration), and type (FITT) of activity associated with improvements in CRF.

  5. Calculate a target heart rate range by either the heart rate reserve or percent of maximal HR method.

  6. Discuss guidelines related to progression that facilitate the transition from easy to more demanding exercise programs.

  7. Explain how the target heart rate (THR) helps adjust exercise intensity in times of high heat, humidity, or while at altitude.

  8. Describe the health benefits of resistance training and summarize recommended resistance-training and stretching programs for adults.


  • Prescription of Exercise 368

    • Dose-Response 369

    • Physical Activity and Health 369

  • General Guidelines for Improving Fitness 371

    • Screening 373

    • Progression 373

    • Warm-Up, Stretch, and Cool-Down, Stretch 373

  • Exercise Prescription for CRF 373

    • Frequency 374

    • Intensity 374

    • Time (Duration) 376

  • Sequence of Physical Activity 377

    • Walking 378

    • Jogging 378

    • Games and Sports 378

  • Strength and Flexibility Training 379

  • Environmental Concerns 380



effect (response)


physical activity (PA)

physical fitness

target heart rate (THR) range


In Chap. 14, we discussed a variety of risk factors related to cardiovascular and other diseases. Physical inactivity had long been considered only a secondary risk factor in the development of CHD—that is, an inactive lifestyle would increase a person’s risk for CHD only if other primary risk factors were present. However, as explained in Chap. 14, this is no longer the case. Numerous studies (57, 59, 70, 75) confirm that physical inactivity is a primary risk factor for coronary heart disease (CHD), similar to smoking, hypertension, and high serum cholesterol. These studies also show that regular vigorous physical activity is instrumental in reducing the risk of CHD in those who smoke or are hypertensive (50, 58). Based on this growing body of evidence, the American Heart Association (AHA) recognized physical inactivity as a primary or major risk factor (7). Finally, epidemiological studies show that increases in physical activity (60) and fitness (11) are associated with a reduced death rate from all causes as well as from CHD. This means that physical activity should be used along with other therapies to reduce the risk of CHD in those possessing other risk factors. Consequently, there ...

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