Assessing Physical Activity and Fitness in the Office Setting

Abstract

The terms physical activity, exercise, and physical fitness are often confused and sometimes used interchangeably. Physical activity is defined as any body movement produced by skeletal muscle that results in energy expenditure.1 Exercise is physical activity that is planned and repetitive with a goal of improving physical fitness. Physical fitness is a set of attributes that are health-related, skill-related, or both. Physical fitness is difficult to address without discussing its components. The American Alliance of Health, Physical Education, Recreation, and Dance (AAHPERD) identifies the five components of health-related physical fitness as cardiorespiratory endurance, muscular strength, muscular endurance, flexibility, and body composition.2 There are no guidelines for pediatricians in regard to addressing physical activity and fitness in the office setting. This statement will review fitness assessment options and recommend practical interventions. BENEFITS OF EXERCISE Cardiovascular fitness is important in the prevention of adult coronary artery disease, hypertension, and obesity. In adults, to produce an increase in cardiorespiratory fitness, an exercise must be performed for a minimum duration of 20 minutes, three times a week, at an intensity of at least 60% of maximum heart rate. This is the basis for the exercise recommendations of the American College of Sports Medicine,3 which were also adopted for the Health Objectives for 1990.4 More recent studies have suggested that less intense physical activity also benefits health. An increasing number of scientists are promoting moderate to vigorous activity,5 because maximizing cardiovascular fitness may not be necessary to elicit changes in lifelong health. The greatest benefits of physical activity in adults are achieved when the least active individuals become moderately active.6