The impact of physical activity in preventive and rehabilitative cardiology.

Worldwide exercise training is used for purposes of the preventive and the rehabilitative cardiology. After some historical remarks the consequences of prolonged bed rest as a type of lack of exercise are described. It follows the recommendation of a suitable quality, quantity and intensity of exercise training for preventive medicine. Peripheral and central adaptations are described as well as the significance for hemodynamic and metabolic changes. Animal trials with primates give also a clear evidence about positive effects of exercise training. First convincing results are also delivered by the cardiac rehabilitation of heart infraction patients in connection with physical training. The main reasons for a protective importance of endurance training may be peripheral and central metabolic and hemodynamic adaptations with reduce the oxygen demand of the heart muscle. The flow properties of the blood are improved, combined with an anti-thrombotic effect. Endurance training induces alterations in the lipoprotein-metabolism which could be useful for protection against atherosclerosis as well as changes in the hormonal regulation. Most of the epidemiological studies confirm the physiologically expected results.