Recommended Exercise Methods

Very inexpensive exercise machines tend to be flimsy and hard to adjust, but many sturdy machines are available at moderate prices. The higher-end models may utilize computers to record calories burned, speed, and mileage. While their readouts may provide motivation and gauge the intensity of a workout, however, they are not always accurate.

The following are a few observations on specific equipment:

• A good floor mat is important to provide cushioning for all home exercises.
• A simple jump rope improves aerobic endurance for people who are able to perform high-impact exercise. Jumping rope should be done on a floor mat plus a surface that has some give to avoid joint injury.
• For burning calories, the treadmill has been ranked best, followed by stair climbers, the rowing machine, cross-country ski machine, and stationary bicycle. (Elliptical trainers, however, may be even better than treadmills for increasing heart rate, calorie expenditure, and oxygen consumption.)
• Stationary bikes condition leg muscles and are fairly economical and easy to use safely. The pedals should turn smoothly, the seat height should adjust easily, and the bike's computer should be able to adjust intensity.
• Stair machines also condition leg muscles. They offer very intense, low-impact workouts and may be as effective as running with less chance of injury.
• Rowing and cross-country ski machines exercise both the upper and lower body.

Strength or Resistance Training

Benefits of Strength Exercise. While aerobic exercise increases endurance and helps the heart, it does not build upper body strength or tone muscles. Strength-training exercises provide the following benefits:

• Build muscle strength while burning fat
• Help maintain bone density
• Improve digestion

It is also associated with a lower risk for heart disease, possibly because it lowers LDL (the so-called "bad") cholesterol levels.

Click the icon to see an image of cholesterol.

Strength exercise is beneficial for everyone, even people in their 90s. It is the only form of exercise that can slow and even reverse the decline in muscle mass, bone density, and strength that occurs with aging. Please note: People at risk for cardiovascular disease should not perform strength exercises without checking with a doctor.

Types of Muscle Contractions. There are three types of muscle contractions involved in strength training:

• Isometric contractions do not change the length of the muscle. An example is pushing against a wall.
• Concentric contractions shorten muscles. An example is the "up" phase of a bicep curl.
• Eccentric contractions lengthen muscles. An example is the "down" phase as weights are lowered.

Click the icon to see an image of isometric exercise.

Strength-Training Regimens. Strength training involves intense and short-duration activities. For beginners, adding 10 to 20 minutes of modest strength training two to three times a week may be appropriate. The following are some guidelines for starting a strength regimen:

• The sequence of a strength training session should begin with training large muscles and multiple joints at higher intensity and end with small muscle and single joint exercises at lower intensities.
• Both concentric (shortening) and eccentric (lengthening) muscle actions should be performed. Emphasizing eccentric contractions (the movements that lengthen muscles) is of increasing interest. This approach involves slowing and increasing the duration of these "down" movements. It appears to significantly increase blood flow, and some evidence suggests it may achieve stronger muscles more quickly and improve cardiovascular function compared to a standard movements. It may be particularly beneficial for older people and some people with chronic health problems. Eccentric training increases the risk for muscle soreness and injury, however, and this approach is still controversial.
• Strength training involves moving specific muscles in the same pattern against a resisting force (such as a weight) for a preset number of times. This is called a repetition. Students should first choose a weight that is about half of what would require a maximum effort in one repetition. In other words, if it would take maximum effort to do a single repetition with a 10-pound dumbbell, than the person would start with a five-pound dumbbell. In the beginning, most people can start with one set of 8 to 15 repetitions per muscle group with low weights. As individuals are able to perform one or two repetitions over their routine, weights can be increased by 2 - 10%.
• Breathe slowly and rhythmically. Exhale as the movement begins. Inhale when returning to the starting point.
• The first half of each repetition typically lasts 2 to 3 seconds. The return to the original position lasts 4 seconds.
• An alternative technique called "super slow" training stretches out one repetition to a 14-second count. This method places far more stress on the muscle group, so fewer repetitions are needed. A full week of recovery is required before repeating this workout. The goal is to initiate changes in the muscles so that the body continues to burn calories after the exercise. Some people report dramatic results from this approach, but scientific verification of these anecdotes is not available. It is very tedious, in any case, and people have a hard time sticking with it. People with high blood pressure should not use this approach.
• Joints should be moved rhythmically through their full range of motion during a repetition and not locked up.
• For maximum benefit, one should allow 48 hours between workouts for full muscle recovery.

Click the icon to see the proper way to breathe during exercise.

Strength-Training Equipment. Unlike aerobic exercise, strength training almost always requires some equipment. Strength-training equipment does not, however, have to cost anything.

• Any heavy object that can be held in the hand, such as a plastic bottle filled with sand or water, can serve as a weight.
• Dumbbells (1 to 10 pounds) and resistance bands are inexpensive, portable, and effective.
• Wearable weights help strengthen and tone the upper body.
• Ankle weights strengthen and tone muscles in the lower body. Wearable ankle weights should not be worn during high-impact aerobics or jumping.
• Handgrips strengthen arms and are good for relieving tension.
• A pull-up bar can be mounted in a doorway for chin-ups and pull-ups.

More elaborate and expensive home equipment for working body muscles is also available, costing from $100 to over $1,000. No one should purchase or use strength-training equipment without instruction from a professional.

Flexibility Training (Stretching)

Benefits of Flexibility Training. Flexibility training uses stretching exercises. Many stretching exercises are particularly beneficial for the back. In general, flexibility training provides the following benefits:

• Prevents cramps, stiffness, and injuries
• Improves joint and muscle movement (range of motion)

Certain flexibility practices such as yoga and tai chi, also involve meditation and breathing techniques that reduce stress. Such practices appear to have many health and mental benefits and may be very suitable and highly beneficial for many older people and patients with certain chronic diseases.

Click the icon to see an image of flexibility exercise.

Flexibility Training Regiments. Doctors recommend performing stretching exercises for 10 to 12 minutes at least three times a week. The following are some general guidelines:

• When stretching, exhale and extend the muscles to the point of tension, not pain, and hold for 20 to 60 seconds. (Beginners may need to start with a 5- to 10-second stretch.)
• Breath evenly and constantly while holding the stretch.
• Inhale when returning to a relaxed position. (Holding your breath defeats the purpose; it causes muscle contraction and raises blood pressure.)
• It is important when doing stretches that involve the back to relax the spine, to keep the lower back flush with the mat, and to work only the muscles required for changing position, often only the abdomen.