According to Hippocrates, "Eating alone cannot make a person healthy. It is also necessary to exercise." In this article, we will tell you about one of the six important pillars of lifestyle medicine, which is 'physical activity (Physical activity)’

                Physical activity that has a positive impact on health It is necessary to consider various elements to design exercise that is suitable for each person's condition, such as those over 65 years old., People who are pregnant or have certain medical conditions, etc. Therefore, it is important to assess the physical fitness of each person in order to plan an effective and safe exercise, consisting of 5 topics:

1. Body composition (Body composition) is the proportion of fat mass. Muscles, bones, and other body elements such as body water, etc., can be evaluated with a machine.Bioelectrical Impedance Analysis (BIA) Or the initial assessment can be made using the body mass index (Body Mass Index, BMI) Combined with waist circumference, but the standard method with precision (Gold standard) It will be a machine.Dual-Energy X-ray Absorptiometry (DEXA)
2. Cardiovascular endurance (Cardiovascular endurance) is the ability of the heart and lungs to transport oxygen to the muscles. It can be assessed by walking or running tests, such as the stepping up and down test (Step test) or cycling (Ergometer test)
3. Muscle strength and endurance (Muscular strength and endurance) Divided into:
   1. Muscle strengthIt is the maximum amount of force that a muscle can lift in one time. It can be estimated by the weight it can lift.
   2. Muscle enduranceis the ability of muscles to work continuously for a certain period of time, which can be assessed by the number of times they can do it.
      ( The endurance and strength of the muscle group are evaluated differently. For example, the strength of the upper muscles is used.Bench press, Strength of the lower muscles is used in the pose.Smith machine squat And if you evaluate the durability, you will use the posture.Curl-ups and posture.Push-ups)
4. Flexibility (Flexibility) is the maximum distance of movement of the joint in bending or stretching. This can be assessed by a flexion test. Forward along the ruler as far as possible (Sit-and-reach test) To assess the distance and direction of movement of the joints for restriction.
5. Balancing (Balance) It is the ability to control the body in a straight line and maintain the balance of posture in a specific area.Single leg balance test or balancing while moving, for example:Y balance test

Exercise planning with the principle of 'FITT-P’

               Exercise with principlesFITT-P It considers five elements to ensure the highest efficiency of exercise, including frequency (Frequency), Weight (Intensity), Duration (Time), Type (Type), and progress (Progression)

• Cardio exercises to keep your lungs and heart healthy (Cardiovascular exercise)

Generally, the recommended is 150-300 minutes per week. For moderate-intensity exercise and 75-150 minutes per week. For high-intensity exercise. This intensity can be assessed by the heart rate per minute.

The duration of each workout can be divided into short periods of 5 minutes each time to more than 60 minutes continuously, depending on individual health restrictions.

Cardio exercise is divided into 2 types: impact (Impact) e.g. running and non-impact (Non-impact) For example, cycling, swimming, etc., it is recommended to do both alternately.

When exercising until the body becomes stronger. The frequency, duration, and intensity of exercise can be increased. However, it is necessary to evaluate the body's fitness well, such as high-intensity exercise for a short period of time, also known asHIIT (High Intensity Interval Training) It should not be on the exercise plan until it is possible to do more than 20 minutes of continuous moderate-intensity exercise.

• Exercises to increase flexibility (Flexibility exercise)

Generally, it is recommended to stay at 2-7 days a week, focusing on stretching the tight muscles more frequently. The intensity of stretching should be assessed from a mild to moderate level of tension according to what each person can tolerate. Do not continue to stretch until you feel pain, as this may cause muscle injury.

Stretching (Static stretching) It is often used for stretching after exercise. This type of stretching reduces muscle tension, and the effectiveness of the stretch depends on the technique used, the duration of the stretch, and the duration of rest.

Animated stretching (Dynamic stretching) It stretches the muscles while moving. This is done before a workout (Warm up) To prepare the muscles used for exercise, make blood flow. Increase oxygen circulation and prevent injury.

Rhythmic stretching (Ballistic stretching) It is a stretch by making the muscles tense and slack alternately. It is suitable for stretching before playing sports that require fast movement, and you should be careful not to get too fast and cause injury.

Stretching through nervous system stimulation (Proprioceptive Neuromuscular Facilitation Stretching) It is a complex technique. It uses coordination between the muscles and the nervous system, often used in athletes or physical therapy. People with severe muscle tension problems

Flexibility is important for effective movement. Stretching can help reduce injuries from sports or exercise. But on the other hand, excessive stretching can cause injury. It can cause injury. That's why it's important to have the right level of stretching.

• Strength exercise

       It is a different exercise from either cardio or flexibility. The number of sets per muscle, the number of repetitions in each set. The intensity in terms of weight lifted and feel. Selection of the type of exercise, the sequence of exercises. Rest between sets and duration of exercises, as well as the rhythm of repetition (Repetition tempo)

       Those who start the exercise Muscle strength training must learn to train the correct posture; the connection between the muscles and the mind; the initial weight assessment and degree of movement, which should be consulted by a specialist at the beginning.

Exercise depends on the size and amount (Dose-response) The more you do, the more you will benefit. But to exercise effectively, it is best to have an assessment of your physical condition and good planning. If there is advice from an exercise expert, whether it is a specialist, a physical therapist or a trainer, depending on the physical condition of each person. However, don't forget that moving your body, no matter how small, is better than staying still. As the sentence goes, "Doing any physical activity is better than doing none.”

 
By Medical Team BDMS Wellness Clinic Institute and the Association of Doctors to Rehabilitate and Promote Obesity Education. Krung Ung Thep (BARSO)

Reference List:

1. Young J, Bonnet JP, Sokolof J. Lifestyle Medicine: Physical Activity. J Fam Pract. 2022 Jan;71(Suppl 1 Lifestyle):S17-S23
2. Rippe JM. Physical Activity and Lifestyle Medicine. Am J Lifestyle Med. 2021 May 1;15(3):212–3.
3. Weerapong P, Hume PA, Kolt GS. Stretching: mechanisms and benefits for sport performance and injury prevention. Physical Therapy Reviews. 2004 Dec 1;9(4):189-206.