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=== Types of exercise: ===
=== Types of exercise: ===
<div style='text-align:justify;'>There are mainly four types of exercises namely:<br/> a) Endurance, strength, balance and flexibility<ref name="ref7">NIH. Four Types of Exercise Can Improve Your Health and Physical Ability | National Institute on Aging [Internet]. National Institute on Aging NIA. 2021 [cited 2022 Dec 14]. Available from: https://www.nia.nih.gov/health/four-types-exercise-can-improve-your-health-and-physical-ability</ref>. Endurance exercises otherwise known as aerobic exercises, improve heart rate and respiratory rate. They help in preventing diseases due to wear and tear. Swimming, dancing, brisk walking etc. are some examples of endurance exercises. Strengthening exercises increase muscle strength, prevent falls and improve body balance. They include weight training, wall push-ups, lifting the body weight etc. Balance exercises enhance body balance and thereby prevent falls (eg: yoga, heel to toe walking). Flexibility exercises are stretching itself.<br/>'''Over-exertion (ativyayama):''' Magnitude and duration of exercise are to be determined prior to designing the schedule considering the physique, age, health status, amount of physical activity etc. In order to gain a fascinating physical appearance in a short period many people, especially celebrities follow unhealthy aggressive exercise protocol. Recent alarming events, of celebrity death in their 40’s and 50’s point towards the illogical unhealthy exercise schedule. <br/>'''Contemporary approach:''' Exercise and work-out has become a part of a popular lifestyle measure in addition of being health promotion tool. Group exercises like dance, zumba etc. are mainly meant for fun gathering methods. Intention of such activities are relaxation, shaping the body, and in most cases, an a lacunae surfaces in an analytical approach in implementing these activities based on the individual’s needs. Additionally, self-exercise/ work-out, using social media is very common which also shares, the same drawback. <br/>'''Personalization of exercise:''' Physique, physical activity, age, dietary intake, etc. of each individual is variable, so exercise must be designed in accordance with the needs of the person. <br/>'''Combined effect of diet and exercise:''' In order to achieve fitness and health, diet restriction or exercise alone is not very beneficial. Combined and wise execution of these two are the key to achieve the expected results<ref name="ref8">Magkos F, Hjorth MF, Astrup A. Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2020 Oct;16(10):545-555. doi: 10.1038/s41574-020-0381-5. Epub 2020 Jul 20. PMID: 32690918.</ref><ref name="ref9">Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P; Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014 Oct;114(10):1557-68. doi: 10.1016/j.jand.2014.07.005. PMID: 25257365; PMCID: PMC4180002.</ref>. Vyayama is hence, included in daily regimen (dinacharya) with an optimal magnitude. <br/>'''Role of prajna and prajnaparadha in exercise adherence:''' Awareness regarding one’s health status, bad habits, health behavior (dhi) are the key for initiating action- (dhriti). Both these bring forth enthusiasm and endurance towards exercise (maintenance/ adherence). When the individual lacks enthusiasm (dhriti bhramsha/ prajnaparadha), the adherence to exercise fades. Thus, continuous loop of prajna installation and prajnaparadha installation (relapse) play in cyclical adherence and non-adherence to exercise, which is the core theme behind ‘dushchikitsya atisthoola’ concept. <br/>Fit India Movement: An Indian government initiative aimed at improving the health of citizens by daily exercise. It was launched on the National sports day 2019 (August 29). It includes age appropriate fitness protocol for 5-18 years, 18-65 years and above 65. </div>
<div style='text-align:justify;'>There are mainly four types of exercises namely:<br/> a) Endurance, strength, balance and flexibility<ref name="ref7">NIH. Four Types of Exercise Can Improve Your Health and Physical Ability | National Institute on Aging [Internet]. National Institute on Aging NIA. 2021 [cited 2022 Dec 14]. Available from: https://www.nia.nih.gov/health/four-types-exercise-can-improve-your-health-and-physical-ability</ref>. Endurance exercises otherwise known as aerobic exercises, improve heart rate and respiratory rate. They help in preventing diseases due to wear and tear. Swimming, dancing, brisk walking etc. are some examples of endurance exercises. Strengthening exercises increase muscle strength, prevent falls and improve body balance. They include weight training, wall push-ups, lifting the body weight etc. Balance exercises enhance body balance and thereby prevent falls (eg: yoga, heel to toe walking). Flexibility exercises are stretching itself.<br/>'''Over-exertion (ativyayama):''' Magnitude and duration of exercise are to be determined prior to designing the schedule considering the physique, age, health status, amount of physical activity etc. In order to gain a fascinating physical appearance in a short period many people, especially celebrities follow unhealthy aggressive exercise protocol. Recent alarming events, of celebrity death in their 40’s and 50’s point towards the illogical unhealthy exercise schedule. <br/>'''Contemporary approach:''' Exercise and work-out has become a part of a popular lifestyle measure in addition of being health promotion tool. Group exercises like dance, zumba etc. are mainly meant for fun gathering methods. Intention of such activities are relaxation, shaping the body, and in most cases, an a lacunae surfaces in an analytical approach in implementing these activities based on the individual’s needs. Additionally, self-exercise/ work-out, using social media is very common which also shares, the same drawback. <br/>'''Personalization of exercise:''' Physique, physical activity, age, dietary intake, etc. of each individual is variable, so exercise must be designed in accordance with the needs of the person. <br/>'''Combined effect of diet and exercise:''' In order to achieve fitness and health, diet restriction or exercise alone is not very beneficial. Combined and wise execution of these two are the key to achieve the expected results<ref name="ref8">Magkos F, Hjorth MF, Astrup A. Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2020 Oct;16(10):545-555. doi: 10.1038/s41574-020-0381-5. Epub 2020 Jul 20. PMID: 32690918.</ref><ref name="ref9">Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P; Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014 Oct;114(10):1557-68. doi: 10.1016/j.jand.2014.07.005. PMID: 25257365; PMCID: PMC4180002.</ref>. Vyayama is hence, included in daily regimen (dinacharya) with an optimal magnitude. <br/>'''Role of prajna and prajnaparadha in exercise adherence:''' Awareness regarding one’s health status, bad habits, health behavior (dhi) are the key for initiating action- (dhriti). Both these bring forth enthusiasm and endurance towards exercise (maintenance/ adherence). When the individual lacks enthusiasm (dhriti bhramsha/ prajnaparadha), the adherence to exercise fades. Thus, continuous loop of prajna installation and prajnaparadha installation (relapse) play in cyclical adherence and non-adherence to exercise, which is the core theme behind ‘dushchikitsya atisthoola’ concept. <br/>Fit India Movement: An Indian government initiative aimed at improving the health of citizens by daily exercise. It was launched on the National sports day 2019 (August 29). It includes age appropriate fitness protocol for 5-18 years, 18-65 years and above 65. </div>
== Current researches ==
=== Therapeutic exercise ===
<ul><li>Systematic regular exercise can improve cognitive function and memory. <ref name="ref10">Ptomey LT, Szabo AN, Willis EA, Gorczyca AM, Greene JL, Danon JC, et al. Changes in cognitive function after a 12-week exercise intervention in adults with Down syndrome. Disabil Heal J. 2019;11(3):486–90.</ref>.</li>
<li>Exercise can be used as a tool for primary prevention in the past phase (before the onset), secondary prevention (in present cases) and prognosis of heart failure. <ref name="ref11">Cattadori G, Segurini C, Picozzi A, Padeletti L, Anzà C. Exercise and heart failure: an update. ESC Hear Fail. 2018;5(2):222–32.</ref>. </li>
<li>Regular aerobic exercise can decrease the depressive symptoms and thereby the pro-inflammatory IL6. <ref name="ref12">Ventura J, McEwen S, Subotnik K, Hellemann G, Ghadiali M, Rahimdel A, et al.<br/>Changes in inflammation are related to depression and amount of aerobic exercise in first <br/>episode schizophrenia. Early Interv Psychiatry. 2021;15(1):213–6.</ref>. </li>
<li>A study recommends that hypertensive individuals should aim to perform moderate intensity aerobic exercise activity for at least 30 minutes on most (preferably all) days of the week in addition to resistance exercises on 2–3 days/week. <ref name="ref13">Sharman JE, La Gerche A, Coombes JS. Exercise and cardiovascular risk in patients with <br/>hypertension. Am J Hypertens. 2015;28(2):147–58.</ref>. </li>
<li>Studies show that there is no improvement in Hba1c with high dose of exercise. <ref name="ref14">Wrench E, Rattley K, Lambert JE, Killick R, Hayes LD, Lauder RM, et al. There is no <br/>dose–response relationship between the amount of exercise and improvement in HbA1c in <br/>interventions over 12 weeks in patients with type 2 diabetes: a meta-analysis and meta- <br/>regression. Acta Diabetol [Internet]. 2022;59(11):1399–415. Available from: <br/>https://doi.org/10.1007/s00592-022-01918-8. </ref> </li>
<li>Low amount of moderate intensity exercise combined with diet is the most effective intervention for improving health-related quality of life. Also, low amount of moderate intensity exercise provides the greatest impact on mental well- being. <ref name="ref15">Collins KA, Ross LM, Piner LW, Fos LB, Slentz CA, Bateman LA, et al. Amount and <br/>intensity effects of exercise training alone versus a combined diet and exercise lifestyle <br/>intervention on health-related quality of life in the STRRIDE-PD randomized trial. BMJ <br/>Open Diabetes Res Care. 2022;10(1):1–10. </ref>. </li>
<li>Chronic exposure to exercise in obese children and adolescents shows increase in heart rate, parasympathetic activity and sympathetic-vagal balance. <ref name="ref16">Dias RM, Moraes ÍAP, Dantas MTAP, Fernani DCGL, Fontes AMGG, Silveira AC, et al. <br/>Influence of chronic exposure to exercise on heart rate variability in children and adolescents <br/>affected by obesity: A systematic review and meta-analysis. Int J Environ Res Public Health. <br/>2021;18(21):1–14.</ref>. </li>
<li>Voluntary exercise helps in the influx of immune cells in tumors, and reduction in tumor incidence and growth among mouse models. <ref name="ref17">Idorn M, thor Straten P. Exercise and cancer: from “healthy” to “therapeutic”? Cancer <br/>Immunol Immunother. 2017;66(5):667–71.</ref>.
<li>Aerobic exercise is the best tool for treating Parkinson's disease <ref name="ref18">Alberts JL, Rosenfeldt AB. The Universal Prescription for Parkinson’s Disease: Exercise. <br/>J Parkinsons Dis. 2020;10(s1):S21–7.</ref>. </li>
<li>Physical exercise can be used as an alternative to antidepressants in older adults <ref name="ref19">López-Torres Hidalgo J, Aguilar Salmerón L, Boix Gras C, Campos Rosa M, Escobar <br/>Rabadán F, Escolano Vizcaíno C, et al. Effectiveness of physical exercise in the <br/>treatment of depression in older adults as an alternative to antidepressant drugs in <br/>primary care. BMC Psychiatry. 2019;19(1):1–7.</ref>.</li></ul>