Health-and-Fitness online information.

Whether you're in a "cube" or have a private office, turn your work space into a personalized gym with exercises you can do at your desk. Perform any of the moves below as a one-minute break or string five or 10 of them together to create a mini-workout; either way you'll feel more refreshed and vital. Mix and match the activities, which provide benefits based on the following key: (c) cardio, (s) strength/core strength, (f) flexibility and mobility, (r) restorative and (a) awareness.

quick starts (s, c)

Strength breaks:

1. SIT ON A STABILITY BALL instead of a chair; this will strengthen your abs and back and improve your posture.

2. KEEP A RESISTANCE TUBE or a set of light dumbbells in a drawer for a quick set of biceps curls or shoulder presses between phone calls.

Cardio breaks:

1. ALWAYS TAKE THE STAIRS instead of the elevator.

2.TAKE THE LONG ROUTE to the copier or the lunchroom. Use a bathroom on a different floor.

3. KEEP A PAIR OF ATHLETIC SHOES at the office; use your lunch hour for a brisk walk.

4. STAND UP AND PACE while talking on the phone; you'll burn 2 to 4 calories a minute

cubicle calisthenics (s)

Chair row/press: Using a chair with wheels, hold onto your desk at arm's length and underhand; contract your abs and pull yourself in until your elbows are behind your torso. Push yourself away and repeat.

Sit squat: Squat until your thighs barely touch the seat of a chair. Stand and repeat.

Seated crunch: Keeping your lower back pressed against a chairback, pull your abs in and crunch a few inches.

Leg toner: Sit, holding the desk edge with straight arms. Lift both feet off the floor, knees bent; alternately straighten and bend the legs.

Tri-dip: with hands on and hips off the seat edge of a stable chair, bend and straighten your elbows. Keep your knees bent and feet flat.

Bun burn: Tighten your butt, hold for 2 seconds and release; repeat.

desk stretches (f, r)

Foot saver: Keeping them slightly elevated, point and flex your feet and rotate your ankles in circles.

Back reviver: Sitting on the edge of your chair, hinge forward from the hips, letting your head and arms hang forward and down. Roll up.

Chest expander: Sitting or standing, place your fingertips behind your head and press your elbows back and open, squeezing the shoulder blades together.

Side tilt: With fingers interlaced overhead and arms straight, lean left and hold. Repeat to the right.

Arm wrap; Hug yourself, grasping opposite upper arms. Inhale, lift the elbows up to shoulder height, and exhale to round the spine and stretch the upper back.

Neck/shoulder release; Lean your left ear to your shoulder; repeat to the right. Shrug both shoulders up, then drop them, rolling them forward and back.

Low-back/butt shift: Sitting, bring your left knee up and hold with both hands as you tilt the pelvis under. Repeat with the right knee.

It starts when the training wheels are removed from your bike and you're expected to move forward, continues when you measure yourself against your high school peers on the playing field, and reaches a critical mass of sorts when you put your talents into the job market for the first time. Life is an unending series of tests, friend. And each test has one thing in common with all the others: the pressure not to fail.

Now that you've established a career and a relationship--you gave up the idea of living solo in Bora Bora--you probably figure you don't have to take no more stinkin' tests, right?

Surprise! We've got another one for you. But relax, this test doesn't involve multiple-choice questions or a No. 2 pencil (you can use your Visor for the easy calculations you'll have to do), no pass/fail pressure. It's a fitness test, designed by two experts exclusively for Men's Fitness readers.

By testing yourself in various fitness components--cardiovascular capacity, body-fat distribution, flexibility, and muscular strength and endurance--you can get a snapshot of your strengths and weaknesses and evaluate just how effective your training program is. Fitness testing "provides a benchmark for improvement over time," says test co-creator Richard' Cotton, spokesperson for the American Council on Exercise and an editor of ACE's Personal Trainer Manual.

"You can see how well you're improving, because you ... have some real numbers, which are psychologically perceived as being more objective, more real than just, I feel better, or, My clothes fit better," adds Cotton's collaborator on the test, Roger Earle, co-editor of Essentials of Strength Training and Conditioning and a former strength-and-conditioning coach at Creighton University.

Here's the plan: Take the test. Record your results. Whether you're new to fitness or a returnee, stick to a regular program and you should see improvements quickly, so test yourself every four to six weeks. If you're a workout regular, improvements will be more long-range, and you can wait eight to 16 weeks before retesting. You can also mix and match trials not covered (for example, pull-ups and running stairs) in order to suit your needs.

Keep notes on your performance and the test conditions, and retest later under the same conditions to see how you've progressed. If you're just starting a workout program or are over 40 years old, consult a doctor, and give yourself a month or two to adapt to training before you take the test. And merely by taking the test, you get an A for making an effort to improve your fitness.

1. CARDIOVASCULAR FITNESS

Test: Resting Heart Rote

Why: The better your endurance and cardiovascular fitness, the lower your resting heart rate, because of the increased amount of blood that the heart pumps with each beat. Your resting heart rate usually decreases as your cardiovascular fitness improves.

How: Take your pulse in the morning, just before you get out of bed. Count for a full minute, or for 30 seconds and multiply by two.

How you compare: The average rate for men is about 70 beats per minute, but there can be a wide range here--"normal" extends from 40 to 100. Aerobically fit people usually are below 60; an astronaut's heart rate is even lower.

Drawbacks: Some people have a naturally elevated heart rate no matter what their level of fitness. Conversely, if you start with a naturally low rate, you may not see significant improvement over time. The best application is for monitoring overtraining--if you notice an elevation of 10 to 15 beats per minute, you may not be recovered from the previous day's training.

Test: Rockport Fitness Walking Test (for beginner/ intermediate)

Why: This test measures your cardio efficiency, giving you an approximation of your V02 max, which is the amount of oxygen per minute your body is able to use while exercising. The higher your V02 max, the better your endurance, which means the faster and longer you can walk, jog, bike or row.

How: Warm up by walking and doing light stretching on a quarter-mile track. Then do a one-mile walk (four laps) as fast as possible, stopping if you feel dizzy or experience any chest pain. After completing the mile, keep walking but slow the pace.

Immediately take your pulse for 10 seconds, counting the first beat a zero, then multiply by six. Record your pulse and the time it took you to complete the mile, then cool down for five minutes.

How you compare: Before you calculate your V02 max, first a little math: Multiply 0.388 by your age to get A; 0.077 by your weight in pounds to get B; 3.265 by your mile-walk time in minutes to get C; and 0.156 by your recorded pulse to get D. Next, figure your estimated V02 max using the following formula: V02 max equals 139.168 minus A, B, C and D. The V02 max of the average fit male is 40 milligrams a minute.

`I've never had a mammogram because I fear the pain of a breast biopsy.'

THE FEAR OF BREAST BIOPSIES

Q I'm a 42-year-old mother of two boys and I'm in pretty good shape. I had a physical examination about five years ago, but I have never had a mammogram because I fear the pain that would come with a breast biopsy if the test detected something. I want to take the test, but I can't face the potential for pain. Is there any way I can avoid the pain that comes with a breast biopsy (if it's necessary)? S.C., Los Angeles

A Since you have surpassed the age of 40, most doctors say it is a good idea for women who have reached that milestone to get regular mammograms, an X-ray of the breast tissue that can detect breast cancer in its early stages. You are like thousands of other women who are apprehensive about getting a mammogram because of what it could reveal and the procedures that follow. If the test reveals some suspicious-looking tissue, many women don't want to have to endure the pain associated with a needle biopsy.

Fortunately, the Food and Drug Administration has approved a new breast imaging device (T-Scan 2000), which is used as a follow-up step to a mammogram and, using electricity instead of needles, distinguishes malignant tumor tissue from surrounding normal tissue.

Of the 25 million women who get mammograms annually, doctors say nearly I million require further testing to determine whether cancerous tissue is present. Medical experts continue to stress the importance of regular mammograms because the majority of women who develop breast cancer do not have a family history of the disease, nor do they fall into any other special high-risk category.

DANGERS OF A CRASH DIET

Q Please help! I have a friend who wants to lose about 20 pounds in a hurry, and she is considering going on a crash diet to do it. I've told her that's not a good idea. What can I tell her that may convince her to forget about this plan and lose the weight sensibly? T.M., Detroit

A Tell her that, from a health standpoint, there's nothing good about a crash diet. In fact, doctors say such a diet could cause your friend some serious and, possibly, permanent physiological problems. The healthiest and longest-lasting weight loss occurs when you take it slowly, losing 1/2 pound to 1 pound a week.

Nuritionists say most quick-fix or crash diets, especially those based on eating only from one food group (for example, foods high in protein), aren't nutritionally balanced and may eventually harm the body. Such diets, specialists say, can put tremendous stress on the body and seriously affect a number of organs.

Because a crash diet isn't a healthy idea, tell your friend she should follow the simple and straightforward advice from the Dietetic Association, the U.S. Department of Agriculture and the National Institutes of Health: Eat less and exercise more. Nutritionists say the most successful weight-loss programs are those that combine diet and physical activity. A low-fat, low-calorie diet, combined with increased physical activity, can help your friend lose more weight and keep it off longer than either way can achieve alone.

CHOOSING A DOCTOR

Q At the beginning of the new year, I decided to get a new lease on life and take better care of myself. The first thing I want to do is get a physical exam, but I've never had one and don't have a doctor. What are some of the things I need to consider when choosing a doctor? N.P., Denver

A There are several important things to consider when choosing a doctor, but first and foremost among them is to find someone with whom you can be comfortable and open. Internists and family physicians are the two largest groups of primary care doctors for adults. Look for a doctor who has the training and background that meets your needs; has privileges at the hospital of your choice; is part of your health plan, unless you can afford to pay extra; listens to you; encourages you to ask questions; explains things clearly; and treats you and your concerns with respect.

Friends and family members can help you in your search or you can contact doctor-locator services that will match you with a doctor who meets your needs and desires.

Take the plunge into the wonderful world of swimming for a lifetime of physical fitness.

Dr. Jane Katz's love affair with water began at age two when her father taught her to swim. Today, the well-known author, college professor, and authority on swimming and exercise physiology says that she spends most of her time "babbling about bubbles," helping others learn about and enjoy the sport. And like many of her students, Dr. Katz is a "seasoned" athlete, who continues to break world records and compete in senior swimming competitions around the world.

"Older is better," says Jane Katz, who at 58 is widely recognized as a world-class Masters long-distance and synchronized swimming champion and ranked among the top six All-Time U.S. Masters swimmers. Dr. Katz tirelessly promotes the sport across the country and has appeared on such programs as "Good Morning, America," the "Today" show, and "The Saturday Evening Post Health Show."

For Dr. Katz and millions of other senior swimmers, water is a wonderfully forgiving medium that is gentle on older joints, muscles, and bones. And unlike many other sports, swimming works all major muscle groups and is particularly good for building upper body strength.

The Post spoke with Dr. Katz about how others can "lap up" the benefits of aquatics at every age.

Q: Does water offer benefits that land exercises can't?

A: People who can't move easily on land can do so in the water. The beauty of buoyancy and the hydro-static effect of the water give you that upward feeling and help to protect your joints, making water a great rehabilitation medium.

In chin-deep water, you only weigh one tenth of your apparent body weight on land. In chest-deep water, you-weigh about 75 percent, while you weigh about 50 percent in waist-deep water. If you are in thigh-deep water, water provides resistance while still allowing you to move. Depending on where you are in the water, it gives you a variable gravitational effect, allowing you to work against the resistance of water vertically, horizontally, and circularly. If someone does not have a great range of motion or is deconditioned (overweight or out of shape), the water's buoyancy allows you to move more freely with a greater range of motion.

Q: Is swimming useful in addressing health concerns?

A: Absolutely. Water is a great rehabilitation medium. People who are overweight and out of shape are not going to run five miles. But they can water-walk and get into shape and maybe then choose a combination of land and water exercises. Water allows you the opportunity to get to a level of fitness where you are able to do other exercises.

I started the W.E.T. (Water Exercise Techniques) Workout[R] because I was in a terrible car accident 22 years ago before sports medicine came into vogue. I embraced activity, particularly water activity, as beneficial. I created my own program, and the W.E.T. Workout is the result.

Q: What exercises are good for people with arthritis?

A: In the water, people with arthritis can work on increasing the range of motion of their joints. As range of motion increases, they can return to activities that may have been "lost" to disability. For those with arthritis, water temperature should ideally be at least 85 degrees. This warmth, along with the buoyancy and resistive properties of water, can help decrease pain or stiffness and improve joint flexibility. Some people also experience increased muscle strength and improved coordination, endurance, and ability to perform their daily tasks.

If you have arthritis, there are several modifications that you can make to your program. First, increase the amount of time spent on warmups. Second, decrease the already-reduced impact by keeping one foot on the ground at all times. Replace jogs and hops with rocking and stretching on your toes. Third, reduce stress on joints by using a reduced number of repetitions of moves. Usually, residual pain after two hours indicates that you overdid it and should do less during the next session.

Doctors often advise people with arthritis to soak in warm water in the morning before beginning daily activities. Morning is a time when many people with arthritis find that pain and stiffness is at its worst.

In any workout, the protocol, or anatomy, of a workout is very important. Start with a warmup of about five minutes, using easy exercises such as water-walking and stretches. In water, you can walk forward, backward, or circularly. I call this "sweats to wets," because you are bringing familiar land-based exercises into the water workout. Some people will say, "I don't know how to swim, so I can't exercise in the water." We are not talking about swimming yet. For someone who does know how to swim or is learning, it is a great way to reinforce and train.

AFAA recently conducted three Pacific Air Force (PACAF) fitness tours. The first took place at United States Air Force Bases in Okinawa, Misawa, and Yokota, Japan, as well as Osan, Korea. The second included Andersen Air Force Base (AFB), Guam, and Hickam AFB, Hawaii. Recently, AFAA completed the third at Elmendorf and Eielsen Air Force Bases in Alaska. Each tour consisted of the Primary Group Exercise Certification as well as Indoor Cycling, Resistance Training and Mat Science I workshops. Active duty and retired military personnel, military dependents, Department of Defense employees, fitness center as well as health and wellness center staff participated in the courses.

In scheduling the classes, PACAF Headquarters Athletic Manager Bob George's goals were to ensure PACAF military fitness center personnel remain current with the fitness industry and promote smart training principles. As a result, the group exercise programs offered a variety of classes instructed by certified fitness professionals and, most importantly, physical fitness within the United States Air Force was supported.

AFAA's PACAF Tour Certification Specialists Monica Garber and Lisa Hamlin commented instructing members of the United States Air Force was an opportunity of a lifetime. AFAA was well received, the participants eager to learn and the classes highly successful.

For over two decades, AFAA has supported the United States military forces by providing fitness education on-board military installations worldwide. AFAA offers up to a 25 percent discount to active duty and retired military members as well as their dependents when courses are scheduled on military installations. In addition, Department of Defense employees currently employed at a hosting military installation are eligible to receive the discount.

1) The MUSCLE & FITNESS Knife Giveaway is open to legal residents of the United States, eighteen (18) years or older. Employees of Weider Publications, LLC., and American Media, Inc. ("AMI"), and their subsidiaries, affiliates, immediate family members, corporate suppliers and advertisers are not eligible.

2) NO PURCHASE IS NECESSARY.

3) One (1) randomly selected winner will receive a free Wusthof Grand Prix Chef's Knife, valued at $99.99.

4) One (1) randomly selected winner will receive a free Wusthof Classic Cleaver, valued at $80.00.

5) The MUSCLE & FITNESS Knife Giveaway runs from March 7, 2006, to April 18, 2006. To enter, contestants must print on a postcard deliverable to the U.S. Post Office your name, address, age, day and evening phone numbers with area code, and e-mail address (if available). You must specify which knife you want to win on the postcard. Address your postcard to MUSCLE & FITNESS Knife Giveaway, c/o MUSCLE & FITNESS, 21100 Erwin St., Woodland Hills, CA 91367.

6) Entries must be received by April 18, 2006, for a drawing to be held on or about May 18, 2006, at the offices of Weider Publications, LLC.

7) THIS SWEEPSTAKES IS NOT SPONSORED BY, ENDORSED OR AFFILIATED WITH Wusthof.

8) All entries become the property of Weider Publications, LLC., which assumes no responsibility for late, misdirected, mislabeled or lost entries. Winners agree to publication and/or display of their name, address, likeness and entry form, which may be required by Weider Publication, LLC. Winners may also be required to sign Weider Publication, LLC.'s Declaration of Eligibility and Publicity/Liability Release in order to collect any prizes.

9) Multiple entries are permitted, but not more than one entry per postcard can be awarded.

10) Winners will be selected in a random drawing under the supervision of Weider Publications, LLC. Winners will be notified by phone. Odds of winning will be determined by the number of entries received. Prizes have no cash value and there are no substitutions of prizes.

11) The MUSCLE & FITNESS Knife Giveaway is void where prohibited or restricted by law.

12) This sweepstakes is sponsored by Weider Publications, LLC.

13) Names of the winners may be obtained by sending a self-addressed stamped envelope to MUSCLE & FITNESS Knife Giveaway Winners, c/o MUSCLE & FITNESS, 21100 Erwin St., Woodland Hills, CA 91367.

MUSCLE & FITNESS (ISSN 0744-5105) is published monthly by Weider Publications, LLC., a division of American Media, Inc., 415 Madison Ave., 14th Floor, New York, NY 10017. Editorial offices at Weider Publications, LLC., 21100 Erwin St., Woodland Hills, CA 91367. Periodicals Rates Postage Paid at the New York, NY, Post Office and at additional Mailing offices. Copyright Weider Publications, LLC., 2006. All rights reserved. Canada Post International Publications Mail Sales Agreement No. 40028566. Canadian B.N. 89579 2885 RT. Copyright under the Universal Copyright Convention and International Copyright Convention. Copyright reserved under the Pan-American Copyright Convention. Todos derechos reservados segun la Convention Pan Americana de Propriedad Literaria Artistica. Subscription rate is $34.97 for 12 issues in U.S.A For orders outside U.S.A. add $17.00 U.S. for postage. Orders outside of U.S.A. must be prepaid in U.S. funds. For Customer Service and back issues, call toll free (800) 340-8954. U.S. POSTMASTER: Send U.S. address changes to: MUSCLE & FITNESS, P.O. Box 37208, Boone, IA 50037-0208. CANADA POSTMASTER: Send Canadian address changes to American Media, Inc., P.O. Box 907 STN Main, Markham, ON L3P OA7, Canada. From time to time we make our subscriber list available to companies that sell goods and services by mail that we believe would interest our readers. If you would rather not receive such mailings, please send your current mailing label to: MUSCLE & FITNESS, P.O. Box 37208, Boone, IA 50037. All materials, articles, reports and photos published in this magazine are the property of Weider Publications, LLC., and cannot be used without permission in writing. MUSCLE & FITNESS is not responsible for returning unsolicited manuscripts, photographs or other materials. Weider Publications, LLC., and American Media, Inc., publisher of MUSCLE & FITNESS, does not promote or endorse any of the products or services advertised by third-party advertisers in this publication. Nor does Weider Publications, LLC., or American Media, Inc., verify the accuracy of any claims made in conjunction with such advertisements. Title Trademark registered in U.S. Patent Office. Reprinted by special agreement in England, Germany, Italy, Austria, Japan, Canada, Netherlands, Korea, Poland, Slovak Republic, Lebanon and China. PRINTED IN U.S.A.

The prevalence of overweight in youth has increased dramatically in recent years and has disproportionately affected many ethnic groups including Hispanics. The most recent data from the 1999 to 2000 National Health and Nutrition Examination Survey indicate that approximately 40% of 6- to 11-year-old Hispanic youth possess an age- and gender-specific BMI > 85% percentile, a level that is approximately double that found in whites. It is evident that the health risks, such as fat hyperinsulinemia, impaired glucose tolerance (IGT), and type 2 diabetes, that accompany a high degree of body fat manifest early in life. Although a host of hereditary and environmental variables are linked to these health risks, the relationships between metabolic risk factors for type 2 diabetes and lifestyle related variables, including cardiorespiratory fitness and physical activity (PA), have not been investigated previously in overweight Hispanic youth with a family history of type 2 diabetes. Therefore, a recent study evaluated the relationships between insulin sensitivity/secretion and fitness/activity in the population described above.

Fifty-five and forty Hispanic boys and girls, respectively, participated in this study. After an overnight fast, a frequently sampled intravenous glucose tolerance test was used to determine the insulin sensitivity index (SI), the acute insulin response, and the disposition index. Cardiorespiratory fitness (maximal oxygen uptake [V[O.sub.2max]]) was evaluated using a treadmill protocol, and PA was determined by an interviewer-administered questionnaire. Body composition was measured using DXA.

Regardless of how cardiorespiratory fitness was expressed--relative to body weight, or relative to lean tissue mass--boys possessed greater fitness levels than girls. Boys also had higher fasting glucose levels than girls, but both group means were within the normally accepted range. Unadjusted correlations indicated that V[O.sub.2max] was negatively related to SI and disposition index, and positively associated with fasting insulin. However, these relationships were no longer significant once gender, Tanner stage, fat mass and soft lean tissue mass were included. Body mass explained 53% of the variance in SI and that V[O.sub.2max] was not independently related to SI. Cardiorespiratory fitness was positively related to both fat mass and soft lean tissue mass. PA was not related to any measure of insulin sensitivity and secretion.

The findings demonstrated that cardiorespiratory fitness was not independently related to insulin sensitivity and secretion in overweight Hispanic children with a family history of type 2 diabetes once gender, Tanner stage and body composition were controlled for. The results also highlight the fact that conclusions may vary depending on how fitness data are expressed, which fitness indicators are included in the analyses, and how differences in body composition are considered in the analyses. However, it is evident that to reduce the risk of diabetes, improvements in body composition may be required, and increasing the time spent performing various physical activities may facilitate this.

HOW I GOT FIT

SINGLE-MOM STRATEGIES

Maria Bronaugh, 30, Milwaukee Finding Time: "I'm a single mother with an 8-year-old daughter, a 7-year-old son and a 5-month-old daughter. Despite my hectic days as a mentor and teacher, I manage to work out three or four days a week. How? I found a gym with activities for the kids. While I work out, they can go swimming, take tennis lessons, walk through a maze or play computer games."

Fitness Formula: "So I don't get bored, I cross-train. Running and lifting weights are my favorite activities because they make me feel rejuvenated. I also use the stair climber and take Spinning [cycling] and aerobics classes."

Motivation: "I want to stay active and healthy for my children. Once I go for a run, I'm calmer and I have more patience with them. Weight training keeps me toned. I don't know what I'd do without the extra energy my workouts give me."

Advice: * "Get your children involved. Go bike riding or swimming together; take long walks or dance classes." * "Reach out to other moms. A friend can watch your children while you work out, and vice versa."

BUYING IT: Bottled Water

Not long ago we would have laughed at the idea of paying for what we could get free: [H.sub.2]O. Then all those bottled-water companies began offering wet stuff we assumed was superior in taste and purity to tap water. But a recent study from the Natural Resources Defense Council, a national nonprofit organization, found 33 percent of the 103 brands tested to be contaminated with bacteria; some had excess fluoride and even arsenic!

Most bottled water is safe, but if you want to be sure, stick with brands that are members of the International Bottled Water Association, a trade organization that sets high purity standards and ensures quality through unannounced plant inspections. Top-selling members include Arrowhead and Evian. Call (800) WATER-11 to see if your favorite brand is a member. Also read the label. Federal guidelines require bottlers to name the source of water on labels. Artesian, mineral and spring water come from natural sources.

Shoulder Toner

To lift that baby or bag of groceries with ease, try this shoulder exercise demonstrated by New York personal trainer and actress Cheryl Simone. How to do it: Stand with your feet hip width apart and knees slightly bent. (1) Hold a light free weight in each hand with your arms hanging straight down beside your thighs, palms facing inward. (2) Take three seconds to lift your left arm forward to just below shoulder height. Don't bend your elbow. Pause for one second, then lower arm for three seconds to the starting position. Do two sets of 16 to 20 repetitions. Repeat with your right arm. Do two days a week.

Whether you're exchanging holiday goodies with a yoga enthusiast or weight-room addict, we've got the perfect present just for them.

For the outdoor-sport gal

1. Hot Chillys keeps the cold weather out with its "Salsa" Micro-Elite Panel Zip T ($65; 800-468-2445, hotchillys.com).

2. illumiNITE's "Momentum MicroWeave" solid color block jacket ($85; 800-497-6171) reflects bright geometric patterns when light hits it at night.

3. Garmin's small, lightweight "Forerunner 201" GPS system ($160; 888-442-7646, garmin.com) fits on your wrist like a watch but can calculate speed, distance, pace and calorie burn.

For the yogini

4. Crescent Moon's innovative "Convertible Tote" ($80; 714-399-1450, crescentmoonyoga.com) has an adjustable mat wrap to carry any size yoga or Pilates mat to class. The matching cotton nonslip practice rug sold separately is a perfect fit ($50).

5. Shrimp Yoga ($85; 877-964-9642, shrimpyoga.com) offers a preppy navy and white bag with a shrimp pattern. (Mention Shape and get $10 off phone orders!)

6. Timbuk2's yoga bag ($100; timbuk2.com) has an outside roll-flap to secure a yoga mat, a water-bottle pocket and inside compartments.

For the weight-room junkie

7. A Morning Cup of Strengthening (Crane Hill Publishers, 2004; $13; booksamillion.com), by Beth Pierpoint, offers a 15-minute strength routine to start your day, complete with a companion audio CD.

8. The Strength and Toning Deck (Chronicle Books, 2004; $15; 800-722-6657, chroniclebooks.com), by Shirley Archer, contains 50 strength-training moves in a portable box to take to the gym or on your next trip. Follow the numbered sequences for a predetermined workout or mix and match.

For the Pilates practitioner

9. Capezio's straight-cut French terry pant ($40; 800-234-4858, capeziodance.com) sits low on the waist for ease and comfort. A matching zip-front hoodie ($50) and drawstring miniskirt ($25) make this line a happy blend of functional and fashionable.

10. Tranquil Space Yoga's wrap "tranquiliT" sleeveless rayon-jersey top ($55; tranquilspace.com) clings and keeps you covered in class yet is chic enough to wear to a cafe afterward.

Numerous studies have demonstrated the positive health benefits of increased fitness levels achieved through regular physical activity and exercise. These benefits accrue in healthy individuals as well as in those participating in secondary and tertiary prevention programs. Physical therapists promote increased fitness to their patients by developing and implementing plans of care that incorporate exercise and physical activity as well as by providing education about the positive health benefits of an active lifestyle. These efforts occur most easily in outpatient and community-based physical therapy practices serving patients with less involved and/or reversible functional limitations or disabilities. In addition, these settings usually have the necessary equipment and facilities with which to perform exercise testing, training, and education. However, patients in acute, rehabilitation, and home health environments also require progressive increases in fitness levels to support functional recovery and adaptation. Development of a plan of care incorporating fitness principles in any practice setting depends upon a physical therapist's understanding of contemporary concepts and terminology pertaining to fitness and of the elements of an exercise prescription. The purpose of this paper is to review fitness principles and elements and to demonstrate their application for adult patient management across the continuum of physical therapy practice. Emphasis is placed on health-related physical fitness and its contribution to the rehabilitation of impairments, functional limitations, and disabilities.

INTRODUCTION

Contemporary public health efforts emphasize an active lifestyle to maintain or enhance fitness levels for general health. For example, physical activity is the first of 10 leading health indicators developed by the US Department of Health and Human Services.1 In addition, the US Surgeon General recommends that adults engage in at least 30 minutes of moderate-intensity physical activity on most if not all days of the week.2 This focus on an active lifestyle is prompted in part by studies that demonstrate the positive health benefits resulting from increased cardiorespiratory fitness. Investigators have reported decreased risk of death from all causes in both genders3,4 as well as decreased risk for development of coronary heart disease,5 stroke,6,7 and metabolic syndrome.8 Fit older adults also may accrue protective benefits.9 Promotion of physical activity as part of a general primary prevention program is an understandable public health initiative in light of these research findings.

The usefulness of progressive physical activity in secondary and tertiary prevention efforts also is well documented. In 2004, the American Heart Association published exercise and physical activity guidelines for individuals poststroke based on an accumulation of individual studies demonstrating these interventions resulted in improvements in aerobic capacity and sensorimotor function.10 A recent systematic review indicated that increased activity levels assist with weight loss and prevention of weight regain in overweight and obese individuals.11 In addition, a meta-analysis of studies of controlled physical activity reported improvements in cardiorespiratory fitness, symptoms, and vigor in cancer survivors12 while another indicated exercise-induced increases in physical performance, cognitive function, and behavior in patients with cognitive deficits and dementia.13 Finally, other summaries of evidence suggest a role for physical activity in the management of low back pain, osteoarthritis, osteoporosis, and various neuromuscular diseases although a dose-response relationship between activity levels and outcomes has yet to be identified for specific conditions.14,15

Physical therapists promote increased fitness to their patients by developing and implementing plans of care that incorporate exercise and physical activity as well as by providing education about the positive health benefits of an active lifestyle.16-18 These efforts occur most easily in outpatient and community-based physical therapy practices serving patients with less involved and/or reversible functional limitations and disabilities (ie, athletic injuries, early stages of arthritis, transient ischemic attack, etc.). In addition, these settings usually have the necessary equipment and facilities with which to perform exercise testing, training, and education. However, patients in acute, rehabilitation, and home health environments also may benefit from a plan of care that lays the foundation for increased fitness levels.

Development of a plan of care incorporating fitness elements in any practice setting depends upon a physical therapist's understanding of contemporary concepts and terminology pertaining to fitness and of the elements of an exercise prescription. The purpose of this paper is to review fitness principles and elements and to demonstrate their application for adult patients across the continuum of physical therapy practice. Emphasis is placed on health-related physical fitness and its contribution to the rehabilitation of impairments, functional limitations, and disabilities.

Recently, the National Association for Sport and Physical Education (NASPE) released guidelines for encouraging early childhood physical activity. We're not talking about calisthenics for toddlers.

The guidelines encourage infants and toddlers to explore their surroundings, promote motor skill development, describe safe play areas which provide plenty of room for all sorts of motions, and emphasize an increased awareness of the importance of physical activity.

According to the NASPE, "Although it may appear that sitting up, rolling over, and crawling emerge naturally, these behaviors are clearly influenced by the parent and/or caregiver and the environmental stimulations available to the infant."

For toddlers, the guidelines recommend:

* At least 30 minutes of structured physical activity each day

* 60 minutes to several hours of unstructured physical activity each day

* Sedentary activities shouldn't extend beyond 60 minutes without a break that includes physical activity

For preschoolers, the guidelines recommend:

* At least 60 minutes of structured physical activity each day

* Several hours of unstructured physical activity each day

* Sedentary activities shouldn't extend beyond 60 minutes without a break that includes physical activity

Children tend to mimic what they see their parents, other adults, and older peers doing. If parents want their children to consider physical activity an important part of their lives, they must see that it's an important part of their parents' lives.

It's also important not to push young children into structured, high-pressure, organized sports too soon. It's generally accepted that children aren't ready for such activities until the age of six years old and older. Pushing them too hard or too early may lead to burnout and a dislike of physical activity.

A superintendent's strategy for getting fit in less time than you think

"I have flabby thighs, but fortunately, my stomach covers them."

"If God meant for us to touch our toes, he would have put them further up on our body."

Do those statements describe your philosophy of physical fitness? If so, this article is intended for you. If you are interested in some practical tips to help you get in shape, read on.

If your day is as busy as those of most school administrators, you work nonstop from early morning until late at night. Your day is jam-packed with decisions, meetings and people vying for your attention. Often, you do not even stop for lunch.

Evenings are almost as busy. Typically, you spend at least two evenings a week at meetings or school activities. Weekends are no better. Rather than relaxing at home, you are attending school or community events.

When you are not immersed in your job, you are focused on tending to your personal life, trying to carve out time for the family and friends whose needs often take a back seat to your professional obligations.

One consequence of our busy lives as superintendents is that our own physical well-being is low on our list of priorities. We simply can't or don't make the time to take care of ourselves physically. However, fitness is vital to our mental and physical health.

As a fellow superintendent who knows how busy your life can be, I offer to you the following tips for getting and staying in good physical shape. You should be able to incorporate them into your already hectic lifestyle with little or no extra time.

Get Physical

Before you start any physical fitness program, make sure your doctor gives you the green light. Discuss with your physician your current physical condition and work together to develop a plan to lose weight, lower your blood pressure, reduce your cholesterol or address other health-related issues. Then, follow the plan.

A doctor once refused to treat my father until he gave up smoking. He said he would not waste his time treating a man with a death wish. That doctor's frankness was what it took for my father to finally give up smoking. Do you need that type of ultimatum to get going on a fitness plan?

Stop smoking and drinking. Taken as directed, cigarettes can result in lung cancer and emphysema. Excessive alcohol impairs your health and good judgment, two fundamental requirements for a productive life. Are any benefits you derive from smoking and drinking worth the costs? Reach for water instead of a beer or glass of wine. Take a walk instead of smoking a cigarette.

Eat right. Your doctor, nutritionist or health teacher can give you advice based on your physical condition and your goals. Because I often do not have time for lunch, I used to find myself eating three candy bars during the day to satisfy my hunger. Now I keep a box of raisins or other healthy snacks in my desk drawer and reach for them when I am hungry.

Try to eat regular, smaller meals. Avoid grazing throughout the office or school. Someone always seems to be celebrating a birthday or some other occasion. If we sampled all the food at every event, we would soon notice--and so would everyone else.

Lose weight. Why do school administrators have such big chairs? Answer: To hold their overweight bodies. That, of course, is a very general and presumptuous statement, but after attending meetings with other school administrators for the past 17 years, I have observed that about 70 percent of school administrators could stand to lose between 10 and 40 pounds.

I still remember vividly my first overnight hiking trip in the Adirondack Mountains. After about three miles of hiking with my 40-pound pack, we stopped for a break and I took off my pack. It felt great to shed those 40 pounds!

Some people are carrying a heavy pack like that with them all the time, wherever they go. Think of the energy and stamina you would have if you eliminated your pack of excess weight.

Start Walking

Losing weight doesn't have to be a painful, time-consuming project. You don't have to spend countless hours at the gym "pumping iron." Instead, incorporate more walking into your daily life.

For example, park on the far side of the parking lot and walk as far as possible to the office. Get up periodically and walk around the building. Take the stairs rather than the elevator or escalator. If walking up the stairs is hard, start by walking down the stairs.

Mow your lawn with a push mower. It is the equivalent of going for a walk and allows you to get some exercise and yard work done at the same time. If you golf, park the cart and walk the course with your golf clubs.

Walk with your spouse, family members and friends. Walking is a great way to get in shape, spend time with your family and relieve stress at the same time.

Build strength training into your walking. I wear a pair of 1 1/2-lb. ankle weights that I bought for less than $10 at the local sporting goods store. They are small enough that I can wear them under a pair of pants while I walk around the school or in the neighborhood.

LongIsland.com has named ECA World Fitness Vice President Gary Scott their fitness expert. As LongIsland.com's expert, Scott writes and posts articles on their Web site each month. He is certified with ACSM, ACE, AFAA, ISSA and AEA. Scott is also the president of the East Coast Instructor Training School. East Coast Instructor Training School offers a variety of programs to those interested in pursuing a health and fitness career or want to enhance their skills and receive professional support and opportunities.... Few aerobic exercises can match the physical benefits of a step aerobics workout, yet there is always room for innovation. After years of using the regular step bench, Deborah Sithole, R.N., of Albertson, New York, has created the Modular Exercise Stepper. The modular stepper is versatile because it is portable, can be doubled for added height and reduced for storage. For more information, visit modularstep.com or contact Deborah Sithole at modularsteps@aol.com or (888) 283-6350 ... Parents are giving "two thumbs up" to organized youth sports according to a report sponsored by the Sporting Goods Manufacturers Association (SGMA) and conducted by American Sports Data, Inc. The majority of parents agree that organized youth sports generate "improved physical fitness," "personal growth," "wholesome lifestyles," "good moral behavior" and "healthier eating habits." To order a copy of Organized Youth Team Sports Participation in the U.S., visit www.SGMA.com and click on Market Studies and Reports. You can also contact Mary Ellen Bishop at mesgma@aol.com or (561) 840-1121 ... Promoting fitness among children and new product lines, Cindy Crawford announced a partnership with EAS in June 2001 to advocate healthy, active lifestyles through a combination of nutrition and exercise. EAS will introduce a new line of products geared toward teens and young adults, a new fitness magazine specifically for women in addition to the popular AdvantEdge[R] line of active lifestyle nutrition products. For more information, contact Marlene Petter at (215) 439-2281 or mpetter@eas.com ... Helping health and fitness expand on the Web, International Council on Active Aging (ICCA) launches its Web site www.icaa.cc. Join today and access information, resources, education and tools to help you attract and serve the fastest growing and most affluent market. Their next launch will be their bimonthly publication, Journal on Active Aging, available January 2002 ... American Leisure is also launching a new addition to their corporation--the Spa and Salon Equipment Division. American Leisure offers clients a cutting-edge approach to design and equipment specifications.

Expert Advice on Health and Fitness

`I'm 49 and already experiencing what could be the beginning of impotence.'

TREATMENT FOR IMPOTENCE

Q I just recently turned 49 and already am experiencing what could be the beginning stages of impotence. It scares me because I don't want to lose the intimacy that I enjoy with my wife. I know that the miracle drug Viagra is supposed to work very well, but if it doesn't, short of an implant, what other possible steps could correct my situation? M.M., Oakland, Calif.

A Your concern is understandable, but the first thing that you should do is schedule an appointment to see your doctor for a complete physical examination. Impotence, also known as erectile dysfunction, can be caused by a number of factors, and an examination is the only way to determine what steps should be taken.

Erectile dysfunction, described as the inability to get and maintain an erection satisfactory for intercourse, affects 30 million Americans, and doctors say 50 percent of all men who are 40 to 70 years old experience some form of erectile dysfunction. The condition can be related to physical causes, including diabetes, high blood pressure and hardening of the arteries leading to the penis. There also are non-physical contributors like depression and stress, but when they disappear, doctors say the impotence usually disappears.

Until the widespread use of Viagra two years ago, patients could choose from a variety of basically undesirable treatments--including prostethetic devices, pumps, suppositories and injections. Today, in addition to Viagra and other medications, possible solutions include sexual counseling and hormone replacement therapy.

POLIO SHOTS OR ORAL VACCINE?

Q Help me, please! I'm a concerned mother, and I need some answers. In the past few weeks, I've heard that there could be some danger associated with the way the medication used to prevent polio is given to children. Which way is safer for my 6-year-old child, polio shots or the oral vaccine? B.J., Columbia, S.C.

A There has been ongoing controversy concerning which vaccine is better and perhaps safer. But the Centers for Disease Control and Prevention (CDC) recently said polio shots are better than the oral vaccine for children because of the slight chance that the oral dose can lead to polio infection.

The oral vaccine, which was developed by Dr. Albert Sabin, has been used for nearly 40 years and has played a huge role in the elimination of polio. But doctors says because the vaccine is made with a live virus, each year it causes about eight people in the United States to become infected with polio.

The injectible vaccine, which was developed by Dr. Jonas Salk almost 50 years ago, relies on a killed virus. Although Salk and some other medical experts have insisted that the polio shot is safer than the oral vaccine, other scientists believe it isn't as effective at providing lifelong immunity.

The CDC recommends that the oral vaccine should be used only in cases of widespread outbreaks, for children traveling to areas where polio is widespread and for children whose parents stop short of pursuing all four shots in the polio regimen.

NEW TEST FOR CERVICAL CANCER

Q Although I don't like to visit my doctor for an examination, I routinely get a regular Pap smear because cervical cancer has struck some of my close family members. I don't particularly like the test and recently heard about a new one that could replace the Pap smear. What is it, and is it available now? P.N., Philadelphia

A You are referring to a new gene-based test that medical experts believe is better than the Pap test at identifying precancerous and malignant changes in the cervix. The test, which is not yet available for widespread use, would allow women to test themselves at home for human papillomavirus, which is linked to cervical cancer.

Until the new test is available, the Pap smear is the best defense against cervical cancer, which doctors say is "a virtually preventable disease." Testing is vital, since more than half of the women who develop the cancer in the United States had not had a Pap smear in the three years before they were stricken.

Nothing like a dose of bright sunshine and warm air to get you energized for exercise this season. If you've been on fitness hiatus, now is prime time-with your doctor's permission-to shake off that sluggishness, stretch those muscles and get pumped for fitness with these warm-weather workouts:

* STEP IT UP. Walking and running do wonders for your health, from burning fat, building muscle and boosting your metabolism to lowering high blood pressure, reducing your risk of heart disease and stroke and relieving anxiety and depression.

But before you challenge folks to eat your dust, gear up with athletic shoes designed for walking or running to get the most mileage and comfort. Also, walk or run on softer surfaces like grass or a sports track instead of pounding the pavement to reduce stress to your back and joints. And always stretch your muscles before, during and after your workout to avoid cramps and strains.

If you're a fitness-walking novice, don't try to break any records your first few sessions. Start slowly, then gradually pick up the pace. You don't have to sprint, but you need to step with purpose to reap the full benefits. Aim to walk a mile in 30 minutes, then once you reach your goal, cut that time in half. If running is more your speed, start with a slow jog-walk regimen: walk one block, jog the next, then repeat. As your fitness level increases, gradually reduce the walking portion.

* ROLL YOUR WAY TO FITNESS. Skating, rollerblading and cycling give your muscles a good workout and give you a great reason to park the car and wheel around town. If it's been a minute since you balanced on two wheels or four, go short distances at an easy pace those first few trips to prime the muscles in your legs, thighs and buttocks for exercise and to prevent strains and injuries.

If you've never learned to bike or skate, now is a perfect time to take a class so that you'll be ready to show off your wheel skills by summer. And remember, even pros can take a fall, so always wear a helmet, wrist and knee guards to protect yourself.

* LET THE GAMES BEGIN. Longer days and warmer weather make for ideal sporting conditions. So whether your game of choice is basketball, baseball, softball, soccer, tennis, golf or beach volleyball, nurture your hidden athlete and work in some fitness by playing a sport this season. Not athletically inclined? Join a sports class at the local health club, YMCA or your city's park district to beef up on the basics. After all, learning is half the fun.

The cost of physical frailty in seniors is high not only due to medical care, but also in the loss of quality of life. As life expectancy of Americans continues to increase, so does the possibility of living longer with major physical limitations. More people over the age of 70 are experiencing difficulty performing everyday functions, such as dressing and bathing. However, according to Robert E. Rikli, Ph.D. and C. Jessie Jones, Ph.D., the authors of the Senior Fitness Test Manual, much of the usual age-related decline in physical ability is preventable and possibly reversible through proper attention to fitness levels and physical activity. Most important is the early detection of physical weaknesses and appropriate changes in physical activity habits.

The Senior Fitness Test Manual (Human Kinetics; $29.00), contains easy-to-use tests to assess the fitness levels of older adults. Its purpose is to identify and treat emerging weaknesses before a senior becomes too weak to pick up a bag of groceries, climb stairs or worse, get out of bed in the morning. The book contains complete information on administering and scoring the tests, providing feedback to test participants and organizing/testing groups of older adults. The book also provides sample forms, tables and charts presented in copy-ready form to be used in your programs.

Companion resources, the Senior Fitness Test Video ($30.00), demonstrate procedures used to administer the test to both individuals as well as groups and the Senior Fitness Test Software ($63.95), helps track scores over a period of time, compares the scores to norms and prints useful reports.