%!PS-Adobe-3.0
%%Title: CHAP2.PDF
%%BoundingBox: 19 9 593 784
%%CreationDate: 09/27/96 16:00:41
%%Pages: 1
%%Requirements: None
%%LanguageLevel: 1
%%EndComments
%%BeginProlog
%%BeginProcSet: Pscript_Win_Driver_Min 2.0 0
userdict/Pscript_Win_Driver_Min 10 dict dup begin put/b{bind def}bind def/|{
def}b/LH{showpage}b/initialize{begin userdict begin}b/terminate{pop end end}b
/setjn{{statusdict/jobname known{statusdict/jobname 3 -1 roll put}if}stopped
cleartomark}b/colspRefresh{}b end
%%EndProcSet
%%BeginResource: file Pscript_Win_Utils 2.0 0
/|/def load def/,/load load |/~/exch , |/?/ifelse , |/!/pop , |/`/begin , |/^
/index , |/@/dup , |/+/translate , |/$/roll , |/U/userdict , |/M/moveto , |/-
/rlineto , |/&/currentdict , |/:/gsave , |/;/grestore , |/F/false , |/T/true ,
|/N/newpath , |/E/end , |/Ac/arc , |/An/arcn , |/A/ashow , |/D/awidthshow , |
/C/closepath , |/V/div , |/O/eofill , |/L/fill , |/I/lineto , |/-C/rcurveto ,
|/-M/rmoveto , |/+S/scale , |/Ji/setfont , |/Lc/setlinecap , |/Lj/setlinejoin
, |/Lw/setlinewidth , |/S/show , |/LH/showpage , |/K/stroke , |/W/widthshow ,
|/R/rotate , |/b{bind |}bind |/bd{bind |}bind |/xd{~ |}bd/ld{, |}bd/lw/Lw ld
/lc/Lc ld/lj/Lj ld/sg/setgray ld/L2? F/languagelevel where{! languagelevel 2
ge{! T}if}if |/g{@ not{U/DefIf_save save put}if U/DefIf_bool 2 ^ put}b
/DefIf_El{if U/DefIf_bool get not @{U/DefIf_save get restore}if}b/e{DefIf_El !
}b/self & |/reinitialize{[/TextInit/GraphInit/UtilsInit counttomark{@ where{
self eq}{F}?{cvx exec}{!}?}repeat cleartomark}b/initialize{`{/ADO_mxRot ~ |
/TextInitialised? F | reinitialize E}{U/Pscript_Win_Data 200 dict @ ` put
/ADO_mxRot ~ |/TextInitialised? F | reinitialize}?}b/terminate{!{& self eq{
exit}{E}?}loop E}b/suspend/terminate , |/resume{` Pscript_Win_Data `}b/snap{
transform 0.25 sub round 0.25 add ~ 0.25 sub round 0.25 add ~ itransform}b
/dsnap{dtransform round ~ round ~ idtransform}b<04>cvn{}|/setjn{{statusdict
/jobname known{statusdict/jobname 3 -1 $ put}if}stopped cleartomark}b/solid{[]
0 setdash}b/setdsh{0 setdash}b/colspRefresh{}b/rp{4 2 $ M 1 ^ 0 - 0 ~ - neg 0
-}b/rr{1 ^ 0 - 0 ~ - neg 0 - C}b
%%EndResource
%%BeginResource: file Pscript_Win_Utils_L1 2.0 0
L2? not g{/rf{N rp L}b/fx{1 1 dtransform @ 0 ge{1 sub 1}{1 add -0.25}? 3 -1 $
@ 0 ge{1 sub 1}{1 add -0.25}? 3 1 $ 4 1 $ idtransform 4 -2 $ idtransform}b/BZ{
4 -2 $ snap + +S fx rf}b/rs{N rp C K}b/rc{N rp clip N}b/sg{setgray}b/sco{
setrgbcolor}b/sgco{{sg}{sco}?}b}e
%%EndResource
%%BeginResource: file Pscript_Win_Utils_L2 2.0 0
L2? g{/colspA/DeviceGray |/colspABC/DeviceRGB |/setAorABC{{colspA}{colspABC}?
setcolorspace}b/rf/rectfill , |/fx{1 1 dtransform @ 0 ge{1 sub 0.5}{1 add -0.5
}? 3 -1 $ @ 0 ge{1 sub 0.5}{1 add -0.5}? 3 1 $ 4 1 $ idtransform 4 -2 $
idtransform}b/BZ{4 -2 $ snap + +S fx rf}b/rs/rectstroke , |/rc/rectclip , |/sg
{@ @ setcolor}b/sco{setcolor}b/colspRefresh{colspABC setcolorspace}b/sgco{{sg
}{sco}?}b/UtilsInit{F setglobal}b/definecolorrendering{/ColorRendering
defineresource !}b/findcolorrendering{@/ColorRendering resourcestatus{! !
/ColorRendering findresource T}{! F}?}b/selectcolorrendering{@/ColorRendering
resourcestatus{! !/ColorRendering}{!/DefaultColorRendering/ColorRendering}?
findresource setcolorrendering}b}e
%%EndResource
%%EndProlog
%%BeginSetup
Pscript_Win_Driver_Min dup /initialize get exec
[{0
/languagelevel where{pop languagelevel}{1}ifelse 2 ge{1 dict dup/JobTimeout 4 -1 roll put setuserparams}{statusdict/setjobtimeout get exec}ifelse
} stopped cleartomark
[{240
/languagelevel where{pop languagelevel}{1}ifelse 2 ge{1 dict dup/WaitTimeout 4 -1 roll put setuserparams}{statusdict/waittimeout 3 -1 roll put}ifelse
} stopped cleartomark
[{
statusdict /manualfeed false put
} stopped cleartomark
[{
%%BeginFeature: *InputSlot AutoSelect Tray
%%EndFeature
} stopped cleartomark
[{
%%BeginFeature: *PageSize US Letter
letter
%%EndFeature
} stopped cleartomark
/mysetup [ 1.000 0 0 1.000 0 0 ] |
%%EndSetup
%%Page: 1 1
%%BeginPageSetup
[{
%%BeginFeature: *Resolution 300dpi
%%EndFeature
} stopped cleartomark
[{
%%BeginFeature: *Duplex
%%EndFeature
} stopped cleartomark
mysetup concat colspRefresh
: 1.000 1.000 1.000 sco 19 -8 612 792 rf ; %%EndPageSetup
%%BeginDocument: Pscript_Win_PassThrough
%%BeginFont: Optima-Bold
%!FontType1-1.0: Optima-Bold 1
13 dict begin
/FontName /Optima-Bold def
/FontType 1 def
/FontBBox {-97 -271 1000 921} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 12 dict dup begin
/version (001.001) readonly def
/Notice (Optima is a trademark of Allied Corporation.) readonly def
/FullName (Optima Bold) readonly def
/FamilyName (Optima) readonly def
/ItalicAngle 0 def
/isFixedPitch false def
/UnderlinePosition -141 def
/UnderlineThickness 38 def
/Weight (Bold) def
/BaseFontName (Optima-Bold) def
end def
/Encoding StandardEncoding def
currentdict end
currentfile eexec
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cleartomark
%%EndFont
%%BeginFont: Berkeley-Medium
%!FontType1-1.0: Berkeley-Medium 1
13 dict begin
/FontName /Berkeley-Medium def
/FontType 1 def
/FontBBox {-93 -255 1083 842} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 12 dict dup begin
/version (001.000) readonly def
/Notice (Copyright (c) 1989 Adobe Systems Incorporated. All Rights Reserved.ITC Berkeley Oldstyle is a trademark of International Typeface Corporation.) readonly def
/FullName (ITC Berkeley Oldstyle Medium) readonly def
/FamilyName (Berkeley) readonly def
/ItalicAngle 0 def
/isFixedPitch false def
/UnderlinePosition -100 def
/UnderlineThickness 50 def
/Weight (Medium) def
/BaseFontName (Berkeley-Medium) def
end def
/Encoding StandardEncoding def
currentdict end
currentfile eexec
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cleartomark
%%EndFont
%%BeginFont: Berkeley-Bold
%!FontType1-1.0: Berkeley-Bold 1
13 dict begin
/FontName /Berkeley-Bold def
/FontType 1 def
/FontBBox {-102 -250 1129 847} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 12 dict dup begin
/version (001.000) readonly def
/Notice (Copyright (c) 1989 Adobe Systems Incorporated. All Rights Reserved.ITC Berkeley Oldstyle is a trademark of International Typeface Corporation.) readonly def
/FullName (ITC Berkeley Oldstyle Bold) readonly def
/FamilyName (Berkeley) readonly def
/ItalicAngle 0 def
/isFixedPitch false def
/UnderlinePosition -100 def
/UnderlineThickness 50 def
/Weight (Bold) def
/BaseFontName (Berkeley-Bold) def
end def
/Encoding StandardEncoding def
currentdict end
currentfile eexec
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cleartomark
%%EndFont
%%BeginFont: Optima
%!FontType1-1.0: Optima 1
13 dict begin
/FontName /Optima def
/FontType 1 def
/FontBBox {-78 -271 1000 919} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 12 dict dup begin
/version (001.001) readonly def
/Notice (Optima is a trademark of Allied Corporation.) readonly def
/FullName ( Optima.Oblique ) readonly def
/FamilyName (Optima) readonly def
/ItalicAngle -11 def
/isFixedPitch false def
/UnderlinePosition -141 def
/UnderlineThickness 38 def
/Weight (Roman) def
/BaseFontName (Optima) def
end def
/Encoding StandardEncoding def
currentdict end
currentfile eexec
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cleartomark
%%EndFont
%%BeginFont: Berkeley-Italic
%!FontType1-1.0: Berkeley-Italic 1
13 dict begin
/FontName /Berkeley-Italic def
/FontType 1 def
/FontBBox {-130 -260 1019 839} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 12 dict dup begin
/version (001.000) readonly def
/Notice (Copyright (c) 1989 Adobe Systems Incorporated. All Rights Reserved.ITC Berkeley Oldstyle is a trademark of International Typeface Corporation.) readonly def
/FullName (ITC Berkeley Oldstyle Italic) readonly def
/FamilyName (Berkeley) readonly def
/ItalicAngle -8 def
/isFixedPitch false def
/UnderlinePosition -100 def
/UnderlineThickness 50 def
/Weight (Medium) def
/BaseFontName (Berkeley-Italic) def
end def
/Encoding StandardEncoding def
currentdict end
currentfile eexec
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cleartomark
%%EndFont
%%BeginFont: Berkeley-BoldItalic
%!FontType1-1.0: Berkeley-BoldItalic 1
13 dict begin
/FontName /Berkeley-BoldItalic def
/FontType 1 def
/FontBBox {-158 -260 1022 844} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 12 dict dup begin
/version (001.000) readonly def
/Notice (Copyright (c) 1989 Adobe Systems Incorporated. All Rights Reserved.ITC Berkeley Oldstyle is a trademark of International Typeface Corporation.) readonly def
/FullName (ITC Berkeley Oldstyle Bold Italic) readonly def
/FamilyName (Berkeley) readonly def
/ItalicAngle -8 def
/isFixedPitch false def
/UnderlinePosition -100 def
/UnderlineThickness 50 def
/Weight (Bold) def
/BaseFontName (Berkeley-BoldItalic) def
end def
/Encoding StandardEncoding def
currentdict end
currentfile eexec
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/currentpacking where{pop currentpacking true setpacking}if
userdict /PDF 75 dict put
%%BeginFile: pdfvars.prc
%%Copyright: Copyright 1987-1994 Adobe Systems Incorporated. All Rights Reserved.
userdict /PDFVars 59 dict dup begin put
/_save 0 def
/_cshow 0 def
/InitAll 0 def
/TermAll 0 def
/_lp /none def
/_doClip 0 def
%% old (PDFVars was 51, not 59)
%% % paint operators
%% /_fc 0 def % set color before fill occurs
%% /_sc 0 def % set color before stroke occurs
%% % color operands
%% /_gf null def % gray fill color
%% /_cf 4 array def % cmyk fill color
%% /_rgbf 3 array def % rgb fill color
%% /_gs null def % same for stroke
%% /_cs 4 array def
%% /_rgbs 3 array def
%% end old
%% new
/_sfcs 0 def
/_sfc 0 def
/_sscs 0 def
/_ssc 0 def
/_fcs 0 def
/_scs 0 def
/_f1 1 array def
/_f3 3 array def
/_f4 4 array def
/_fc null def
/_s1 1 array def
/_s3 3 array def
/_s4 4 array def
/_sc null def
%% end new
/_inT false def
/_tr -1 def
/_rise 0 def
/_ax 0 def
/_cx 0 def
/_ld 0 def
/_tm matrix def
/_ctm matrix def
/_mtx matrix def
/_hy (-) def
/_fScl 0 def
/_hs 1 def
/_pdfEncodings 2 array def
/Tj 0 def
/_italMtx[1 0 .212557 1 0 0]def
/_basefont 0 def
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end
%%EndFile
PDFVars begin PDF begin
%%BeginFile: pdfutil.prc
%%Copyright: Copyright 1993 Adobe Systems Incorporated. All Rights Reserved.
/bd {bind def} bind def
/ld {load def} bd
/dd { PDFVars 3 1 roll put } bd
/xdd { exch dd } bd
/Level2?
/languagelevel where { pop languagelevel 2 ge } { false } ifelse
def
/here {
dup currentdict exch known
{ currentdict exch get true }
{ pop false }
ifelse
} bd
/isdefined? { where { pop true } { false } ifelse } bd
/StartLoad { dup dup not { /_save save dd } if } bd
/EndLoad { if not { _save restore } if } bd
/npop { { pop } repeat } bd
%%EndFile
%%BeginFile: l2compat
%%Copyright: Copyright 1987-1993 Adobe Systems Incorporated. All Rights Reserved.
/cshow isdefined? not StartLoad {
/cshow {
exch /_cshow xdd
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} bd
} EndLoad
/setcmykcolor isdefined? not StartLoad {
/setcmykcolor {
1 sub 4 1 roll
3 {
3 index add neg dup 0 lt { pop 0 } if
3 1 roll
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setrgbcolor
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/rectclip isdefined? not StartLoad {
/re 0 def
/rectclip { newpath re clip newpath } bd
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/execform {
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BBox aload pop
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%%Copyright: Copyright 1987-1994 Adobe Systems Incorporated. All Rights Reserved.
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{
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transform
0.25 sub round 0.25 add exch
0.25 sub round 0.25 add exch
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/m { pl moveto } bd
/l { pl lineto } bd
/c { pl curveto } bd
}
ifelse
/v { currentpoint 6 2 roll c } bd
/y { 2 copy c } bd
/h/closepath ld
/d/setdash ld
/j/setlinejoin ld
/J/setlinecap ld
/M/setmiterlimit ld
/w/setlinewidth ld
/cf currentflat def
/i {
dup 0 eq { pop cf } if
setflat
} bd
/ilp { /_lp /none dd } bd
/sfc {
_lp /fill ne {
_sfcs
_sfc
/_lp /fill dd
} if
} bd
/ssc {
_lp /stroke ne {
_sscs
_ssc
/_lp /stroke dd
} if
} bd
/n {
_doClip 1 ge {
_doClip 1 eq { clip } { eoclip } ifelse
/_doClip 0 dd
} if
newpath
} bd
/f {
_doClip 1 ge
{
gsave sfc fill grestore
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newpath
ilp
/_doClip 0 dd
}
{ sfc fill }
ifelse
} bd
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_doClip 1 ge
{
gsave sfc eofill grestore
_doClip 1 eq { clip } { eoclip } ifelse
newpath
ilp
/_doClip 0 dd
}
{ sfc eofill }
ifelse
} bd
/S {
_doClip 1 ge
{
gsave ssc stroke grestore
_doClip 1 eq { clip } { eoclip } ifelse
newpath
ilp
/_doClip 0 dd
}
{ ssc stroke }
ifelse
} bd
/s { h S } bd
/B {
_doClip dup 1 ge
gsave f grestore
{
gsave S grestore
1 eq { clip } { eoclip } ifelse
newpath
ilp
/_doClip 0 dd
}
{ pop S }
ifelse
} bd
/b { h B } bd
/B* {
_doClip dup 1 ge
gsave f* grestore
{
gsave S grestore
1 eq { clip } { eoclip } ifelse
newpath
ilp
/_doClip 0 dd
}
{ pop S }
ifelse
} bd
/b* { h B* } bd
/W { /_doClip 1 dd } bd
/W* { /_doClip 2 dd } bd
/q/save ld
/Q { restore ilp } bd
Level2? not StartLoad {
/cs
{
dup where { pop load } if
/_sfcs { } dd
dup type /arraytype eq
{ dup 0 get /Indexed eq { 1 } { 0 } ifelse get }
if
dup /DeviceCMYK eq
{
/_fc _f4 dd
/_sfc { _fc aload pop setcmykcolor } dd
}
{
dup /DeviceRGB eq
{
/_fc _f3 dd
/_sfc { _fc aload pop setrgbcolor } dd
}
{
/_fc _f1 dd
/_sfc { _fc aload pop setgray } dd
}
ifelse
}
ifelse
pop
} bd
/CS
{
dup where { pop load } if
/_sscs { } dd
dup type /arraytype eq
{ dup 0 get /Indexed eq { 1 } { 0 } ifelse get }
if
dup /DeviceCMYK eq
{
/_sc _s4 dd
/_ssc { _sc aload pop setcmykcolor } dd
}
{
dup /DeviceRGB eq
{
/_sc _s3 dd
/_ssc { _sc aload pop setrgbcolor } dd
}
%%% /Pattern not impl'd
{
/_sc _s1 dd
/_ssc { _sc aload pop setgray } dd
}
ifelse
}
ifelse
pop
} bd
/ri { pop } bd
} EndLoad
Level2? StartLoad {
/cs
{
dup where { pop load } if
dup /_fcs xdd
/_sfcs { _fcs setcolorspace } dd
dup type /arraytype eq
{ dup 0 get /Indexed eq { 1 } { 0 } ifelse get }
if
dup /DeviceCMYK eq
{ /_fc _f4 dd }
{
dup /DeviceRGB eq dup /CIEBasedABC eq or
{ /_fc _f3 dd }
{ /_fc _f1 dd }
ifelse
}
ifelse
pop
/_sfc { _fc aload pop setcolor } dd
} bd
/CS
{
dup where { pop load } if
dup /_scs xdd
/_sscs { _scs setcolorspace } dd
dup type /arraytype eq
{ dup 0 get /Indexed eq { 1 } { 0 } ifelse get }
if
dup /DeviceCMYK eq
{ /_sc _s4 dd }
{
dup /DeviceRGB eq dup /CIEBasedABC eq or
{ /_sc _s3 dd }
{ /_sc _s1 dd }
ifelse
}
ifelse
pop
/_ssc { _sc aload pop setcolor } dd
} bd
/ri {
/findcolorrendering isdefined?
{
findcolorrendering pop
dup /ColorRendering resourcestatus
{
pop pop
/ColorRendering findresource
setcolorrendering
}
{ pop }
ifelse
}
{ pop }
ifelse
} bd
} EndLoad
/sc
{
_fc astore pop
ilp
} bd
/SC
{
_sc astore pop
ilp
} bd
/g { /DefaultGray cs sc } bd
/rg { /DefaultRGB cs sc } bd
/k { /DeviceCMYK cs sc } bd
/pc { /DeviceGray cs pop 0.5 sc } bd
/G { /DefaultGray CS SC } bd
/RG { /DefaultRGB CS SC } bd
/K { /DeviceCMYK CS SC } bd
/PC { /DeviceGray CS pop 0.5 SC } bd
/cm { _mtx astore concat } bd
/re {
4 2 roll m
1 index 0 rlineto
0 exch rlineto
neg 0 rlineto
h
} bd
/RC/rectclip ld
/EF/execform ld
/PS { cvx exec } bd
/initgs {
/DefaultGray where
{ pop }
{ /DefaultGray /DeviceGray dd }
ifelse
/DefaultRGB where
{ pop }
{ /DefaultRGB /DeviceRGB dd }
ifelse
0 g 0 G
[]0 d 0 j 0 J 10 M 1 w
} bd
%%EndFile
%%BeginFile: pdftext.prc
%%Copyright: Copyright 1987-1994 Adobe Systems Incorporated. All Rights Reserved.
PDF /PDFText 51 dict dup begin put
/initialize { /TZ isdefined? not { PDFText begin } if } bd
/terminate { currentdict PDFText eq { end } if } bd
/CopyFont {
{
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} forall
} bd
/modEnc {
/_enc xdd
/_icode 0 dd
counttomark 1 sub -1 0
{
index
dup type /nametype eq
{
_enc _icode 3 -1 roll put
_icode 1 add
}
if
/_icode xdd
} for
cleartomark
_enc
} bd
/trEnc {
/_enc xdd
255 -1 0 {
exch dup -1 eq
{ pop /.notdef }
{ Encoding exch get }
ifelse
_enc 3 1 roll put
} for
pop
_enc
} bd
/TE {
/_i xdd
StandardEncoding 256 array copy modEnc
_pdfEncodings exch _i exch put
} bd
/TZ
{
/_usePDFEncoding xdd
findfont
dup length 2 add dict
begin
{
1 index /FID ne { def } { pop pop } ifelse
} forall
/FontName exch def
_usePDFEncoding 0 ge
{
/Encoding _pdfEncodings _usePDFEncoding get def
pop
}
{
_usePDFEncoding -1 eq
{
counttomark 0 eq
{ pop }
{
Encoding 256 array copy
modEnc /Encoding exch def
}
ifelse
}
{
256 array
trEnc /Encoding exch def
}
ifelse
}
ifelse
FontName currentdict
end
definefont pop
}
bd
/swj {
dup 4 1 roll
dup length exch stringwidth
exch 5 -1 roll 3 index mul add
4 1 roll 3 1 roll mul add
6 2 roll /_cnt 0 dd
{1 index eq {/_cnt _cnt 1 add dd} if} forall pop
exch _cnt mul exch _cnt mul 2 index add 4 1 roll 2 index add 4 1 roll pop pop
} bd
/jss {
4 1 roll
{
2 npop
(0) exch 2 copy 0 exch put
gsave
32 eq
{
exch 6 index 6 index 6 index 5 -1 roll widthshow
currentpoint
}
{
false charpath currentpoint
4 index setmatrix stroke
}
ifelse
grestore
moveto
2 copy rmoveto
} exch cshow
6 npop
} def
/jsp
{
{
2 npop
(0) exch 2 copy 0 exch put
32 eq
{ exch 5 index 5 index 5 index 5 -1 roll widthshow }
{ false charpath }
ifelse
2 copy rmoveto
} exch cshow
5 npop
} bd
/trj { _cx 0 32 _ax 0 6 5 roll } bd
/pjsf { trj sfc awidthshow } bd
/pjss { trj _ctm ssc jss } bd
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/_Tjdef [
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{
dup
currentpoint 3 2 roll
pjsf
newpath moveto
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} bind
{
trj swj rmoveto
} bind
{
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{
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{
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pjsc
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0 0 moveto
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_tr 3 gt {clip} if
_ctm setmatrix newpath
} bd
/Tr {
_inT { _tr 3 le {currentpoint newpath moveto} if } if
dup /_tr xdd
_Tjdef exch get /Tj xdd
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/Td { _mtx translate _tm _tm concatmatrix pop iTm 0 0 moveto } bd
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/Tz { 100 div /_hs xdd iTm } bd
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/' { 0 0 3 -1 roll " } bd
/" { exch Tc exch Tw T* Tj } bd
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{
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{ Tj }
{ 0 exch Tk }
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} bd
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/T3Defs {
/BuildChar
{
1 index /Encoding get exch get
1 index /BuildGlyph get exec
}
def
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exch begin
GlyphProcs exch get exec
end
} def
} bd
/MakeBold {
findfont dup dup length 2 add dict
begin
CopyFont
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/dummybold currentdict
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definefont
8 dict begin
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/FontBBox[0 0 1 1]def
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{
exch begin
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( )dup 0 4 -1 roll put
dup stringwidth
1 index 0 ne { exch .03 add exch }if
setcharwidth
0 0 moveto
gsave
dup show
grestore
_basefonto setfont
show
end
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currentdict
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definefont pop
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dup length dict
begin
CopyFont
currentdict
end
definefont pop
}bd
/MakeBoldItalic {
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MakeBold
/dummybold
MakeItalic
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%%EndFile
PDFText begin
[39/quotesingle 96/grave 128/Adieresis/Aring/Ccedilla/Eacute/Ntilde/Odieresis
/Udieresis/aacute/agrave/acircumflex/adieresis/atilde/aring/ccedilla/eacute
/egrave/ecircumflex/edieresis/iacute/igrave/icircumflex/idieresis/ntilde
/oacute/ograve/ocircumflex/odieresis/otilde/uacute/ugrave/ucircumflex
/udieresis/dagger/degree/cent/sterling/section/bullet/paragraph/germandbls
/registered/copyright/trademark/acute/dieresis/.notdef/AE/Oslash
/.notdef/plusminus/.notdef/.notdef/yen/mu/.notdef/.notdef
/.notdef/.notdef/.notdef/ordfeminine/ordmasculine/.notdef/ae/oslash
/questiondown/exclamdown/logicalnot/.notdef/florin/.notdef/.notdef
/guillemotleft/guillemotright/ellipsis/.notdef/Agrave/Atilde/Otilde/OE/oe
/endash/emdash/quotedblleft/quotedblright/quoteleft/quoteright/divide
/.notdef/ydieresis/Ydieresis/fraction/currency/guilsinglleft/guilsinglright
/fi/fl/daggerdbl/periodcentered/quotesinglbase/quotedblbase/perthousand
/Acircumflex/Ecircumflex/Aacute/Edieresis/Egrave/Iacute/Icircumflex
/Idieresis/Igrave/Oacute/Ocircumflex/.notdef/Ograve/Uacute/Ucircumflex
/Ugrave/dotlessi/circumflex/tilde/macron/breve/dotaccent/ring/cedilla
/hungarumlaut/ogonek/caron
0 TE
[1/dotlessi/caron 39/quotesingle 96/grave
127/bullet/bullet/bullet/quotesinglbase/florin/quotedblbase/ellipsis
/dagger/daggerdbl/circumflex/perthousand/Scaron/guilsinglleft/OE
/bullet/bullet/bullet/bullet/quoteleft/quoteright/quotedblleft
/quotedblright/bullet/endash/emdash/tilde/trademark/scaron
/guilsinglright/oe/bullet/bullet/Ydieresis/space/exclamdown/cent/sterling
/currency/yen/brokenbar/section/dieresis/copyright/ordfeminine
/guillemotleft/logicalnot/hyphen/registered/macron/degree/plusminus
/twosuperior/threesuperior/acute/mu/paragraph/periodcentered/cedilla
/onesuperior/ordmasculine/guillemotright/onequarter/onehalf/threequarters
/questiondown/Agrave/Aacute/Acircumflex/Atilde/Adieresis/Aring/AE/Ccedilla
/Egrave/Eacute/Ecircumflex/Edieresis/Igrave/Iacute/Icircumflex/Idieresis
/Eth/Ntilde/Ograve/Oacute/Ocircumflex/Otilde/Odieresis/multiply/Oslash
/Ugrave/Uacute/Ucircumflex/Udieresis/Yacute/Thorn/germandbls/agrave
/aacute/acircumflex/atilde/adieresis/aring/ae/ccedilla/egrave/eacute
/ecircumflex/edieresis/igrave/iacute/icircumflex/idieresis/eth/ntilde
/ograve/oacute/ocircumflex/otilde/odieresis/divide/oslash/ugrave/uacute
/ucircumflex/udieresis/yacute/thorn/ydieresis
1 TE
end
currentdict readonly pop end end
/currentpacking where {pop setpacking}if
PDFVars/InitAll{
PDF/initialize get exec
PDFText/initialize get exec
initgs 0 Tr
}put
PDFVars/TermAll{
PDFText/terminate get exec
PDF/terminate get exec
}put
PDFVars/InitAll get exec
%%Page: 1 1
save
PDFVars/InitAll get exec
%PDF_BeginEncoding: F5 Optima-Bold
[ 39/quotesingle 96/grave 127/.notdef/Adieresis/Aring/Ccedilla
/Eacute/Ntilde/Odieresis/Udieresis/aacute/agrave
/acircumflex/adieresis/atilde/aring/ccedilla/eacute
/egrave/ecircumflex/edieresis/iacute/igrave/icircumflex
/idieresis/ntilde/oacute/ograve/ocircumflex/odieresis
/otilde/uacute/ugrave/ucircumflex/udieresis/dagger
/degree/cent/sterling/section/bullet/paragraph
/germandbls/registered/copyright/trademark/acute/dieresis
/notequal/AE/Oslash/infinity/plusminus/lessequal
/greaterequal/yen/mu/partialdiff/summation/product
/pi/integral/ordfeminine/ordmasculine/Omega/ae
/oslash/questiondown/exclamdown/logicalnot/radical/florin
/approxequal/Delta/guillemotleft/guillemotright/ellipsis/blank
/Agrave/Atilde/Otilde/OE/oe/endash
/emdash/quotedblleft/quotedblright/quoteleft/quoteright/divide
/lozenge/ydieresis/Ydieresis/fraction/currency/guilsinglleft
/guilsinglright/fi/fl/daggerdbl/periodcentered/quotesinglbase
/quotedblbase/perthousand/Acircumflex/Ecircumflex/Aacute/Edieresis
/Egrave/Iacute/Icircumflex/Idieresis/Igrave/Oacute
/Ocircumflex/apple/Ograve/Uacute/Ucircumflex/Ugrave
/dotlessi/circumflex/tilde/macron/breve/dotaccent
/ring/cedilla/hungarumlaut/ogonek/caron
/F5/Optima-Bold -1 TZ
%PDF_EndEncoding
%PDF_BeginEncoding: F7 Berkeley-Medium
[ 39/quotesingle 96/grave 127/.notdef/Adieresis/Aring/Ccedilla
/Eacute/Ntilde/Odieresis/Udieresis/aacute/agrave
/acircumflex/adieresis/atilde/aring/ccedilla/eacute
/egrave/ecircumflex/edieresis/iacute/igrave/icircumflex
/idieresis/ntilde/oacute/ograve/ocircumflex/odieresis
/otilde/uacute/ugrave/ucircumflex/udieresis/dagger
/degree/cent/sterling/section/bullet/paragraph
/germandbls/registered/copyright/trademark/acute/dieresis
/notequal/AE/Oslash/infinity/plusminus/lessequal
/greaterequal/yen/mu/partialdiff/summation/product
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(Introduction)Tj
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[(The exercise boom is not )8 (just a fad; it is a return)]TJ
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[(great number)16 (s)-44 ( of people only during the last)]TJ
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[(\(Eaton, )21 (Shostak, )54 (K)-26 (onner )11 (1988)18 (,)-14 ( p)-14 (.)-14 ( 1)-14 (6)-14 (8)-6 (\))]TJ
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(improve health among entire populations. The chap-)Tj
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(ter focuses on Western \(i.e., Greco-Roman\) history,)Tj
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(leading to current American attitudes and guidelines)Tj
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(regarding physical activity. These guidelines are)Tj
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(discussed in detail in the last half of the chapter. To)Tj
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(flesh out this narrow focus on Western traditions, as)Tj
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(emphasis of the chapter, this chapter begins by)Tj
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(of the historical prominence of physical activity in)Tj
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(lives. Investigations of preindustrial societies still)Tj
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(time for both rest and recreational physical endeavors.)Tj
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[(Eaton, Shostak, and )-6 (Konner)33 ( \(1988\) describe a)]TJ
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[(\322Paleolithic )10 (rhythm)12 (\323 \(p. 32\) observed among con-)]TJ
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(activity in this report. This natural cycle of regu-)Tj
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(most of human existence. Sustenance preoccupa-)Tj
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(and has recently been shown to decrease the incidence)Tj
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(see Chapter 4\).)Tj
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(were known to be essential principles of daily)Tj
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(living. The )Tj
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(Ajur Veda,)Tj
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[( a collection of health and)]TJ
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[(emotions )10 (and )10 (were )8 (prerequisites for religious ex-)]TJ
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(perience. In both India and China during this)Tj
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(period, the linking of exercise and health may)Tj
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(medicine \(Snook 1984\).)Tj
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(Though less directly concerned with physical)Tj
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(health than with social and religious attainment,)Tj
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(was a prominent feature of all major aspects of life)Tj
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(\(Nabokov 1981\). Long before the Europeans in-)Tj
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(ern-day lacrosse. Even today, the Tarahumarahe of)Tj
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(northern Mexico play a version of kickball that)Tj
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(1981; Eaton, Shostak, Konner 1988\).)Tj
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[(W)34 (estern Historical Perspective)]TJ
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(\(as is discussed throughout this section\), the ancient)Tj
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[(1)-8 (9)-11 (65)23 (\))-8 (.)-37 ( In the classical-era Olympic Games, the Greeks)]TJ
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(the ancient Greeks.)Tj
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(atic observation.)Tj
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(Among the ancient Greeks, the recognition that)Tj
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(proper amounts of physical activity are necessary for)Tj
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(healthy living dates back to at least the 5th century)Tj
T*
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(B.C. \(Berryman 1992\). The lessons found in the)Tj
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(healthier lives.)Tj
1.636 -1.227 TD
0.135 Tw
(Christobal Mendez, who received his medical)Tj
-1.636 -1.182 TD
0.204 Tw
(training at the University of Salamanca, was the)Tj
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/F13 1 Tf
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(Book of Bodily Exercise )Tj
/F7 1 Tf
9.727 0 TD
0.016 Tw
(\(1553\). His novel and com-)Tj
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(prehensive ideas preceded developments in exercise)Tj
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(unique to the early 20th century. The book consists)Tj
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T*
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T*
0.028 Tw
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0.017 Tw
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(\(1960 reprint, p. 22\).)Tj
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(In 1569, Hieronymus Mercurialis\325 )Tj
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0.203 Tw
(The Art of)Tj
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(Gymnastics Among the Ancients)Tj
/F7 1 Tf
13.409 0 TD
0.203 Tw
[( was published in)]TJ
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0.136 Tw
(rial from nearly 200 works by Greek and Roman)Tj
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(authors. In general, Mercurialis established the fol-)Tj
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(lowing exercise principles: people who are ill should)Tj
23.955 56.409 TD
0.028 Tw
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(conditions; special exercises should be prescribed on)Tj
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[(an individual basis for convalescent, )13 (weak, )-9 (and )-9 (older)]TJ
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[(patients; people who lead sedentary lives)-7 ( )39 (need ex-)]TJ
0 -1.182 TD
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[(ercise)-8 ( )30 (urgently; each exercise should preserve the)]TJ
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0.011 Tc
0.034 Tw
[(existing healthy state; exercise should n)24 (ot )10 (disturb)]TJ
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0.011 Tw
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(exercise)Tj
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0.137 Tw
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[(healthy)18 ( people should exercise regularly.)]TJ
1.636 -1.182 TD
0.003 Tc
0.047 Tw
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0.015 Tw
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(compounds of mercury and drugs\321\322heroic\323 medi-)Tj
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T*
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1.636 -1.227 TD
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7.045 0 TD
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0 -1.227 TD
-0.055 Tw
(and \322most useful\323 exercise but considered riding on)Tj
0 -1.182 TD
0.005 Tw
(horseback as the \322most manly\323 and \322most healthy\323)Tj
T*
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(\(1734 reprint, p. 94\). He also advocated exercises in)Tj
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0 -1.182 TD
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(to promote perspiration and improve circulation.)Tj
1.636 -1.182 TD
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(John Wesley\325s )Tj
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5.909 0 TD
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(Primitive Physic,)Tj
/F7 1 Tf
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[( first published in)]TJ
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0.105 Tw
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(Cheyne. In his preface, Wesley noted that \322the power)Tj
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(greater than can well be conceived; especially in)Tj
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(those who add temperance thereto\323 \(1793 reprint,)Tj
0 -1.227 TD
0.003 Tc
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[(p)-10 (.)-6 ( iv\). William Buchan\325s classic)]TJ
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[( Domestic Medicine,)]TJ
/F7 1 Tf
-13.227 -1.182 TD
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(written in 1769, prescribed proper regimen for im-)Tj
T*
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(proving individual and family health. The book)Tj
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(contained rules for the healthy and the sick and)Tj
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(stressed the importance of exercise for good health in)Tj
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(both children and adults.)Tj
1.636 -1.182 TD
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(During the 19th century, both the classical Greek)Tj
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(tradition and the general hygiene movement were)Tj
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(finding their way into the United States through)Tj
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0 -1.182 TD
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T*
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0 -1.182 TD
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(was made to popularize the Greek laws of health, to)Tj
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0.028 Tw
(make each person responsible for the maintenance)Tj
0 -1.182 TD
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T*
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0.172 Tw
(regulation, the responsibility for personal health,)Tj
0 -1.182 TD
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0 -1.227 TD
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(much, slept too long, or did not get enough exercise,)Tj
0 -1.182 TD
-0.038 Tw
(they could only blame themselves for illness. By the)Tj
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(same token, they could also determine their own)Tj
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(good health \(Cassedy 1977; Numbers 1977;)Tj
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(Verbrugge 1981; Morantz 1984\).)Tj
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0.13 Tw
(A.F.M. Willich\325s )Tj
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7.318 0 TD
0.125 Tw
(Lectures on Diet and Regimen)Tj
/F7 1 Tf
-8.955 -1.182 TD
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(\(1801\) emphasized the necessity of exercise within)Tj
0 -1.227 TD
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(the bounds of moderation. He included information)Tj
0 -1.182 TD
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(on specific exercises, the time for exercise, and the)Tj
T*
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(duration of exercise. The essential advantages of)Tj
0 -1.227 TD
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(exercise included increased bodily strength, improved)Tj
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0.021 Tw
(circulation of the blood and all other bodily fluids,)Tj
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(aid in necessary secretions and excretions, help in)Tj
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(clearing and refining the blood, and removal of)Tj
T*
(obstructions.)Tj
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(John Gunn\325s classic )Tj
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8.455 0 TD
(Domestic Medicine, Or Poor)Tj
-10.091 -1.182 TD
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(Man\325s Friend)Tj
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5.136 0 TD
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(, was first published in 1830. His section)Tj
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(entitled \322Exercise\323 recommended temperance, exer-)Tj
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0.12 Tw
(cise, and rest and valued nature\325s way over tradi-)Tj
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0.254 Tw
(tional medical treatment. He also recommended)Tj
0 -1.182 TD
0.251 Tw
(exercise for women and claimed that all of the)Tj
T*
0.207 Tw
(\322diseases of delicate women\323 like \322hysterics and)Tj
0 -1.227 TD
-0.092 Tw
(hypochondria, arise from want of due exercise in the)Tj
0 -1.182 TD
0.134 Tw
(open, mild, and pure air\323 \(1986 reprint, p. 109\).)Tj
0 -1.227 TD
0.014 Tw
(Finally, in an interesting statement for the 1830s if)Tj
0 -1.182 TD
0.045 Tw
(not the 1990s, Gunn recommended a training sys-)Tj
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(tem for all: \322The advantages of the training systems)Tj
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(are not confined to pedestrians or walkers\321or to)Tj
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0.157 Tw
(pugilists or boxers alone; or to horses which are)Tj
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(trained for the chase and the race track; they extend)Tj
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0.101 Tw
(to man in all conditions; and were training intro-)Tj
T*
0.099 Tw
(duced into the United States, and made use of by)Tj
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0.023 Tw
(physicians in many cases instead of medical drugs,)Tj
23.955 56.409 TD
0.186 Tw
(the beneficial consequences in the cure of many)Tj
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(diseases would be very great indeed\323 \(p. 113\).)Tj
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(Associating Physical Inactivity with Disease)Tj
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11 0 0 11 329.5 654.5 Tm
0.003 Tc
-0.065 Tw
(Throughout history, numerous health professionals)Tj
T*
-0.084 Tw
(have observed that sedentary people appear to suffer)Tj
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0.154 Tw
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0 -1.182 TD
-0.118 Tw
(example is found in the writings of English physician)Tj
T*
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(Thomas Cogan, author of )Tj
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10.318 0 TD
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(The Haven of Health)Tj
/F7 1 Tf
7.773 0 TD
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[( \(1584\);)]TJ
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0.003 Tc
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(he recommended his book to students who, because)Tj
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0.102 Tw
(of their sedentary ways, were believed to be most)Tj
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(susceptible to sickness.)Tj
1.636 -1.182 TD
0.092 Tw
(In his 1713 book )Tj
/F13 1 Tf
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(Diseases of Workers)Tj
/F7 1 Tf
8.273 0 TD
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(, Bernar-)Tj
-17.636 -1.227 TD
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T*
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0 -1.182 TD
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(and Their Diseases,\323 Ramazzini noted that \322those)Tj
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0.081 Tw
(workers,\325 such as cobblers and tailors, suffer from)Tj
T*
0.12 Tw
(their own particular diseases.\323 He concluded that)Tj
0 -1.227 TD
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(\322these workers . . . suffer from general ill-health and)Tj
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(an excessive accumulation of unwholesome humors)Tj
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(caused by their sedentary life,\323 and he urged them to)Tj
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0.208 Tw
(at least exercise on holidays \322so to some extent)Tj
T*
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(counteract the harm done by many days of sedentary)Tj
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(life\323 \(1964 trans., pp. 281\320285\).)Tj
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(Shadrach Ricketson, a New York physician, wrote)Tj
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0.003 Tc
0.087 Tw
(the first American text on hygiene and preventive)Tj
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(Means of)Tj
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(Preserving Health and Preventing Diseases)Tj
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(, Ricketson)Tj
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(explained that \322a certain proportion of exercise is not)Tj
T*
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(much less essential to a healthy or vigorous constitu-)Tj
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(tion, than drink, food, and sleep; for we see that)Tj
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(people, whose )Tj
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[(mit )67 (of exercise, soon become pale,)]TJ
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[(tion, and )9 (encourages )-10 (perspiration\323)-5 ( )]TJ
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[(\(pp. )]TJ
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(152\320153\).)Tj
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0.224 Tw
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0 -1.182 TD
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0.196 Tw
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0 -1.182 TD
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(physical education \(Rogers 1934\). At the same time,)Tj
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0.067 Tw
(the combination of increased leisure time for many)Tj
0 -1.227 TD
-0.019 Tw
(Americans and a growing national interest in college)Tj
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(and high school sports shifted the emphasis on physi-)Tj
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(cal education away from the earlier aim of enhancing)Tj
0 -1.182 TD
0.133 Tw
(performance and health to a new focus on sports-)Tj
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(related skills and the worthy use of leisure time.)Tj
1.636 -1.227 TD
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0.068 Tw
(Physical efficiency was a term widely used in)Tj
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-0.018 Tw
(the literature of the 1930s. Another term, physical)Tj
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-0.065 Tw
(condition, also found its way into research reports.)Tj
0 -1.182 TD
0.161 Tw
(In 1936, Arthur Steinhaus published one of the)Tj
0 -1.227 TD
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(earliest articles on \322physical fitness\323 in the )Tj
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-18.318 -1.182 TD
0.204 Tw
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/F7 1 Tf
19.727 0 TD
0.211 Tw
(; in)Tj
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-0.016 Tw
(1938, C. H. McCloy\325s article \322Physical Fitness and)Tj
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(Citizenship\323 appeared in the same journal.)Tj
1.636 -1.182 TD
-0.04 Tw
(As the United States entered World War II, the)Tj
-1.636 -1.227 TD
0.054 Tw
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0.014 Tw
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0.131 Tw
(ness testing and preparedness. In October 1940,)Tj
0 -1.182 TD
0.011 Tw
(President Franklin Roosevelt named John Kelly, a)Tj
T*
0.258 Tw
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0 -1.227 TD
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0 -1.227 TD
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(York City and the director of civilian defense for the)Tj
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T*
0.01 Tw
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0.229 Tw
(among girls and women \(Park 1989; Berryman)Tj
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1.636 -1.182 TD
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0.007 Tw
(In 1943, Arthur Steinhaus chaired a committee)Tj
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(physical fitness under the direction of the Federal)Tj
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0.013 Tc
0.205 Tw
(Security Agency. Crampton and his 73-member)Tj
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-0.129 Tw
[(a)-8 (d)-19 (visory council were charged with developing physi-)]TJ
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(Park 1989\).)Tj
1.636 -1.182 TD
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(In 1941, Morris Fishbein, editor of the )Tj
/F13 1 Tf
15.818 0 TD
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(Journal of)Tj
-17.455 -1.227 TD
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(the American Medical Association,)Tj
/F7 1 Tf
13.864 0 TD
0.036 Tw
[( stated that \322from)]TJ
-13.864 -1.182 TD
0.12 Tw
(the point of view on physical fitness we are a far)Tj
23.955 56.409 TD
0.109 Tw
(better nation now than we were in 1917,\323 but he)Tj
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0.167 Tw
(cautioned Americans not to believe \322we have at-)Tj
T*
0.041 Tw
(tained an optimum in physical fitness\323 \(p. 54\). He)Tj
0 -1.227 TD
-0.023 Tw
(realized the magnitude of the fitness problem when)Tj
0 -1.182 TD
0.006 Tw
(he noted that the poor results of physical examina-)Tj
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(tions reported by the Selective Service Boards were \322a)Tj
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(challenge to the medical profession, to the social)Tj
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(scientists, the physical educators, the public health)Tj
0 -1.227 TD
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(officials, and all those concerned in the United States)Tj
0 -1.182 TD
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(with the physical improvement of our population\323)Tj
0 -1.227 TD
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(\(p. 55\). The goals most frequently cited for physical)Tj
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(respiratory endurance, muscular growth, flexibility,)Tj
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(speed, agility, balance, and accuracy \(Larson and)Tj
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(Yocom 1951\).)Tj
1.636 -1.182 TD
0.212 Tw
(After World War II concluded, a continuing)Tj
-1.636 -1.227 TD
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-0.077 Tw
[(intere)8 (st in physical fitness convinced other key mem-)]TJ
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0.226 Tw
(bers of the medical profession and the American)Tj
T*
0.124 Tw
(Medical Association to continue studying exercise.)Tj
0 -1.227 TD
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(Much of this interest can be attributed to the pioneer-)Tj
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(ing work of Thomas K. Cureton, Jr., and his Physical)Tj
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(Fitness Research Laboratory at the University of Illinois)Tj
0 -1.182 TD
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(\(Shea 1993\). Cardiologists, health education special-)Tj
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0.011 Tw
(ists, and physicians in preventive medicine were be-)Tj
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0 -1.182 TD
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(overall health and efficiency of the heart and circula-)Tj
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0.258 Tw
(tory system. In 1946, the American Medical)Tj
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0.12 Tw
(Association\325s Bureau of Health Education designed)Tj
T*
0.181 Tw
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0 -1.182 TD
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(the nation in the development of satisfactory health)Tj
0 -1.227 TD
0.034 Tw
(education programs\323 \(Fishbein 1947, p. 1009\). The)Tj
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0.069 Tw
(program became an important link among physical)Tj
T*
0.001 Tw
(educators, physicians, and physiologists.)Tj
1.636 -1.227 TD
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-1.636 -1.182 TD
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-0.129 Tw
(to physical fitness, including that of President Dwight)Tj
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0.149 Tw
[(D. Eisenhower, was the publication of the )21 (article)]TJ
0 -1.182 TD
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[(\322Muscular Fitness and Health\323 in the December)17 ( )-9 (1953)]TJ
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(issue of the )Tj
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[(Journal of Health, Physical )37 (Education,)]TJ
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0.013 Tc
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[(a)-10 (n)-10 (d)-24 ( Recreation)]TJ
/F7 1 Tf
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(. The authors, Hans Kraus and Ruth)Tj
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[(Hirschland of the Institute of Physical )12 (Medicine)]TJ
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(Bellevue Medical Center, stated that 56.6 per-)Tj
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[(cent)-24 ( o)20 (f)20 ( )]TJ
3.167 0 TD
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[(the )105 (American schoolchildren tested \322failed)]TJ
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0.135 Tw
[(t)10 (o)10 ( meet even a minimum standard required)27 ( )9 (f)10 (o)10 (r)]TJ
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(Senator James Duff of these startling test results.)Tj
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(Duff, in turn, brought the research to the attention of)Tj
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0.028 Tw
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0 -1.182 TD
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(and exercise experts to a meeting in 1955 to examine)Tj
0 -1.227 TD
0.039 Tw
(this issue in more depth. A President\325s Conference)Tj
0 -1.182 TD
0.078 Tw
(on Fitness of American Youth, held in June 1956,)Tj
T*
0 Tc
-0.128 Tw
(was attended by 150 leaders from government, physi-)Tj
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0.003 Tc
0.029 Tw
(cal education, medical, public health, sports, civic,)Tj
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(and recreational organizations. This meeting even-)Tj
0 -1.227 TD
0.181 Tw
(tually led to the establishment of the President\325s)Tj
0 -1.182 TD
-0.004 Tc
-0.103 Tw
[(Council on Youth Fitness and the President\325s Citi)30 (zens)]TJ
T*
0.003 Tc
0.193 Tw
(Advisory Committee on the Fitness of American)Tj
0 -1.227 TD
0.017 Tw
(Youth \(Hackensmith 1966; Van Dalen and Bennett)Tj
0 -1.182 TD
(1971\).)Tj
1.636 -1.227 TD
-0.05 Tw
(When John Kennedy became president in 1961,)Tj
-1.636 -1.182 TD
0.056 Tw
(one of his first actions was to call a conference on)Tj
0 -1.227 TD
0.23 Tw
(physical fitness and young people. In 1963, the)Tj
0 -1.182 TD
0.024 Tw
(President\325s Council on Youth Fitness was renamed)Tj
T*
-0.093 Tw
(the President\325s Council on Physical Fitness. In 1968,)Tj
0 -1.227 TD
-0.044 Tw
(the word \322sports\323 was added to the name, making it)Tj
0 -1.182 TD
-0.003 Tc
-0.129 Tw
(the President\325s Council on Physical Fitness and Sports)Tj
0 -1.227 TD
0.003 Tc
0.033 Tw
(\(PCPFS\). The PCPFS was charged with promoting)Tj
0 -1.182 TD
-0.101 Tw
(physical activity, fitness, and sports for Americans of)Tj
T*
0.001 Tw
(all ages.)Tj
1.636 -1.227 TD
-0.014 Tw
(During the 1960s, a number of educational and)Tj
-1.636 -1.182 TD
0.098 Tw
(public health organizations published articles and)Tj
0 -1.227 TD
-0.042 Tw
(statements on the importance of fitness for children)Tj
0 -1.182 TD
0.071 Tw
(and youths. The American Association for Health,)Tj
0 -1.227 TD
0.03 Tw
(Physical Education, and Recreation \(AAHPER\) ex-)Tj
0 -1.182 TD
0.134 Tw
(panded its physical fitness testing program to in-)Tj
T*
-0.1 Tw
(clude college-aged men and women. The association)Tj
0 -1.227 TD
-0.114 Tw
(developed new norms from data collected from more)Tj
0 -1.182 TD
0.155 Tw
(than 11,000 boys and girls 10\32017 years old. The)Tj
0 -1.227 TD
-0.097 Tw
(AAHPER also joined with the President\325s Council on)Tj
0 -1.182 TD
0.242 Tw
(Physical Fitness to conduct the AAHPER Youth)Tj
T*
0.213 Tw
(Fitness Test, which had motivational awards. In)Tj
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(1966, President Lyndon Johnson\325s newly created)Tj
0 -1.182 TD
0.159 Tw
(Presidential Physical Fitness Award was incorpo-)Tj
0 -1.227 TD
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(rated into the program.)Tj
1.636 -1.182 TD
-0.015 Tc
-0.129 Tw
(In the mid-1970s, the need to promote the health\321)Tj
-1.636 -1.227 TD
-0.005 Tc
-0.038 Tw
(rather than exclusively the performance\321benefits of)Tj
0 -1.182 TD
0.127 Tw
(exercise and physical fitness began to reappear. In)Tj
23.955 56.409 TD
0.203 Tw
(1975, AAHPER stated it was time to differentiate)Tj
0 -1.182 TD
0.09 Tw
(physical fitness related to health from performance)Tj
T*
0.181 Tw
(related to athletic ability \(Blair, Falls, Pate 1983\).)Tj
0 -1.227 TD
0.161 Tw
(Accordingly, AAHPER commissioned the develop-)Tj
0 -1.182 TD
-0.086 Tw
(ment of the Health Related Physical Fitness Test. This)Tj
0 -1.227 TD
0.025 Tw
(move in youth fitness paralleled the adoption of the)Tj
0 -1.182 TD
0.244 Tw
[(aerobic concept, which promoted endurance-)9 (type)]TJ
T*
0 Tw
(exercise among the public \(Cooper 1968\).)Tj
/F5 1 Tf
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(Exercise Physiology Research and Health)Tj
/F7 1 Tf
11 0 0 11 311.5 575.5 Tm
0.003 Tc
-0.038 Tw
(The study of the physiology of exercise in a modern)Tj
0 -1.227 TD
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(Activity Recommendations,\323 later in this chapter\).)Tj
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[(of ener)-11 (gy expenditure when the body is at rest and during)]TJ
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[(body)50 (.)]TJ
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[(\321A)21 ( method of estimating ener)46 (gy)]TJ
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[(expenditure by measuring respiratory gases.)-5 ( )-11 (Given that the)]TJ
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(2)Tj
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(2)Tj
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(equals that used and released by body tissues, caloric)Tj
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(expenditure can be measured by CO)Tj
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(2)Tj
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[( production and O)]TJ
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(2)Tj
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(consumption.)Tj
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(*)Tj
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(Cardiorespiratory endurance \(cardiorespiratory fitness\))Tj
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(\321A)Tj
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(health-related component of physical fitness that relates to the)Tj
T*
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[(ability of the cir)36 (culatory and respiratory systems to supply oxygen)]TJ
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(\240)Tj
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(Coordination)Tj
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-0.069 Tw
(\321A skill-related component of physical fitness that)Tj
-5.667 -1.167 TD
0 Tc
-0.054 Tw
(relates to the ability to use the senses, such as sight and hearing,)Tj
T*
0.116 Tw
(together with body parts in performing motor tasks smoothly)Tj
T*
0.001 Tw
[(and accurately)89 (.)]TJ
6.3 0 0 6.3 118.5 258 Tm
(\240)Tj
/F5 1 Tf
9 0 0 9 60 240.5 Tm
0.008 Tc
(Detraining)Tj
/F11 1 Tf
4.722 0 TD
0 Tw
(\321Changes the body undergoes in response to a)Tj
-4.722 -1.167 TD
(reduction or cessation of regular physical training.)Tj
/F5 1 Tf
6.3 0 0 6.3 258 232.5 Tm
(*)Tj
9 0 0 9 60 214.5 Tm
0 Tc
0.125 Tw
(Endurance training/endurance activities)Tj
/F11 1 Tf
17.611 0 TD
(\321Repetitive, aerobic)Tj
-17.611 -1.167 TD
0 Tw
[(use of lar)38 (ge muscles \(e.g., walking,)8 ( )-55 (bicycling, swimming\).)]TJ
6.3 0 0 6.3 282 206.5 Tm
(\340)Tj
/F5 1 Tf
9 0 0 9 60 188.5 Tm
[(Exercise)-14 ( )]TJ
/F11 1 Tf
3.778 0 TD
-0.063 Tw
[(\(exer)46 (cise training\)\321Planned, structured, and repetitive)]TJ
-3.778 -1.167 TD
0.127 Tw
(bodily movement done to improve or maintain one or more)Tj
T*
0 Tw
(components of physical fitness.)Tj
/F5 1 Tf
0 -1.667 TD
-0.001 Tc
(Flexibility)Tj
/F11 1 Tf
4.278 0 TD
0 Tc
-0.036 Tw
(\321A health-related component of physical fitness that)Tj
-4.278 -1.167 TD
0 Tw
(relates to the range of motion available at a joint.)Tj
6.3 0 0 6.3 249 144.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 60 126.5 Tm
-0.04 Tw
(Kilocalorie \(kcal\))Tj
/F11 1 Tf
7.389 0 TD
[(\321A)53 ( measurement of ener)11 (gy)108 (. 1 kilocalorie = 1)]TJ
-7.389 -1.167 TD
0 Tw
(Calorie = 4,184 joules = 4.184 kilojoules.)Tj
/F5 1 Tf
28.833 63.667 TD
-0.005 Tc
-0.07 Tw
(Kilojoule \(kjoule\))Tj
/F11 1 Tf
7.278 0 TD
[(\321A)43 ( measurement of ener)-16 (gy)98 (.)-5 ( )-20 (4.184 kilojoules)-234 (=)]TJ
-7.278 -1.167 TD
0 Tc
0 Tw
(4,184 joules = 1 Calorie = 1 kilocalorie.)Tj
/F5 1 Tf
0 -1.722 TD
-0.001 Tc
-0.07 Tw
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/F11 1 Tf
11.5 0 TD
(\321The difference between maximum)Tj
-11.5 -1.167 TD
0 Tc
0 Tw
(heart rate and resting heart rate.)Tj
6.3 0 0 6.3 442 655 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 637.5 Tm
0.008 Tc
0.051 Tw
(Maximal oxygen uptake \()Tj
11.333 0.222 TD
0.055 Tc
0 Tw
( \372)Tj
0.222 -0.222 TD
0.018 Tc
(VO)Tj
5.2 0 0 5.2 437 635.5 Tm
(2)Tj
/F11 1 Tf
0.577 0 TD
( )Tj
/F5 1 Tf
9 0 0 9 442 637.5 Tm
0.008 Tc
0.051 Tw
(max \))Tj
/F11 1 Tf
2.5 0 TD
(\321The maximal capacity)Tj
-16.111 -1.167 TD
0 Tc
0.001 Tw
[(f)-8 (o)-8 (r)15 ( oxygen consumption by the body during maximal exertion.)]TJ
T*
-0.008 Tc
-0.07 Tw
[(It is also known as aerobic power)79 (, maximal oxygen consumption,)]TJ
T*
0 Tc
0 Tw
[(and cardiorespiratory endurance capacity)98 (.)]TJ
6.3 0 0 6.3 481.5 608.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 590.5 Tm
0.001 Tc
0.139 Tw
[(Maxima)-10 (l)12 ( heart rate \(H)-9 (R)-10 ( )-15 (max\))]TJ
/F11 1 Tf
13.389 0 TD
(\321The highest heart rate value)Tj
-13.389 -1.167 TD
0 Tc
0 Tw
(attainable during an all-out effort to the point of exhaustion.)Tj
6.3 0 0 6.3 550 582.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 564.5 Tm
0.026 Tc
0.139 Tw
(Metabolic equivalent \(MET\))Tj
/F11 1 Tf
13.056 0 TD
(\321A unit used to estimate the)Tj
-13.056 -1.167 TD
0 Tc
-0.011 Tw
[(metabolic cost \(oxygen consumption\) of physical activity)57 (. One)]TJ
T*
0.023 Tw
(MET equals the resting metabolic rate of approximately 3.5 ml)Tj
T*
(O)Tj
5.2 0 0 5.2 327 531 Tm
(2)Tj
6 0 0 6 331 533 Tm
(\245)Tj
9 0 0 9 337 533 Tm
-0.002 Tc
(kg)Tj
6.3 0 0 6.3 346 535.5 Tm
(-1)Tj
6 0 0 6 354 533 Tm
(\245)Tj
9 0 0 9 360 533 Tm
(min)Tj
6.3 0 0 6.3 374.5 535.5 Tm
(-1)Tj
9 0 0 9 380.5 533 Tm
(.)Tj
6.3 0 0 6.3 382.5 535.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 517.5 Tm
0 Tc
0 Tw
(Muscle fiber)Tj
/F11 1 Tf
5.389 0 TD
(\321An individual muscle cell.)Tj
6.3 0 0 6.3 478 520 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 502 Tm
0.019 Tw
(Muscular endurance)Tj
/F11 1 Tf
8.944 0 TD
(\321The ability of the muscle to continue to)Tj
-8.944 -1.167 TD
0 Tw
(perform without fatigue.)Tj
6.3 0 0 6.3 412.5 494 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 476.5 Tm
0.025 Tc
(Overtraining)Tj
/F11 1 Tf
5.889 0 TD
0.139 Tw
(\321The attempt to do more work than can be)Tj
-5.889 -1.167 TD
0 Tc
0 Tw
(physically tolerated.)Tj
6.3 0 0 6.3 397 468.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 450.5 Tm
0.001 Tc
0.139 Tw
(Physical activity)Tj
/F11 1 Tf
7.222 0 TD
(\321Bodily movement that is produced by the)Tj
-7.222 -1.167 TD
0 Tc
0.079 Tw
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T*
-0.003 Tw
[(ener)49 (gy expenditure.)]TJ
/F5 1 Tf
0 -1.722 TD
-0.028 Tw
(Physical fitness)Tj
/F11 1 Tf
6.556 0 TD
(\321A set of attributes that people have or achieve)Tj
-6.556 -1.167 TD
0 Tw
[(that relates to the ability to perform physical activity)65 (.)]TJ
/F5 1 Tf
0 -1.722 TD
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(Power)Tj
/F11 1 Tf
2.722 0 TD
-0.004 Tc
-0.069 Tw
(\321A skill-related component of physical fitness that relates)Tj
-2.722 -1.167 TD
0 Tc
0 Tw
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/F5 1 Tf
0 -1.722 TD
0.03 Tc
0.139 Tw
(Relative perceived exertion \(RPE\))Tj
/F11 1 Tf
15.944 0 TD
[(\321A person\325)101 (s subjective)]TJ
-15.944 -1.167 TD
0 Tc
-0.058 Tw
[(assessment of how hard he or she is working. The Bor)52 (g scale is a)]TJ
T*
0 Tw
(numerical scale for rating perceived exertion.)Tj
6.3 0 0 6.3 494 343.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 326 Tm
-0.007 Tc
-0.07 Tw
(Reaction time)Tj
/F11 1 Tf
5.889 0 TD
(\321A skill-related component of physical fitness that)Tj
-5.889 -1.167 TD
-0.01 Tc
[(relates to the time elapsed between s)28 (t)-10 (imulation and the beginning)]TJ
T*
0 Tc
0 Tw
(of the reaction to it.)Tj
6.3 0 0 6.3 395 307.5 Tm
(\240)Tj
/F5 1 Tf
9 0 0 9 319.5 289.5 Tm
0.009 Tc
0.139 Tw
(Resistance training)Tj
/F11 1 Tf
8.556 0 TD
[(\321T)129 (raining designed to increase strength,)]TJ
-8.556 -1.167 TD
0 Tc
0 Tw
[(power)103 (, and muscle endurance.)]TJ
6.3 0 0 6.3 438.5 281.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 263.5 Tm
0.088 Tw
(Resting heart rate)Tj
/F11 1 Tf
7.889 0 TD
(\321The heart rate at rest, averaging 60 to 80)Tj
-7.889 -1.167 TD
0 Tw
(beats per minute.)Tj
6.3 0 0 6.3 386 255.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 237.5 Tm
-0.011 Tc
(Retraining)Tj
/F11 1 Tf
4.389 0 TD
-0.01 Tc
-0.07 Tw
[(\321Recovery of conditioning after a period of inactivity)74 (.)]TJ
6.3 0 0 6.3 558.5 240 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 222 Tm
-0.002 Tc
(Speed)Tj
/F11 1 Tf
2.611 0 TD
-0.001 Tc
-0.069 Tw
(\321A skill-related component of physical fitness that relates)Tj
-2.611 -1.167 TD
0 Tc
0.079 Tw
(to the ability to perform a movement within a short period of)Tj
T*
-0.001 Tc
(time.)Tj
6.3 0 0 6.3 339 203.5 Tm
(\240)Tj
/F5 1 Tf
9 0 0 9 319.5 186 Tm
(Strength)Tj
/F11 1 Tf
3.667 0 TD
0 Tc
0 Tw
[(\321The ability of the muscle to exert for)40 (ce.)]TJ
6.3 0 0 6.3 512 188.5 Tm
(*)Tj
/F5 1 Tf
9 0 0 9 319.5 170.5 Tm
-0.006 Tc
-0.069 Tw
[(T)105 (raining heart rate \(THR\))]TJ
/F11 1 Tf
10.556 0 TD
[(\321A)41 ( heart rate goal established by using)]TJ
-10.556 -1.167 TD
0 Tc
-0.027 Tw
[(the heart rate equivalent to a selected training level \(per)36 (centage)]TJ
T*
(of )Tj
/F5 1 Tf
1.056 0.222 TD
-0.054 Tc
0 Tw
( \372)Tj
/F11 1 Tf
0.056 -0.222 TD
0.008 Tc
(VO)Tj
5.2 0 0 5.2 343.5 147.5 Tm
-0.074 Tc
(2 )Tj
9 0 0 9 347.5 149.5 Tm
0 Tc
-0.053 Tw
[(max \). For example, if a training level of 75 per)49 (cent)-5 ( )]TJ
/F5 1 Tf
21.889 0.222 TD
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0 Tw
( \372)Tj
/F11 1 Tf
0.056 -0.222 TD
0.008 Tc
(VO)Tj
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(2)Tj
9 0 0 9 319.5 139 Tm
-0.001 Tc
-0.07 Tw
[(max)-8 ( )-16 (is desired, the)]TJ
/F5 1 Tf
7.778 0.222 TD
-0.054 Tc
0 Tw
( \372)Tj
/F11 1 Tf
0.056 -0.222 TD
0.007 Tc
(VO)Tj
5.2 0 0 5.2 403.5 137 Tm
0.021 Tc
(2 )Tj
9 0 0 9 407.5 139 Tm
-0.001 Tc
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(at 75 percent is determined and the heart)Tj
-9.778 -1.167 TD
0 Tc
0 Tw
(rate corresponding to this)Tj
/F5 1 Tf
10.889 0.222 TD
( )Tj
/F11 1 Tf
0.278 -0.222 TD
0.008 Tc
(VO)Tj
5.2 0 0 5.2 433.5 126.5 Tm
(2)Tj
9 0 0 9 436.5 128.5 Tm
0 Tc
( is selected as the THR.)Tj
6.3 0 0 6.3 526 131 Tm
(*)Tj
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0.008 Tc
(22)Tj
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-22.182 63.727 TD
0.003 Tc
-0.001 Tw
(Physical Activity and Health)Tj
/F7 1 Tf
0 -2.818 TD
-0.005 Tc
0.182 Tw
(said to include cardiorespiratory fitness, muscular)Tj
0 -1.182 TD
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(strength and endurance, body composition, and flex-)Tj
T*
0.06 Tw
(ibility. The relative importance of any one attribute)Tj
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/F9 1 Tf
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0.003 Tc
(Health. )Tj
/F7 1 Tf
3.273 0 TD
-0.101 Tw
(The 1988 International Consensus Con-)Tj
-4.909 -1.227 TD
0.076 Tw
(ference on Physical Activity, Physical Fitness, and)Tj
0 -1.182 TD
0.049 Tw
(Health \(Bouchard et al. 1990\) defined health as \322a)Tj
0 -1.227 TD
-0.04 Tw
(human condition with physical, social, and psycho-)Tj
0 -1.182 TD
0.183 Tw
(logical dimensions, each characterized on a con-)Tj
T*
0.129 Tw
(tinuum with positive and negative poles. Positive)Tj
0 -1.227 TD
-0.029 Tw
(health is associated with a capacity to enjoy life and)Tj
0 -1.182 TD
-0.055 Tw
(to withstand challenges; it is not merely the absence)Tj
0 -1.227 TD
0.052 Tw
(of disease. Negative health is associated with mor-)Tj
0 -1.182 TD
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(bidity and, in the extreme, with premature mortal-)Tj
T*
0.137 Tw
(ity.\323 Thus, when considering the role of physical)Tj
0 -1.227 TD
-0.079 Tw
(activity in promoting health, one must acknowledge)Tj
0 -1.182 TD
-0.003 Tw
(the importance of psychological well-being, as well)Tj
0 -1.227 TD
0.001 Tw
(as physical health.)Tj
/F5 1 Tf
14 0 0 14 48 447 Tm
-0.001 Tc
0 Tw
(Evolution of Physical Activity)Tj
0 -1.214 TD
-0.002 Tc
(Recommendations)Tj
/F7 1 Tf
11 0 0 11 48 414.5 Tm
0.003 Tc
-0.089 Tw
(In the middle of the 20th century, recommendations)Tj
0 -1.182 TD
0.145 Tw
(for physical activity to achieve fitness and health)Tj
0 -1.227 TD
0.102 Tw
(benefits were based on systematic comparisons of)Tj
0 -1.182 TD
0.153 Tw
(effects from different profiles of exercise training)Tj
0 -1.227 TD
0.081 Tw
(\(Cureton 1947; Karvonen, Kentala, Mustala 1957;)Tj
0 -1.182 TD
0.213 Tw
(Christensen 1960; Yakolav et al. 1961; Reindell,)Tj
T*
-0.097 Tw
(Roskamm, Gerschler 1962\). In the 1960s and 1970s,)Tj
0 -1.227 TD
0.009 Tw
(expert panels and committees, operating under the)Tj
0 -1.182 TD
-0.109 Tw
(auspices of health- or fitness-oriented organizations,)Tj
0 -1.227 TD
0.015 Tw
(began to recommend specific physical activity pro-)Tj
0 -1.182 TD
-0.098 Tw
(grams or exercise prescriptions for improving physi-)Tj
T*
0.013 Tc
0.259 Tw
(cal performance capacity or health \(President\325s)Tj
0 -1.227 TD
0.003 Tc
-0.058 Tw
(Council on Physical Fitness 1965; AHA 1972, 1975;)Tj
0 -1.182 TD
0.062 Tw
(ACSM 1975\). These recommendations were based)Tj
0 -1.227 TD
0.041 Tw
(on substantial clinical experience and on scientific)Tj
0 -1.182 TD
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1.636 -1.227 TD
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(VO)Tj
6.4 0 0 6.4 142.5 668 Tm
(2)Tj
11 0 0 11 146 671.5 Tm
-0.019 Tw
[( max is most accurately deter-)]TJ
-8.909 -1.182 TD
0.124 Tw
(mined by measuring expired air composition and)Tj
0 -1.227 TD
0.074 Tw
(respiratory volume during maximal exertion. This)Tj
0 -1.182 TD
-0.017 Tw
(procedure requires relatively expensive equipment,)Tj
T*
0.092 Tw
(highly trained technicians, and time and coopera-)Tj
0 -1.227 TD
0.003 Tw
(tion from the participant, all of which usually limit)Tj
0 -1.182 TD
-0.086 Tw
(its use in large epidemiologic studies \(Montoye et al.)Tj
0 -1.227 TD
0 Tw
(1970; King et al. 1991\).)Tj
1.636 -1.182 TD
-0.005 Tc
0.134 Tw
(Because the individual variation in mechanical)Tj
-1.636 -1.227 TD
0.058 Tw
(and metabolic efficiency is for activities that do not)Tj
0 -1.182 TD
-0.044 Tw
(require much skill\321such as walking or running on a)Tj
T*
0.003 Tc
0.057 Tw
(motor-driven treadmill, cycling on a stationary bi-)Tj
0 -1.227 TD
-0.02 Tw
(cycle ergometer, or climbing steps\321oxygen uptake)Tj
0 -1.182 TD
0.085 Tw
(can be quite accurately estimated from the rate of)Tj
0 -1.227 TD
0.016 Tw
(work \(Siconolfi et al. 1982\). Thus,)Tj
/F9 1 Tf
14.5 0.182 TD
0.005 Tc
0 Tw
( \372)Tj
/F7 1 Tf
0.091 -0.182 TD
0.003 Tc
(VO)Tj
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(2)Tj
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0.016 Tw
[( max can be)]TJ
-16.273 -1.182 TD
-0.051 Tw
(estimated from the peak exercise workload during a)Tj
T*
-0.122 Tw
(maximal exercise test without measuring respiratory)Tj
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0.099 Tw
(gases. Such procedures require an accurately cali-)Tj
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0.066 Tw
(brated exercise device, careful adherence to a spe-)Tj
0 -1.227 TD
0.044 Tc
0.259 Tw
(cific protocol, and good cooperation by the)Tj
0 -1.182 TD
0.003 Tc
-0.065 Tw
(participant. They have been used in numerous exer-)Tj
T*
0.2 Tw
(cise training studies for evaluating the effects of)Tj
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0.077 Tw
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0.101 Tw
(mance, in secondary prevention trials for patients)Tj
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0.042 Tw
(after hospitalization for myocardial infarction, and)Tj
0 -1.182 TD
-0.071 Tw
(in some large-scale observational studies \(Blair et al.)Tj
T*
-0.001 Tw
(1989; Sidney et al. 1992\).)Tj
1.636 -1.227 TD
0.013 Tc
0.141 Tw
(Any maximal test to assess cardiorespiratory)Tj
-1.636 -1.182 TD
0.089 Tw
(fitness imposes a burden on both the participant)Tj
0 -1.227 TD
0.052 Tw
(and the examiner. To reduce this burden, several)Tj
0 -1.182 TD
0.097 Tw
(submaximal exercise testing protocols have been)Tj
0 -1.227 TD
0.211 Tw
(developed. With these protocols, the heart rate)Tj
0 -1.182 TD
-0.029 Tw
(response to a specified workload is used to predict)Tj
T*
(the)Tj
/F9 1 Tf
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0.005 Tc
0 Tw
( \372)Tj
/F7 1 Tf
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0.013 Tc
(VO)Tj
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(2)Tj
11 0 0 11 83 236 Tm
-0.003 Tw
( max. The underlying assumption \(besides)Tj
-3.182 -1.227 TD
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0 -1.182 TD
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(gen uptake\) is that the participant\325s maximal heart)Tj
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-0.07 Tw
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-0.084 Tw
(are adequately met when a standardized protocol is)Tj
T*
-0.125 Tw
(used to test a large sample of healthy adults. In some)Tj
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0.077 Tw
(cases, no extrapolation to maximal values is per-)Tj
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0.098 Tw
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-0.057 Tw
(ness is expressed as the heart rate at a set workload)Tj
0 -1.182 TD
0.212 Tw
(\(e.g., heart rate at 5 kilometers/hour or at 100)Tj
T*
0.015 Tw
(watts\) or at the workload required to reach a spe-)Tj
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0.108 Tw
(cific submaximal heart rate \(workload at a heart)Tj
0 -1.182 TD
0 Tw
(rate of 120 beats/minute\).)Tj
25.591 57.591 TD
0.023 Tc
-0.02 Tw
(In another approach to assessing cardiorespi-)Tj
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0.111 Tw
(ratory fitness, participants usually walk, jog, or)Tj
T*
-0.029 Tw
(run a specified time or distance, and their perfor-)Tj
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0.124 Tw
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/F9 1 Tf
17.091 0.182 TD
0.141 Tc
0 Tw
( \372)Tj
/F7 1 Tf
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0.023 Tc
(VO)Tj
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(2)Tj
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0.124 Tw
[( max)]TJ
-19.091 -1.182 TD
0.027 Tw
(\(Cooper 1968\). These procedures have been fre-)Tj
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0.03 Tw
(quently used to test the cardiorespiratory fitness)Tj
0 -1.182 TD
-0.11 Tw
(of children, of young adults, or of groups that have)Tj
T*
-0.053 Tw
(occupation-related physical fitness requirements,)Tj
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-0.096 Tw
(such as military and emergency service personnel.)Tj
0 -1.182 TD
0.212 Tw
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0 -1.227 TD
0.091 Tw
(near-maximal effort by the participant and thus)Tj
0 -1.182 TD
0.033 Tw
(have not been used for older persons or those at)Tj
T*
-0.114 Tw
(increased risk for CVD. The advantage is that large)Tj
0 -1.227 TD
0.016 Tc
-0.123 Tw
[(numbers )-9 (of )-9 (participants can be tested rapidly at low)]TJ
0 -1.182 TD
0.013 Tc
0.129 Tw
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0.144 Tw
(participants must be willing to exert themselves)Tj
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0 Tw
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/F11 1 Tf
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0.003 Tc
0.001 Tw
(Muscular Fitness)Tj
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(Common measures of muscular fitness are muscular)Tj
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(strength, muscular endurance, flexibility, and bal-)Tj
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T*
-0.065 Tw
(can be measured during performance of either static)Tj
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0.166 Tw
(or dynamic muscle contraction \(NCHS, Wilmore)Tj
0 -1.182 TD
0.023 Tw
(1989\). Because muscular strength is specific to the)Tj
0 -1.227 TD
0.162 Tw
(muscle group, the testing of one group does not)Tj
0 -1.182 TD
0.024 Tw
(provide accurate information about the strength of)Tj
T*
0.218 Tw
(other muscle groups \(Clarke 1973\). Thus, for a)Tj
0 -1.227 TD
0.19 Tw
(comprehensive assessment, strength testing must)Tj
0 -1.182 TD
-0.084 Tw
(involve at least several major muscle groups, includ-)Tj
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(ing the upper body, trunk, and lower body. Standard)Tj
0 -1.182 TD
0.036 Tw
(tests have included the bench press, leg extension,)Tj
T*
0.193 Tw
(and biceps curl using free weights. The heaviest)Tj
0 -1.227 TD
0.034 Tw
(weight a person can lift only one time through the)Tj
0 -1.182 TD
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(full range of motion for a particular muscle group is)Tj
0 -1.227 TD
-0.011 Tw
(considered the person\325s maximum strength for that)Tj
0 -1.182 TD
0 Tw
(specific muscle group.)Tj
1.636 -1.227 TD
0.056 Tw
(Muscular endurance is specific to each muscle)Tj
-1.636 -1.182 TD
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(group. Most tests for use in the general population do)Tj
T*
0.141 Tw
(not distinguish between muscular endurance and)Tj
0 -1.227 TD
-0.101 Tw
(muscular strength. Tests of muscular endurance and)Tj
0 -1.182 TD
-0.082 Tw
(strength, which include sit-ups, push-ups, bent-arm)Tj
0 -1.227 TD
-0.048 Tw
(hangs, and pull-ups, must be properly administered)Tj
0 -1.182 TD
-0.012 Tw
(and may not discriminate well in some populations)Tj
T*
-0.001 Tw
(\(e.g., pull-ups are not a good test for many popula-)Tj
0 -1.227 TD
-0.003 Tw
(tions because a high percentage of those tested will)Tj
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0.172 Tw
(have 0 scores\). Few laboratory tests of muscular)Tj
0 -1.227 TD
-0.073 Tw
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0 -1.182 TD
-0.12 Tw
(ally involve having the participant perform a series of)Tj
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0.05 Tw
(the test duration is used as a measure of muscular)Tj
0 -1.182 TD
(endurance.)Tj
1.636 -1.227 TD
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-1.636 -1.182 TD
0.212 Tw
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0 -1.227 TD
-0.064 Tw
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0 -1.182 TD
0.082 Tw
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T*
0.013 Tc
-0.025 Tw
(Field testing of flexibility frequently has been lim-)Tj
0 -1.227 TD
0.004 Tc
-0.056 Tw
[(ited)-19 ( to the sit-and-reach test, which is considered to)]TJ
0 -1.182 TD
0.003 Tc
-0.107 Tw
(be a measure of lower back and hamstring flexibility.)Tj
0 -1.227 TD
-0.097 Tw
(The criterion method for measuring flexibility in the)Tj
0 -1.182 TD
-0.011 Tw
(laboratory is goniometry, which is used to measure)Tj
T*
-0.088 Tw
(the angle of the joint at both extremes in the range of)Tj
0 -1.227 TD
0.001 Tw
(motion \(NCHS, Wilmore 1989\).)Tj
1.636 -1.182 TD
-0.071 Tw
[( Balance, agility, and coordination are especially)]TJ
-1.636 -1.227 TD
-0.124 Tw
(important among older persons, who are more prone)Tj
0 -1.182 TD
-0.095 Tw
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0 -1.227 TD
-0.016 Tw
(bone mineral density. Field methods for measuring)Tj
0 -1.182 TD
0.243 Tw
(balance, agility, and coordination have included)Tj
T*
0.18 Tw
(various balance stands \(e.g., one-foot stand with)Tj
0 -1.227 TD
-0.121 Tw
(eyes open and with eyes closed; standing on a narrow)Tj
0 -1.182 TD
0.085 Tw
(block\) and balance walks on a narrow line or rail)Tj
0 -1.227 TD
-0.042 Tw
(\(Tse and Bailey 1992\). In the laboratory, computer-)Tj
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0.214 Tw
(based technology is now being used to evaluate)Tj
T*
-0.071 Tw
(balance measured on an electronic force platform or)Tj
0 -1.227 TD
0.043 Tw
(to analyze a videotape recording of the participant)Tj
0 -1.182 TD
-0.056 Tw
(walking \(Lehmann et al. 1990\). Agility or coordina-)Tj
0 -1.227 TD
0.038 Tw
(tion are measured most frequently by using a field)Tj
0 -1.182 TD
-0.017 Tw
(test, such as an agility walk or run \(Cureton 1947\).)Tj
T*
0.131 Tw
(In the laboratory, coordination or reaction/move-)Tj
0 -1.227 TD
-0.109 Tw
(ment time are determined by using electronic signal-)Tj
0 -1.182 TD
0.014 Tc
0.259 Tw
(ing and timing devices \(Spirduso 1975\). More)Tj
0 -1.227 TD
0.003 Tc
0.206 Tw
(development is needed to establish norms using)Tj
0 -1.182 TD
0.194 Tw
(standardized tests for measuring balance, agility,)Tj
T*
0 Tw
(and coordination, especially of older persons.)Tj
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-0.002 Tw
(Body Composition)Tj
/F7 1 Tf
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-0.118 Tw
(In most population-based studies that have provided)Tj
T*
0.138 Tw
(information on the relationship between physical)Tj
T*
0.007 Tw
(activity and morbidity or mortality, body composi-)Tj
0 -1.227 TD
0.044 Tw
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0 -1.182 TD
0.002 Tc
-0.128 Tw
(and weight and calculating body mass index \(weight/)Tj
0 -1.227 TD
0.005 Tc
(height)Tj
6.4 0 0 6.4 95.5 132.5 Tm
(2)Tj
11 0 0 11 98.5 128.5 Tm
0.259 Tw
(\). The preferred method for determining)Tj
-2.955 -1.182 TD
0.003 Tc
0.017 Tw
(amount of body fat and lean body mass in exercise)Tj
T*
-0.041 Tw
(training studies has been hydrostatic or underwater)Tj
0 -1.227 TD
0.212 Tw
(weighing \(NCHS, Wilmore 1989\); however, this)Tj
23.955 56.545 TD
-0.073 Tw
(method lacks accuracy in some populations, includ-)Tj
0 -1.182 TD
0.235 Tw
(ing older persons and children \(Lohman 1986\).)Tj
T*
0.134 Tw
(Anthropometric measurements \(i.e., girths, diam-)Tj
0 -1.227 TD
-0.109 Tw
(eters, and skinfolds\) used to calculate the percentage)Tj
0 -1.182 TD
0.135 Tw
(of body fat have varying degrees of accuracy and)Tj
0 -1.227 TD
0 Tw
(reliability \(Wilmore and Behnke 1970\).)Tj
1.636 -1.182 TD
0.036 Tw
(Data now suggest that the distribution of body)Tj
-1.636 -1.227 TD
0.024 Tw
(fat, especially accumulation in the abdominal area,)Tj
0 -1.182 TD
-0.091 Tw
(and total body fat are significant risk factors for CVD)Tj
T*
-0.079 Tw
(and diabetes \(Bierman and Brunzell 1992; Blumberg)Tj
0 -1.227 TD
-0.034 Tw
(and Alexander 1992\). Researchers have determined)Tj
0 -1.182 TD
0.028 Tw
(the magnitude of this abdominal or central obesity)Tj
0 -1.227 TD
0.039 Tw
(by calculating the waist-to-hip circumference ratio)Tj
0 -1.182 TD
0.004 Tw
(or by using new electronic methods that can image)Tj
T*
0.058 Tw
(regional fat tissue. New technologies that measure)Tj
0 -1.227 TD
-0.034 Tw
(body composition include total body electrical con-)Tj
0 -1.182 TD
-0.099 Tw
(ductivity \(Segal et al. 1985\), bioelectrical impedance)Tj
0 -1.227 TD
0.033 Tw
(\(Lukaski et al. 1986\), magnetic resonance imaging)Tj
0 -1.182 TD
-0.005 Tc
0.19 Tw
[(\(Lohman 1984\), and dual-energy x-ray absorptio)-6 (-)]TJ
T*
0.002 Tc
0.237 Tw
[(metry)-10 ( \(DEXA\) \(Mazess et al. 1990\). These new)]TJ
0 -1.227 TD
0.003 Tc
(procedures have substantial potential to provide)Tj
0 -1.182 TD
-0.108 Tw
(new information on how changes in physical activity)Tj
0 -1.227 TD
0 Tw
(affect body composition and fat distribution.)Tj
/F5 1 Tf
11 0 2.138 11 329.5 393 Tm
(Validity of Measurements)Tj
/F7 1 Tf
11 0 0 11 329.5 378.5 Tm
-0.06 Tw
(Health behaviors are difficult to measure, and this is)Tj
0 -1.182 TD
-0.107 Tw
(certainly true for the behavior of physical activity. Of)Tj
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-0.102 Tw
(particular concern is how well self-reported physical)Tj
0 -1.182 TD
0.229 Tw
(activity accurately represents a person\325s habitual)Tj
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0 -1.182 TD
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(tive sampling of time intervals during which activity)Tj
0 -1.182 TD
-0.001 Tw
(is assessed.)Tj
1.636 -1.227 TD
-0.005 Tc
-0.117 Tw
(One of the principal difficulties in establishing the)Tj
-1.636 -1.182 TD
-0.008 Tw
(validity of a physical activity measure is the lack of a)Tj
0 -1.227 TD
0.045 Tw
(suitable \322gold-standard\323 criterion measure for com-)Tj
0 -1.182 TD
0.07 Tw
(parison. In the absence of a true criterion measure,)Tj
T*
0.197 Tw
(cardiorespiratory fitness has often been used as a)Tj
0 -1.227 TD
0.025 Tw
(validation standard for physical activity surveys. Al-)Tj
0 -1.182 TD
-0.002 Tw
(though habitual physical activity is a major determi-)Tj
0 -1.227 TD
-0.119 Tw
(nant of cardiorespiratory fitness, other factors, such as)Tj
0 -1.182 TD
0.215 Tw
(genetic inheritance, also play a role. Therefore, a)Tj
T*
0.045 Tw
(perfect correlation between physical activity report-)Tj
0 -1.227 TD
0.136 Tw
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0 -1.182 TD
-0.119 Tw
(pected. Nonetheless, correlations of reported physical)Tj
0 -1.227 TD
-0.043 Tw
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0 -1.182 TD
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[(been examined. Table 2-)-12 (5)13 ( shows results from studies)]TJ
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[(1.4)-1965 (Increase to at least 20 percent the proportion of people aged 18 and old\
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3.273 -1.182 TD
0.166 Tw
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16.227 -2.409 TD
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[(1.4c)-1519 (Hispanics aged 18 years and older)-16538 (17%)]TJ
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0 Tc
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0.003 Tw
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0 -1.187 TD
0 Tw
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/F7 1 Tf
11 0 0 11 66 510 Tm
0.003 Tc
-0.076 Tw
[(1.5)-1965 (Reduce to no more than 15 percent the proportion of people aged 6 and ol\
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3.273 -1.227 TD
0.001 Tw
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/F13 1 Tf
16.227 -2.409 TD
0 Tw
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-19.5 -1.227 TD
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-3.273 -1.227 TD
0 Tw
[(1.5d)-1428 (Blacks aged 18 and older)-20348 (20%)]TJ
0 -1.182 TD
[(1.5e)-1519 (Hispanics aged 18 and older)-18943 (25%)]TJ
0 -1.227 TD
[(1.5f)-1669 (American Indians/Alaska Natives aged 18 and older)-9195 (21%)]TJ
/F13 1 Tf
8 0 0 8 66 339.5 Tm
0 Tc
(Note: For this objective, people with disabilities are people who repor\
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/F7 1 Tf
11 0 0 11 66 314 Tm
0.003 Tc
-0.087 Tw
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3.273 -1.182 TD
0 Tw
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-3.273 -1.227 TD
-0.082 Tw
[(1.7*)-1465 (Increase to at least 50 percent the proportion of overweight people aged\
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3.273 -1.182 TD
-0.014 Tw
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/F13 1 Tf
16.227 -2.409 TD
0 Tw
(Special Population Targets)Tj
-19.5 -1.227 TD
[(Adoption of Weight-Loss Practices)-18812 (2000 Target)]TJ
/F7 1 Tf
T*
[(1.7a)-1519 (Overweight Hispanic males)-19285 (24%)]TJ
3.273 -1.182 TD
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-3.273 -1.227 TD
-0.001 Tw
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0 Tw
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/F16 1 Tf
-3.273 -2.455 TD
0.001 Tw
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/F7 1 Tf
0 -2.409 TD
0.124 Tw
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3.273 -1.182 TD
0 Tw
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-3.273 -1.227 TD
-0.106 Tw
[(1.9)-1965 (Increase to at least 50 percent the proportion of school physical educat\
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3.273 -1.182 TD
0 Tw
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/F13 1 Tf
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0 Tc
-0.087 Tw
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0 -1.187 TD
-0.017 Tw
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0 Tw
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/F7 1 Tf
11 0 0 11 48 669 Tm
0.005 Tc
0.258 Tw
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3.273 -1.182 TD
0.003 Tc
0 Tw
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/F13 1 Tf
-3.273 -2.409 TD
0.002 Tw
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/F7 1 Tf
0 -1.227 TD
0.001 Tw
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-0.001 Tw
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0 -1.182 TD
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0 Tw
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0 -2.409 TD
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/F13 1 Tf
T*
0.001 Tw
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/F7 1 Tf
0 -1.227 TD
0 Tw
[(Hiking, biking, and fitness trail miles)-15251 (1 per 10,000 people)]TJ
0 -1.182 TD
-0.001 Tw
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0 -1.227 TD
0 Tw
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28.409 -1.227 TD
-0.001 Tw
(\(250 people per managed acre\))Tj
-28.409 -2.409 TD
-0.111 Tw
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3.273 -1.182 TD
-0.012 Tw
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0 -1.227 TD
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/F16 1 Tf
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/F7 1 Tf
T*
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[(1.13*)-942 (Reduce to no more than 90 per 1,000 people the proportion of all people \
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3.273 -1.182 TD
0 Tw
(difficulty in performing two or more personal care activities thereby pr\
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/F13 1 Tf
13.091 -2.455 TD
(Special Population Targets)Tj
-16.364 -1.182 TD
0.002 Tw
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0 -1.227 TD
0 Tw
[(Self Care \(per 1,000\))-23951 (2000 Target)]TJ
/F7 1 Tf
0 -1.182 TD
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0 -1.227 TD
[(1.13b)-923 (Blacks aged 65 and older)-20711 (98)]TJ
/F13 1 Tf
8 0 0 8 48 246.5 Tm
0 Tc
(Note: Personal care activities are bathing, dressing, using the toilet,\
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[( To provide physicians and the general)]TJ
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(needed to maintain good health.)Tj
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(Physical inactivity characterizes most Ameri-)Tj
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0.148 Tw
(physical activity. Data from the 1990 Youth Risk)Tj
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(Physical activity protects against the develop-)Tj
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(risk factors, including high blood pressure, blood)Tj
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(ment of patients with CVD or those who are at)Tj
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(increased risk for developing CVD, including pa-)Tj
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(ripheral vascular disease, or who have had a prior)Tj
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-0.118 Tw
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(ity is an important component of cardiac rehabilita-)Tj
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(tion, and people with CVD can benefit from)Tj
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(becoming physically active.)Tj
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(Many factors influence adopting and maintaining)Tj
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0.15 Tw
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(Understanding is needed on how such variables in-)Tj
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[(\245)-588 (What are the important questions for future)]TJ
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(sures of physical activity and indices of obesity in)Tj
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[(HDL cholesterol)11 ( )-19 (level changes have been reported.)]TJ
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[( )57 (A number of factors that affect thrombotic)]TJ
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[(function)-20 (\321including hematocrit, fibrinogen, plate-)]TJ
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(related to these factors.)Tj
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(The burden of CVD rests most heavily on the)Tj
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(least active. In addition to its powerful impact on the)Tj
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(cardiovascular system, physical inactivity is also)Tj
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(tured or vigorous exercise program. The majority of)Tj
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(benefits of physical activity can be gained by per-)Tj
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(forming moderate-intensity activities. The amount)Tj
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(or optimal health is a concern due to limited time and)Tj
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(competing activities for most Americans. The amount)Tj
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(and types of physical activity that are needed to)Tj
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(prevent disease and promote health must, therefore,)Tj
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(The quantitative relationship between level of)Tj
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(activity or fitness and magnitude of cardiovascular)Tj
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(benefit may extend across the full range of activity. A)Tj
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(level appropriate to their capacities, needs, and inter-)Tj
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(est. We recommend that all children and adults)Tj
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(tivity on most, or preferably all, days of the week.)Tj
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(Intermittent or shorter bouts of activity \(at least 10)Tj
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(minutes\), including occupational, nonoccupational,)Tj
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1.636 -1.182 TD
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(The appropriate type of activity is best deter-)Tj
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(mined by the individual\325s preferences and what will)Tj
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(minimally active should gradually build up to the)Tj
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(recommended goal of 30 minutes of moderate activ-)Tj
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(ity daily by adding a few minutes each day until)Tj
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(reaching their personal goal to reduce the risk asso-)Tj
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(ciated with suddenly increasing the amount or inten-)Tj
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(sity of exercise. \(The defined levels of effort depend)Tj
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(on individual characteristics such as baseline fitness)Tj
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(and health status.\))Tj
1.636 -1.227 TD
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(Developing muscular strength and joint flexibil-)Tj
-1.636 -1.182 TD
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(ity is also important for an overall activity program to)Tj
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(improve one\325s ability to perform tasks and to reduce)Tj
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(tance \(or strength\) training can improve muscular)Tj
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(function, and evidence suggests that there may be)Tj
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(cardiovascular benefits, especially in older patients)Tj
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(and guidelines are needed. Older people or those)Tj
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0 -1.182 TD
0.092 Tw
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0 -1.227 TD
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(tasks of daily living. Resistance training may contrib-)Tj
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(may help prevent falls in the elderly.)Tj
1.636 -1.227 TD
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(Historical Background, Terminology, Evolution of Recommendations, and Me\
asurement)Tj
/F7 1 Tf
-6.682 -2.818 TD
0.224 Tw
(activity have a slight increase in risk of sudden)Tj
0 -1.182 TD
0.191 Tw
(cardiac death during activity, the health benefits)Tj
T*
0.043 Tw
(outweigh this risk because of the large overall risk)Tj
0 -1.227 TD
(reduction.)Tj
1.636 -1.182 TD
0.078 Tw
(In children and young adults, exertion-related)Tj
-1.636 -1.227 TD
0.059 Tw
(deaths are uncommon and are generally related to)Tj
0 -1.182 TD
0.133 Tw
(congenital heart defects \(e.g., hypertrophic cardi-)Tj
0 -1.227 TD
-0.003 Tw
(omyopathy, Marfan\325s syndrome, severe aortic valve)Tj
0 -1.182 TD
-0.069 Tw
(stenosis, prolonged QT syndromes, cardiac conduc-)Tj
T*
-0.013 Tw
(tion abnormalities\) or to acquired myocarditis. It is)Tj
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0.115 Tw
(recommended that patients with those conditions)Tj
0 -1.182 TD
0.222 Tw
(remain active but not participate in vigorous or)Tj
0 -1.227 TD
-0.002 Tw
(competitive athletics.)Tj
1.636 -1.182 TD
-0.11 Tw
(Because the risks of physical activity are very low)Tj
-1.636 -1.227 TD
0.052 Tw
(compared with the health benefits, most adults do)Tj
0 -1.182 TD
0.039 Tw
(not need medical consultation or pretesting before)Tj
T*
0.05 Tw
(starting a moderate-intensity physical activity pro-)Tj
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0.097 Tw
(gram. However, those with known CVD and men)Tj
0 -1.182 TD
0.05 Tw
(over age 40 and women over age 50 with multiple)Tj
0 -1.227 TD
0.027 Tw
(cardiovascular risk factors who contemplate a pro-)Tj
0 -1.182 TD
0.196 Tw
(gram of vigorous activity should have a medical)Tj
T*
0 Tw
(evaluation prior to initiating such a program.)Tj
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0 Tc
(3. What Are the Benefits and Risks of)Tj
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(Different Types of Physical Activity for)Tj
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(People with Cardiovascular Disease?)Tj
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0.003 Tc
0.02 Tw
[( More than 10 million Americans are afflicted with)]TJ
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-0.045 Tw
(clinically significant CVD, including myocardial in-)Tj
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0.177 Tw
(farction, angina pectoris, peripheral vascular dis-)Tj
0 -1.182 TD
-0.045 Tw
(ease, and congestive heart failure. In addition, more)Tj
T*
0.127 Tw
(than 300,000 patients per year are currently sub-)Tj
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-0.124 Tw
(jected to coronary artery bypass surgery and a similar)Tj
0 -1.182 TD
0.014 Tc
0.259 Tw
(number to percutaneous transluminal coronary)Tj
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0.003 Tc
0.099 Tw
(angioplasty. Increased physical activity appears to)Tj
0 -1.182 TD
-0.07 Tw
(benefit each of these groups. Benefits include reduc-)Tj
T*
-0.055 Tw
(tion in cardiovascular mortality, reduction of symp-)Tj
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0.032 Tc
0.259 Tw
(toms, improvement in exercise tolerance and)Tj
0 -1.182 TD
0.003 Tc
0.16 Tw
(functional capacity, and improvement in psycho-)Tj
0 -1.227 TD
0 Tw
(logical well-being and quality of life.)Tj
1.636 -1.182 TD
-0.005 Tc
-0.079 Tw
[( )-9 (S)-26 (everal studies have shown that exercise training)]TJ
-1.636 -1.227 TD
0.171 Tw
(programs significantly reduce overall mortality, as)Tj
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0.091 Tw
(well as death caused by myocardial infarction. The)Tj
T*
-0.063 Tw
[(reported reductions in mortality have been highest)7 (\321)]TJ
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0.003 Tc
-0.092 Tw
(approximately 25 percent\321in cardiac rehabilitation)Tj
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-0.097 Tw
(programs that have included control of other cardio-)Tj
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-0.03 Tw
(vascular risk factors. Rehabilitation programs using)Tj
0 -1.182 TD
0.055 Tw
(both moderate and vigorous physical activity have)Tj
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-0.007 Tc
-0.129 Tw
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0 -1.182 TD
0.003 Tc
-0.031 Tw
(although the minimal or optimal level and duration)Tj
T*
0.238 Tw
(of exercise required to achieve beneficial effects)Tj
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-0.104 Tw
(remains uncertain. Data are inadequate to determine)Tj
0 -1.182 TD
0.229 Tw
(whether stroke incidence is affected by physical)Tj
0 -1.227 TD
0 Tw
(activity or exercise training.)Tj
1.636 -1.182 TD
0.084 Tw
(The risk of death during medically supervised)Tj
-1.636 -1.227 TD
-0.091 Tw
(cardiac exercise training programs is very low. How-)Tj
0 -1.182 TD
-0.068 Tw
(ever, those who exercise infrequently and have poor)Tj
T*
-0.004 Tw
(functional capacity at baseline may be at somewhat)Tj
0 -1.227 TD
0.206 Tw
(higher risk during exercise training. All patients)Tj
0 -1.182 TD
-0.057 Tw
(with CVD should have a medical evaluation prior to)Tj
0 -1.227 TD
0 Tw
(participation in a vigorous exercise program.)Tj
1.636 -1.182 TD
0.108 Tw
(Appropriately prescribed and conducted exer-)Tj
-1.636 -1.227 TD
(cise training programs improve exercise tolerance)Tj
0 -1.182 TD
-0.008 Tw
(and physical fitness in patients with coronary heart)Tj
T*
-0.05 Tw
(disease. Moderate as well as vigorous exercise train-)Tj
0 -1.227 TD
0.09 Tw
(ing regimens are of value. Patients with low basal)Tj
0 -1.182 TD
-0.071 Tw
(levels of exercise capacity experience the most func-)Tj
0 -1.227 TD
0.118 Tw
(tional benefits, even at relatively modest levels of)Tj
0 -1.182 TD
-0.041 Tw
(physical activity. Patients with angina pectoris typi-)Tj
T*
-0.003 Tw
(cally experience improvement in angina in associa-)Tj
0 -1.227 TD
0.042 Tw
(tion with a reduction in effort-induced myocardial)Tj
0 -1.182 TD
-0.003 Tw
(ischemia, presumably as a result of decreased myo-)Tj
0 -1.227 TD
-0.122 Tw
(cardial oxygen demand and increased work capacity.)Tj
1.636 -1.182 TD
-0.12 Tw
(Patients with congestive heart failure also appear)Tj
-1.636 -1.227 TD
-0.047 Tw
(to show improvement in symptoms, exercise capac-)Tj
0 -1.182 TD
-0.104 Tw
(ity, and functional well-being in response to exercise)Tj
T*
0.004 Tw
(training, even though left ventricular systolic func-)Tj
0 -1.227 TD
-0.046 Tw
(tion appears to be unaffected. The exercise program)Tj
0 -1.182 TD
-0.047 Tw
(should be tailored to the needs of these patients and)Tj
0 -1.227 TD
-0.076 Tw
(supervised closely in view of the marked predisposi-)Tj
0 -1.182 TD
0.026 Tc
0.259 Tw
(tion of these patients to ischemic events and)Tj
T*
0.003 Tc
(arrhythmias.)Tj
1.636 -1.227 TD
0.245 Tw
(Cardiac rehabilitation exercise training often)Tj
-1.636 -1.182 TD
(improves skeletal muscle strength and oxidative)Tj
0 -1.227 TD
-0.007 Tw
(capacity and, when combined with appropriate nu-)Tj
0 -1.182 TD
-0.049 Tw
(tritional changes, may result in weight loss. In addi-)Tj
0 -1.227 TD
-0.074 Tw
(tion, such training generally results in improvement)Tj
0 -1.182 TD
0.1 Tw
(in measures of psychological status, social adjust-)Tj
T*
0.231 Tw
(ment, and functional capacity. However, cardiac)Tj
0 -1.227 TD
-0.066 Tw
(rehabilitation exercise training has less influence on)Tj
0 -1.182 TD
-0.036 Tw
(rates of return to work than many nonexercise vari-)Tj
0 -1.227 TD
0.073 Tw
(ables, including employer attitudes, prior employ-)Tj
0 -1.182 TD
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(ment status, and economic incentives. Multifactorial)Tj
T*
-0.003 Tc
-0.129 Tw
(intervention programs, including nutritional changes)Tj
0 -1.227 TD
0.003 Tc
-0.091 Tw
(and medication plus exercise, are needed to improve)Tj
0 -1.182 TD
-0.077 Tw
(health status and reduce cardiovascular disease risk.)Tj
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0.008 Tc
(46)Tj
/F5 1 Tf
-22.182 63.727 TD
0.003 Tc
-0.001 Tw
(Physical Activity and Health)Tj
/F7 1 Tf
1.636 -2.818 TD
-0.017 Tw
(Cardiac rehabilitation programs have tradition-)Tj
-1.636 -1.182 TD
-0.007 Tc
-0.129 Tw
(ally been institutional-based and group-centered \(e.g.,)Tj
T*
0.003 Tc
-0.037 Tw
(hospitals, clinics, community centers\). Referral and)Tj
0 -1.227 TD
-0.027 Tw
(enrollment rates have been relatively low, generally)Tj
0 -1.182 TD
-0.073 Tw
(ranging from 10 to 25 percent of patients with CHD.)Tj
0 -1.227 TD
-0.066 Tw
(Referral rates are lower for women than for men and)Tj
0 -1.182 TD
0.043 Tw
(lower for non-whites than for whites. Home-based)Tj
T*
-0.111 Tw
(programs have the potential to provide rehabilitative)Tj
0 -1.227 TD
0.174 Tw
(services to a wider population. Home-based pro-)Tj
0 -1.182 TD
0 Tc
-0.129 Tw
(grams incorporating limited hospital visits with regu-)Tj
0 -1.227 TD
0.003 Tc
0.255 Tw
(lar mail or telephone followup by a nurse case)Tj
0 -1.182 TD
-0.036 Tw
(manager have demonstrated significant increases in)Tj
T*
-0.001 Tc
-0.129 Tw
(functional capacity, smoking cessation, and improve-)Tj
0 -1.227 TD
0.003 Tc
-0.018 Tw
(ment in blood lipid levels. A range of options exists)Tj
0 -1.182 TD
0.085 Tw
(in cardiac rehabilitation including site, number of)Tj
0 -1.227 TD
0 Tw
(visits, monitoring, and other services.)Tj
1.636 -1.182 TD
0.073 Tw
(There are clear medical and economic reasons)Tj
-1.636 -1.227 TD
0.23 Tw
(for carrying out cardiac rehabilitation programs.)Tj
0 -1.182 TD
-0.094 Tw
(Optimal outcomes are achieved when exercise train-)Tj
T*
0.254 Tw
(ing is combined with educational messages and)Tj
0 -1.227 TD
-0.071 Tw
(feedback about changing lifestyle. Patients who par-)Tj
0 -1.182 TD
0.104 Tw
(ticipate in cardiac rehabilitation programs show a)Tj
0 -1.227 TD
0.017 Tc
0.259 Tw
(lower incidence of rehospitalization and lower)Tj
0 -1.182 TD
0.003 Tc
-0.094 Tw
(charges per hospitalization. Cardiac rehabilitation is)Tj
T*
0.004 Tw
(a cost-efficient therapeutic modality that should be)Tj
0 -1.227 TD
0 Tw
(used more frequently.)Tj
/F5 1 Tf
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0 Tc
(4. What Are the Successful Approaches to)Tj
0 -1.208 TD
(Adopting and Maintaining a Physically)Tj
0 -1.167 TD
(Active Lifestyle?)Tj
/F7 1 Tf
11 0 0 11 48 309 Tm
0.003 Tc
0.003 Tw
(The cardiovascular benefits from and physiological)Tj
0 -1.227 TD
0.129 Tw
(reactions to physical activity appear to be similar)Tj
0 -1.182 TD
-0.116 Tw
(among diverse population subgroups defined by age,)Tj
T*
-0.123 Tw
(sex, income, region of residence, ethnic background,)Tj
0 -1.227 TD
-0.036 Tw
(and health status. However, the behavioral and atti-)Tj
0 -1.182 TD
-0.059 Tw
(tudinal factors that influence the motivation for and)Tj
0 -1.227 TD
-0.075 Tw
(ability to sustain physical activity are strongly deter-)Tj
0 -1.182 TD
0.063 Tw
(mined by social experiences, cultural background,)Tj
T*
0.153 Tw
(and physical disability and health status. For ex-)Tj
0 -1.227 TD
0.043 Tw
(ample, perceptions of appropriate physical activity)Tj
0 -1.182 TD
0.023 Tw
(differ by gender, age, weight, marital status, family)Tj
0 -1.227 TD
-0.098 Tw
(roles and responsibilities, disability, and social class.)Tj
0 -1.182 TD
0.017 Tw
(Thus, the following general guidelines will need to)Tj
T*
0.176 Tw
(be further refined when one is planning with or)Tj
0 -1.227 TD
0.046 Tw
(prescribing for specific individuals and population)Tj
0 -1.182 TD
-0.066 Tw
(groups, but generally physical activity is more likely)Tj
0 -1.227 TD
0 Tw
(to be initiated and maintained if the individual)Tj
25.045 55.773 TD
[(\245)-588 (Perceives a net benefit.)]TJ
0 -1.455 TD
[(\245)-588 (Chooses an enjoyable activity.)]TJ
T*
[(\245)-588 (Feels competent doing the activity.)]TJ
0 -1.5 TD
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0 -1.455 TD
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0 -1.5 TD
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[(\245)-588 (Can fit the activity into the daily schedule.)]TJ
0 -1.455 TD
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-0.112 Tw
[(\245)-596 (Feels that the activity does not generate financial)]TJ
1.091 -1.182 TD
-0.081 Tw
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-1.091 -1.5 TD
0.003 Tc
0.242 Tw
[(\245)-588 (Experiences a minimum of negative conse-)]TJ
1.091 -1.182 TD
0.049 Tw
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0 -1.227 TD
-0.063 Tw
(peer pressure, and problems with self-identity.)Tj
-1.091 -1.455 TD
-0.109 Tw
[(\245)-588 (Is able to successfully address issues of compet-)]TJ
1.091 -1.182 TD
0.001 Tw
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-1.091 -1.5 TD
-0.113 Tw
[(\245)-588 (Recognizes the need to balance the use of labor-)]TJ
1.091 -1.182 TD
0.006 Tw
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0 -1.227 TD
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-0.13 Tw
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0 -1.182 TD
0.003 Tc
0.166 Tw
(watching television, use of computers\) with)Tj
T*
-0.059 Tw
(activities that involve a higher level of physical)Tj
0 -1.227 TD
(exertion.)Tj
-0.545 -1.455 TD
-0.039 Tw
[( Other people in the individual\325s social environ-)]TJ
-1.636 -1.227 TD
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0 -1.182 TD
0.023 Tw
[(physical activity. Health care providers have a key)]TJ
T*
-0.066 Tw
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0 -1.227 TD
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(reduction behaviors. Preliminary evidence suggests)Tj
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0 -1.227 TD
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0.083 Tw
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T*
-0.016 Tw
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0 -1.227 TD
0.14 Tw
(tively by learning to recognize stages of behavior)Tj
0 -1.182 TD
0.016 Tw
(change, to communicate the need for increased ac-)Tj
0 -1.227 TD
-0.001 Tw
(tivity, to assist the patient in initiating activity, and)Tj
0 -1.182 TD
(by following up appropriately.)Tj
1.636 -1.227 TD
-0.118 Tw
(Family and friends can also be important sources)Tj
-1.636 -1.182 TD
0 Tc
-0.128 Tw
(of support for behavior change. For example, spouses)Tj
T*
0.003 Tc
0.185 Tw
(or friends can serve as \322buddies,\323 joining in the)Tj
0 -1.227 TD
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(physical activity; or a spouse could offer to take on a)Tj
0 -1.182 TD
-0.115 Tw
(household task, giving his or her mate time to engage)Tj
0 -1.227 TD
0.021 Tc
0.259 Tw
(in physical activity. Parents can support their)Tj
0 -1.182 TD
-0.004 Tc
-0.13 Tw
(children\325s activity by providing transportation, praise,)Tj
T*
0.003 Tc
0.036 Tw
(and encouragement, and by participating in activi-)Tj
0 -1.227 TD
0 Tw
(ties with their children.)Tj
1.636 -1.182 TD
0.013 Tc
0.029 Tw
(Worksites have the potential to encourage in-)Tj
-1.636 -1.227 TD
-0.05 Tw
(creased physical activity by offering opportunities,)Tj
0 -1.182 TD
-0.043 Tw
(reminders, and rewards for doing so. For example,)Tj
0 -1.227 TD
-0.123 Tw
(an appropriate indoor area can be set aside to enable)Tj
0 -1.182 TD
0.234 Tw
(walking during lunch hours. Signs placed near)Tj
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1.091 -1.5 TD
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[(\245)-588 (Are appropriate and enjoyable for children of)]TJ
1.091 -1.182 TD
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[(\245)-596 (Appeal to girls as well as to boys, and to children)]TJ
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[(\245)-590 (Can serve as a foundation for activities through-)]TJ
1.091 -1.182 TD
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0.001 Tw
(out life.)Tj
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[(\245)-588 (Are offered on a daily basis.)]TJ
0.545 -1.455 TD
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[( Successful approaches may involve mass educa-)]TJ
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0 -1.227 TD
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T*
-0.102 Tw
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0 -1.227 TD
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(cal activity can facilitate activity maintenance for)Tj
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0.008 Tc
0.259 Tw
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0.003 Tc
-0.003 Tw
(change among the less motivated. As in other areas)Tj
0 -1.182 TD
0.122 Tw
(of health promotion, mass communication strate-)Tj
T*
0.142 Tw
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0 -1.227 TD
0.089 Tw
(These strategies should include a variety of main-)Tj
0 -1.182 TD
0.186 Tw
(stream channels and techniques to reach diverse)Tj
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0.051 Tw
(audiences that acquire information through differ-)Tj
0 -1.182 TD
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(ent media \(e.g., TV, newspaper, radio, Internet\).)Tj
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(5. What Are the Important Considerations)Tj
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0.003 Tc
0.214 Tw
(While much has been learned about the role of)Tj
0 -1.182 TD
0.017 Tw
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T*
0 Tw
(many unanswered questions.)Tj
1.091 -1.5 TD
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[(\245)-588 (Maintain surveillance of physical activity levels)]TJ
1.091 -1.182 TD
-0.033 Tw
(in the U.S. population by age, sex, geographic,)Tj
0 -1.227 TD
0.001 Tw
(and socioeconomic measures.)Tj
22.864 54.909 TD
-0.052 Tw
[(\245)-588 (Develop better methods for analysis and quan-)]TJ
1.091 -1.182 TD
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(tification of activity. These methods should be)Tj
T*
-0.009 Tw
(applicable to both work and leisure time mea-)Tj
0 -1.227 TD
-0.071 Tw
(surements and provide direct quantitative esti-)Tj
0 -1.182 TD
-0.001 Tw
(mates of activity.)Tj
-1.091 -1.5 TD
-0.106 Tw
[(\245)-588 (Conduct physiologic, biochemical, and genetic)]TJ
1.091 -1.182 TD
0.093 Tw
(research necessary to define the mechanisms)Tj
T*
-0.002 Tc
-0.129 Tw
(by which activity affects CVD including changes)Tj
0 -1.227 TD
0.003 Tc
0.037 Tw
(in metabolism as well as cardiac and vascular)Tj
0 -1.182 TD
0.231 Tw
(effects. This will provide new insights into)Tj
0 -1.227 TD
0.029 Tw
(cardiovascular biology that may have broader)Tj
0 -1.182 TD
0 Tw
(implications than for other clinical outcomes.)Tj
-1.091 -1.455 TD
0.179 Tw
[(\245)-588 (Examine the effects of physical activity and)]TJ
1.091 -1.227 TD
0.078 Tw
(cardiac rehabilitation programs on morbidity)Tj
0 -1.182 TD
0 Tw
(and mortality in elderly individuals.)Tj
-1.091 -1.5 TD
-0.117 Tw
[(\245)-588 (Conduct research on the social and psychologi-)]TJ
1.091 -1.182 TD
0.094 Tw
(cal factors that influence adoption of a more)Tj
T*
0.209 Tw
(active lifestyle and the maintenance of that)Tj
0 -1.227 TD
0 Tw
(behavior change throughout life.)Tj
-1.091 -1.455 TD
-0.06 Tw
[(\245)-588 (Carry out controlled randomized clinical trials)]TJ
1.091 -1.227 TD
0.213 Tw
(among children and adolescents to test the)Tj
0 -1.182 TD
0.092 Tw
(effects of increased physical activity on CVD)Tj
T*
-0.038 Tw
(risk factor levels including obesity. The effects)Tj
0 -1.227 TD
0.218 Tw
(of intensity, frequency, and duration of in-)Tj
0 -1.182 TD
-0.12 Tw
(creased physical activity should be examined in)Tj
0 -1.227 TD
-0.001 Tw
(such studies.)Tj
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(Conclusions)Tj
/F7 1 Tf
11 0 0 11 329.5 314 Tm
-0.005 Tc
-0.13 Tw
(Accumulating scientific evidence indicates that physi-)Tj
T*
0.003 Tc
-0.121 Tw
(cal inactivity is a major risk factor for CVD. Moderate)Tj
0 -1.182 TD
0.025 Tw
(levels of regular physical activity confer significant)Tj
T*
-0.128 Tw
(health benefits. Unfortunately, most Americans have)Tj
0 -1.227 TD
0 Tw
(little or no physical activity in their daily lives.)Tj
1.636 -1.182 TD
0 Tc
-0.039 Tw
(All Americans should engage in regular physical)Tj
-1.636 -1.227 TD
0.224 Tw
(activity at a level appropriate to their capacities,)Tj
0 -1.182 TD
0.017 Tw
(needs, and interests. All children and adults should)Tj
0 -1.227 TD
0.208 Tw
(set and reach a goal of accumulating at least 30)Tj
0 -1.182 TD
0.12 Tw
(minutes of moderate-intensity physical activity on)Tj
T*
-0.098 Tw
(most, and preferably all, days of the week. Those who)Tj
0 -1.227 TD
-0.095 Tw
(currently meet these standards may derive additional)Tj
0 -1.182 TD
-0.029 Tw
(health and fitness benefits by becoming more physi-)Tj
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0 Tw
(cally active or including more vigorous activity.)Tj
1.636 -1.182 TD
0.003 Tc
0.149 Tw
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-1.636 -1.227 TD
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0 -1.182 TD
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(should be more widely applied to those with known)Tj
T*
0.112 Tw
(CVD. Well-designed rehabilitation programs have)Tj
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1.091 -1.182 TD
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0.003 Tw
[(\245)-588 (Community support of regular physical activ-)]TJ
1.091 -1.182 TD
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0 -1.227 TD
0.218 Tw
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0 -1.182 TD
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-1.091 -1.5 TD
0.047 Tw
[(\245)-588 (Initiation of a coordinated national campaign)]TJ
1.091 -1.182 TD
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(involving a consortium of collaborating health)Tj
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(Clarke HH, editor. Toward a better understanding of)Tj
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(Mosby Company, 1947.)Tj
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[( 1993;25:628\320642.)]TJ
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( Champaign, IL: Human Kinetics, 1988.)Tj
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(Fitz GW. )Tj
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(Fishbein M. Health of young men under selective service.)Tj
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[(Journal of the American Medical Association)16 ( )]TJ
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T*
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T*
0.056 Tw
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[( American)]TJ
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T*
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(1981;13:65\32067.)Tj
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(tuenda\). )Tj
/F7 1 Tf
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[( Reprint,)]TJ
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(with an introduction by Charles E.)Tj
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( )Tj
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( 1993;25:109\320115.)Tj
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[( New York: Harcourt, )42 (Brace,)]TJ
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0.001 Tw
(and Company, 1927.)Tj
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0.259 Tw
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(Muscular activity. )Tj
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0.259 Tw
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-11.35 -1.2 TD
0.005 Tc
0 Tw
(Wilkins, 1926.)Tj
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(Hill AV. The physiological basis of athletic records. )Tj
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(Hill AV. The physiological basis of athletic records.)Tj
/F13 1 Tf
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[( Scien-)]TJ
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(tific Monthly )Tj
/F7 1 Tf
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(1925b;21:409\320428.)Tj
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(Hippocrates. )Tj
/F13 1 Tf
5.45 0 TD
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(Translated by W.H.S. Jones)Tj
/F13 1 Tf
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(.)Tj
/F7 1 Tf
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[( Cam-)]TJ
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(bridge, MA: Harvard University Press, 1953.)Tj
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(Hitchcock E. )Tj
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(Rev. ed.)Tj
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0 Tw
(New York: Ivison, Phinney, 1861.)Tj
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0.073 Tw
(Horvath SM, Horvath EC. )Tj
/F13 1 Tf
11.4 0 TD
0.07 Tw
(The Harvard Fatigue Labora-)Tj
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(tory: its history and contributions. )Tj
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(Englewood Cliffs, NJ:)Tj
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(Prentice-Hall, 1973.)Tj
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(Huang Ti. )Tj
/F13 1 Tf
4.4 0 TD
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(Nei Ching Su Wen: the Yellow Emperor\325s classic)Tj
-3.2 -1.2 TD
0.14 Tw
(of internal medicine. )Tj
/F7 1 Tf
8.9 0 TD
0.145 Tw
(Translated by Ilza Veith. Balti-)Tj
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0 Tw
(more: Williams and Wilkins, 1949.)Tj
-1.2 -1.7 TD
0.015 Tc
0.236 Tw
(Huard P, Wong M. )Tj
/F13 1 Tf
9.3 0 TD
0.228 Tw
(Chinese medicine. )Tj
/F7 1 Tf
8.1 0 TD
0.236 Tw
(Translated by)Tj
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-0.103 Tw
(Bernard Fielding. London: Weidenfeld and Nicolson,)Tj
T*
(1968.)Tj
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0.005 Tc
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(Jacobs DR, Ainsworth BE, Hartman TJ, Leon AS. A simul-)Tj
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0.22 Tw
(taneous evaluation of 10 commonly used physical)Tj
T*
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(activity questionnaires. )Tj
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(1993;25:81\32091.)Tj
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(Jaeger W. )Tj
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(Paideia: the ideals of Greek culture. T)Tj
/F7 1 Tf
14.45 0 TD
-0.123 Tw
(ranslated by)Tj
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0.173 Tw
(Gilbert Highet.)Tj
/F13 1 Tf
6.5 0 TD
0.168 Tw
[( Vol. 1. Archaic Greece\321the mind of)]TJ
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(Athens. )Tj
/F7 1 Tf
3.3 0 TD
0.082 Tw
(2nd ed. New York: Oxford University Press,)Tj
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(1965.)Tj
25.15 62.1 TD
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(Kannel WB, Wilson P, Blair SN. Epidemiological assess-)Tj
1.2 -1.2 TD
0.156 Tw
(ment of the role of physical activity and fitness in)Tj
T*
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-0.128 Tw
(development of cardiovascular disease. )Tj
/F13 1 Tf
15.85 0 TD
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[(American Heart)]TJ
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/F7 1 Tf
3.2 0 TD
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(Karvonen MJ, Kentala E, Mustala O. The effects of training)Tj
1.2 -1.2 TD
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5.7 0 TD
(Acta Medica Exp Fenn)Tj
/F7 1 Tf
8.8 0 TD
[( 1957;35:308\320315.)]TJ
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0.005 Tc
0.044 Tw
(Kashiwazaki H, Inaoka T, Suzuki T, Kondo Y. Correla-)Tj
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(tions of pedometer readings with energy expenditure)Tj
T*
-0.1 Tw
(in workers during free-living daily activities. )Tj
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18.3 0 TD
(European)Tj
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(Journal of Applied Physiology)Tj
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11.9 0 TD
( 1986;54:585\320590.)Tj
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-0.13 Tw
(Katzenstein G. Ueber die Einwirkung der Muskelth\212tigkeit)Tj
1.2 -1.2 TD
0.005 Tc
0.034 Tw
(auf den Stoffverbrauch des Menschen. Pfl\237ger EFW.)Tj
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T*
0.017 Tw
(Archiv f\237r die gesammte Physiologie des Menschen und)Tj
T*
0 Tw
(der Thiere. )Tj
/F7 1 Tf
4.65 0 TD
(Bonn:)Tj
/F13 1 Tf
2.45 0 TD
( )Tj
/F7 1 Tf
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(M. Hager, 1891:49:330\320404.)Tj
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1.2 -1.2 TD
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(RF. Group- vs home-based exercise training in healthy)Tj
T*
0.111 Tw
(older men and women: a community-based clinical)Tj
T*
0.018 Tc
(trial. )Tj
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0.017 Tc
0.25 Tw
(Journal of the American Medical Association)Tj
/F7 1 Tf
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(1991;266:1535\3201542.)Tj
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0.004 Tc
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(Klein PD, James WPT, Wong WW, Irving CS, Murgatroyd)Tj
1.2 -1.2 TD
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0.097 Tw
(PR, Cabrera M, et al. Calorimetric validation of the)Tj
T*
0.15 Tw
(doubly labelled water method for determination of)Tj
T*
-0.053 Tw
(energy expenditure in man. )Tj
/F13 1 Tf
11.65 0 TD
-0.052 Tw
(Human Nutrition, Clinical)Tj
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(Nutrition )Tj
/F7 1 Tf
4 0 TD
(1984;38C:95\320106.)Tj
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0.121 Tw
(Klesges LM, Klesges RC. The assessment of children\325s)Tj
1.2 -1.2 TD
0.018 Tw
(physical activity: a comparison of methods. )Tj
/F13 1 Tf
18.55 0 TD
(Medicine)Tj
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0 Tw
(and Science in Sports and Exercise )Tj
/F7 1 Tf
14.05 0 TD
(1987;19:511\320517.)Tj
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(Knehr CA, Dill DB, Neufeld W. Training and its effects on)Tj
1.2 -1.2 TD
-0.111 Tw
(man at rest and at work. )Tj
/F13 1 Tf
9.8 0 TD
-0.107 Tw
(American Journal of Physiology)Tj
/F7 1 Tf
-9.8 -1.2 TD
(1942;136:148\320156.)Tj
-1.2 -1.7 TD
0.134 Tw
(Kraus H, Hirschland RP. Muscular fitness and health.)Tj
/F13 1 Tf
1.2 -1.2 TD
0.035 Tw
(Journal for Health, Physical Education, and Recreation)Tj
/F7 1 Tf
T*
(1953;24:17\32019.)Tj
-1.2 -1.75 TD
-0.062 Tw
(Kriska AM, Sandler RB, Cauley JA, LaPorte RE, Hom DL,)Tj
1.2 -1.2 TD
0.087 Tw
(Pambianco G. The assessment of historical physical)Tj
T*
0.215 Tw
(activity and its relation to adult bone parameters.)Tj
/F13 1 Tf
T*
-0.003 Tc
-0.125 Tw
(American Journal of Epidemiology )Tj
/F7 1 Tf
13.2 0 TD
-0.005 Tc
(1988;127:1053\3201063.)Tj
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0.005 Tc
0.016 Tw
(Lagrange F. )Tj
/F13 1 Tf
5.2 0 TD
0.015 Tw
(Physiology of bodily exercise )Tj
/F7 1 Tf
11.85 0 TD
([188])Tj
/F13 1 Tf
2.35 0 TD
(.)Tj
/F7 1 Tf
0.25 0 TD
0.016 Tw
[( Reprint,)]TJ
-18.45 -1.2 TD
0 Tw
(New York: D. Appleton, 1890.)Tj
-1.2 -1.75 TD
0.132 Tw
(Lakka TA, Nyyssonen K, Salonen JT. Higher levels of)Tj
1.2 -1.2 TD
-0.031 Tw
(conditioning leisure-time physical activity are associ-)Tj
T*
-0.099 Tw
(ated with reduced levels of stored iron in Finnish men.)Tj
/F13 1 Tf
T*
-0.001 Tw
(American Journal of Epidemiology )Tj
/F7 1 Tf
14.05 0 TD
(1994;140:148\320160.)Tj
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0.006 Tc
0.259 Tw
(Langenfeld H. Auf dem wege zur sportwissenschaft:)Tj
1.2 -1.2 TD
0.005 Tc
0.233 Tw
(mediziner und leibes\237bungen im 19. jahrhundert.)Tj
/F13 1 Tf
T*
(Stadion )Tj
/F7 1 Tf
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ET
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0.003 Tc
0 Tw
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asurement)Tj
/F7 1 Tf
10 0 0 10 66 712 Tm
0.005 Tc
-0.123 Tw
(LaPorte RE, Black-Sandler R, Cauley JA, Link M, Bayles C,)Tj
1.2 -1.2 TD
0.006 Tw
(Marks B. The assessment of physical activity in older)Tj
T*
-0.123 Tw
(women: analysis of the interrelationship and reliability)Tj
T*
0.146 Tw
(of activity monitoring, activity surveys, and caloric)Tj
T*
(intake. )Tj
/F13 1 Tf
3.15 0 TD
-0.001 Tw
(Journal of Gerontology )Tj
/F7 1 Tf
9.4 0 TD
(1983;38:394\320397.)Tj
-13.75 -1.75 TD
-0.003 Tc
0.148 Tw
(LaPorte RE, Montoye HJ, Caspersen CJ. Assessment of)Tj
1.2 -1.2 TD
0.089 Tw
(physical activity in epidemiologic research: problems)Tj
T*
0.232 Tw
(and prospects. )Tj
/F13 1 Tf
6.65 0 TD
0.224 Tw
(Public Health Reports )Tj
/F7 1 Tf
9.4 0 TD
-0.004 Tc
(1985;100:131\320)Tj
-16.05 -1.2 TD
(146.)Tj
-1.2 -1.75 TD
0.005 Tc
0.138 Tw
(Larson LA, Yocom RD. )Tj
/F13 1 Tf
10.45 0 TD
0.133 Tw
(Measurement and evaluation in)Tj
-9.25 -1.2 TD
0.172 Tw
(physical, health, and recreation education. )Tj
/F7 1 Tf
18.1 0 TD
0.178 Tw
(St. Louis:)Tj
-18.1 -1.2 TD
0 Tw
(C.V. Mosby, 1951.)Tj
-1.2 -1.7 TD
-0.098 Tw
(Lavoisier AL. Exp\216riences sur la respiration des animaux,)Tj
1.2 -1.2 TD
-0.099 Tw
(et sur les changemens qui arrivent \210 l\325air en passant par)Tj
T*
0.145 Tw
(leur poumon. )Tj
/F13 1 Tf
6.3 0 TD
0.14 Tw
(Histoire de l\325Acad\216mie Royale des Sci-)Tj
-6.3 -1.2 TD
(ences. )Tj
/F7 1 Tf
2.65 0 TD
0 Tw
(Paris: Acad\216mie des Sciences, 1777:185\320194.)Tj
-3.85 -1.75 TD
0.164 Tw
(Lavoisier AL, de LaPlace PS. M\216moire sur la chaleur.)Tj
/F13 1 Tf
1.2 -1.2 TD
0.023 Tc
0.25 Tw
(Histoire de l\325Acad\216mie Royale des Sciences. )Tj
/F7 1 Tf
19.8 0 TD
(Paris:)Tj
-19.8 -1.2 TD
0.005 Tc
0 Tw
(Acad\216mie des Sciences, 1780:355\320408.)Tj
-1.2 -1.75 TD
-0.064 Tw
(Lehmann JF, Boswell S, Price R, Burleigh A, de Lateur BJ,)Tj
1.2 -1.2 TD
0.013 Tw
(Jaffe KM, et al. Quantitative evaluation of sway as an)Tj
T*
-0.101 Tw
(indicator of functional balance in post-traumatic brain)Tj
T*
(injury. )Tj
/F13 1 Tf
3 0 TD
-0.072 Tw
(Archives of Physical Medicine and Rehabilitation)Tj
/F7 1 Tf
-3 -1.2 TD
(1990;71:955\320962.)Tj
-1.2 -1.75 TD
-0.055 Tw
(Leon AS, Jacobs DR Jr, DeBacker G, Taylor HL. Relation-)Tj
1.2 -1.2 TD
-0.081 Tw
(ship of physical characteristics and life habits to tread-)Tj
T*
0 Tc
-0.129 Tw
(mill exercise capacity. )Tj
/F13 1 Tf
9 0 TD
-0.124 Tw
(American Journal of Epidemiology)Tj
/F7 1 Tf
-9 -1.2 TD
0.005 Tc
(1981;113:653\320660.)Tj
-1.2 -1.75 TD
-0.022 Tw
(Leonard FE, Affleck GB. )Tj
/F13 1 Tf
10.4 0 TD
-0.021 Tw
(A guide to the history of physical)Tj
-9.2 -1.2 TD
(education. )Tj
/F7 1 Tf
4.25 0 TD
-0.102 Tw
(3rd ed. Philadelphia: Lea and Febiger, 1947.)Tj
-5.45 -1.7 TD
-0.112 Tw
(Lewis D. )Tj
/F13 1 Tf
3.7 0 TD
-0.108 Tw
(The new gymnastics for men, women, and children.)Tj
/F7 1 Tf
-2.5 -1.2 TD
0 Tw
(New York: Clarke Brothers, 1883.)Tj
-1.2 -1.75 TD
0.018 Tw
(Licht S. History [of therapeutic exercise]. In: Basmajian)Tj
1.2 -1.2 TD
0.242 Tw
(JV, editor. )Tj
/F13 1 Tf
5 0 TD
0.234 Tw
(Therapeutic exercise. )Tj
/F7 1 Tf
9.2 0 TD
0.242 Tw
(4th ed. Baltimore:)Tj
-14.2 -1.2 TD
0 Tw
(Williams and Wilkins, 1984:1\32044.)Tj
-1.2 -1.75 TD
0.187 Tw
(Lohman TG. Applicability of body composition tech-)Tj
1.2 -1.2 TD
-0.088 Tw
(niques and constants for children and youths. )Tj
/F13 1 Tf
18.85 0 TD
(Exercise)Tj
-18.85 -1.2 TD
-0.001 Tw
(and Sport Sciences Reviews )Tj
/F7 1 Tf
11.15 0 TD
(1986;14:325\320357.)Tj
-12.35 -1.75 TD
0.059 Tw
(Lohman TG. Research progress in validation of labora-)Tj
1.2 -1.2 TD
-0.08 Tw
(tory methods of assessing body composition. )Tj
/F13 1 Tf
18.6 0 TD
(Medicine)Tj
-18.6 -1.2 TD
0 Tw
(and Science in Sports and Exercise )Tj
/F7 1 Tf
14.1 0 TD
(1984;16:596\320603.)Tj
-15.3 -1.75 TD
-0.015 Tw
(Lukaski HC, Bolonchuk WW, Hall CB, Siders WA. Vali-)Tj
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25.15 62.45 TD
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(liams, Lea, and Company, 1952.)Tj
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17.6 0 TD
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18 0 TD
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T*
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T*
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T*
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