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“WALKING FOR HEALTH”
Walking is a rhythmic, dynamic, aerobic activity of the large skeletal muscles, which confers the multifarious benefits of this activity with minimal adverse effects (Jeremy N. Morris and Adrianne E. Hardman). Walking at a rate faster than customary, frequently and regularly, taking the participant into the “ training Zone” of over 70% of maximum heart rate, develops and sustains physical fitness; the cardiovascular capacity and endurance for bodily work and movement in everyday life that also provides reserves for meeting exceptional demands. The muscles of the legs, limb girdle and lower trunk are strengthened and the flexibility of their cardinal joints preserved; posture and carriage may improve.
Any amount of walking, and at any pace, expends energy: Hence the important long-term potential of walking for weight control. Dynamic aerobic exercise as in walking enhances a multiple of bodily processes that are inherent in skeletal muscle activity, including the metabolism of high-density lipoproteins and insulin/glucose dynamics. Walking is also the most common weight-bearing activity and there are indications at all ages of increase in related bone strength.
The pleasurable and therapeutic, psychological and social dimensions of walking, whilst evident, have been surprisingly little studied. Nor has an economic assessment of the benefits and costs of walking been attempted.
Walking is beneficial through promoting improved fitness and/or greater physiological activity and energy turnover. Two main modes of such action can be distinguished: (1) acute, short term effects of the exercise: and (2) chronic, cumulative adaptations depending on habitual activity over weeks and months.
Walking is often included in studies of exercise in relation to disease, but it has seldom been specifically tested. There is, nonetheless, growing evidence of gains in the prevention of heart attack and reduction of total death rates, in the treatment of hypertension, intermittent claudication and musculoskeletal disorders, and in the rehabilitation after heart attack and in respiratory disease.
Walking is the most natural activity and the only sustained dynamic aerobic exercise that is common to everyone except for the seriously disabled or very frail. No special skills or equipment are required. Walking is convenient and may be accommodated in occupational and domestic routines. It is self-regulating in intensity, duration and frequency; and having a low ground impact, is inherently safe.
Unlike so much physical activity, there is little, if any, decline in middle age. It is a year-round, readily repeatable, self-reinforcing, habit-forming activity and the main option for increasing physical activity in sedentary populations.
Levels of walking in modern societies are often low. Familiar social inequalities may be evident. There are indications of a serious decline of walking in children, though further surveys of their activity, fitness and health are required. Some of the downsides associated with walking in a modern environment relate to the incidence of fatal and non-fatal road casualties, especially among children and old people, and to the deteriorating air quality due to traffic fumes, which mounting evidence implicates in the several stages of respiratory disease.
Walking is ideal as a gentle start-up for the sedentary, including the inactive, immobile elderly, bringing a bonus of independence and social well-being. As general policy, a gradual progression is indicated from a slow to a regular pace and on 30 minutes or more of brisk (i.e. 6.4km/h) walking most days. These levels should achieve the major gains of activity and health-related fitness without adverse effects. Alternatively, such targets as this can be suggested for personal motivation, clinical practice, and public health.
The average middle-aged person should be comfortably able to walk on the level for approximately one mile (just over 1.5km) at 6.4km/h, and on a slope of 1 in 20 at 4.8 km/h. However, many cannot do so because of inactivity-induced unfitness. The physiological threshold of “comfort” represents 70% of maximum heart rate. Trials across the age span are required in primary care and community programs to evaluate such approaches, and the benefits and costs more generally of possible initiatives towards more walking.
Walking by quantity and pace, is under-researched, particularly in the middle-aged and elderly. Randomized controlled trials are required of its physiological effects on blood pressure, thrombogenesis, immune function; and of walking in the prevention and/or treatment of non-insulin dependant (type 2) diabetes mellitus, osteoporosis, anxiety and depression and back pain.
Low levels of walking are a major factor in today’s widespread waste of the potential for health and well-being that is due to physical inactivity. This waste is manifest in impaired functional capacities, overweight, disease, disability, premature death and the concomitant human and economic costs. This review seeks to assemble evidence of the health gains of walking as a resource for the multifarious professionals and students, practitioners, investigators and policy makers.
Reproduced by kind permission of Nordic UK |