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Wikipedia

Exercise

November 06, 2023

"Workout" redirects here. For other uses, see Exercise (disambiguation) and Workout (disambiguation).

Exercise is intentional physical activity to enhance or maintain fitness and overall health.[1][2]

Cycling is a popular form of exercise.
Weight training

It is performed for various reasons, including weight loss or maintenance, to aid growth and improve strength, develop muscles and the cardiovascular system, hone athletic skills, improve health,[3] or simply for enjoyment. Many individuals choose to exercise outdoors where they can congregate in groups, socialize, and improve well-being as well as mental health.[4][5]

In terms of health benefits, usually, 2.5 hours of moderate-intensity exercise per week is recommended for reducing the risk of health issues.[6][7][8] At the same time, even doing a small amount of exercise is healthier than doing none. Already doing an hour and a quarter (11 minutes/day) of exercise could reduce the risk of early death, cardiovascular disease, stroke, and cancer.[9][10]

Classification

Physical exercises are generally grouped into three types, depending on the overall effect they have on the human body:[11]

Physical exercise can also include training that focuses on accuracy, agility, power, and speed.[15]

Types of exercise can also be classified as dynamic or static. 'Dynamic' exercises such as steady running, tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly, albeit transiently, during the performance of the exercise.[16]

Health effects

Main article: Exercise physiology
 
Exercise in a gym

Physical exercise is important for maintaining physical fitness and can contribute to maintaining a healthy weight, regulating the digestive system, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system. Some studies indicate that exercise may increase life expectancy and the overall quality of life.[17] People who participate in moderate to high levels of physical exercise have a lower mortality rate compared to individuals who by comparison are not physically active.[18] Moderate levels of exercise have been correlated with preventing aging by reducing inflammatory potential.[19] The majority of the benefits from exercise are achieved with around 3500 metabolic equivalent (MET) minutes per week, with diminishing returns at higher levels of activity.[20] For example, climbing stairs 10 minutes, vacuuming 15 minutes, gardening 20 minutes, running 20 minutes, and walking or bicycling for transportation 25 minutes on a daily basis would together achieve about 3000 MET minutes a week.[20] A lack of physical activity causes approximately 6% of the burden of disease from coronary heart disease, 7% of type 2 diabetes, 10% of breast cancer and 10% of colon cancer worldwide.[21] Overall, physical inactivity causes 9% of premature mortality worldwide.[21]

Fitness

Main article: Physical fitness

Most people can increase fitness by increasing physical activity levels.[22] Increases in muscle size from resistance training are primarily determined by diet and testosterone.[23] This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population.[24][25] There is evidence that exercising in middle age may lead to better physical ability later in life.[26]

Early motor skills and development is also related to physical activity and performance later in life. Children who are more proficient with motor skills early on are more inclined to be physically active, and thus tend to perform well in sports and have better fitness levels. Early motor proficiency has a positive correlation to childhood physical activity and fitness levels, while less proficiency in motor skills results in a more sedentary lifestyle.[27]

The type and intensity of physical activity performed may have an effect on a person's fitness level. There is some weak evidence that high-intensity interval training may improve a person's VO2 max slightly more than lower intensity endurance training.[28] However, unscientific fitness methods could lead to sports injuries.[29]

Cardiovascular system

Main article: Cardiovascular fitness

The beneficial effect of exercise on the cardiovascular system is well documented. There is a direct correlation between physical inactivity and cardiovascular disease, and physical inactivity is an independent risk factor for the development of coronary artery disease. Low levels of physical exercise increase the risk of cardiovascular diseases mortality.[30][31]

Children who participate in physical exercise experience greater loss of body fat and increased cardiovascular fitness.[32] Studies have shown that academic stress in youth increases the risk of cardiovascular disease in later years; however, these risks can be greatly decreased with regular physical exercise.[33]

There is a dose-response relationship between the amount of exercise performed from approximately 700–2000 kcal of energy expenditure per week and all-cause mortality and cardiovascular disease mortality in middle-aged and elderly men. The greatest potential for reduced mortality is seen in sedentary individuals who become moderately active.

Studies have shown that since heart disease is the leading cause of death in women, regular exercise in aging women leads to healthier cardiovascular profiles.

Most beneficial effects of physical activity on cardiovascular disease mortality can be attained through moderate-intensity activity (40–60% of maximal oxygen uptake, depending on age). Persons who modify their behavior after myocardial infarction to include regular exercise have improved rates of survival. Persons who remain sedentary have the highest risk for all-cause and cardiovascular disease mortality.[34] According to the American Heart Association, exercise reduces the risk of cardiovascular diseases, including heart attack and stroke.[31]

Some have suggested that increases in physical exercise might decrease healthcare costs, increase the rate of job attendance, as well as increase the amount of effort women put into their jobs.[35]

Immune system

Although there have been hundreds of studies on physical exercise and the immune system, there is little direct evidence on its connection to illness.[36] Epidemiological evidence suggests that moderate exercise has a beneficial effect on the human immune system; an effect which is modeled in a J curve. Moderate exercise has been associated with a 29% decreased incidence of upper respiratory tract infections (URTI), but studies of marathon runners found that their prolonged high-intensity exercise was associated with an increased risk of infection occurrence.[36] However, another study did not find the effect. Immune cell functions are impaired following acute sessions of prolonged, high-intensity exercise, and some studies have found that athletes are at a higher risk for infections. Studies have shown that strenuous stress for long durations, such as training for a marathon, can suppress the immune system by decreasing the concentration of lymphocytes.[37] The immune systems of athletes and nonathletes are generally similar. Athletes may have a slightly elevated natural killer cell count and cytolytic action, but these are unlikely to be clinically significant.[36]

Vitamin C supplementation has been associated with a lower incidence of upper respiratory tract infections in marathon runners.[36]

Biomarkers of inflammation such as C-reactive protein, which are associated with chronic diseases, are reduced in active individuals relative to sedentary individuals, and the positive effects of exercise may be due to its anti-inflammatory effects. In individuals with heart disease, exercise interventions lower blood levels of fibrinogen and C-reactive protein, an important cardiovascular risk marker.[38] The depression in the immune system following acute bouts of exercise may be one of the mechanisms for this anti-inflammatory effect.[36]

Cancer

A systematic review evaluated 45 studies that examined the relationship between physical activity and cancer survival rates. According to the review, "[there] was consistent evidence from 27 observational studies that physical activity is associated with reduced all-cause, breast cancer–specific, and colon cancer–specific mortality. There is currently insufficient evidence regarding the association between physical activity and mortality for survivors of other cancers."[39] Evidence suggests that exercise may positively affect the quality of life in cancer survivors, including factors such as anxiety, self-esteem and emotional well-being.[40] For people with cancer undergoing active treatment, exercise may also have positive effects on health-related quality of life, such as fatigue and physical functioning.[41] This is likely to be more pronounced with higher intensity exercise.[41]

Exercise may contribute to a reduction of cancer-related fatigue in survivors of breast cancer.[42] Although there is only limited scientific evidence on the subject, people with cancer cachexia are encouraged to engage in physical exercise.[43] Due to various factors, some individuals with cancer cachexia have a limited capacity for physical exercise.[44][45] Compliance with prescribed exercise is low in individuals with cachexia and clinical trials of exercise in this population often have high drop-out rates.[44][45]

There is low-quality evidence for an effect of aerobic physical exercises on anxiety and serious adverse events in adults with hematological malignancies.[46] Aerobic physical exercise may result in little to no difference in the mortality, quality of life, or physical functioning.[46] These exercises may result in a slight reduction in depression and reduction in fatigue.[46]

Neurobiological

This section is an excerpt from Neurobiological effects of physical exercise.[edit]
 
A woman engaging in aerobic exercise (jogging)

The neurobiological effects of physical exercise are numerous and involve a wide range of interrelated effects on brain structure,[47] brain function, and cognition.[48][49][50][51] A large body of research in humans has demonstrated that consistent aerobic exercise (e.g., 30 minutes every day) induces persistent improvements in certain cognitive functions, healthy alterations in gene expression in the brain, and beneficial forms of neuroplasticity and behavioral plasticity; some of these long-term effects include: increased neuron growth, increased neurological activity (e.g., c-Fos and BDNF signaling), improved stress coping, enhanced cognitive control of behavior, improved declarative, spatial, and working memory, and structural and functional improvements in brain structures and pathways associated with cognitive control and memory.[48][49][50][51][52][53][54][55][56][57] The effects of exercise on cognition have important implications for improving academic performance in children and college students, improving adult productivity, preserving cognitive function in old age, preventing or treating certain neurological disorders, and improving overall quality of life.[48][58][59][60]

In healthy adults, aerobic exercise has been shown to induce transient effects on cognition after a single exercise session and persistent effects on cognition following regular exercise over the course of several months.[48][57][61] People who regularly perform an aerobic exercise (e.g., running, jogging, brisk walking, swimming, and cycling) have greater scores on neuropsychological function and performance tests that measure certain cognitive functions, such as attentional control, inhibitory control, cognitive flexibility, working memory updating and capacity, declarative memory, spatial memory, and information processing speed.[48][52][54][56][57][61][62][63] The transient effects of exercise on cognition include improvements in most executive functions (e.g., attention, working memory, cognitive flexibility, inhibitory control, problem solving, and decision making) and information processing speed for a period of up to 2 hours after exercising.[61]

Aerobic exercise induces short- and long-term effects on mood and emotional states by promoting positive affect, inhibiting negative affect, and decreasing the biological response to acute psychological stress.[61] Over the short-term, aerobic exercise functions as both an antidepressant and euphoriant,[64][65][66][67] whereas consistent exercise produces general improvements in mood and self-esteem.[68][69]

Regular aerobic exercise improves symptoms associated with a variety of central nervous system disorders and may be used as adjunct therapy for these disorders. There is clear evidence of exercise treatment efficacy for major depressive disorder and attention deficit hyperactivity disorder.[58][66][70][71][72] The American Academy of Neurology's clinical practice guideline for mild cognitive impairment indicates that clinicians should recommend regular exercise (two times per week) to individuals who have been diagnosed with this condition.[73] Reviews of clinical evidence also support the use of exercise as an adjunct therapy for certain neurodegenerative disorders, particularly Alzheimer's disease and Parkinson's disease.[74][75][76][77][78][79] Regular exercise is also associated with a lower risk of developing neurodegenerative disorders.[77][80] A large body of preclinical evidence and emerging clinical evidence supports the use of exercise as an adjunct therapy for the treatment and prevention of drug addictions.[81][82][83][84][85] Regular exercise has also been proposed as an adjunct therapy for brain cancers.[86]

Depression

This is an excerpt from Neurobiological effects of physical exercise § Major depressive disorder.[edit]

A number of medical reviews have indicated that exercise has a marked and persistent antidepressant effect in humans,[52][66][67][70][87][88] an effect believed to be mediated through enhanced BDNF signaling in the brain.[55][70] Several systematic reviews have analyzed the potential for physical exercise in the treatment of depressive disorders. The 2013 Cochrane Collaboration review on physical exercise for depression noted that, based upon limited evidence, it is more effective than a control intervention and comparable to psychological or antidepressant drug therapies.[87] Three subsequent 2014 systematic reviews that included the Cochrane review in their analysis concluded with similar findings: one indicated that physical exercise is effective as an adjunct treatment (i.e., treatments that are used together) with antidepressant medication;[70] the other two indicated that physical exercise has marked antidepressant effects and recommended the inclusion of physical activity as an adjunct treatment for mild–moderate depression and mental illness in general.[66][67] One systematic review noted that yoga may be effective in alleviating symptoms of prenatal depression.[89] Another review asserted that evidence from clinical trials supports the efficacy of physical exercise as a treatment for depression over a 2–4 month period.[52] These benefits have also been noted in old age, with a review conducted in 2019 finding that exercise is an effective treatment for clinically diagnosed depression in older adults.[90]

A meta-analysis from July 2016 concluded that physical exercise improves overall quality of life in individuals with depression relative to controls.[58][91]

Continuous aerobic exercise can induce a transient state of euphoria, colloquially known as a "runner's high" in distance running or a "rower's high" in crew, through the increased biosynthesis of at least three euphoriant neurochemicals: anandamide (an endocannabinoid),[92] β-endorphin (an endogenous opioid),[93] and phenethylamine (a trace amine and amphetamine analog).[94][95][96]

Sleep

Preliminary evidence from a 2012 review indicated that physical training for up to four months may increase sleep quality in adults over 40 years of age.[97] A 2010 review suggested that exercise generally improved sleep for most people, and may help with insomnia, but there is insufficient evidence to draw detailed conclusions about the relationship between exercise and sleep.[98] A 2018 systematic review and meta-analysis suggested that exercise can improve sleep quality in people with insomnia.[99]

Libido

One 2013 study found that exercising improved sexual arousal problems related to antidepressant use.[100]

Respiratory system

People who participate in physical exercise experience increased cardiovascular fitness.[medical citation needed] There is some level of concern about additional exposure to air pollution when exercising outdoors, especially near traffic.[101]

Mechanism of effects

Skeletal muscle

Main article: Skeletal muscle

Resistance training and subsequent consumption of a protein-rich meal promotes muscle hypertrophy and gains in muscle strength by stimulating myofibrillar muscle protein synthesis (MPS) and inhibiting muscle protein breakdown (MPB).[102][103] The stimulation of muscle protein synthesis by resistance training occurs via phosphorylation of the mechanistic target of rapamycin (mTOR) and subsequent activation of mTORC1, which leads to protein biosynthesis in cellular ribosomes via phosphorylation of mTORC1's immediate targets (the p70S6 kinase and the translation repressor protein 4EBP1).[102][104] The suppression of muscle protein breakdown following food consumption occurs primarily via increases in plasma insulin.[102][105][106] Similarly, increased muscle protein synthesis (via activation of mTORC1) and suppressed muscle protein breakdown (via insulin-independent mechanisms) has also been shown to occur following ingestion of β-hydroxy β-methylbutyric acid.[102][105][106][107]

Aerobic exercise induces mitochondrial biogenesis and an increased capacity for oxidative phosphorylation in the mitochondria of skeletal muscle, which is one mechanism by which aerobic exercise enhances submaximal endurance performance.[108][102][109] These effects occur via an exercise-induced increase in the intracellular AMP:ATP ratio, thereby triggering the activation of AMP-activated protein kinase (AMPK) which subsequently phosphorylates peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), the master regulator of mitochondrial biogenesis.[102][109][110]

 
Diagram of the molecular signaling cascades that are involved in myofibrillar muscle protein synthesis and mitochondrial biogenesis in response to physical exercise and specific amino acids or their derivatives (primarily L-leucine and HMB).[102] Many amino acids derived from food protein promote the activation of mTORC1 and increase protein synthesis by signaling through Rag GTPases.[102][111]
Abbreviations and representations
 • PLD: phospholipase D
 • PA: phosphatidic acid
 • mTOR: mechanistic target of rapamycin
 • AMP: adenosine monophosphate
 • ATP: adenosine triphosphate
 • AMPK: AMP-activated protein kinase
 • PGC-1α: peroxisome proliferator-activated receptor gamma coactivator-1α
 • S6K1: p70S6 kinase
 • 4EBP1: eukaryotic translation initiation factor 4E-binding protein 1
 • eIF4E: eukaryotic translation initiation factor 4E
 • RPS6: ribosomal protein S6
 • eEF2: eukaryotic elongation factor 2
 • RE: resistance exercise; EE: endurance exercise
 • Myo: myofibrillar; Mito: mitochondrial
 • AA: amino acids
 • HMB: β-hydroxy β-methylbutyric acid
 • ↑ represents activation
 • Τ represents inhibition
 
Resistance training stimulates muscle protein synthesis (MPS) for a period of up to 48 hours following exercise (shown by dotted line).[103] Ingestion of a protein-rich meal at any point during this period will augment the exercise-induced increase in muscle protein synthesis (shown by solid lines).[103]

Other peripheral organs

 
Summary of long-term adaptations to regular aerobic and anaerobic exercise. Aerobic exercise can cause several central cardiovascular adaptations, including an increase in stroke volume (SV)[112] and maximal aerobic capacity (VO2 max),[112][113] as well as a decrease in resting heart rate (RHR).[114][115][116] Long-term adaptations to resistance training, the most common form of anaerobic exercise, include muscular hypertrophy,[117][118] an increase in the physiological cross-sectional area (PCSA) of muscle(s), and an increase in neural drive,[119][120] both of which lead to increased muscular strength.[121] Neural adaptations begin more quickly and plateau prior to the hypertrophic response.[122][123]

Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ. That is, contracting muscles release multiple substances known as myokines which promote the growth of new tissue, tissue repair, and multiple anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases.[124] Exercise reduces levels of cortisol, which causes many health problems, both physical and mental.[125] Endurance exercise before meals lowers blood glucose more than the same exercise after meals.[126] There is evidence that vigorous exercise (90–95% of VO2 max) induces a greater degree of physiological cardiac hypertrophy than moderate exercise (40 to 70% of VO2 max), but it is unknown whether this has any effects on overall morbidity and/or mortality.[127] Both aerobic and anaerobic exercise work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). Ventricular hypertrophy, the thickening of the ventricular walls, is generally beneficial and healthy if it occurs in response to exercise.

Central nervous system

Further information: Neurobiological effects of physical exercise § Neuroplasticity

The effects of physical exercise on the central nervous system are mediated in part by specific neurotrophic factor hormones that are released into the blood stream by muscles, including BDNF, IGF-1, and VEGF.[128][129][130][131][132][133]

Public health measures

Community-wide and school campaigns are often used in an attempt to increase a population's level of physical activity. Studies to determine the effectiveness of these types of programs need to be interpreted cautiously as the results vary.[22] There is some evidence that certain types of exercise programmes for older adults, such as those involving gait, balance, co-ordination and functional tasks, can improve balance.[134] Following progressive resistance training, older adults also respond with improved physical function.[135] Brief interventions promoting physical activity may be cost-effective, however this evidence is weak and there are variations between studies.[136]

Environmental approaches appear promising: signs that encourage the use of stairs, as well as community campaigns, may increase exercise levels.[137] The city of Bogotá, Colombia, for example, blocks off 113 kilometers (70 mi) of roads on Sundays and holidays to make it easier for its citizens to get exercise. Such pedestrian zones are part of an effort to combat chronic diseases and to maintain a healthy BMI.[138][139]

Parents can promote physical activity by modelling healthy levels of physical activity or by encouraging physical activity.[140] According to the Centers for Disease Control and Prevention in the United States, children and adolescents should do 60 minutes or more of physical activity each day.[141] Implementing physical exercise in the school system and ensuring an environment in which children can reduce barriers to maintain a healthy lifestyle is essential.

The European Commission's Directorate-General for Education and Culture (DG EAC) has dedicated programs and funds for Health Enhancing Physical Activity (HEPA) projects[142] within its Horizon 2020 and Erasmus+ program, as research showed that too many Europeans are not physically active enough. Financing is available for increased collaboration between players active in this field across the EU and around the world, the promotion of HEPA in the EU and its partner countries, and the European Sports Week. The DG EAC regularly publishes a Eurobarometer on sport and physical activity.

Exercise trends

Main article: Exercise trends

Worldwide there has been a large shift toward less physically demanding work.[143] This has been accompanied by increasing use of mechanized transportation, a greater prevalence of labor-saving technology in the home, and fewer active recreational pursuits.[143] Personal lifestyle changes, however, can correct the lack of physical exercise.[medical citation needed]

Research published in 2015 suggests that incorporating mindfulness into physical exercise interventions increases exercise adherence and self-efficacy, and also has positive effects both psychologically and physiologically.[144]

Social and cultural variation

Exercising looks different in every country, as do the motivations behind exercising.[4] In some countries, people exercise primarily indoors (such as at home or health clubs), while in others, people primarily exercise outdoors. People may exercise for personal enjoyment, health and well-being, social interactions, competition or training, etc. These differences could potentially be attributed to a variety of reasons including geographic location and social tendencies.

In Colombia, for example, citizens value and celebrate the outdoor environments of their country. In many instances, they use outdoor activities as social gatherings to enjoy nature and their communities. In Bogotá, Colombia, a 70-mile stretch of road known as the Ciclovía is shut down each Sunday for bicyclists, runners, rollerbladers, skateboarders and other exercisers to work out and enjoy their surroundings.[148]

Similarly to Colombia, citizens of Cambodia tend to exercise socially outside. In this country, public gyms have become quite popular. People will congregate at these outdoor gyms not only to use the public facilities, but also to organize aerobics and dance sessions, which are open to the public.[149]

Sweden has also begun developing outdoor gyms, called utegym. These gyms are free to the public and are often placed in beautiful, picturesque environments. People will swim in rivers, use boats, and run through forests to stay healthy and enjoy the natural world around them. This works particularly well in Sweden due to its geographical location.[150]

Exercise in some areas of China, particularly among those who are retired, seems to be socially grounded. In the mornings, square dances are held in public parks; these gatherings may include Latin dancing, ballroom dancing, tango, or even the jitterbug. Dancing in public allows people to interact with those with whom they would not normally interact, allowing for both health and social benefits.[151]

These sociocultural variations in physical exercise show how people in different geographic locations and social climates have varying motivations and methods of exercising. Physical exercise can improve health and well-being, as well as enhance community ties and appreciation of natural beauty.[4]

Nutrition and recovery

Proper nutrition is as important to health as exercise. When exercising, it becomes even more important to have a good diet to ensure that the body has the correct ratio of macronutrients while providing ample micronutrients, to aid the body with the recovery process following strenuous exercise.[152]

Active recovery is recommended after participating in physical exercise because it removes lactate from the blood more quickly than inactive recovery. Removing lactate from circulation allows for an easy decline in body temperature, which can also benefit the immune system, as an individual may be vulnerable to minor illnesses if the body temperature drops too abruptly after physical exercise.[153]

Exercise has an effect on appetite, but whether it increases or decreases appetite varies from individual to individual, and is affected by the intensity and duration of the exercise.[154]

Excessive exercise

This section is an excerpt from Overtraining.[edit]
Overtraining occurs when a person exceeds their body's ability to recover from strenuous exercise.[155] Overtraining can be described as a point where a person may have a decrease in performance and plateauing as a result of failure to consistently perform at a certain level or training load; a load which exceeds their recovery capacity.[156] People who are overtrained cease making progress, and can even begin to lose strength and fitness. Overtraining is also known as chronic fatigue, burnout and overstress in athletes.[157][158] It is suggested that there are different variations of overtraining, firstly monotonous program over training suggest that repetition of the same movement such as certain weight lifting and baseball batting can cause performance plateau due to an adaption of the central nervous system which results from a lack of stimulation.[156] A second example of overtraining is described as chronic overwork type training where the subject may be training with too high intensity or high volume and not allowing sufficient recovery time for the body.[156] Up to 10% of elite endurance athletes and 10% of American college swimmers are affected by overtraining syndrome (unexplained underperformance for approximately 2 weeks even after having adequate resting time).[159]

History

See also: Aerobic exercise § History, Fitness culture, and History of physical training and fitness
 
Roper's gymnasium, Philadelphia, US, c. 1831

The benefits of exercise have been known since antiquity. Dating back to 65 BCE, it was Marcus Cicero, Roman politician and lawyer, who stated: "It is exercise alone that supports the spirits, and keeps the mind in vigor."[160] Exercise was also seen to be valued later in history during the Early Middle Ages as a means of survival by the Germanic peoples of Northern Europe.[161]

More recently, exercise was regarded as a beneficial force in the 19th century. In 1858 Archibald MacLaren opened a gymnasium at the University of Oxford and instituted a training regimen for Major Frederick Hammersley and 12 non-commissioned officers.[162] This regimen was assimilated into the training of the British Army, which formed the Army Gymnastic Staff in 1860 and made sport an important part of military life.[163][164][165] Several mass exercise movements were started in the early twentieth century as well. The first and most significant of these in the UK was the Women's League of Health and Beauty, founded in 1930 by Mary Bagot Stack, that had 166,000 members in 1937.[166]

The link between physical health and exercise (or lack of it) was further established in 1949 and reported in 1953 by a team led by Jerry Morris.[167][168] Morris noted that men of similar social class and occupation (bus conductors versus bus drivers) had markedly different rates of heart attacks, depending on the level of exercise they got: bus drivers had a sedentary occupation and a higher incidence of heart disease, while bus conductors were forced to move continually and had a lower incidence of heart disease.[168]

Other animals

Studies of animals indicate that physical activity may be more adaptable than changes in food intake to regulate energy balance.[169]

Mice having access to activity wheels engaged in voluntary exercise and increased their propensity to run as adults.[170] Artificial selection of mice exhibited significant heritability in voluntary exercise levels,[171] with "high-runner" breeds having enhanced aerobic capacity,[172] hippocampal neurogenesis,[173] and skeletal muscle morphology.[174]

The effects of exercise training appear to be heterogeneous across non-mammalian species. As examples, exercise training of salmon showed minor improvements of endurance,[175] and a forced swimming regimen of yellowtail amberjack and rainbow trout accelerated their growth rates and altered muscle morphology favorable for sustained swimming.[176][177] Crocodiles, alligators, and ducks showed elevated aerobic capacity following exercise training.[178][179][180] No effect of endurance training was found in most studies of lizards,[178][181] although one study did report a training effect.[182] In lizards, sprint training had no effect on maximal exercise capacity,[182] and muscular damage from over-training occurred following weeks of forced treadmill exercise.[181]

See also

Main article: Outline of exercise

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  51. ^ a b Denham J, Marques FZ, O'Brien BJ, Charchar FJ (February 2014). "Exercise: putting action into our epigenome". Sports Med. 44 (2): 189–209. doi:10.1007/s40279-013-0114-1. PMID 24163284. S2CID 30210091. Aerobic physical exercise produces numerous health benefits in the brain. Regular engagement in physical exercise enhances cognitive functioning, increases brain neurotrophic proteins, such as brain-derived neurotrophic factor (BDNF), and prevents cognitive diseases. Recent findings highlight the role of aerobic exercise in modulating chromatin remodelers. ... These results were the first to demonstrate that acute and relatively short aerobic exercise modulates epigenetic modifications. The transient epigenetic modifications observed due to chronic running training have also been associated with improved learning and stress-coping strategies, epigenetic changes, and increased c-Fos-positive neurons ... Nonetheless, these studies demonstrate the existence of epigenetic changes after acute and chronic exercise and show they are associated with improved cognitive function and elevated markers of neurotrophic factors and neuronal activity (BDNF and c-Fos). ... The aerobic exercise training-induced changes to miRNA profile in the brain seem to be intensity-dependent. These few studies provide a basis for further exploration into potential miRNAs involved in brain and neuronal development and recovery via aerobic exercise.
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  56. ^ a b Buckley J, Cohen JD, Kramer AF, McAuley E, Mullen SP (2014). "Cognitive control in the self-regulation of physical activity and sedentary behavior". Front Hum Neurosci. 8: 747. doi:10.3389/fnhum.2014.00747. PMC 4179677. PMID 25324754.
  57. ^ a b c Cox EP, O'Dwyer N, Cook R, Vetter M, Cheng HL, Rooney K, O'Connor H (August 2016). "Relationship between physical activity and cognitive function in apparently healthy young to middle-aged adults: A systematic review". J. Sci. Med. Sport. 19 (8): 616–628. doi:10.1016/j.jsams.2015.09.003. PMID 26552574. A range of validated platforms assessed CF across three domains: executive function (12 studies), memory (four studies) and processing speed (seven studies). ... In studies of executive function, five found a significant ES in favour of higher PA, ranging from small to large. Although three of four studies in the memory domain reported a significant benefit of higher PA, there was only one significant ES, which favoured low PA. Only one study examining processing speed had a significant ES, favouring higher PA.
    CONCLUSIONS: A limited body of evidence supports a positive effect of PA on CF in young to middle-aged adults. Further research into this relationship at this age stage is warranted. ...
    Significant positive effects of PA on cognitive function were found in 12 of the 14 included manuscripts, the relationship being most consistent for executive function, intermediate for memory, and weak for processing speed.
  58. ^ a b c Schuch FB, Vancampfort D, Rosenbaum S, Richards J, Ward PB, Stubbs B (July 2016). "Exercise improves physical and psychological quality of life in people with depression: A meta-analysis including the evaluation of control group response". Psychiatry Res. 241: 47–54. doi:10.1016/j.psychres.2016.04.054. PMID 27155287. S2CID 4787287. Exercise has established efficacy as an antidepressant in people with depression. ... Exercise significantly improved physical and psychological domains and overall QoL. ... The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL.
  59. ^ Pratali L, Mastorci F, Vitiello N, Sironi A, Gastaldelli A, Gemignani A (November 2014). "Motor Activity in Aging: An Integrated Approach for Better Quality of Life". International Scholarly Research Notices. 2014: 257248. doi:10.1155/2014/257248. PMC 4897547. PMID 27351018. Research investigating the effects of exercise on older adults has primarily focused on brain structural and functional changes with relation to cognitive improvement. In particular, several cross-sectional and intervention studies have shown a positive association between physical activity and cognition in older persons [86] and an inverse correlation with cognitive decline and dementia [87]. Older adults enrolled in a 6-month aerobic fitness intervention increased brain volume in both gray matter (anterior cingulate cortex, supplementary motor area, posterior middle frontal gyrus, and left superior temporal lobe) and white matter (anterior third of corpus callosum) [88]. In addition, Colcombe and colleagues showed that older adults with higher cardiovascular fitness levels are better at activating attentional resources, including decreased activation of the anterior cingulated cortex. One of the possible mechanisms by which physical activity may benefit cognition is that physical activity maintains brain plasticity increases brain volume, stimulates neurogenesis and synaptogenesis, and increases neurotrophic factors in different areas of the brain, possibly providing reserve against later cognitive decline and dementia [89, 90].
  60. ^ Mandolesi L, Polverino A, Montuori S, Foti F, Ferraioli G, Sorrentino P, Sorrentino G (27 April 2018). "Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits". Frontiers in Psychology. 9: 509. doi:10.3389/fpsyg.2018.00509. PMC 5934999. PMID 29755380.
  61. ^ a b c d Basso JC, Suzuki WA (March 2017). "The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review". Brain Plasticity. 2 (2): 127–152. doi:10.3233/BPL-160040. PMC 5928534. PMID 29765853. A large collection of research in humans has shown that a single bout of exercise alters behavior at the level of affective state and cognitive functioning in several key ways. In terms of affective state, acute exercise decreases negative affect, increases positive affect, and decreases the psychological and physiological response to acute stress. These effects have been reported to persist for up to 24 hours after exercise cessation. In terms of cognitive functioning, acute exercise primarily enhances executive functions dependent on the prefrontal cortex including attention, working memory, problem-solving, cognitive flexibility, verbal fluency, decision-making, and inhibitory control. These positive changes have been demonstrated to occur with very low to very high exercise intensities, with effects lasting for up to two hours after the end of the exercise bout (Fig. 1A). Moreover, many of these neuropsychological assessments measure several aspects of behavior including both accuracy of performance and speed of processing. McMorris and Hale performed a meta-analysis examining the effects of acute exercise on both accuracy and speed of processing, revealing that speed significantly improved post-exercise, with minimal or no effect on accuracy. These authors concluded that increasing task difficulty or complexity may help to augment the effect of acute exercise on accuracy. ... However, in a comprehensive meta-analysis, Chang and colleagues found that exercise intensities ranging from very light (<50% MHR) to very hard (>93% MHR) have all been reported to improve cognitive functioning.
  62. ^ Services, Department of Health & Human. "Exercise and mental health". betterhealth.vic.gov.au. Retrieved 19 November 2022.
  63. ^ "Exercise and Mental Health". Exercise Psychology: 93–94. 2013. doi:10.5040/9781492595502.part-002. ISBN 9781492595502.
  64. ^ Cunha GS, Ribeiro JL, Oliveira AR (June 2008). "[Levels of beta-endorphin in response to exercise and overtraining]". Arq Bras Endocrinol Metabol (in Portuguese). 52 (4): 589–598. doi:10.1590/S0004-27302008000400004. PMID 18604371. Interestingly, some symptoms of OT are related to beta-endorphin (beta-end(1-31)) effects. Some of its effects, such as analgesia, increasing lactate tolerance, and exercise-induced euphoria, are important for training.
  65. ^ Boecker H, Sprenger T, Spilker ME, Henriksen G, Koppenhoefer M, Wagner KJ, Valet M, Berthele A, Tolle TR (2008). "The runner's high: opioidergic mechanisms in the human brain". Cereb. Cortex. 18 (11): 2523–2531. doi:10.1093/cercor/bhn013. PMID 18296435. The runner's high describes an euphoric state resulting from long-distance running.
  66. ^ a b c d Josefsson T, Lindwall M, Archer T (2014). "Physical exercise intervention in depressive disorders: meta-analysis and systematic review". Scand J Med Sci Sports. 24 (2): 259–272. doi:10.1111/sms.12050. PMID 23362828. S2CID 29351791.
  67. ^ a b c Rosenbaum S, Tiedemann A, Sherrington C, Curtis J, Ward PB (2014). "Physical activity interventions for people with mental illness: a systematic review and meta-analysis". J Clin Psychiatry. 75 (9): 964–974. doi:10.4088/JCP.13r08765. PMID 24813261. This systematic review and meta-analysis found that physical activity reduced depressive symptoms among people with a psychiatric illness. The current meta-analysis differs from previous studies, as it included participants with depressive symptoms with a variety of psychiatric diagnoses (except dysthymia and eating disorders). ... This review provides strong evidence for the antidepressant effect of physical activity; however, the optimal exercise modality, volume, and intensity remain to be determined. ... Few interventions exist whereby patients can hope to achieve improvements in both psychiatric symptoms and physical health simultaneously without significant risks of adverse effects. Physical activity offers substantial promise for improving outcomes for people living with mental illness, and the inclusion of physical activity and exercise programs within treatment facilities is warranted given the results of this review.
  68. ^ Szuhany KL, Bugatti M, Otto MW (October 2014). "A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor". J Psychiatr Res. 60C: 56–64. doi:10.1016/j.jpsychires.2014.10.003. PMC 4314337. PMID 25455510. Consistent evidence indicates that exercise improves cognition and mood, with preliminary evidence suggesting that brain-derived neurotrophic factor (BDNF) may mediate these effects. The aim of the current meta-analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms. We conducted a meta-analysis of 29 studies (N = 1111 participants) examining the effect of exercise on BDNF levels in three exercise paradigms: (1) a single session of exercise, (2) a session of exercise following a program of regular exercise, and (3) resting BDNF levels following a program of regular exercise. Moderators of this effect were also examined. Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise (Hedges' g = 0.46, p < 0.001). Further, regular exercise intensified the effect of a session of exercise on BDNF levels (Hedges' g = 0.59, p = 0.02). Finally, results indicated a small effect of regular exercise on resting BDNF levels (Hedges' g = 0.27, p = 0.005). ... Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans.
  69. ^ Lees C, Hopkins J (2013). "Effect of aerobic exercise on cognition, academic achievement, and psychosocial function in children: a systematic review of randomized control trials". Prev Chronic Dis. 10: E174. doi:10.5888/pcd10.130010. PMC 3809922. PMID 24157077. This omission is relevant, given the evidence that aerobic-based physical activity generates structural changes in the brain, such as neurogenesis, angiogenesis, increased hippocampal volume, and connectivity (12,13). In children, a positive relationship between aerobic fitness, hippocampal volume, and memory has been found (12,13). ... Mental health outcomes included reduced depression and increased self-esteem, although no change was found in anxiety levels (18). ... This systematic review of the literature found that [aerobic physical activity (APA)] is positively associated with cognition, academic achievement, behavior, and psychosocial functioning outcomes. Importantly, Shephard also showed that curriculum time reassigned to APA still results in a measurable, albeit small, improvement in academic performance (24).  ... The actual aerobic-based activity does not appear to be a major factor; interventions used many different types of APA and found similar associations. In positive association studies, the intensity of the aerobic activity was moderate to vigorous. The amount of time spent in APA varied significantly between studies; however, even as little as 45 minutes per week appeared to have a benefit.
  70. ^ a b c d Mura G, Moro MF, Patten SB, Carta MG (2014). "Exercise as an add-on strategy for the treatment of major depressive disorder: a systematic review". CNS Spectr. 19 (6): 496–508. doi:10.1017/S1092852913000953. PMID 24589012. S2CID 32304140. Considered overall, the studies included in the present review showed a strong effectiveness of exercise combined with antidepressants. ...
    Conclusions
    This is the first review to have focused on exercise as an add-on strategy in the treatment of MDD. Our findings corroborate some previous observations that were based on few studies and which were difficult to generalize. Given the results of the present article, it seems that exercise might be an effective strategy to enhance the antidepressant effect of medication treatments. Moreover, we hypothesize that the main role of exercise on treatment-resistant depression is in inducing neurogenesis by increasing BDNF expression, as was demonstrated by several recent studies.
  71. ^ Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O (July 2016). "Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review". J. Neural Transm. (Vienna). 124 (Suppl 1): 3–26. doi:10.1007/s00702-016-1593-7. PMC 5281644. PMID 27400928.
  72. ^ Kamp CF, Sperlich B, Holmberg HC (July 2014). "Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters". Acta Paediatr. 103 (7): 709–14. doi:10.1111/apa.12628. PMID 24612421. S2CID 45881887. The present review summarises the impact of exercise interventions (1–10 weeks in duration with at least two sessions each week) on parameters related to ADHD in 7-to 13-year-old children. We may conclude that all different types of exercise (here yoga, active games with and without the involvement of balls, walking, and athletic training) attenuate the characteristic symptoms of ADHD and improve social behaviour, motor skills, strength and neuropsychological parameters without any undesirable side effects. Available reports do not reveal which type, intensity, duration, and frequency of exercise is most effective in this respect, and future research focusing on this question with randomised and controlled long-term interventions is warranted.
  73. ^ Petersen RC, Lopez O, Armstrong MJ, Getchius T, Ganguli M, Gloss D, Gronseth GS, Marson D, Pringsheim T, Day GS, Sager M, Stevens J, Rae-Grant A (January 2018). "Practice guideline update summary: Mild cognitive impairment – Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology". Neurology. Special article. 90 (3): 126–135. doi:10.1212/WNL.0000000000004826. PMC 5772157. PMID 29282327. In patients with MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may improve cognitive measures. ... Clinicians should recommend regular exercise (Level B). ... For patients diagnosed with MCI, clinicians should recommend regular exercise (twice/week) as part of an overall approach to management (Level B).
  74. ^ Farina N, Rusted J, Tabet N (January 2014). "The effect of exercise interventions on cognitive outcome in Alzheimer's disease: a systematic review". Int Psychogeriatr. 26 (1): 9–18. doi:10.1017/S1041610213001385. PMID 23962667. S2CID 24936334. Six RCTs were identified that exclusively considered the effect of exercise in AD patients. Exercise generally had a positive effect on the rate of cognitive decline in AD. A meta-analysis found that exercise interventions have a positive effect on global cognitive function, 0.75 (95% CI = 0.32–1.17). ... The most prevalent subtype of dementia is Alzheimer's disease (AD), accounting for up to 65.0% of all dementia cases ... Cognitive decline in AD is attributable at least in part to the buildup of amyloid and tau proteins, which promote neuronal dysfunction and death (Hardy and Selkoe, 2002; Karran et al., 2011). Evidence in transgenic mouse models of AD, in which the mice have an artificially elevated amyloid load, suggests that exercise programs are able to improve cognitive function (Adlard et al., 2005; Nichol et al., 2007). Adlard and colleagues also determined that the improvement in cognitive performance occurred in conjunction with a reduced amyloid load. Research that includes direct indices of change in such biomarkers will help to determine the mechanisms by which exercise may act on cognition in AD.
  75. ^ Rao AK, Chou A, Bursley B, Smulofsky J, Jezequel J (January 2014). "Systematic review of the effects of exercise on activities of daily living in people with Alzheimer's disease". Am J Occup Ther. 68 (1): 50–56. doi:10.5014/ajot.2014.009035. PMC 5360200. PMID 24367955. Alzheimer's disease (AD) is a progressive neurological disorder characterized by loss in cognitive function, abnormal behavior, and decreased ability to perform basic activities of daily living [(ADLs)] ... All studies included people with AD who completed an exercise program consisting of aerobic, strength, or balance training or any combination of the three. The length of the exercise programs varied from 12 weeks to 12 months. ... Six studies involving 446 participants tested the effect of exercise on ADL performance ... exercise had a large and significant effect on ADL performance (z = 4.07, p < .0001; average effect size = 0.80). ... These positive effects were apparent with programs ranging in length from 12 wk (Santana-Sosa et al., 2008; Teri et al., 2003) and intermediate length of 16 wk (Roach et al., 2011; Vreugdenhil et al., 2012) to 6 mo (Venturelli et al., 2011) and 12 mo (Rolland et al., 2007). Furthermore, the positive effects of a 3-mo intervention lasted 24 mo (Teri et al., 2003). ... No adverse effects of exercise on ADL performance were noted. ... The study with the largest effect size implemented a walking and aerobic program of only 30 min four times a week (Venturelli et al., 2011).
  76. ^ Mattson MP (2014). "Interventions that improve body and brain bioenergetics for Parkinson's disease risk reduction and therapy". J Parkinsons Dis. 4 (1): 1–13. doi:10.3233/JPD-130335. PMID 24473219.
  77. ^ a b Grazina R, Massano J (2013). "Physical exercise and Parkinson's disease: influence on symptoms, disease course and prevention". Rev Neurosci. 24 (2): 139–152. doi:10.1515/revneuro-2012-0087. PMID 23492553. S2CID 33890283.
  78. ^ van der Kolk NM, King LA (September 2013). "Effects of exercise on mobility in people with Parkinson's disease". Mov. Disord. 28 (11): 1587–1596. doi:10.1002/mds.25658. PMID 24132847. S2CID 22822120.
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External links

  • Adult Compendium of Physical Activities – a website containing lists of Metabolic Equivalent of Task (MET) values for a number of physical activities, based upon PMID 8292105, 10993420 and 21681120
  • MedLinePlus Topic on Exercise and Physical Fitness
  • Physical activity and the environment – guidance on the promotion and creation of physical environments that support increased levels of physical activity.
  • Science Daily's reference on physical exercise

November 06, 2023
exercise, workout, redirects, here, other, uses, disambiguation, workout, disambiguation, intentional, physical, activity, enhance, maintain, fitness, overall, health, cycling, popular, form, exercise, weight, trainingit, performed, various, reasons, including. Workout redirects here For other uses see Exercise disambiguation and Workout disambiguation Exercise is intentional physical activity to enhance or maintain fitness and overall health 1 2 Cycling is a popular form of exercise Weight trainingIt is performed for various reasons including weight loss or maintenance to aid growth and improve strength develop muscles and the cardiovascular system hone athletic skills improve health 3 or simply for enjoyment Many individuals choose to exercise outdoors where they can congregate in groups socialize and improve well being as well as mental health 4 5 In terms of health benefits usually 2 5 hours of moderate intensity exercise per week is recommended for reducing the risk of health issues 6 7 8 At the same time even doing a small amount of exercise is healthier than doing none Already doing an hour and a quarter 11 minutes day of exercise could reduce the risk of early death cardiovascular disease stroke and cancer 9 10 Contents 1 Classification 2 Health effects 2 1 Fitness 2 2 Cardiovascular system 2 3 Immune system 2 4 Cancer 2 5 Neurobiological 2 5 1 Depression 2 6 Sleep 2 7 Libido 2 8 Respiratory system 3 Mechanism of effects 3 1 Skeletal muscle 3 2 Other peripheral organs 3 3 Central nervous system 4 Public health measures 5 Exercise trends 5 1 Social and cultural variation 6 Nutrition and recovery 7 Excessive exercise 8 History 9 Other animals 10 See also 11 References 12 External linksClassificationPhysical exercises are generally grouped into three types depending on the overall effect they have on the human body 11 Aerobic exercise is any physical activity that uses large muscle groups and causes the body to use more oxygen than it would while resting 11 The goal of aerobic exercise is to increase cardiovascular endurance 12 Examples of aerobic exercise include running cycling swimming brisk walking skipping rope rowing hiking dancing playing tennis continuous training and long distance running 11 Anaerobic exercise which includes strength and resistance training can firm strengthen and increase muscle mass as well as improve bone density balance and coordination 11 Examples of strength exercises are push ups pull ups lunges squats bench press Anaerobic exercise also includes weight training functional training Eccentric Training interval training sprinting and high intensity interval training which increase short term muscle strength 11 13 Flexibility exercises stretch and lengthen muscles 11 Activities such as stretching help to improve joint flexibility and keep muscles limber 11 The goal is to improve the range of motion which can reduce the chance of injury 11 14 Physical exercise can also include training that focuses on accuracy agility power and speed 15 Types of exercise can also be classified as dynamic or static Dynamic exercises such as steady running tend to produce a lowering of the diastolic blood pressure during exercise due to the improved blood flow Conversely static exercise such as weight lifting can cause the systolic pressure to rise significantly albeit transiently during the performance of the exercise 16 Health effectsMain article Exercise physiology nbsp Exercise in a gymPhysical exercise is important for maintaining physical fitness and can contribute to maintaining a healthy weight regulating the digestive system building and maintaining healthy bone density muscle strength and joint mobility promoting physiological well being reducing surgical risks and strengthening the immune system Some studies indicate that exercise may increase life expectancy and the overall quality of life 17 People who participate in moderate to high levels of physical exercise have a lower mortality rate compared to individuals who by comparison are not physically active 18 Moderate levels of exercise have been correlated with preventing aging by reducing inflammatory potential 19 The majority of the benefits from exercise are achieved with around 3500 metabolic equivalent MET minutes per week with diminishing returns at higher levels of activity 20 For example climbing stairs 10 minutes vacuuming 15 minutes gardening 20 minutes running 20 minutes and walking or bicycling for transportation 25 minutes on a daily basis would together achieve about 3000 MET minutes a week 20 A lack of physical activity causes approximately 6 of the burden of disease from coronary heart disease 7 of type 2 diabetes 10 of breast cancer and 10 of colon cancer worldwide 21 Overall physical inactivity causes 9 of premature mortality worldwide 21 Fitness Main article Physical fitness Most people can increase fitness by increasing physical activity levels 22 Increases in muscle size from resistance training are primarily determined by diet and testosterone 23 This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population 24 25 There is evidence that exercising in middle age may lead to better physical ability later in life 26 Early motor skills and development is also related to physical activity and performance later in life Children who are more proficient with motor skills early on are more inclined to be physically active and thus tend to perform well in sports and have better fitness levels Early motor proficiency has a positive correlation to childhood physical activity and fitness levels while less proficiency in motor skills results in a more sedentary lifestyle 27 The type and intensity of physical activity performed may have an effect on a person s fitness level There is some weak evidence that high intensity interval training may improve a person s VO2 max slightly more than lower intensity endurance training 28 However unscientific fitness methods could lead to sports injuries 29 Cardiovascular system Main article Cardiovascular fitness The beneficial effect of exercise on the cardiovascular system is well documented There is a direct correlation between physical inactivity and cardiovascular disease and physical inactivity is an independent risk factor for the development of coronary artery disease Low levels of physical exercise increase the risk of cardiovascular diseases mortality 30 31 Children who participate in physical exercise experience greater loss of body fat and increased cardiovascular fitness 32 Studies have shown that academic stress in youth increases the risk of cardiovascular disease in later years however these risks can be greatly decreased with regular physical exercise 33 There is a dose response relationship between the amount of exercise performed from approximately 700 2000 kcal of energy expenditure per week and all cause mortality and cardiovascular disease mortality in middle aged and elderly men The greatest potential for reduced mortality is seen in sedentary individuals who become moderately active Studies have shown that since heart disease is the leading cause of death in women regular exercise in aging women leads to healthier cardiovascular profiles Most beneficial effects of physical activity on cardiovascular disease mortality can be attained through moderate intensity activity 40 60 of maximal oxygen uptake depending on age Persons who modify their behavior after myocardial infarction to include regular exercise have improved rates of survival Persons who remain sedentary have the highest risk for all cause and cardiovascular disease mortality 34 According to the American Heart Association exercise reduces the risk of cardiovascular diseases including heart attack and stroke 31 Some have suggested that increases in physical exercise might decrease healthcare costs increase the rate of job attendance as well as increase the amount of effort women put into their jobs 35 Immune system Although there have been hundreds of studies on physical exercise and the immune system there is little direct evidence on its connection to illness 36 Epidemiological evidence suggests that moderate exercise has a beneficial effect on the human immune system an effect which is modeled in a J curve Moderate exercise has been associated with a 29 decreased incidence of upper respiratory tract infections URTI but studies of marathon runners found that their prolonged high intensity exercise was associated with an increased risk of infection occurrence 36 However another study did not find the effect Immune cell functions are impaired following acute sessions of prolonged high intensity exercise and some studies have found that athletes are at a higher risk for infections Studies have shown that strenuous stress for long durations such as training for a marathon can suppress the immune system by decreasing the concentration of lymphocytes 37 The immune systems of athletes and nonathletes are generally similar Athletes may have a slightly elevated natural killer cell count and cytolytic action but these are unlikely to be clinically significant 36 Vitamin C supplementation has been associated with a lower incidence of upper respiratory tract infections in marathon runners 36 Biomarkers of inflammation such as C reactive protein which are associated with chronic diseases are reduced in active individuals relative to sedentary individuals and the positive effects of exercise may be due to its anti inflammatory effects In individuals with heart disease exercise interventions lower blood levels of fibrinogen and C reactive protein an important cardiovascular risk marker 38 The depression in the immune system following acute bouts of exercise may be one of the mechanisms for this anti inflammatory effect 36 Cancer A systematic review evaluated 45 studies that examined the relationship between physical activity and cancer survival rates According to the review there was consistent evidence from 27 observational studies that physical activity is associated with reduced all cause breast cancer specific and colon cancer specific mortality There is currently insufficient evidence regarding the association between physical activity and mortality for survivors of other cancers 39 Evidence suggests that exercise may positively affect the quality of life in cancer survivors including factors such as anxiety self esteem and emotional well being 40 For people with cancer undergoing active treatment exercise may also have positive effects on health related quality of life such as fatigue and physical functioning 41 This is likely to be more pronounced with higher intensity exercise 41 Exercise may contribute to a reduction of cancer related fatigue in survivors of breast cancer 42 Although there is only limited scientific evidence on the subject people with cancer cachexia are encouraged to engage in physical exercise 43 Due to various factors some individuals with cancer cachexia have a limited capacity for physical exercise 44 45 Compliance with prescribed exercise is low in individuals with cachexia and clinical trials of exercise in this population often have high drop out rates 44 45 There is low quality evidence for an effect of aerobic physical exercises on anxiety and serious adverse events in adults with hematological malignancies 46 Aerobic physical exercise may result in little to no difference in the mortality quality of life or physical functioning 46 These exercises may result in a slight reduction in depression and reduction in fatigue 46 Neurobiological This section is an excerpt from Neurobiological effects of physical exercise edit nbsp A woman engaging in aerobic exercise jogging The neurobiological effects of physical exercise are numerous and involve a wide range of interrelated effects on brain structure 47 brain function and cognition 48 49 50 51 A large body of research in humans has demonstrated that consistent aerobic exercise e g 30 minutes every day induces persistent improvements in certain cognitive functions healthy alterations in gene expression in the brain and beneficial forms of neuroplasticity and behavioral plasticity some of these long term effects include increased neuron growth increased neurological activity e g c Fos and BDNF signaling improved stress coping enhanced cognitive control of behavior improved declarative spatial and working memory and structural and functional improvements in brain structures and pathways associated with cognitive control and memory 48 49 50 51 52 53 54 55 56 57 The effects of exercise on cognition have important implications for improving academic performance in children and college students improving adult productivity preserving cognitive function in old age preventing or treating certain neurological disorders and improving overall quality of life 48 58 59 60 In healthy adults aerobic exercise has been shown to induce transient effects on cognition after a single exercise session and persistent effects on cognition following regular exercise over the course of several months 48 57 61 People who regularly perform an aerobic exercise e g running jogging brisk walking swimming and cycling have greater scores on neuropsychological function and performance tests that measure certain cognitive functions such as attentional control inhibitory control cognitive flexibility working memory updating and capacity declarative memory spatial memory and information processing speed 48 52 54 56 57 61 62 63 The transient effects of exercise on cognition include improvements in most executive functions e g attention working memory cognitive flexibility inhibitory control problem solving and decision making and information processing speed for a period of up to 2 hours after exercising 61 Aerobic exercise induces short and long term effects on mood and emotional states by promoting positive affect inhibiting negative affect and decreasing the biological response to acute psychological stress 61 Over the short term aerobic exercise functions as both an antidepressant and euphoriant 64 65 66 67 whereas consistent exercise produces general improvements in mood and self esteem 68 69 Regular aerobic exercise improves symptoms associated with a variety of central nervous system disorders and may be used as adjunct therapy for these disorders There is clear evidence of exercise treatment efficacy for major depressive disorder and attention deficit hyperactivity disorder 58 66 70 71 72 The American Academy of Neurology s clinical practice guideline for mild cognitive impairment indicates that clinicians should recommend regular exercise two times per week to individuals who have been diagnosed with this condition 73 Reviews of clinical evidence also support the use of exercise as an adjunct therapy for certain neurodegenerative disorders particularly Alzheimer s disease and Parkinson s disease 74 75 76 77 78 79 Regular exercise is also associated with a lower risk of developing neurodegenerative disorders 77 80 A large body of preclinical evidence and emerging clinical evidence supports the use of exercise as an adjunct therapy for the treatment and prevention of drug addictions 81 82 83 84 85 Regular exercise has also been proposed as an adjunct therapy for brain cancers 86 Depression This is an excerpt from Neurobiological effects of physical exercise Major depressive disorder edit A number of medical reviews have indicated that exercise has a marked and persistent antidepressant effect in humans 52 66 67 70 87 88 an effect believed to be mediated through enhanced BDNF signaling in the brain 55 70 Several systematic reviews have analyzed the potential for physical exercise in the treatment of depressive disorders The 2013 Cochrane Collaboration review on physical exercise for depression noted that based upon limited evidence it is more effective than a control intervention and comparable to psychological or antidepressant drug therapies 87 Three subsequent 2014 systematic reviews that included the Cochrane review in their analysis concluded with similar findings one indicated that physical exercise is effective as an adjunct treatment i e treatments that are used together with antidepressant medication 70 the other two indicated that physical exercise has marked antidepressant effects and recommended the inclusion of physical activity as an adjunct treatment for mild moderate depression and mental illness in general 66 67 One systematic review noted that yoga may be effective in alleviating symptoms of prenatal depression 89 Another review asserted that evidence from clinical trials supports the efficacy of physical exercise as a treatment for depression over a 2 4 month period 52 These benefits have also been noted in old age with a review conducted in 2019 finding that exercise is an effective treatment for clinically diagnosed depression in older adults 90 A meta analysis from July 2016 concluded that physical exercise improves overall quality of life in individuals with depression relative to controls 58 91 Continuous aerobic exercise can induce a transient state of euphoria colloquially known as a runner s high in distance running or a rower s high in crew through the increased biosynthesis of at least three euphoriant neurochemicals anandamide an endocannabinoid 92 b endorphin an endogenous opioid 93 and phenethylamine a trace amine and amphetamine analog 94 95 96 Sleep Preliminary evidence from a 2012 review indicated that physical training for up to four months may increase sleep quality in adults over 40 years of age 97 A 2010 review suggested that exercise generally improved sleep for most people and may help with insomnia but there is insufficient evidence to draw detailed conclusions about the relationship between exercise and sleep 98 A 2018 systematic review and meta analysis suggested that exercise can improve sleep quality in people with insomnia 99 Libido One 2013 study found that exercising improved sexual arousal problems related to antidepressant use 100 Respiratory system People who participate in physical exercise experience increased cardiovascular fitness medical citation needed There is some level of concern about additional exposure to air pollution when exercising outdoors especially near traffic 101 Mechanism of effectsSkeletal muscle Main article Skeletal muscle Resistance training and subsequent consumption of a protein rich meal promotes muscle hypertrophy and gains in muscle strength by stimulating myofibrillar muscle protein synthesis MPS and inhibiting muscle protein breakdown MPB 102 103 The stimulation of muscle protein synthesis by resistance training occurs via phosphorylation of the mechanistic target of rapamycin mTOR and subsequent activation of mTORC1 which leads to protein biosynthesis in cellular ribosomes via phosphorylation of mTORC1 s immediate targets the p70S6 kinase and the translation repressor protein 4EBP1 102 104 The suppression of muscle protein breakdown following food consumption occurs primarily via increases in plasma insulin 102 105 106 Similarly increased muscle protein synthesis via activation of mTORC1 and suppressed muscle protein breakdown via insulin independent mechanisms has also been shown to occur following ingestion of b hydroxy b methylbutyric acid 102 105 106 107 Aerobic exercise induces mitochondrial biogenesis and an increased capacity for oxidative phosphorylation in the mitochondria of skeletal muscle which is one mechanism by which aerobic exercise enhances submaximal endurance performance 108 102 109 These effects occur via an exercise induced increase in the intracellular AMP ATP ratio thereby triggering the activation of AMP activated protein kinase AMPK which subsequently phosphorylates peroxisome proliferator activated receptor gamma coactivator 1a PGC 1a the master regulator of mitochondrial biogenesis 102 109 110 nbsp Diagram of the molecular signaling cascades that are involved in myofibrillar muscle protein synthesis and mitochondrial biogenesis in response to physical exercise and specific amino acids or their derivatives primarily L leucine and HMB 102 Many amino acids derived from food protein promote the activation of mTORC1 and increase protein synthesis by signaling through Rag GTPases 102 111 Abbreviations and representations PLD phospholipase D PA phosphatidic acid mTOR mechanistic target of rapamycin AMP adenosine monophosphate ATP adenosine triphosphate AMPK AMP activated protein kinase PGC 1a peroxisome proliferator activated receptor gamma coactivator 1a S6K1 p70S6 kinase 4EBP1 eukaryotic translation initiation factor 4E binding protein 1 eIF4E eukaryotic translation initiation factor 4E RPS6 ribosomal protein S6 eEF2 eukaryotic elongation factor 2 RE resistance exercise EE endurance exercise Myo myofibrillar Mito mitochondrial AA amino acids HMB b hydroxy b methylbutyric acid represents activation T represents inhibition nbsp Resistance training stimulates muscle protein synthesis MPS for a period of up to 48 hours following exercise shown by dotted line 103 Ingestion of a protein rich meal at any point during this period will augment the exercise induced increase in muscle protein synthesis shown by solid lines 103 Other peripheral organs nbsp Summary of long term adaptations to regular aerobic and anaerobic exercise Aerobic exercise can cause several central cardiovascular adaptations including an increase in stroke volume SV 112 and maximal aerobic capacity VO2 max 112 113 as well as a decrease in resting heart rate RHR 114 115 116 Long term adaptations to resistance training the most common form of anaerobic exercise include muscular hypertrophy 117 118 an increase in the physiological cross sectional area PCSA of muscle s and an increase in neural drive 119 120 both of which lead to increased muscular strength 121 Neural adaptations begin more quickly and plateau prior to the hypertrophic response 122 123 Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ That is contracting muscles release multiple substances known as myokines which promote the growth of new tissue tissue repair and multiple anti inflammatory functions which in turn reduce the risk of developing various inflammatory diseases 124 Exercise reduces levels of cortisol which causes many health problems both physical and mental 125 Endurance exercise before meals lowers blood glucose more than the same exercise after meals 126 There is evidence that vigorous exercise 90 95 of VO2 max induces a greater degree of physiological cardiac hypertrophy than moderate exercise 40 to 70 of VO2 max but it is unknown whether this has any effects on overall morbidity and or mortality 127 Both aerobic and anaerobic exercise work to increase the mechanical efficiency of the heart by increasing cardiac volume aerobic exercise or myocardial thickness strength training Ventricular hypertrophy the thickening of the ventricular walls is generally beneficial and healthy if it occurs in response to exercise Central nervous system Further information Neurobiological effects of physical exercise Neuroplasticity The effects of physical exercise on the central nervous system are mediated in part by specific neurotrophic factor hormones that are released into the blood stream by muscles including BDNF IGF 1 and VEGF 128 129 130 131 132 133 Public health measuresCommunity wide and school campaigns are often used in an attempt to increase a population s level of physical activity Studies to determine the effectiveness of these types of programs need to be interpreted cautiously as the results vary 22 There is some evidence that certain types of exercise programmes for older adults such as those involving gait balance co ordination and functional tasks can improve balance 134 Following progressive resistance training older adults also respond with improved physical function 135 Brief interventions promoting physical activity may be cost effective however this evidence is weak and there are variations between studies 136 Environmental approaches appear promising signs that encourage the use of stairs as well as community campaigns may increase exercise levels 137 The city of Bogota Colombia for example blocks off 113 kilometers 70 mi of roads on Sundays and holidays to make it easier for its citizens to get exercise Such pedestrian zones are part of an effort to combat chronic diseases and to maintain a healthy BMI 138 139 Parents can promote physical activity by modelling healthy levels of physical activity or by encouraging physical activity 140 According to the Centers for Disease Control and Prevention in the United States children and adolescents should do 60 minutes or more of physical activity each day 141 Implementing physical exercise in the school system and ensuring an environment in which children can reduce barriers to maintain a healthy lifestyle is essential The European Commission s Directorate General for Education and Culture DG EAC has dedicated programs and funds for Health Enhancing Physical Activity HEPA projects 142 within its Horizon 2020 and Erasmus program as research showed that too many Europeans are not physically active enough Financing is available for increased collaboration between players active in this field across the EU and around the world the promotion of HEPA in the EU and its partner countries and the European Sports Week The DG EAC regularly publishes a Eurobarometer on sport and physical activity Exercise trendsMain article Exercise trends Worldwide there has been a large shift toward less physically demanding work 143 This has been accompanied by increasing use of mechanized transportation a greater prevalence of labor saving technology in the home and fewer active recreational pursuits 143 Personal lifestyle changes however can correct the lack of physical exercise medical citation needed Research published in 2015 suggests that incorporating mindfulness into physical exercise interventions increases exercise adherence and self efficacy and also has positive effects both psychologically and physiologically 144 Sports activities for exercising nbsp Running helps in achieving physical fitness 145 nbsp Skateboarding is good for cardiovascular health 146 better source needed nbsp Swimming as an exercise tones muscles and builds strength 147 nbsp Athletics ex pole vault as a form of exercise nbsp Football as an exerciseSocial and cultural variation Exercising looks different in every country as do the motivations behind exercising 4 In some countries people exercise primarily indoors such as at home or health clubs while in others people primarily exercise outdoors People may exercise for personal enjoyment health and well being social interactions competition or training etc These differences could potentially be attributed to a variety of reasons including geographic location and social tendencies In Colombia for example citizens value and celebrate the outdoor environments of their country In many instances they use outdoor activities as social gatherings to enjoy nature and their communities In Bogota Colombia a 70 mile stretch of road known as the Ciclovia is shut down each Sunday for bicyclists runners rollerbladers skateboarders and other exercisers to work out and enjoy their surroundings 148 Similarly to Colombia citizens of Cambodia tend to exercise socially outside In this country public gyms have become quite popular People will congregate at these outdoor gyms not only to use the public facilities but also to organize aerobics and dance sessions which are open to the public 149 Sweden has also begun developing outdoor gyms called utegym These gyms are free to the public and are often placed in beautiful picturesque environments People will swim in rivers use boats and run through forests to stay healthy and enjoy the natural world around them This works particularly well in Sweden due to its geographical location 150 Exercise in some areas of China particularly among those who are retired seems to be socially grounded In the mornings square dances are held in public parks these gatherings may include Latin dancing ballroom dancing tango or even the jitterbug Dancing in public allows people to interact with those with whom they would not normally interact allowing for both health and social benefits 151 These sociocultural variations in physical exercise show how people in different geographic locations and social climates have varying motivations and methods of exercising Physical exercise can improve health and well being as well as enhance community ties and appreciation of natural beauty 4 Nutrition and recoveryProper nutrition is as important to health as exercise When exercising it becomes even more important to have a good diet to ensure that the body has the correct ratio of macronutrients while providing ample micronutrients to aid the body with the recovery process following strenuous exercise 152 Active recovery is recommended after participating in physical exercise because it removes lactate from the blood more quickly than inactive recovery Removing lactate from circulation allows for an easy decline in body temperature which can also benefit the immune system as an individual may be vulnerable to minor illnesses if the body temperature drops too abruptly after physical exercise 153 Exercise has an effect on appetite but whether it increases or decreases appetite varies from individual to individual and is affected by the intensity and duration of the exercise 154 Excessive exerciseThis section is an excerpt from Overtraining edit Overtraining occurs when a person exceeds their body s ability to recover from strenuous exercise 155 Overtraining can be described as a point where a person may have a decrease in performance and plateauing as a result of failure to consistently perform at a certain level or training load a load which exceeds their recovery capacity 156 People who are overtrained cease making progress and can even begin to lose strength and fitness Overtraining is also known as chronic fatigue burnout and overstress in athletes 157 158 It is suggested that there are different variations of overtraining firstly monotonous program over training suggest that repetition of the same movement such as certain weight lifting and baseball batting can cause performance plateau due to an adaption of the central nervous system which results from a lack of stimulation 156 A second example of overtraining is described as chronic overwork type training where the subject may be training with too high intensity or high volume and not allowing sufficient recovery time for the body 156 Up to 10 of elite endurance athletes and 10 of American college swimmers are affected by overtraining syndrome unexplained underperformance for approximately 2 weeks even after having adequate resting time 159 HistoryThis article is missing information about times and places when exercise was viewed negatively Please expand the article to include this information Further details may exist on the talk page August 2021 See also Aerobic exercise History Fitness culture and History of physical training and fitness nbsp Roper s gymnasium Philadelphia US c 1831The benefits of exercise have been known since antiquity Dating back to 65 BCE it was Marcus Cicero Roman politician and lawyer who stated It is exercise alone that supports the spirits and keeps the mind in vigor 160 Exercise was also seen to be valued later in history during the Early Middle Ages as a means of survival by the Germanic peoples of Northern Europe 161 More recently exercise was regarded as a beneficial force in the 19th century In 1858 Archibald MacLaren opened a gymnasium at the University of Oxford and instituted a training regimen for Major Frederick Hammersley and 12 non commissioned officers 162 This regimen was assimilated into the training of the British Army which formed the Army Gymnastic Staff in 1860 and made sport an important part of military life 163 164 165 Several mass exercise movements were started in the early twentieth century as well The first and most significant of these in the UK was the Women s League of Health and Beauty founded in 1930 by Mary Bagot Stack that had 166 000 members in 1937 166 The link between physical health and exercise or lack of it was further established in 1949 and reported in 1953 by a team led by Jerry Morris 167 168 Morris noted that men of similar social class and occupation bus conductors versus bus drivers had markedly different rates of heart attacks depending on the level of exercise they got bus drivers had a sedentary occupation and a higher incidence of heart disease while bus conductors were forced to move continually and had a lower incidence of heart disease 168 Other animalsStudies of animals indicate that physical activity may be more adaptable than changes in food intake to regulate energy balance 169 Mice having access to activity wheels engaged in voluntary exercise and increased their propensity to run as adults 170 Artificial selection of mice exhibited significant heritability in voluntary exercise levels 171 with high runner breeds having enhanced aerobic capacity 172 hippocampal neurogenesis 173 and skeletal muscle morphology 174 The effects of exercise training appear to be heterogeneous across non mammalian species As examples exercise training of salmon showed minor improvements of endurance 175 and a forced swimming regimen of yellowtail amberjack and rainbow trout accelerated their growth rates and altered muscle morphology favorable for sustained swimming 176 177 Crocodiles alligators and ducks showed elevated aerobic capacity following exercise training 178 179 180 No effect of endurance training was found in most studies of lizards 178 181 although one study did report a training effect 182 In lizards sprint training had no effect on maximal exercise capacity 182 and muscular damage from over training occurred following weeks of forced treadmill exercise 181 See also nbsp Medicine portal nbsp Society portal nbsp Sports portalMain article Outline of exercise Active living Behavioural change theories Bodybuilding Exercise hypertension Exercise intensity Exercise intolerance Exercise induced anaphylaxis Exercise induced asthma Exercise induced nausea Kinesiology Metabolic equivalent Neurobiological effects of physical exercise Non exercise associated thermogenesis Supercompensation Unilateral training Warming upReferences Kylasov A Gavrov S 2011 Diversity Of Sport non destructive evaluation Paris UNESCO Encyclopedia of Life Support Systems pp 462 91 ISBN 978 5 89317 227 0 Liberman Daniel 2020 Exercised Vintage Books ISBN 0593295390 7 great reasons why exercise matters Mayo Clinic Retrieved 2 November 2018 a b c Bergstrom K Muse T Tsai M Strangio S 19 January 2011 Fitness for Foreigners Slate Retrieved 5 December 2016 Deslandes A Moraes H Ferreira 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Physical Fitness Based on Deep Learning Emergency Medicine International 2022 3891109 doi 10 1155 2022 3891109 PMC 9239833 PMID 35774151 Warburton DE Nicol CW Bredin SS March 2006 Health benefits of physical activity the evidence CMAJ 174 6 801 809 doi 10 1503 cmaj 051351 PMC 1402378 PMID 16534088 a b American Heart Association Recommendations for Physical Activity in Adults American Heart Association 14 December 2017 Retrieved 5 May 2018 Lumeng JC March 2006 Small group physical education classes result in important health benefits The Journal of Pediatrics 148 3 418 419 doi 10 1016 j jpeds 2006 02 025 PMID 17243298 Ahaneku JE Nwosu CM Ahaneku GI June 2000 Academic stress and cardiovascular health Academic Medicine 75 6 567 568 doi 10 1097 00001888 200006000 00002 PMID 10875499 Fletcher GF Balady G Blair SN Blumenthal J Caspersen C Chaitman B et al August 1996 Statement on exercise benefits and recommendations for physical activity programs for all Americans A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology American Heart Association Circulation 94 4 857 862 doi 10 1161 01 CIR 94 4 857 PMID 8772712 S2CID 2392781 Reed JL Prince SA Cole CA Fodor JG Hiremath S Mullen KA et al December 2014 Workplace physical activity interventions and moderate to vigorous intensity physical activity levels among working age women a systematic review protocol Systematic Reviews 3 1 147 doi 10 1186 2046 4053 3 147 PMC 4290810 PMID 25526769 a b c d e Gleeson M August 2007 Immune function in sport and exercise Journal of Applied Physiology 103 2 693 699 doi 10 1152 japplphysiol 00008 2007 PMID 17303714 S2CID 18112931 Brolinson PG Elliott D July 2007 Exercise and the immune system Clinics in Sports Medicine 26 3 311 319 doi 10 1097 01893697 200220010 00013 PMID 17826186 S2CID 91074779 Swardfager W Herrmann N Cornish S Mazereeuw G Marzolini S Sham L Lanctot KL April 2012 Exercise intervention and inflammatory markers in coronary artery disease a meta analysis American Heart Journal 163 4 666 676 doi 10 1016 j ahj 2011 12 017 PMID 22520533 Ballard Barbash R Friedenreich CM Courneya KS Siddiqi SM McTiernan A Alfano CM June 2012 Physical activity biomarkers and disease outcomes in cancer survivors a systematic review Journal of the National Cancer Institute 104 11 815 840 doi 10 1093 jnci djs207 PMC 3465697 PMID 22570317 Mishra SI Scherer RW Geigle PM Berlanstein DR Topaloglu O Gotay CC Snyder C August 2012 Exercise interventions on health related quality of life for cancer survivors The Cochrane Database of Systematic Reviews 2012 8 CD007566 doi 10 1002 14651858 cd007566 pub2 PMC 7387117 PMID 22895961 a b Mishra SI Scherer RW Snyder C Geigle PM Berlanstein DR Topaloglu O August 2012 Exercise interventions on health related quality of life for people with cancer during active treatment The Cochrane Database of Systematic Reviews 2012 8 CD008465 doi 10 1002 14651858 cd008465 pub2 PMC 7389071 PMID 22895974 Meneses Echavez JF Gonzalez Jimenez E Ramirez Velez R February 2015 Effects of supervised exercise on cancer related fatigue in breast cancer survivors a systematic review and meta analysis BMC Cancer 15 1 77 doi 10 1186 s12885 015 1069 4 PMC 4364505 PMID 25885168 Grande AJ Silva V Maddocks M September 2015 Exercise for cancer cachexia in adults Executive summary of a Cochrane Collaboration systematic review Journal of Cachexia Sarcopenia and Muscle 6 3 208 211 doi 10 1002 jcsm 12055 PMC 4575551 PMID 26401466 a b Sadeghi M Keshavarz Fathi M Baracos V Arends J Mahmoudi M Rezaei N July 2018 Cancer cachexia Diagnosis assessment and treatment Critical Reviews in Oncology Hematology 127 91 104 doi 10 1016 j critrevonc 2018 05 006 PMID 29891116 S2CID 48363786 a b Solheim TS Laird BJ Balstad TR Bye A Stene G Baracos V et al September 2018 Cancer cachexia rationale for the MENAC Multimodal Exercise Nutrition and Anti inflammatory medication for Cachexia trial BMJ Supportive amp Palliative Care 8 3 258 265 doi 10 1136 bmjspcare 2017 001440 PMID 29440149 S2CID 3318359 a b c Knips L Bergenthal N Streckmann F Monsef I Elter T Skoetz N et al Cochrane Hematological Malignancies Group January 2019 Aerobic physical exercise for adult patients with haematological malignancies The Cochrane Database of Systematic Reviews 1 1 CD009075 doi 10 1002 14651858 CD009075 pub3 PMC 6354325 PMID 30702150 The Impact of Exercise on Mental Health lokyatha com Retrieved 19 November 2022 a b c d e Erickson KI Hillman CH Kramer AF August 2015 Physical activity brain and cognition Current Opinion in Behavioral Sciences 4 27 32 doi 10 1016 j cobeha 2015 01 005 S2CID 54301951 a b Paillard T Rolland Y de Souto Barreto P July 2015 Protective Effects of Physical Exercise in Alzheimer s Disease and Parkinson s Disease A Narrative Review J Clin Neurol 11 3 212 219 doi 10 3988 jcn 2015 11 3 212 PMC 4507374 PMID 26174783 Aerobic physical exercise PE activates the release of neurotrophic factors and promotes angiogenesis thereby facilitating neurogenesis and synaptogenesis which in turn improve memory and cognitive functions Exercise limits the alteration in dopaminergic neurons in the substantia nigra and contributes to optimal functioning of the basal ganglia involved in motor commands and control by adaptive mechanisms involving dopamine and glutamate neurotransmission a b McKee AC Daneshvar DH Alvarez VE Stein TD January 2014 The neuropathology of sport Acta Neuropathol 127 1 29 51 doi 10 1007 s00401 013 1230 6 PMC 4255282 PMID 24366527 The benefits of regular exercise physical fitness and sports participation on cardiovascular and brain health are undeniable Exercise also enhances psychological health reduces age related loss of brain volume improves cognition reduces the risk of developing dementia and impedes neurodegeneration a b Denham J Marques FZ O Brien BJ Charchar FJ February 2014 Exercise putting action into our epigenome Sports Med 44 2 189 209 doi 10 1007 s40279 013 0114 1 PMID 24163284 S2CID 30210091 Aerobic physical exercise produces numerous health benefits in the brain Regular engagement in physical exercise enhances cognitive functioning increases brain neurotrophic proteins such as brain derived neurotrophic factor BDNF and prevents cognitive diseases Recent findings highlight the role of aerobic exercise in modulating chromatin remodelers These results were the first to demonstrate that acute and relatively short aerobic exercise modulates epigenetic modifications The transient epigenetic modifications observed due to chronic running training have also been associated with improved learning and stress coping strategies epigenetic changes and increased c Fos positive neurons Nonetheless these studies demonstrate the existence of epigenetic changes after acute and chronic exercise and show they are associated with improved cognitive function and elevated markers of neurotrophic factors and neuronal activity BDNF and c Fos The aerobic exercise training induced changes to miRNA profile in the brain seem to be intensity dependent These few studies provide a basis for further exploration into potential miRNAs involved in brain and neuronal development and recovery via aerobic exercise a b c d Gomez Pinilla F Hillman C January 2013 The influence of exercise on cognitive abilities Comprehensive Physiology pp 403 428 doi 10 1002 cphy c110063 ISBN 9780470650714 PMC 3951958 PMID 23720292 a href Template Cite book html title Template Cite book cite book a journal ignored help Erickson KI Leckie RL Weinstein AM September 2014 Physical activity fitness and gray matter volume Neurobiol Aging 35 Suppl 2 S20 528 doi 10 1016 j neurobiolaging 2014 03 034 PMC 4094356 PMID 24952993 a b Guiney H Machado L February 2013 Benefits of regular aerobic exercise for executive functioning in healthy populations Psychon Bull Rev 20 1 73 86 doi 10 3758 s13423 012 0345 4 PMID 23229442 S2CID 24190840 a b Erickson KI Miller DL Roecklein KA 2012 The aging hippocampus interactions between exercise depression and BDNF Neuroscientist 18 1 82 97 doi 10 1177 1073858410397054 PMC 3575139 PMID 21531985 a b Buckley J Cohen JD Kramer AF McAuley E Mullen SP 2014 Cognitive control in the self regulation of physical activity and sedentary behavior Front Hum Neurosci 8 747 doi 10 3389 fnhum 2014 00747 PMC 4179677 PMID 25324754 a b c Cox EP O Dwyer N Cook R Vetter M Cheng HL Rooney K O Connor H August 2016 Relationship between physical activity and cognitive function in apparently healthy young to middle aged adults A systematic review J Sci Med Sport 19 8 616 628 doi 10 1016 j jsams 2015 09 003 PMID 26552574 A range of validated platforms assessed CF across three domains executive function 12 studies memory four studies and processing speed seven studies In studies of executive function five found a significant ES in favour of higher PA ranging from small to large Although three of four studies in the memory domain reported a significant benefit of higher PA there was only one significant ES which favoured low PA Only one study examining processing speed had a significant ES favouring higher PA CONCLUSIONS A limited body of evidence supports a positive effect of PA on CF in young to middle aged adults Further research into this relationship at this age stage is warranted Significant positive effects of PA on cognitive function were found in 12 of the 14 included manuscripts the relationship being most consistent for executive function intermediate for memory and weak for processing speed a b c Schuch FB Vancampfort D Rosenbaum S Richards J Ward PB Stubbs B July 2016 Exercise improves physical and psychological quality of life in people with depression A meta analysis including the evaluation of control group response Psychiatry Res 241 47 54 doi 10 1016 j psychres 2016 04 054 PMID 27155287 S2CID 4787287 Exercise has established efficacy as an antidepressant in people with depression Exercise significantly improved physical and psychological domains and overall QoL The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL Pratali L Mastorci F Vitiello N Sironi A Gastaldelli A Gemignani A November 2014 Motor Activity in Aging An Integrated Approach for Better Quality of Life International Scholarly Research Notices 2014 257248 doi 10 1155 2014 257248 PMC 4897547 PMID 27351018 Research investigating the effects of exercise on older adults has primarily focused on brain structural and functional changes with relation to cognitive improvement In particular several cross sectional and intervention studies have shown a positive association between physical activity and cognition in older persons 86 and an inverse correlation with cognitive decline and dementia 87 Older adults enrolled in a 6 month aerobic fitness intervention increased brain volume in both gray matter anterior cingulate cortex supplementary motor area posterior middle frontal gyrus and left superior temporal lobe and white matter anterior third of corpus callosum 88 In addition Colcombe and colleagues showed that older adults with higher cardiovascular fitness levels are better at activating attentional resources including decreased activation of the anterior cingulated cortex One of the possible mechanisms by which physical activity may benefit cognition is that physical activity maintains brain plasticity increases brain volume stimulates neurogenesis and synaptogenesis and increases neurotrophic factors in different areas of the brain possibly providing reserve against later cognitive decline and dementia 89 90 Mandolesi L Polverino A Montuori S Foti F Ferraioli G Sorrentino P Sorrentino G 27 April 2018 Effects of Physical Exercise on Cognitive Functioning and Wellbeing Biological and Psychological Benefits Frontiers in Psychology 9 509 doi 10 3389 fpsyg 2018 00509 PMC 5934999 PMID 29755380 a b c d Basso JC Suzuki WA March 2017 The Effects of Acute Exercise on Mood Cognition Neurophysiology and Neurochemical Pathways A Review Brain Plasticity 2 2 127 152 doi 10 3233 BPL 160040 PMC 5928534 PMID 29765853 A large collection of research in humans has shown that a single bout of exercise alters behavior at the level of affective state and cognitive functioning in several key ways In terms of affective state acute exercise decreases negative affect increases positive affect and decreases the psychological and physiological response to acute stress These effects have been reported to persist for up to 24 hours after exercise cessation In terms of cognitive functioning acute exercise primarily enhances executive functions dependent on the prefrontal cortex including attention working memory problem solving cognitive flexibility verbal fluency decision making and inhibitory control These positive changes have been demonstrated to occur with very low to very high exercise intensities with effects lasting for up to two hours after the end of the exercise bout Fig 1A Moreover many of these neuropsychological assessments measure several aspects of behavior including both accuracy of performance and speed of processing McMorris and Hale performed a meta analysis examining the effects of acute exercise on both accuracy and speed of processing revealing that speed significantly improved post exercise with minimal or no effect on accuracy These authors concluded that increasing task difficulty or complexity may help to augment the effect of acute exercise on accuracy However in a comprehensive meta analysis Chang and colleagues found that exercise intensities ranging from very light lt 50 MHR to very hard gt 93 MHR have all been reported to improve cognitive functioning Services Department of Health amp Human Exercise and mental health betterhealth vic gov au Retrieved 19 November 2022 Exercise and Mental Health Exercise Psychology 93 94 2013 doi 10 5040 9781492595502 part 002 ISBN 9781492595502 Cunha GS Ribeiro JL Oliveira AR June 2008 Levels of beta endorphin in response to exercise and overtraining Arq Bras Endocrinol Metabol in Portuguese 52 4 589 598 doi 10 1590 S0004 27302008000400004 PMID 18604371 Interestingly some symptoms of OT are related to beta endorphin beta end 1 31 effects Some of its effects such as analgesia increasing lactate tolerance and exercise induced euphoria are important for training Boecker H Sprenger T Spilker ME Henriksen G Koppenhoefer M Wagner KJ Valet M Berthele A Tolle TR 2008 The runner s high opioidergic mechanisms in the human brain Cereb Cortex 18 11 2523 2531 doi 10 1093 cercor bhn013 PMID 18296435 The runner s high describes an euphoric state resulting from long distance running a b c d Josefsson T Lindwall M Archer T 2014 Physical exercise intervention in depressive disorders meta analysis and systematic review Scand J Med Sci Sports 24 2 259 272 doi 10 1111 sms 12050 PMID 23362828 S2CID 29351791 a b c Rosenbaum S Tiedemann A Sherrington C Curtis J Ward PB 2014 Physical activity interventions for people with mental illness a systematic review and meta analysis J Clin Psychiatry 75 9 964 974 doi 10 4088 JCP 13r08765 PMID 24813261 This systematic review and meta analysis found that physical activity reduced depressive symptoms among people with a psychiatric illness The current meta analysis differs from previous studies as it included participants with depressive symptoms with a variety of psychiatric diagnoses except dysthymia and eating disorders This review provides strong evidence for the antidepressant effect of physical activity however the optimal exercise modality volume and intensity remain to be determined Few interventions exist whereby patients can hope to achieve improvements in both psychiatric symptoms and physical health simultaneously without significant risks of adverse effects Physical activity offers substantial promise for improving outcomes for people living with mental illness and the inclusion of physical activity and exercise programs within treatment facilities is warranted given the results of this review Szuhany KL Bugatti M Otto MW October 2014 A meta analytic review of the effects of exercise on brain derived neurotrophic factor J Psychiatr Res 60C 56 64 doi 10 1016 j jpsychires 2014 10 003 PMC 4314337 PMID 25455510 Consistent evidence indicates that exercise improves cognition and mood with preliminary evidence suggesting that brain derived neurotrophic factor BDNF may mediate these effects The aim of the current meta analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms We conducted a meta analysis of 29 studies N 1111 participants examining the effect of exercise on BDNF levels in three exercise paradigms 1 a single session of exercise 2 a session of exercise following a program of regular exercise and 3 resting BDNF levels following a program of regular exercise Moderators of this effect were also examined Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise Hedges g 0 46 p lt 0 001 Further regular exercise intensified the effect of a session of exercise on BDNF levels Hedges g 0 59 p 0 02 Finally results indicated a small effect of regular exercise on resting BDNF levels Hedges g 0 27 p 0 005 Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans Lees C Hopkins J 2013 Effect of aerobic exercise on cognition academic achievement and psychosocial function in children a systematic review of randomized control trials Prev Chronic Dis 10 E174 doi 10 5888 pcd10 130010 PMC 3809922 PMID 24157077 This omission is relevant given the evidence that aerobic based physical activity generates structural changes in the brain such as neurogenesis angiogenesis increased hippocampal volume and connectivity 12 13 In children a positive relationship between aerobic fitness hippocampal volume and memory has been found 12 13 Mental health outcomes included reduced depression and increased self esteem although no change was found in anxiety levels 18 This systematic review of the literature found that aerobic physical activity APA is positively associated with cognition academic achievement behavior and psychosocial functioning outcomes Importantly Shephard also showed that curriculum time reassigned to APA still results in a measurable albeit small improvement in academic performance 24 The actual aerobic based activity does not appear to be a major factor interventions used many different types of APA and found similar associations In positive association studies the intensity of the aerobic activity was moderate to vigorous The amount of time spent in APA varied significantly between studies however even as little as 45 minutes per week appeared to have a benefit a b c d Mura G Moro MF Patten SB Carta MG 2014 Exercise as an add on strategy for the treatment of major depressive disorder a systematic review CNS Spectr 19 6 496 508 doi 10 1017 S1092852913000953 PMID 24589012 S2CID 32304140 Considered overall the studies included in the present review showed a strong effectiveness of exercise combined with antidepressants Conclusions This is the first review to have focused on exercise as an add on strategy in the treatment of MDD Our findings corroborate some previous observations that were based on few studies and which were difficult to generalize Given the results of the present article it seems that exercise might be an effective strategy to enhance the antidepressant effect of medication treatments Moreover we hypothesize that the main role of exercise on treatment resistant depression is in inducing neurogenesis by increasing BDNF expression as was demonstrated by several recent studies Den Heijer AE Groen Y Tucha L Fuermaier AB Koerts J Lange KW Thome J Tucha O July 2016 Sweat it out The effects of physical exercise on cognition and behavior in children and adults with ADHD a systematic literature review J Neural Transm Vienna 124 Suppl 1 3 26 doi 10 1007 s00702 016 1593 7 PMC 5281644 PMID 27400928 Kamp CF Sperlich B Holmberg HC July 2014 Exercise reduces the symptoms of attention deficit hyperactivity disorder and improves social behaviour motor skills strength and neuropsychological parameters Acta Paediatr 103 7 709 14 doi 10 1111 apa 12628 PMID 24612421 S2CID 45881887 The present review summarises the impact of exercise interventions 1 10 weeks in duration with at least two sessions each week on parameters related to ADHD in 7 to 13 year old children We may conclude that all different types of exercise here yoga active games with and without the involvement of balls walking and athletic training attenuate the characteristic symptoms of ADHD and improve social behaviour motor skills strength and neuropsychological parameters without any undesirable side effects Available reports do not reveal which type intensity duration and frequency of exercise is most effective in this respect and future research focusing on this question with randomised and controlled long term interventions is warranted Petersen RC Lopez O Armstrong MJ Getchius T Ganguli M Gloss D Gronseth GS Marson D Pringsheim T Day GS Sager M Stevens J Rae Grant A January 2018 Practice guideline update summary Mild cognitive impairment Report of the Guideline Development Dissemination and Implementation Subcommittee of the American Academy of Neurology Neurology Special article 90 3 126 135 doi 10 1212 WNL 0000000000004826 PMC 5772157 PMID 29282327 In patients with MCI exercise training 6 months is likely to improve cognitive measures and cognitive training may improve cognitive measures Clinicians should recommend regular exercise Level B For patients diagnosed with MCI clinicians should recommend regular exercise twice week as part of an overall approach to management Level B Farina N Rusted J Tabet N January 2014 The effect of exercise interventions on cognitive outcome in Alzheimer s disease a systematic review Int Psychogeriatr 26 1 9 18 doi 10 1017 S1041610213001385 PMID 23962667 S2CID 24936334 Six RCTs were identified that exclusively considered the effect of exercise in AD patients Exercise generally had a positive effect on the rate of cognitive decline in AD A meta analysis found that exercise interventions have a positive effect on global cognitive function 0 75 95 CI 0 32 1 17 The most prevalent subtype of dementia is Alzheimer s disease AD accounting for up to 65 0 of all dementia cases Cognitive decline in AD is attributable at least in part to the buildup of amyloid and tau proteins which promote neuronal dysfunction and death Hardy and Selkoe 2002 Karran et al 2011 Evidence in transgenic mouse models of AD in which the mice have an artificially elevated amyloid load suggests that exercise programs are able to improve cognitive function Adlard et al 2005 Nichol et al 2007 Adlard and colleagues also determined that the improvement in cognitive performance occurred in conjunction with a reduced amyloid load Research that includes direct indices of change in such biomarkers will help to determine the mechanisms by which exercise may act on cognition in AD Rao AK Chou A Bursley B Smulofsky J Jezequel J January 2014 Systematic review of the effects of exercise on activities of daily living in people with Alzheimer s disease Am J Occup Ther 68 1 50 56 doi 10 5014 ajot 2014 009035 PMC 5360200 PMID 24367955 Alzheimer s disease AD is a progressive neurological disorder characterized by loss in cognitive function abnormal behavior and decreased ability to perform basic activities of daily living ADLs All studies included people with AD who completed an exercise program consisting of aerobic strength or balance training or any combination of the three The length of the exercise programs varied from 12 weeks to 12 months Six studies involving 446 participants tested the effect of exercise on ADL performance exercise had a large and significant effect on ADL performance z 4 07 p lt 0001 average effect size 0 80 These positive effects were apparent with programs ranging in length from 12 wk Santana Sosa et al 2008 Teri et al 2003 and intermediate length of 16 wk Roach et al 2011 Vreugdenhil et al 2012 to 6 mo Venturelli et al 2011 and 12 mo Rolland et al 2007 Furthermore the positive effects of a 3 mo intervention lasted 24 mo Teri et al 2003 No adverse effects of exercise on ADL performance were noted The study with the largest effect size implemented a walking and aerobic program of only 30 min four times a week Venturelli et al 2011 Mattson MP 2014 Interventions that improve body and brain bioenergetics for Parkinson s disease risk reduction and therapy J Parkinsons Dis 4 1 1 13 doi 10 3233 JPD 130335 PMID 24473219 a b Grazina R Massano J 2013 Physical exercise and Parkinson s disease influence on symptoms disease course and prevention Rev Neurosci 24 2 139 152 doi 10 1515 revneuro 2012 0087 PMID 23492553 S2CID 33890283 van der Kolk NM King LA September 2013 Effects of exercise on mobility in people with Parkinson s disease Mov Disord 28 11 1587 1596 doi 10 1002 mds 25658 PMID 24132847 S2CID 22822120 Tomlinson CL Patel S Meek C Herd CP Clarke CE Stowe R Shah L Sackley CM Deane KH Wheatley K Ives N September 2013 Physiotherapy versus placebo or no intervention in Parkinson s disease Cochrane Database Syst Rev 9 9 CD002817 doi 10 1002 14651858 CD002817 pub4 PMC 7120224 PMID 24018704 Blondell SJ Hammersley Mather R Veerman JL May 2014 Does physical activity prevent cognitive decline and dementia A systematic review and meta analysis of longitudinal studies BMC Public Health 14 510 doi 10 1186 1471 2458 14 510 PMC 4064273 PMID 24885250 Longitudinal observational studies show an association between higher levels of physical activity and a reduced risk of cognitive decline and dementia A case can be made for a causal interpretation Future research should use objective measures of physical activity adjust for the full range of confounders and have adequate follow up length Ideally randomised controlled trials will be conducted On the whole the results do however lend support to the notion of a causal relationship between physical activity cognitive decline and dementia according to the established criteria for causal inference Carroll ME Smethells JR February 2016 Sex Differences in Behavioral Dyscontrol Role in Drug Addiction and Novel Treatments Front Psychiatry 6 175 doi 10 3389 fpsyt 2015 00175 PMC 4745113 PMID 26903885 There is accelerating evidence that physical exercise is a useful treatment for preventing and reducing drug addiction In some individuals exercise has its own rewarding effects and a behavioral economic interaction may occur such that physical and social rewards of exercise can substitute for the rewarding effects of drug abuse The value of this form of treatment for drug addiction in laboratory animals and humans is that exercise if it can substitute for the rewarding effects of drugs could be self maintained over an extended period of time Work to date in laboratory animals and humans regarding exercise as a treatment for drug addiction supports this hypothesis However a RTC study was recently reported by Rawson et al whereby they used 8 weeks of exercise as a post residential treatment for METH addiction showed a significant reduction in use confirmed by urine screens in participants who had been using meth 18 days or less a month Animal and human research on physical exercise as a treatment for stimulant addiction indicates that this is one of the most promising treatments on the horizon emphasis added Lynch WJ Peterson AB Sanchez V Abel J Smith MA September 2013 Exercise as a novel treatment for drug addiction a neurobiological and stage dependent hypothesis Neurosci Biobehav Rev 37 8 1622 1644 doi 10 1016 j neubiorev 2013 06 011 PMC 3788047 PMID 23806439 Olsen CM December 2011 Natural rewards neuroplasticity and non drug addictions Neuropharmacology 61 7 1109 1122 doi 10 1016 j neuropharm 2011 03 010 PMC 3139704 PMID 21459101 Similar to environmental enrichment studies have found that exercise reduces self administration and relapse to drugs of abuse Cosgrove et al 2002 Zlebnik et al 2010 There is also some evidence that these preclinical findings translate to human populations as exercise reduces withdrawal symptoms and relapse in abstinent smokers Daniel et al 2006 Prochaska et al 2008 and one drug recovery program has seen success in participants that train for and compete in a marathon as part of the program Butler 2005 In humans the role of dopamine signaling in incentive sensitization processes has recently been highlighted by the observation of a dopamine dysregulation syndrome in some patients taking dopaminergic drugs This syndrome is characterized by a medication induced increase in or compulsive engagement in non drug rewards such as gambling shopping or sex Evans et al 2006 Aiken 2007 Lader 2008 Linke SE Ussher M 2015 Exercise based treatments for substance use disorders evidence theory and practicality Am J Drug Alcohol Abuse 41 1 7 15 doi 10 3109 00952990 2014 976708 PMC 4831948 PMID 25397661 The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs In contrast to the scarce intervention trials to date a relative abundance of literature on the theoretical and practical reasons supporting the investigation of this topic has been published numerous theoretical and practical reasons support exercise based treatments for SUDs including psychological behavioral neurobiological nearly universal safety profile and overall positive health effects Zhou Y Zhao M Zhou C Li R July 2015 Sex differences in drug addiction and response to exercise intervention From human to animal studies Front Neuroendocrinol 40 24 41 doi 10 1016 j yfrne 2015 07 001 PMC 4712120 PMID 26182835 Collectively these findings demonstrate that exercise may serve as a substitute or competition for drug abuse by changing DFosB or cFos immunoreactivity in the reward system to protect against later or previous drug use As briefly reviewed above a large number of human and rodent studies clearly show that there are sex differences in drug addiction and exercise The sex differences are also found in the effectiveness of exercise on drug addiction prevention and treatment as well as underlying neurobiological mechanisms The postulate that exercise serves as an ideal intervention for drug addiction has been widely recognized and used in human and animal rehabilitation In particular more studies on the neurobiological mechanism of exercise and its roles in preventing and treating drug addiction are needed Cormie P Nowak AK Chambers SK Galvao DA Newton RU April 2015 The potential role of exercise in neuro oncology Front Oncol 5 85 doi 10 3389 fonc 2015 00085 PMC 4389372 PMID 25905043 a b Cooney GM Dwan K Greig CA Lawlor DA Rimer J Waugh FR McMurdo M Mead GE September 2013 Exercise for depression Cochrane Database Syst Rev 2013 9 CD004366 doi 10 1002 14651858 CD004366 pub6 PMC 9721454 PMID 24026850 Exercise is moderately more effective than a control intervention for reducing symptoms of depression but analysis of methodologically robust trials only shows a smaller effect in favour of exercise When compared to psychological or pharmacological therapies exercise appears to be no more effective though this conclusion is based on a few small trials Brene S Bjornebekk A Aberg E Mathe AA Olson L Werme M 2007 Running is rewarding and antidepressive Physiol Behav 92 1 2 136 140 doi 10 1016 j physbeh 2007 05 015 PMC 2040025 PMID 17561174 Gong H Ni C Shen X Wu T Jiang C February 2015 Yoga for prenatal depression a systematic review and meta analysis BMC Psychiatry 15 14 doi 10 1186 s12888 015 0393 1 PMC 4323231 PMID 25652267 Miller KJ Goncalves Bradley DC Areerob P Hennessy D Mesagno C Grace F 2020 Comparative effectiveness of three exercise types to treat clinical depression in older adults A systematic review and network meta analysis of randomised controlled trials Ageing Research Reviews 58 100999 doi 10 1016 j arr 2019 100999 hdl 1959 17 172086 PMID 31837462 S2CID 209179889 Chaturvedi SK Chandra PS Issac MK Sudarshan CY September 1993 Somatization misattributed to non pathological vaginal discharge Journal of Psychosomatic Research 37 6 575 579 doi 10 1016 0022 3999 93 90051 G PMID 8410743 Tantimonaco M Ceci R Sabatini S Catani MV Rossi A Gasperi V Maccarrone M July 2014 Physical activity and the endocannabinoid system an overview Cellular and Molecular Life Sciences 71 14 2681 2698 doi 10 1007 s00018 014 1575 6 PMID 24526057 S2CID 14531019 Dinas PC Koutedakis Y Flouris AD June 2011 Effects of exercise and physical activity on depression Irish Journal of Medical Science 180 2 319 325 doi 10 1007 s11845 010 0633 9 PMID 21076975 S2CID 40951545 Szabo A Billett E Turner J October 2001 Phenylethylamine a possible link to the antidepressant effects of exercise British Journal of Sports Medicine 35 5 342 343 doi 10 1136 bjsm 35 5 342 PMC 1724404 PMID 11579070 Lindemann L Hoener MC May 2005 A renaissance in trace amines inspired by a novel GPCR family Trends in Pharmacological Sciences 26 5 274 281 doi 10 1016 j tips 2005 03 007 PMID 15860375 Berry MD January 2007 The potential of trace amines and their receptors for treating neurological and psychiatric diseases Reviews on Recent Clinical Trials 2 1 3 19 doi 10 2174 157488707779318107 PMID 18473983 S2CID 7127324 Yang PY Ho KH Chen HC Chien MY 2012 Exercise training improves sleep quality in middle aged and older adults with sleep problems a systematic review Journal of Physiotherapy 58 3 157 163 doi 10 1016 S1836 9553 12 70106 6 PMID 22884182 Buman MP King AC 2010 Exercise as a Treatment to Enhance Sleep American Journal of Lifestyle Medicine 31 5 514 doi 10 1177 1559827610375532 S2CID 73314918 Banno M Harada Y Taniguchi M Tobita R Tsujimoto H Tsujimoto Y et al 2018 Exercise can improve sleep quality a systematic review and meta analysis PeerJ 6 e5172 doi 10 7717 peerj 5172 PMC 6045928 PMID 30018855 Lorenz TA Meston CM June 2012 Acute exercise improves physical sexual arousal in women taking antidepressants Annals of Behavioral Medicine 43 3 352 361 doi 10 1007 s12160 011 9338 1 PMC 3422071 PMID 22403029 Laeremans M Dons E Avila Palencia I Carrasco Turigas G Orjuela Mendoza JP Anaya Boig E et al September 2018 Black Carbon Reduces the Beneficial Effect of Physical Activity on Lung Function Medicine and Science in Sports and Exercise 50 9 1875 1881 doi 10 1249 MSS 0000000000001632 hdl 10044 1 63478 PMID 29634643 S2CID 207183760 a b c d e f g h Brook MS Wilkinson DJ Phillips BE Perez Schindler J Philp A Smith K Atherton PJ January 2016 Skeletal muscle homeostasis and plasticity in youth and ageing impact of nutrition and exercise Acta Physiologica 216 1 15 41 doi 10 1111 apha 12532 PMC 4843955 PMID 26010896 a b c Phillips SM May 2014 A brief review of critical processes in exercise induced muscular hypertrophy Sports Medicine 44 Suppl 1 S71 S77 doi 10 1007 s40279 014 0152 3 PMC 4008813 PMID 24791918 Brioche T Pagano AF Py G Chopard A August 2016 Muscle wasting and aging Experimental models fatty infiltrations and prevention PDF Molecular Aspects of Medicine 50 56 87 doi 10 1016 j mam 2016 04 006 PMID 27106402 S2CID 29717535 a b Wilkinson DJ Hossain T Hill DS Phillips BE Crossland H Williams J et al June 2013 Effects of leucine and its metabolite b hydroxy b methylbutyrate on human skeletal muscle protein metabolism The Journal of Physiology 591 11 2911 2923 doi 10 1113 jphysiol 2013 253203 PMC 3690694 PMID 23551944 a b Wilkinson DJ Hossain T Limb MC Phillips BE Lund J Williams JP et al December 2018 Impact of the calcium form of b hydroxy b methylbutyrate upon human skeletal muscle protein metabolism Clinical Nutrition 37 6 Pt A 2068 2075 doi 10 1016 j clnu 2017 09 024 PMC 6295980 PMID 29097038 Ca HMB led a significant and rapid lt 60 min peak in plasma HMB concentrations 483 6 14 2 mM p lt 0 0001 This rise in plasma HMB was accompanied by increases in MPS PA 0 046 0 004 h CaHMB 0 072 0 004 h p lt 0 001 and suppressions in MPB PA 7 6 1 2 mmol Phe per leg min 1 Ca HMB 5 2 0 8 mmol Phe per leg min 1 p lt 0 01 During the first 2 5 h period we gathered postabsorptive fasted measurements the volunteers then consumed 3 42 g of Ca HMB equivalent to 2 74 g of FA HMB It may seem difficult for one to reconcile that acute provision of CaHMB in the absence of exogenous nutrition i e EAA s and following an overnight fast is still able to elicit a robust perhaps near maximal stimulation of MPS i e raising the question as to where the additional AA s substrates required for supporting this MPS response are coming from It would appear that the AA s to support this response are derived from endogenous intracellular plasma pools and or protein breakdown which will increase in fasted periods To conclude a large single oral dose 3 g of Ca HMB robustly near maximally stimulates skeletal muscle anabolism in the absence of additional nutrient intake the anabolic effects of Ca HMB are equivalent to FA HMB despite purported differences in bioavailability Fig 4 Phillips SM July 2015 Nutritional supplements in support of resistance exercise to counter age related sarcopenia Advances in Nutrition 6 4 452 460 doi 10 3945 an 115 008367 PMC 4496741 PMID 26178029 Wibom R Hultman E Johansson M Matherei K Constantin Teodosiu D Schantz PG November 1992 Adaptation of mitochondrial ATP production in human skeletal muscle to endurance training and detraining Journal of Applied Physiology 73 5 2004 2010 doi 10 1152 jappl 1992 73 5 2004 PMID 1474078 a b Boushel R Lundby C Qvortrup K Sahlin K October 2014 Mitochondrial plasticity with exercise training and extreme environments Exercise and Sport Sciences Reviews 42 4 169 174 doi 10 1249 JES 0000000000000025 PMID 25062000 S2CID 39267910 Valero T 2014 Mitochondrial biogenesis pharmacological approaches Current Pharmaceutical Design 20 35 5507 5509 doi 10 2174 138161282035140911142118 hdl 10454 13341 PMID 24606795 Lipton JO Sahin M October 2014 The neurology of mTOR Neuron 84 2 275 291 doi 10 1016 j neuron 2014 09 034 PMC 4223653 PMID 25374355 Figure 2 The mTOR Signaling Pathway a b Wang E Naess MS Hoff J Albert TL Pham Q Richardson RS Helgerud J April 2014 Exercise training induced changes in metabolic capacity with age the role of central cardiovascular plasticity Age 36 2 665 676 doi 10 1007 s11357 013 9596 x PMC 4039249 PMID 24243396 Potempa K Lopez M Braun LT Szidon JP Fogg L Tincknell T January 1995 Physiological outcomes of aerobic exercise training in hemiparetic stroke patients Stroke 26 1 101 105 doi 10 1161 01 str 26 1 101 PMID 7839377 Wilmore JH Stanforth PR Gagnon J Leon AS Rao DC Skinner JS Bouchard C July 1996 Endurance exercise training has a minimal effect on resting heart rate the Heritage Study Medicine and Science in Sports and Exercise 28 7 829 835 doi 10 1097 00005768 199607000 00009 PMID 8832536 Carter JB Banister EW Blaber AP 2003 Effect of endurance exercise on autonomic control of heart rate Sports Medicine 33 1 33 46 doi 10 2165 00007256 200333010 00003 PMID 12477376 S2CID 40393053 Chen CY Dicarlo SE January 1998 Endurance exercise training induced resting Bradycardia A brief review Sports Medicine Training and Rehabilitation 8 1 37 77 doi 10 1080 15438629709512518 Crewther BT Heke TL Keogh JW February 2013 The effects of a resistance training program on strength body composition and baseline hormones in male athletes training concurrently for rugby union 7 s The Journal of Sports Medicine and Physical Fitness 53 1 34 41 PMID 23470909 Schoenfeld BJ June 2013 Postexercise hypertrophic adaptations a reexamination of the hormone hypothesis and its applicability to resistance training program design Journal of Strength and Conditioning Research 27 6 1720 1730 doi 10 1519 JSC 0b013e31828ddd53 PMID 23442269 S2CID 25068522 Dalgas U Stenager E Lund C Rasmussen C Petersen T Sorensen H et al July 2013 Neural drive increases following resistance training in patients with multiple sclerosis Journal of Neurology 260 7 1822 1832 doi 10 1007 s00415 013 6884 4 PMID 23483214 S2CID 848583 Staron RS Karapondo DL Kraemer WJ Fry AC Gordon SE Falkel JE et al March 1994 Skeletal muscle adaptations during early phase of heavy resistance training in men and women Journal of Applied Physiology 76 3 1247 1255 doi 10 1152 jappl 1994 76 3 1247 PMID 8005869 S2CID 24328546 Folland JP Williams AG 2007 The adaptations to strength training morphological and neurological contributions to increased strength Sports Medicine 37 2 145 168 doi 10 2165 00007256 200737020 00004 PMID 17241104 S2CID 9070800 Moritani T deVries HA June 1979 Neural factors versus hypertrophy in the time course of muscle strength gain American Journal of Physical Medicine 58 3 115 130 PMID 453338 Narici MV Roi GS Landoni L Minetti AE Cerretelli P 1989 Changes in force cross sectional area and neural activation during strength training and detraining of the human quadriceps European Journal of Applied Physiology and Occupational Physiology 59 4 310 319 doi 10 1007 bf02388334 PMID 2583179 S2CID 2231992 Pedersen BK July 2013 Muscle as a secretory organ Comprehensive Physiology 3 3 1337 1362 doi 10 1002 cphy c120033 ISBN 978 0 470 65071 4 PMID 23897689 Cohen S Williamson GM January 1991 Stress and infectious disease in humans Psychological Bulletin 109 1 5 24 doi 10 1037 0033 2909 109 1 5 PMID 2006229 Borer KT Wuorinen EC Lukos JR Denver JW Porges SW Burant CF August 2009 Two bouts of exercise before meals but not after meals lower fasting blood glucose Medicine and Science in Sports and Exercise 41 8 1606 1614 doi 10 1249 MSS 0b013e31819dfe14 PMID 19568199 S2CID 207184758 Wisloff U Ellingsen O Kemi OJ July 2009 High intensity interval training to maximize cardiac benefits of exercise training Exercise and Sport Sciences Reviews 37 3 139 146 doi 10 1097 JES 0b013e3181aa65fc PMID 19550205 S2CID 25057561 Paillard T Rolland Y de Souto Barreto P July 2015 Protective Effects of Physical Exercise in Alzheimer s Disease and Parkinson s Disease A Narrative Review Journal of Clinical Neurology 11 3 212 219 doi 10 3988 jcn 2015 11 3 212 PMC 4507374 PMID 26174783 Aerobic physical exercise PE activates the release of neurotrophic factors and promotes angiogenesis thereby facilitating neurogenesis and synaptogenesis which in turn improve memory and cognitive functions Exercise limits the alteration in dopaminergic neurons in the substantia nigra and contributes to optimal functioning of the basal ganglia involved in motor commands and control by adaptive mechanisms involving dopamine and glutamate neurotransmission Szuhany KL Bugatti M Otto MW January 2015 A meta analytic review of the effects of exercise on brain derived neurotrophic factor Journal of Psychiatric Research 60 56 64 doi 10 1016 j jpsychires 2014 10 003 PMC 4314337 PMID 25455510 Consistent evidence indicates that exercise improves cognition and mood with preliminary evidence suggesting that brain derived neurotrophic factor BDNF may mediate these effects The aim of the current meta analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms We conducted a meta analysis of 29 studies N 1111 participants examining the effect of exercise on BDNF levels in three exercise paradigms 1 a single session of exercise 2 a session of exercise following a program of regular exercise and 3 resting BDNF levels following a program of regular exercise Moderators of this effect were also examined Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise Hedges g 0 46 p lt 0 001 Further regular exercise intensified the effect of a session of exercise on BDNF levels Hedges g 0 59 p 0 02 Finally results indicated a small effect of regular exercise on resting BDNF levels Hedges g 0 27 p 0 005 Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans Bouchard J Villeda SA January 2015 Aging and brain rejuvenation as systemic events Journal of Neurochemistry 132 1 5 19 doi 10 1111 jnc 12969 PMC 4301186 PMID 25327899 From a molecular perspective elevated systemic levels of circulating growth factors such as vascular endothelial growth factor and insulin like growth factor 1 IGF 1 in blood elicited by increased exercise have been shown to mediate in part enhancements in neurogenesis Trejo et al 2001 Fabel et al 2003 Silverman MN Deuster PA October 2014 Biological mechanisms underlying the role of physical fitness in health and resilience Interface Focus 4 5 20140040 doi 10 1098 rsfs 2014 0040 PMC 4142018 PMID 25285199 Importantly physical exercise can improve growth factor signalling directly or indirectly by reducing pro inflammatory signalling Exercise induced increases in brain monoamines norepinephrine and serotonin may also contribute to increased expression of hippocampal BDNF 194 In addition other growth factors insulin like growth factor 1 IGF 1 and vascular endothelial growth factor have been shown to play an important role in BDNF induced effects on neuroplasticity as well as exerting neuroprotective effects of their own thereby contributing to the beneficial effects of exercise on brain health Gomez Pinilla F Hillman C January 2013 The influence of exercise on cognitive abilities Comprehensive Physiology 3 1 403 428 doi 10 1002 cphy c110063 ISBN 978 0 470 65071 4 PMC 3951958 PMID 23720292 Abundant research in the last decade has shown that exercise is one of the strongest promoters of neurogenesis in the brain of adult rodents and humans and this has introduced the possibility that proliferating neurons could contribute to the cognitive enhancement observed with exercise In addition to BDNF the actions of IGF 1 and vascular endothelial growth factor VEGF 54 are considered essential for the angiogenic and neurogenic effects of exercise in the brain Although the action of exercise on brain angiogenesis has been known for many years 10 it is not until recently that neurovascular adaptations in the hippocampus have been associated with cognitive function 29 Exercise enhances the proliferation of brain endothelial cells throughout the brain 113 hippocampal IGF gene expression 47 and serum levels of both IGF 178 and VEGF 63 IGF 1 and VEGF apparently produced in the periphery support exercise induced neurogenesis and angiogenesis as corroborated by blocking the effects of exercise using antibodies against IGF 1 47 or VEGF 63 Tarumi T Zhang R January 2014 Cerebral hemodynamics of the aging brain risk of Alzheimer disease and benefit of aerobic exercise Frontiers in Physiology 5 6 doi 10 3389 fphys 2014 00006 PMC 3896879 PMID 24478719 Exercise related improvements in brain function and structure may be conferred by the concurrent adaptations in vascular function and structure Aerobic exercise increases the peripheral levels of growth factors e g BDNF IFG 1 and VEGF which cross the blood brain barrier BBB and stimulate neurogenesis and angiogenesis Trejo et al 2001 Lee et al 2002 Fabel et al 2003 Lopez Lopez et al 2004 Consistent with this exercise related enlargement of hippocampus was accompanied by increases in cerebral blood volume and capillary densities Pereira et al 2007 Enhanced cerebral perfusion may not only facilitate the delivery of energy substrates but also lower the risk of vascular related brain damages including WMH and silent infarct Tseng et al 2013 Furthermore regular aerobic exercise is associated with lower levels of Ab deposition in individuals with APOE4 positive Head et al 2012 which may also reduce the risk of cerebral amyloid angiopathy and microbleeds Poels et al 2010 Howe TE Rochester L Neil F Skelton DA Ballinger C November 2011 Exercise for improving balance in older people The Cochrane Database of Systematic Reviews John Wiley amp Sons Ltd 11 CD004963 doi 10 1002 14651858 cd004963 pub3 PMID 22071817 S2CID 205176433 Liu CJ Latham NK July 2009 Progressive resistance strength training for improving physical function in older adults The Cochrane Database of Systematic Reviews 2009 3 CD002759 doi 10 1002 14651858 CD002759 pub2 PMC 4324332 PMID 19588334 Gc V Wilson EC Suhrcke M Hardeman W Sutton S April 2016 Are brief interventions to increase physical activity cost effective A systematic review British Journal of Sports Medicine 50 7 408 417 doi 10 1136 bjsports 2015 094655 PMC 4819643 PMID 26438429 Kahn EB Ramsey LT Brownson RC Heath GW Howze EH Powell KE et al May 2002 The effectiveness of interventions to increase physical activity A systematic review American Journal of Preventive Medicine 22 4 Suppl 73 107 doi 10 1016 S0749 3797 02 00434 8 PMID 11985936 Duran VH Stopping the rising tide of chronic diseases Everyone s Epidemic Pan American Health Organization paho org Retrieved 10 January 2009 Dons E Rojas Rueda D Anaya Boig E Avila Palencia I Brand C Cole Hunter T et al October 2018 Transport mode choice and body mass index Cross sectional and longitudinal evidence from a European wide study PDF Environment International 119 119 109 116 doi 10 1016 j envint 2018 06 023 hdl 10044 1 61061 PMID 29957352 S2CID 49607716 Xu H Wen LM Rissel C 19 March 2015 Associations of parental influences with physical activity and screen time among young children a systematic review Journal of Obesity 2015 546925 doi 10 1155 2015 546925 PMC 4383435 PMID 25874123 Youth Physical Activity Guidelines Centers for Disease Control and Prevention 23 January 2019 Health and Participation European Commission 25 June 2013 Archived from the original on 5 July 2019 a b WHO Obesity and overweight World Health Organization Archived from the original on 18 December 2008 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Overtraining Syndrome in the Athlete Current Sports Medicine Reports 13 1 45 51 doi 10 1249 jsr 0000000000000027 PMID 24412891 S2CID 38361107 Whyte Gregory Harries Mark Williams Clyde 2005 ABC of sports and exercise medicine Blackwell Publishing pp 46 49 ISBN 978 0 7279 1813 0 Quotes About Exercise Top 10 List History of Fitness unm edu Retrieved 20 September 2017 Physical culture Encyclopedia Britannica Retrieved 20 September 2017 Bogdanovic N 2017 Fit to Fight A History of the Royal Army Physical Training Corps 1860 2015 Bloomsbury ISBN 978 1 4728 2421 9 Campbell JD 2016 The Army Isn t All Work Physical Culture and the Evolution of the British Army 1860 1920 Routledge ISBN 978 1 317 04453 6 Mason T Riedi E 2010 Sport and the Military The British Armed Forces 1880 1960 Cambridge University Press ISBN 978 1 139 78897 7 The Fitness League History The Fitness League Archived from the original on 29 July 2009 Retrieved 8 April 2015 Kuper S 11 September 2009 The man who invented exercise Financial Times Archived from the original on 10 December 2022 Retrieved 12 September 2009 a b Morris JN Heady JA Raffle PA Roberts CG Parks JW November 1953 Coronary heart disease and physical activity of work Lancet 262 6795 1053 1057 doi 10 1016 S0140 6736 53 90665 5 PMID 13110049 Zhu S Eclarinal J Baker MS Li G Waterland RA February 2016 Developmental programming of energy balance regulation is physical activity more programmable than food intake The Proceedings of the Nutrition Society 75 1 73 77 doi 10 1017 s0029665115004127 PMID 26511431 Acosta W Meek TH Schutz H Dlugosz EM Vu KT Garland T October 2015 Effects of early onset voluntary exercise on adult physical activity and associated phenotypes in mice Physiology amp Behavior 149 279 286 doi 10 1016 j physbeh 2015 06 020 PMID 26079567 Swallow JG Carter PA Garland T May 1998 Artificial selection for increased wheel running behavior in house mice Behavior Genetics 28 3 227 237 doi 10 1023 A 1021479331779 PMID 9670598 S2CID 18336243 Swallow JG Garland T Carter PA Zhan WZ Sieck GC January 1998 Effects of voluntary activity and genetic selection on aerobic capacity in house mice Mus domesticus Journal of Applied Physiology 84 1 69 76 doi 10 1152 jappl 1998 84 1 69 PMID 9451619 Rhodes JS van Praag H Jeffrey S Girard I Mitchell GS Garland T Gage FH October 2003 Exercise increases hippocampal neurogenesis to high levels but does not improve spatial learning in mice bred for increased voluntary wheel running Behavioral Neuroscience 117 5 1006 1016 doi 10 1037 0735 7044 117 5 1006 PMID 14570550 Garland T Morgan MT Swallow JG Rhodes JS Girard I Belter JG Carter PA June 2002 Evolution of a small muscle polymorphism in lines of house mice selected for high activity levels Evolution International Journal of Organic Evolution 56 6 1267 1275 doi 10 1554 0014 3820 2002 056 1267 EOASMP 2 0 CO 2 PMID 12144025 S2CID 198158847 Gallaugher PE Thorarensen H Kiessling A Farrell AP August 2001 Effects of high intensity exercise training on cardiovascular function oxygen uptake internal oxygen transport and osmotic balance in chinook salmon Oncorhynchus tshawytscha during critical speed swimming The Journal of Experimental Biology 204 Pt 16 2861 2872 doi 10 1242 jeb 204 16 2861 PMID 11683441 Palstra AP Mes D Kusters K Roques JA Flik G Kloet K Blonk RJ 2015 Forced sustained swimming exercise at optimal speed enhances growth of juvenile yellowtail kingfish Seriola lalandi Frontiers in Physiology 5 506 doi 10 3389 fphys 2014 00506 PMC 4287099 PMID 25620933 Magnoni LJ Crespo D Ibarz A Blasco J Fernandez Borras J Planas JV November 2013 Effects of sustained swimming on the red and white muscle transcriptome of rainbow trout Oncorhynchus mykiss fed a carbohydrate rich diet Comparative Biochemistry and Physiology Part A Molecular amp Integrative Physiology 166 3 510 521 doi 10 1016 j cbpa 2013 08 005 PMID 23968867 a b Owerkowicz T Baudinette RV June 2008 Exercise training enhances aerobic capacity in juvenile estuarine crocodiles Crocodylus porosus Comparative Biochemistry and Physiology Part A Molecular amp Integrative Physiology 150 2 211 216 doi 10 1016 j cbpa 2008 04 594 PMID 18504156 Eme J Owerkowicz T Gwalthney J Blank JM Rourke BC Hicks JW November 2009 Exhaustive exercise training enhances aerobic capacity in American alligator Alligator mississippiensis Journal of Comparative Physiology B Biochemical Systemic and Environmental Physiology 179 8 921 931 doi 10 1007 s00360 009 0374 0 PMC 2768110 PMID 19533151 Butler PJ Turner DL July 1988 Effect of training on maximal oxygen uptake and aerobic capacity of locomotory muscles in tufted ducks Aythya fuligula The Journal of Physiology 401 347 359 doi 10 1113 jphysiol 1988 sp017166 PMC 1191853 PMID 3171990 a b Garland T Else PL Hulbert AJ Tap P March 1987 Effects of endurance training and captivity on activity metabolism of lizards The American Journal of Physiology 252 3 Pt 2 R450 R456 doi 10 1152 ajpregu 1987 252 3 R450 PMID 3826409 S2CID 8771310 a b Husak JF Keith AR Wittry BN March 2015 Making Olympic lizards the effects of specialised exercise training on performance The Journal of Experimental Biology 218 Pt 6 899 906 doi 10 1242 jeb 114975 PMID 25617462 External linksExercise at Wikipedia s sister projects nbsp Definitions from Wiktionary nbsp Media from Commons nbsp Quotations from Wikiquote Adult Compendium of Physical Activities a website containing lists of Metabolic Equivalent of Task MET values for a number of physical activities based upon PMID 8292105 10993420 and 21681120 MedLinePlus Topic on Exercise and Physical Fitness Physical activity and the environment guidance on the promotion and creation of physical environments that support increased levels of physical activity Science Daily s reference on physical exercise Retrieved from https en wikipedia org w index php title Exercise amp oldid 1183038724, wikipedia, wiki, book, books, library,

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