Exercise is physical activity that is planned, structured, and repetitive tocondition the body. Exercise is used to improve health, maintain fitness andfor physical rehabilitation. It is used to prevent or treat heart disease, osteoporosis, weakness, diabetes, obesity, and depression. Range of motion exercise increases or maintains joint function. Strengthening exercises provide appropriate resistance to the muscles to increase endurance and strength. Cardiac rehabilitation exercises improve the cardiovascular system to prevent andrehabilitate heart disorders and diseases. A well-balanced exercise programcan improve general health, build endurance, delay many aging effects, and enhance emotional well-being. Before beginning any exercise program, evaluationby a physician is recommended. Some exercise programs should be supervised by a health care professional, especially if used for rehabilitation. If symptoms of dizziness, nausea, excessive shortness of breath, or chest painare present while exercising, stop the activity and inform the physician.

Range of motion exercise improves movement of a specific joint and includes passive, active, and active assists exercises. Passive range of motion is joint movement by another person or a passive motion machine. When passive rangeof motion is applied, the joint of the person receiving exercise is completely relaxed while the outside force takes the body part, such as a leg or arm,throughout the available range. Injury, surgery, or immobilization of a jointmay affect the normal joint range of motion. Active range of motion is movement of the joint by the person exercising. In active assist range of motion,the joint receives partial assistance from an outside force and is applied bythe exerciser or by the person assisting the individual. Strengthening exercise increases muscle strength and mass, bone strength, and metabolism. A certain level of muscle strength is needed for daily activities, such as walking,running, and climbing stairs. Weight training provides immediate feedback, through observation of progress in muscle growth and improved muscle tone. Strengthening exercise can be isometric, isotonic or isokinetic. Isometric exercise is effective in developing total strength of a particular muscle or groupof muscles and is usually performed against an immovable surface or object,such as pressing the hand against the wall. It is often used for rehabilitation since the exact area of muscle weakness can be isolated and strengthened.It can provide a relatively quick and convenient method for overloading and strengthening muscles without any special equipment and with little chance ofinjury. In isotonic exercise, which includes weight training, calisthenics, chin-ups, push-ups, and sit-ups, the joint is moved during the muscle contraction. Isokinetic exercise combines the best features of isometrics and weighttraining by using machines that control the speed of contraction within the range of motion. It provides muscular overload at a constant preset speed while the muscle mobilizes its force through the full range of motion.

Exercise can be very helpful in preventing and rehabilitating heart disordersand disease. With an exercise program set at a level considered safe for that person, heart failure patients can improve their fitness levels substantially. The increase in endurance should also translate into a more active lifestyle. Endurance or aerobic routines, such as running, brisk walking, cycling,or swimming, increase the strength and efficiency of the heart muscles. Before exercising, proper stretching is important to prevent the possibility of soft tissue injury resulting from tight muscles, tendons, ligaments, and otherjoint related structures. Proper cool down after exercise reduces painful muscle spasms and may decrease frequency and intensity of muscle stiffness the next day. Overexertion can also lead to muscle strains and stress fractures are possibile if activities are too strenuous.

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