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May 13, 1988, Vol 259, No. 18 >
ARTICLE | May 13, 1988

Walking for Health and Fitness FREE

James M. Rippe, MD; Ann Ward, PhD; John P. Porcari, MS; Patty S. Freedson, PhD
[+] Author Affiliations

Reprint requests to the Division of Cardiovascular Medicine, University of Massachusetts Medical Center, 55 Lake Ave N, Worcester, MA 01605 (Dr Rippe).


JAMA. 1988;259(18):2720-2724. doi:10.1001/jama.1988.03720180046031
Text Size: A A A
Published online
Article
References

Recent studies have linked regular physical activity with reduced likelihood of developing coronary heart disease. Even low- and moderate-intensity exercise such as walking, when carried out consistently, is associated with important cardiovascular health benefits. Walking has also been shown to reduce anxiety and tension and aid in weight loss. Regular walking may help improve cholesterol profile, help control hypertension, and slow the process of osteoporosis. Recent physiological studies have demonstrated that brisk walking provides strenuous enough exercise for cardiovascular training in most adults. A recently developed submaximal 1-mile walk test provides a simple and accurate means for estimating aerobic capacity and guiding exercise prescription. These new insights and tools will assist the clinician in the prescription of safe and effective walking programs.

(JAMA 1988;259:2720-2724)

REFERENCES

1 +
Paffenbarger RS Jr, Hyde RT, Wing AL, et al:  Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 1986;;314:605-613.
2 +
Leon AS, Connett J, Jacobs DR Jr, et al:  Leisure-time physical activity levels and risk of coronary heart disease and death: The Multiple Risk Factor Intervention Trial. JAMA 1987;;258:2388-2395.
3 +
Ryan AJ:  Exercise is medicine. Phys SportsMed 1983;;11:10.
4 +
Morris JN, Heady JA, Raffle PAB, et al:  Coronary heart disease and physical activity of work. Lancet 1953;;2265:1053-1057,1111-1120.
5 +
Taylor HL, Klepetar E, Keys A, et al:  Death rates among physically active and sedentary employees of the railroad industry. Am J Public Health 1962;;52:1697-1707.
6 +
Paffenbarger RS Jr, Gima AS, AS, Laughlin ME, et al:  Characteristics of longshoremen related to CHD and stroke. Am J Public Health 1972;;61:1362-1370.
7 +
Rippe J (moderator):  The health benefits of exercise (part 1 of 2). Phys SportsMed 1987;;15:115-132.
8 +
Powell KE, Thompson PD, Casperson CJ, et al:  Physical activity and the incidence of coronary heart disease. Annu Rev Public Health 1987;;8:253-287.
9 +
Morgan WP, Goldston SE (eds): Exercise and Mental Health . Washington, DC, Hemisphere Publishing, 1987;.
10 +
Bahrke MS, Morgan WP:  Anxiety reduction following exercise and meditation. Cognitive Ther Res 1978;;2:323-333.
11 +
Greist JH, Klein MH, Eischens RR, et al:  Running as treatment for depression. Compr Psychiatry 1979;;20:41-53.
12 +
Morgan WP:  Affective beneficence of vigorous physical activity. Med Sci Sports Exerc 1985;;17:94-100.
13 +
Berger BG, Owen DR:  Swimmers really do 'feel better.' Psychol Med 1983;;45:425-433.
14 +
Porcari JP, Ward A, Morgan W, et al:  Effect of walking on state anxiety and blood pressure. Med Sci Sports Exerc 1988;;20:S85.
15 +
Mayer J, Marshall NB, Vitale JJ, et al:  Exercise, food intake and body weight in normal rats and genetically obese adult mice. Am J Physiol 1954;;177:544-548.
16 +
Mayer J, Roy P, Mitra KP:  Relation between caloric intake, body weight and physical work: Studies in an industrial male population in West Bengal. Am J Clin Nutr 1956;;4:169-175.
17 +
Knuttgen HG:  Oxygen debt after submaximal physical exercise. J Appl Physiol 1970;;29:651-657.
18 +
Bielinski R, Schutz Y, Jequier E:  Energy metabolism during the post-exercise recovery in man. Am J Clin Nutr 1985;;42:69-82.
19 +
Pavlou KN, Steffee WP, Lerman RH, et al:  Effects of dieting and exercise on lean body mass, oxygen uptake, and strength. Med Sci Sports Exerc 1985;;17:466-471.
20 +
Lennon D, Nagle F, Stratman F, et al:  Diet and exercise training effects on resting metabolic rate. Int J Obesity 1985;;9:39-47.
21 +
Dahlkoetter J, Callahan EJ, Linton J:  Obesity and the unbalanced energy equation: Exercise vs eating habit change. J Consult Clin Psychol 1979;;47:898-905.
22 +
Goldberg L, Elliot DL:  The effect of exercise on lipid metabolism in men and women. SportsMed 1987;;4:307-321.
23 +
Leon AS, Conrad J, Hunninghake, et al:  Effects of a vigorous walking program on body composition, and carbohydrate and lipid metabolism of obese young men. Am J Clin Nutr 1979;;32:1776-1787.
24 +
Hartung GH, Foreyt JP, Mitchell RE, et al:  Relation of diet to high-density lipoprotein cholesterol in middle-aged marathon runners, joggers and inactive men. N Engl J Med 1980;;302:357-361.
25 +
Wood PD, Haskell W, Klein H, et al:  The distribution of plasma lipoproteins in middle-aged male runners. Metabolism 1976;;25:1249-1257.
26 +
Cook TC, Laporte RE, Washburn RA, et al:  Chronic low level physical activity as a determinant of high density lipoprotein cholesterol and subfractions. Med Sci Sports Exerc 1986;;18:653-657.
27 +
Blackburn H:  Physical activity and hypertension. J Clin Hypertens 1986;;2:154-162.
28 +
Seals DR, Hagberg JM:  The effect of exercise training on human hypertension: A review. Med Sci Sports Exerc 1984;;16:207-215.
29 +
Berchtold P, Jorgens V, Kemmer FW, et al:  Obesity and hypertension: Cardiovascular response to weight reduction. Hypertension 1982;;4( (suppl III) ):III-50-III-55.
30 +
Dehn MM, Bruce RA:  Longitudinal variations in maximal oxygen intake with age and activity. J Appl Physiol 1972;;33:805-807.
31 +
Bortz WM:  Disuse and aging. JAMA 1982;;248:1203-1208.
32 +
Ekblom B, Astrand PO, Saltin B, et al:  Effect of training on circulatory response to exercise. J Appl Physiol 1968;;24:515-528.
33 +
Ekblom B:  Effect of physical training on oxygen transport system in man. Acta Physiol Scand 1969;;328( (suppl) ):9-45.
34 +
Seals DR, Hagberg JM, Hurley BF, et al:  Endurance training in older men and women: II. Cardiovascular response to exercise. J Appl Physiol 1984;;57:1024-1029.
35 +
Rippe J, Ross J, Gurry M, et al: Cardiovascular effects of walking, in Proceedings of the Second International Conference of Physical Activity, Aging and Sports. 1985, p 47.
36 +
Riggs BL, Melton LJ:  Involutional osteoporosis. N Engl J Med 1986;;314:1676-1686.
37 +
Beyer RE, Huang JC, Wilshire GB:  The effect of endurance exercise on bone dimensions, collagen, and calcium in the aged male rat. Exp Gerontol 1985;;20:315-323.
38 +
McDonald R, Hegenauer J, Saltman P:  Age related differences in the bone mineralization pattern of rats following exercise. J Gerontol 1986;;41:445-452.
39 +
Oyster N, Morton M, Linnell S:  Physical activity in post-menopausal women. Med Sci Sports Exerc 1984;;16:44-50.
40 +
Smith EL, Raab D:  Osteoporosis and physical activity. Acta Med Scand 1984;;711( (suppl) ):149-156.
41 +
American College of Sports Medicine: Guidelines for Exercise Testing and Prescription , ed 3. Philadelphia, Lea & Febiger, 1986;.
42 +
LaPorte RE, Dearwater S, Cauley JA, et al:  Physical activity or cardiovascular fitness: Which is more important for health? Phys SportsMed 1985;;13:145-150.
43 +
Porcari J, McCarron R, Kline G, et al:  Is fast walking an adequate aerobic training stimulus in 30-69 year old adults? Phys SportsMed 1987;; 15:119-129.
44 +
Pollock ML, Miller HS Jr, Janeway R, et al:  Effects of walking on body composition and cardiovascular function of middle-aged men. J Appl Physiol 1971;;30:126-130.
45 +
McArdle WD, Katch FI, Pechar GS, et al:  Reliability and interrelationships between maximal oxygen intake, physical work capacity and step-test scores in college women. Med Sci Sports Exerc 1972;;4:182-186.
46 +
Jette M, Campbell J, Mongeau J, et al:  The Canadian Home Fitness Test. Can Med Assoc J 1976;;114:680-683.
47 +
Ryhming I:  A modified Harvard step test for the evaluation of physical fitness. Arbeitsphysioloque 1954;;15:S235-S250.
48 +
Astrand PO, Ryhming I:  A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during submaximal work. J Appl Physiol 1954;;7:218-221.
49 +
Fox EL:  A simple accurate technique for predicting maximal aerobic power. J Appl Physiol 1973;;35:914-916.
50 +
Golding LA, Meyers CR, Sinning WE: The Y's Way to Physical Fitness . Rosemont, Ill, YMCA of America, 1982;.
51 +
Cooper KH:  A means of assessing maximal oxygen intake. JAMA 1968;;203:135-138.
52 +
Ribisl PM, Kachadorian WA:  Maximal oxygen intake prediction in young and middle-aged males. J Sports Med 1969;;9:17-22.
53 +
Kline GM, Porcari JP, Hintermeister R, et al:  Estimation of Vo2 max from a 1-mile track walk, gender, age, and body weight. Med Sci Sports Exerc 1987;;19:253-259.
54 +
O'Hanley S, Ward A, Zwirin L, et al:  Validation of a one-mile walk test in 70-79 year olds . Med Sci Sports Exerc 1987;;19:S167.
55 +
Coleman RJ, Wilkie S, Viscio L, et al:  Validation of 1-mile test for estimating Vo2 max in 20-29 year olds. Med Sci Sports Exerc 1987;;19:S171.
56 +
Ward A, Wilkie S, O'Hanley S, et al:  Estimation of Vo2 max in overweight females. Med Sci Sports Exerc 1987;;19:S169.
57 +
Wilkie S, O'Hanley S, Ward A, et al:  Estimation of Vo2 max from a 1-mile walk test using recovery heart rate. Med Sci Sports Exerc 1987;;19:S168.
58 +
Exercise Testing and Training of Apparently Healthy Individuals . New York, American Heart Association, 1972;.
59 +
Rippe JM, Maher PM, Ockene J:  Care and rehabilitation of the patient following myocardial infarction , in Rippe JM, Irwin RS, Alpert JS, et al (eds): Intensive Care Medicine . Boston, Little Brown & Co Inc, 1985;, pp 366-376.
60 +
Paffenbarger RS Jr:  Exercise in the primary prevention of coronary heart disease , in Pollock ML, Schmidt DH (eds): Heart Disease and Rehabilitation . New York, John Wiley & Sons Inc, 1986;, pp 349-368.
61 +
Pollock ML, Pels AE III, Foster C, et al:  Exercise prescription for rehabilitation of the cardiac patient , in Pollock ML, Schmidt DH (eds): Heart Disease and Rehabilitation . New York, John Wiley & Sons Inc, 1986;, pp 477-516.
62 +
Wenger NK:  Early ambulation after myocardial infarction: Rationale, program components, and results , in Wenger NK, Hellerstein HK (eds): Rehabilitation of the Coronary Patient . New York, John Wiley & Sons Inc, 1978;, pp 53-67.
63 +
Shephard RJ:  The value of exercise in ischemic heart disease: A cumulative analysis. J Cardiopulmonary Rehabil 1983;;3:294-299.
64 +
Shephard RJ:  Recurrence of myocardial infarction: Observations on patients participating in the Ontario Multicenter Exercise Heart Trial. Eur J Cardiol 1980;;11:147-192.
65 +
Shaw LW (for the project staff):  The National Exercise and Heart Disease Project: Effects of a prescribed supervised exercise program on mortality and cardiovascular morbidity in patients after a myocardial infarction. Am J Cardiol 1981;;48:39-46.
66 +
Kallio V:  Results of rehabilitation in coronary patients , in Konig K, Denolin H (eds): Advances in Cardiology . Basel, Switzerland, S Karger AG, 1978;.
67 +
Exercise During Pregnancy and the Postnatal Period . Washington, DC, American College of Obstetrics and Gynecology, 1980;.
68 +
Kashiwa A, Rippe J: Fitness Walking for Women . New York, Putnam Publishing Group, 1987;.
69 +
Collings CA, Curet LB, Mullin JP:  Maternal and fetal responses to a maternal aerobic exercise program. Am J Obstet Gynecol 1983;;145:702-707.
70 +
Wahren J:  Glycogen turnover during exercise in healthy men and in patients with diabetes mellitus. Diabetes 1979;;28( (suppl 1) ):82-89.
71 +
Wahlberg-Henrickson H, Gunnerson R, Defronzo R, et al:  Increased peripheral insulin sensitivity and muscle mitrochondrial enzymes but unchanged blood glucose control in type I diabetes after physical training. Diabetes 1982;;31:1044-1050.
72 +
Trovati M, Carta Q, Cavalot F, et al:  Influence of physical training on blood glucose, glucose tolerance, insulin secretion, and insulin action in non—insulin-dependent diabetic patients. Diabetes Care 1984;;7:416-420.
73 +
Hanson P, Ward A, Painter P:  Exercise training for special patient populations. J Cardiopulmonary Rehabil 1986;;6:104-112.
74 +
Graves JE, Pollock ML, Montain SJ, et al:  The effect of hand-held weights on the physiological responses to walking exercise. Med Sci Sports Exerc 1987;;19:260-265.
75 +
Shoenfeld Y, Keren G, Shimoni T, et al:  Walking: A method for rapid improvement of physical fitness. JAMA 1980;;243:2062-2063.
76 +
Walcott G, Coleman R, MacVeigh M, et al:  Heart rate and Vo2 max response to weighted walking. Med Sci Sports Exerc 1986;;18:S28.
77 +
Pandolf KB, Goldman RF:  Physical conditioning of less fit adults by use of leg weight loading. Arch Phys Med Rehabil 1975;;56:255-261.
78 +
Ward A, Coleman R, Walcott G, et al:  HR/VO2 relationship in weighted and grade walking on a treadmill. J Cardiopulmonary Rehabil 1986;;6:435.
79 +
Rippe J (moderator):  Walking for fitness: A roundtable. Phys SportsMed 1986;;14:144-159.
80 +
Ulene A, Rippe J: Fitness Walking Program: Walk With Your Doc . New York, Random House, 1988;.
81 +
Sweetgall R, Rippe J, Katch F: Fitness Walking . New York, Putnam Publishing Group, 1985;.
82 +
Ward A, Rippe J: Starting Your Personal Fitness Program . Philadelphia, JB Lippincott, 1988;.
83 +
Ward A, Rippe J: Walking for Health and Fitness . Philadelphia, JB Lippincott, 1988;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Paffenbarger RS Jr, Hyde RT, Wing AL, et al:  Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 1986;;314:605-613.
2 +
Leon AS, Connett J, Jacobs DR Jr, et al:  Leisure-time physical activity levels and risk of coronary heart disease and death: The Multiple Risk Factor Intervention Trial. JAMA 1987;;258:2388-2395.
3 +
Ryan AJ:  Exercise is medicine. Phys SportsMed 1983;;11:10.
4 +
Morris JN, Heady JA, Raffle PAB, et al:  Coronary heart disease and physical activity of work. Lancet 1953;;2265:1053-1057,1111-1120.
5 +
Taylor HL, Klepetar E, Keys A, et al:  Death rates among physically active and sedentary employees of the railroad industry. Am J Public Health 1962;;52:1697-1707.
6 +
Paffenbarger RS Jr, Gima AS, AS, Laughlin ME, et al:  Characteristics of longshoremen related to CHD and stroke. Am J Public Health 1972;;61:1362-1370.
7 +
Rippe J (moderator):  The health benefits of exercise (part 1 of 2). Phys SportsMed 1987;;15:115-132.
8 +
Powell KE, Thompson PD, Casperson CJ, et al:  Physical activity and the incidence of coronary heart disease. Annu Rev Public Health 1987;;8:253-287.
9 +
Morgan WP, Goldston SE (eds): Exercise and Mental Health . Washington, DC, Hemisphere Publishing, 1987;.
10 +
Bahrke MS, Morgan WP:  Anxiety reduction following exercise and meditation. Cognitive Ther Res 1978;;2:323-333.
11 +
Greist JH, Klein MH, Eischens RR, et al:  Running as treatment for depression. Compr Psychiatry 1979;;20:41-53.
12 +
Morgan WP:  Affective beneficence of vigorous physical activity. Med Sci Sports Exerc 1985;;17:94-100.
13 +
Berger BG, Owen DR:  Swimmers really do 'feel better.' Psychol Med 1983;;45:425-433.
14 +
Porcari JP, Ward A, Morgan W, et al:  Effect of walking on state anxiety and blood pressure. Med Sci Sports Exerc 1988;;20:S85.
15 +
Mayer J, Marshall NB, Vitale JJ, et al:  Exercise, food intake and body weight in normal rats and genetically obese adult mice. Am J Physiol 1954;;177:544-548.
16 +
Mayer J, Roy P, Mitra KP:  Relation between caloric intake, body weight and physical work: Studies in an industrial male population in West Bengal. Am J Clin Nutr 1956;;4:169-175.
17 +
Knuttgen HG:  Oxygen debt after submaximal physical exercise. J Appl Physiol 1970;;29:651-657.
18 +
Bielinski R, Schutz Y, Jequier E:  Energy metabolism during the post-exercise recovery in man. Am J Clin Nutr 1985;;42:69-82.
19 +
Pavlou KN, Steffee WP, Lerman RH, et al:  Effects of dieting and exercise on lean body mass, oxygen uptake, and strength. Med Sci Sports Exerc 1985;;17:466-471.
20 +
Lennon D, Nagle F, Stratman F, et al:  Diet and exercise training effects on resting metabolic rate. Int J Obesity 1985;;9:39-47.
21 +
Dahlkoetter J, Callahan EJ, Linton J:  Obesity and the unbalanced energy equation: Exercise vs eating habit change. J Consult Clin Psychol 1979;;47:898-905.
22 +
Goldberg L, Elliot DL:  The effect of exercise on lipid metabolism in men and women. SportsMed 1987;;4:307-321.
23 +
Leon AS, Conrad J, Hunninghake, et al:  Effects of a vigorous walking program on body composition, and carbohydrate and lipid metabolism of obese young men. Am J Clin Nutr 1979;;32:1776-1787.
24 +
Hartung GH, Foreyt JP, Mitchell RE, et al:  Relation of diet to high-density lipoprotein cholesterol in middle-aged marathon runners, joggers and inactive men. N Engl J Med 1980;;302:357-361.
25 +
Wood PD, Haskell W, Klein H, et al:  The distribution of plasma lipoproteins in middle-aged male runners. Metabolism 1976;;25:1249-1257.
26 +
Cook TC, Laporte RE, Washburn RA, et al:  Chronic low level physical activity as a determinant of high density lipoprotein cholesterol and subfractions. Med Sci Sports Exerc 1986;;18:653-657.
27 +
Blackburn H:  Physical activity and hypertension. J Clin Hypertens 1986;;2:154-162.
28 +
Seals DR, Hagberg JM:  The effect of exercise training on human hypertension: A review. Med Sci Sports Exerc 1984;;16:207-215.
29 +
Berchtold P, Jorgens V, Kemmer FW, et al:  Obesity and hypertension: Cardiovascular response to weight reduction. Hypertension 1982;;4( (suppl III) ):III-50-III-55.
30 +
Dehn MM, Bruce RA:  Longitudinal variations in maximal oxygen intake with age and activity. J Appl Physiol 1972;;33:805-807.
31 +
Bortz WM:  Disuse and aging. JAMA 1982;;248:1203-1208.
32 +
Ekblom B, Astrand PO, Saltin B, et al:  Effect of training on circulatory response to exercise. J Appl Physiol 1968;;24:515-528.
33 +
Ekblom B:  Effect of physical training on oxygen transport system in man. Acta Physiol Scand 1969;;328( (suppl) ):9-45.
34 +
Seals DR, Hagberg JM, Hurley BF, et al:  Endurance training in older men and women: II. Cardiovascular response to exercise. J Appl Physiol 1984;;57:1024-1029.
35 +
Rippe J, Ross J, Gurry M, et al: Cardiovascular effects of walking, in Proceedings of the Second International Conference of Physical Activity, Aging and Sports. 1985, p 47.
36 +
Riggs BL, Melton LJ:  Involutional osteoporosis. N Engl J Med 1986;;314:1676-1686.
37 +
Beyer RE, Huang JC, Wilshire GB:  The effect of endurance exercise on bone dimensions, collagen, and calcium in the aged male rat. Exp Gerontol 1985;;20:315-323.
38 +
McDonald R, Hegenauer J, Saltman P:  Age related differences in the bone mineralization pattern of rats following exercise. J Gerontol 1986;;41:445-452.
39 +
Oyster N, Morton M, Linnell S:  Physical activity in post-menopausal women. Med Sci Sports Exerc 1984;;16:44-50.
40 +
Smith EL, Raab D:  Osteoporosis and physical activity. Acta Med Scand 1984;;711( (suppl) ):149-156.
41 +
American College of Sports Medicine: Guidelines for Exercise Testing and Prescription , ed 3. Philadelphia, Lea & Febiger, 1986;.
42 +
LaPorte RE, Dearwater S, Cauley JA, et al:  Physical activity or cardiovascular fitness: Which is more important for health? Phys SportsMed 1985;;13:145-150.
43 +
Porcari J, McCarron R, Kline G, et al:  Is fast walking an adequate aerobic training stimulus in 30-69 year old adults? Phys SportsMed 1987;; 15:119-129.
44 +
Pollock ML, Miller HS Jr, Janeway R, et al:  Effects of walking on body composition and cardiovascular function of middle-aged men. J Appl Physiol 1971;;30:126-130.
45 +
McArdle WD, Katch FI, Pechar GS, et al:  Reliability and interrelationships between maximal oxygen intake, physical work capacity and step-test scores in college women. Med Sci Sports Exerc 1972;;4:182-186.
46 +
Jette M, Campbell J, Mongeau J, et al:  The Canadian Home Fitness Test. Can Med Assoc J 1976;;114:680-683.
47 +
Ryhming I:  A modified Harvard step test for the evaluation of physical fitness. Arbeitsphysioloque 1954;;15:S235-S250.
48 +
Astrand PO, Ryhming I:  A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during submaximal work. J Appl Physiol 1954;;7:218-221.
49 +
Fox EL:  A simple accurate technique for predicting maximal aerobic power. J Appl Physiol 1973;;35:914-916.
50 +
Golding LA, Meyers CR, Sinning WE: The Y's Way to Physical Fitness . Rosemont, Ill, YMCA of America, 1982;.
51 +
Cooper KH:  A means of assessing maximal oxygen intake. JAMA 1968;;203:135-138.
52 +
Ribisl PM, Kachadorian WA:  Maximal oxygen intake prediction in young and middle-aged males. J Sports Med 1969;;9:17-22.
53 +
Kline GM, Porcari JP, Hintermeister R, et al:  Estimation of Vo2 max from a 1-mile track walk, gender, age, and body weight. Med Sci Sports Exerc 1987;;19:253-259.
54 +
O'Hanley S, Ward A, Zwirin L, et al:  Validation of a one-mile walk test in 70-79 year olds . Med Sci Sports Exerc 1987;;19:S167.
55 +
Coleman RJ, Wilkie S, Viscio L, et al:  Validation of 1-mile test for estimating Vo2 max in 20-29 year olds. Med Sci Sports Exerc 1987;;19:S171.
56 +
Ward A, Wilkie S, O'Hanley S, et al:  Estimation of Vo2 max in overweight females. Med Sci Sports Exerc 1987;;19:S169.
57 +
Wilkie S, O'Hanley S, Ward A, et al:  Estimation of Vo2 max from a 1-mile walk test using recovery heart rate. Med Sci Sports Exerc 1987;;19:S168.
58 +
Exercise Testing and Training of Apparently Healthy Individuals . New York, American Heart Association, 1972;.
59 +
Rippe JM, Maher PM, Ockene J:  Care and rehabilitation of the patient following myocardial infarction , in Rippe JM, Irwin RS, Alpert JS, et al (eds): Intensive Care Medicine . Boston, Little Brown & Co Inc, 1985;, pp 366-376.
60 +
Paffenbarger RS Jr:  Exercise in the primary prevention of coronary heart disease , in Pollock ML, Schmidt DH (eds): Heart Disease and Rehabilitation . New York, John Wiley & Sons Inc, 1986;, pp 349-368.
61 +
Pollock ML, Pels AE III, Foster C, et al:  Exercise prescription for rehabilitation of the cardiac patient , in Pollock ML, Schmidt DH (eds): Heart Disease and Rehabilitation . New York, John Wiley & Sons Inc, 1986;, pp 477-516.
62 +
Wenger NK:  Early ambulation after myocardial infarction: Rationale, program components, and results , in Wenger NK, Hellerstein HK (eds): Rehabilitation of the Coronary Patient . New York, John Wiley & Sons Inc, 1978;, pp 53-67.
63 +
Shephard RJ:  The value of exercise in ischemic heart disease: A cumulative analysis. J Cardiopulmonary Rehabil 1983;;3:294-299.
64 +
Shephard RJ:  Recurrence of myocardial infarction: Observations on patients participating in the Ontario Multicenter Exercise Heart Trial. Eur J Cardiol 1980;;11:147-192.
65 +
Shaw LW (for the project staff):  The National Exercise and Heart Disease Project: Effects of a prescribed supervised exercise program on mortality and cardiovascular morbidity in patients after a myocardial infarction. Am J Cardiol 1981;;48:39-46.
66 +
Kallio V:  Results of rehabilitation in coronary patients , in Konig K, Denolin H (eds): Advances in Cardiology . Basel, Switzerland, S Karger AG, 1978;.
67 +
Exercise During Pregnancy and the Postnatal Period . Washington, DC, American College of Obstetrics and Gynecology, 1980;.
68 +
Kashiwa A, Rippe J: Fitness Walking for Women . New York, Putnam Publishing Group, 1987;.
69 +
Collings CA, Curet LB, Mullin JP:  Maternal and fetal responses to a maternal aerobic exercise program. Am J Obstet Gynecol 1983;;145:702-707.
70 +
Wahren J:  Glycogen turnover during exercise in healthy men and in patients with diabetes mellitus. Diabetes 1979;;28( (suppl 1) ):82-89.
71 +
Wahlberg-Henrickson H, Gunnerson R, Defronzo R, et al:  Increased peripheral insulin sensitivity and muscle mitrochondrial enzymes but unchanged blood glucose control in type I diabetes after physical training. Diabetes 1982;;31:1044-1050.
72 +
Trovati M, Carta Q, Cavalot F, et al:  Influence of physical training on blood glucose, glucose tolerance, insulin secretion, and insulin action in non—insulin-dependent diabetic patients. Diabetes Care 1984;;7:416-420.
73 +
Hanson P, Ward A, Painter P:  Exercise training for special patient populations. J Cardiopulmonary Rehabil 1986;;6:104-112.
74 +
Graves JE, Pollock ML, Montain SJ, et al:  The effect of hand-held weights on the physiological responses to walking exercise. Med Sci Sports Exerc 1987;;19:260-265.
75 +
Shoenfeld Y, Keren G, Shimoni T, et al:  Walking: A method for rapid improvement of physical fitness. JAMA 1980;;243:2062-2063.
76 +
Walcott G, Coleman R, MacVeigh M, et al:  Heart rate and Vo2 max response to weighted walking. Med Sci Sports Exerc 1986;;18:S28.
77 +
Pandolf KB, Goldman RF:  Physical conditioning of less fit adults by use of leg weight loading. Arch Phys Med Rehabil 1975;;56:255-261.
78 +
Ward A, Coleman R, Walcott G, et al:  HR/VO2 relationship in weighted and grade walking on a treadmill. J Cardiopulmonary Rehabil 1986;;6:435.
79 +
Rippe J (moderator):  Walking for fitness: A roundtable. Phys SportsMed 1986;;14:144-159.
80 +
Ulene A, Rippe J: Fitness Walking Program: Walk With Your Doc . New York, Random House, 1988;.
81 +
Sweetgall R, Rippe J, Katch F: Fitness Walking . New York, Putnam Publishing Group, 1985;.
82 +
Ward A, Rippe J: Starting Your Personal Fitness Program . Philadelphia, JB Lippincott, 1988;.
83 +
Ward A, Rippe J: Walking for Health and Fitness . Philadelphia, JB Lippincott, 1988;.

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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
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