Aging successfully: the importance of physical activity in maintaining health and function.

Physicians caring for middle-aged and older patients frequently overlook the importance of regular physical activity. Exercise on a routine basis is an important component of successful aging. It has been shown that many age-related declines in musculoskeletal function can be markedly reduced by participation in some form of regular exercise. Examination of records from masters athletic competitions has been used to determine the true rate of age-related functional declines in highly trained, healthy individuals and further supports these findings. Declines in physical abilities for masters athletes are gradual, which suggests that for many, the potential for participation in competitive athletics can persist well into the seventh decade of life. Recent studies indicate that health gains can be achieved with relatively low volumes of exercise. Indeed, the greatest benefit is seen when one "goes from doing nothing to doing something." Current data suggest that a cumulative total of 30 to 50 minutes of aerobic exercise a day performed 3 to 5 days a week and one set of resistance exercises targeting the major muscle groups twice a week can produce significant health benefits. The aerobic conditioning requirement need not be a formal or structured activity, but can be satisfied through regular participation in many common physical tasks (e.g., walking, gardening, housekeeping). Musculoskeletal injuries are a major cause of noncompliance with any exercise regimen and are especially debilitating for older individuals. Prompt recognition of injury and treatment that emphasizes alternative conditioning exercises and minimizes "downtime" are especially important. Orthopaedists should be aware of the pattern of musculoskeletal injuries seen in this population, so as to assist their patients in avoiding these problems.