Aerobic exercise is repetitive structured physical activity that requires the body’s metabolic system to use oxygen to produce energy. Aerobic exercise:
- Improves the ability of the cardiovascular system to uptake and deliver oxygen.
- It can be performed in many different formats, with the common feature being achieved at a heart rate of 70-80% of a person’s age-appropriate maximum.
- Considered the cornerstone of endurance training, it is characterized by moderate energy expenditure over long periods of time.
- Any activity that uses large muscle groups can be sustained and rhythmic in nature. 
- Primarily dependent on aerobic energy production, muscle groups activated by this type of exercise rely on aerobic metabolism (the use of oxygen to extract energy in the form of adenosine triphosphate (ATP) from the amino acid carbohydrates and fatty acids). 
- Examples include walking cycling swimming jogging dancing hiking long distance running.
Effects of aerobic exercises
Aerobic exercise is primarily seen in the health-related components of fitness, particularly the effects on cardiovascular endurance and body composition.
For Neuromuscular Adaptation After Aerobic Exercise, click on the link.
The physiological effects of aerobic exercise are explained as follows:
- Heart Rate: Resting heart rate decreases with aerobic training and will decrease with any given workload. Maximum HR remains unchanged.
- Cardiac output: Maximal CO increases, while resting CO stabilizes. Resting SV increased with a corresponding decrease in resting HR.
- Aerobic capacity: Maximum aerobic capacity or maximum oxygen uptake (VO2max) is a measure of the maximum amount of oxygen an individual can use per unit of time during strenuous exercise at sea level.  Maximal aerobic capacity increases with aerobic training. Resting Vo2 stable The same is true for Vo2 for a given workload. These changes are specific to the muscles being trained.
- Stroke Volume: SV increases at rest and remains at a lower HR, resulting in a lower RPP for a given level of exercise.
- Myocardial Oxygen Capacity: Maximum Mvo2 usually does not change, but at a given workload, Mvo2 decreases with training. This reduces angina attacks.
- Peripheral Vascular Resistance (PVR): Aerobic training reduces arterial and arteriolar tone, which reduces cardiac “afterload” and PVR. A reduction in PVR results in lower RPP and lower Mvo2 for a given workload and rest.
These actions contribute to the following benefits to the body:
- Higher endurance during intense physical activity due to increased blood volume
- Lung volume increase
- Cardiac muscle strength
- Increased HDL levels (lower ratio of total cholesterol to HDL reduces risk of atherosclerosis)
- Overcoming and Enhancing Mental and Emotional Health
- Increase bone density.
Healthy adults should aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, or an equal combination of moderate and vigorous activity. It doesn’t have to be done all at once, though. For example, walk briskly for 30 minutes in five days Weeks meet the guidelines. Cardio can even be done in short bursts, such as several walking breaks spread throughout the day. Any activity is better than none .
Why perform exercise tests?
- Make sure it is safe to start cardio training (perform a pre-participation health check (see link)).
- Diagnose the cause – identify the abnormal physiological response
- Prognostic reasons – identifying adverse events
- Reasons for treatment – Measuring the impact of specific interventions; coaching in physical activity; designing exercise prescriptions.
Standard graded exercise tests are used clinically to assess a patient’s ability to tolerate increased intensities of aerobic exercise such as:
- Cycle ergometer
- Bruce Treadmill Test (one of the most commonly used protocols in incline treadmill testing) – A maximal exercise test in which the athlete is completely exhausted as the treadmill speed and incline are increased every three minutes. The length of time on the treadmill is the test score, which can be Used to estimate VO2 max. Heart rate, blood pressure, and perceived exertion levels are also typically collected during the test .
These tests help determine measures of cardiovascular fitness and exercise capacity. 
- Aerobic power max or maximal oxygen uptake (VO2max): It is a measure of the maximum amount of oxygen an individual can use per unit of time during strenuous exercise at sea level. Aerobic power max is usually expressed in absolute power as L/min or normalized body weight as mL · kg−1 · min−1. It is convenient to express oxygen uptake in multiples of sitting/resting requirements.
- Peak metabolic equivalent (MET): A metabolic equivalent (MET) is a unit of seated/resting oxygen uptake (≈3.5 mL O2 per kilogram of body weight per minute [mL · kg−1 · min−1]). MET is a useful, convenient and standardized way to describe absolute intensity of various sports activities. Light physical activity was defined as requiring 3 METs, moderate as 3-6 METs, and vigorous as 6 METs.  V̇o2 max is influenced by age, sexual exercise habits, genetics, and clinical cardiovascular status. 
American College of Sports Medicine (ACSM) 2014 prescribes FITT (Frequency Intensity Time Type) based aerobic exercise for different conditions and age groups. 
Cardiovascular disease/risk factors and aerobic exercise
Cardiovascular disease (CVD) is the leading cause of death worldwide, claiming approximately 17.9 million lives each year. Among many cardiovascular diseases, heart attack and stroke are the most common causes of death. Lifestyle changes are WHO and American Heart Association, which includes diet and exercise.  A supervised cardiac rehabilitation program to guide treatment.
A 2019 randomized controlled trial showed that combined training (30 min/session of aerobic exercise plus 30 min/session of resistance training) 3 days per week for 8 weeks was more effective than aerobic and strength training alone benefit. Joint training significantly reduces the periphery (-4 mmHg) and central diastolic blood pressure (-4 mmHg) increased CRF (4.9 ml/kg/min) increased upper body (4 kg) and lower body (11 kg) strength and increased lean body mass (0.8 kg). 
Diabetes and Aerobic Exercise
A supervised exercise intervention improves glycated hemoglobin (A1C), triglycerides (TG), and cholesterol in patients with type 2 diabetes (9). Both aerobic and resistance exercise are beneficial, and it’s best to do both at the same time. Get at least 150 minutes of aerobic activity per week, and Resistance training is recommended at least 2 times a week. 
Maintaining insulin dosage and exercise duration, as well as carbohydrate intake during and after exercise, is important to prevent post-exercise hypoglycemia. Check out this guide for more details. 
Chronic pain and Aerobic Exercises
Aerobic exercise programs have shown psychophysiological and joint benefits for patients with chronic diseases such as arthritis, osteoarthritis, and fibromyalgia. Aerobic exercise stimulates the release of endorphins, which relieve pain by inhibiting pain pathways. it makes patients Be more active to reduce the fear of moving (kinesophobia) and increase self-confidence.
A systematic review protocol published in 2019 showed the effect of aerobic exercise on chronic nonspecific low back pain. Aerobic exercise lasting 15 to 60 minutes at an intensity of 60 to 90 percent of maximum heart rate showed significant improvements.
Mental health and Aerobic Exercise:
In a systematic review and meta-analysis conducted in 2019, 11 eligible trials (13 comparisons) involving 455 patients performed an average of 45 minutes of moderate-intensity aerobic exercise three times per week for 9.2 weeks, and Shows a significant overall antidepressant effect. 
Pregnancy and Aerobics:
Low-intensity aerobic exercise is key to physical and mental health during pregnancy. Regular low-intensity aerobic exercise during pregnancy will help strengthen your heart and lungs, strengthen your muscles, relieve pregnancy aches and pains, and allow you to get a good night’s sleep. Or, it will help with the demands of pregnancy and childbirth.  A Cochrane systematic review showed that regular aerobic exercise during pregnancy appears to improve (or maintain) physical fitness. 
A meta-analysis of nine randomized controlled trials including 2059 women with uncomplicated singleton pregnancies with a normal body mass index showed that women randomized to the aerobic exercise group had similar rates of PTB, lower GDM GHTN disease profile Uterine labor rates and higher rates of vaginal births delivery. 
Fall risk in older adults and aerobic exercise:
As we age, various physiological changes occur in the body, so lower body muscle strength declines more than upper body muscle strength, which increases the risk of falls in the elderly. Aerobic exercise has been shown to improve balance and gait. 
Children and Aerobics:
According to the latest guidelines, children between the ages of 3 and 5 need to be active throughout the day to promote growth and development. Children this age should get at least 3 hours of physical activity a day, and they must be active throughout the day.  Children and adolescents aged 6 By age 17, you should be engaging in 60 minutes (1 hour) or more of moderate to vigorous physical activity per day. 60 minutes of aerobic activity such as running, walking, swimming and cycling are strongly encouraged to promote overall personal growth.  
- ↑ Jump up to:1.0 1.1 Patel H, Alkhawam H, Madanieh R, Shah N, Kosmas CE, Vittorio TJ. Aerobic vs anaerobic exercise training effects on the cardiovascular system. World journal of cardiology. 2017 Feb 26;9(2):134.
- ↑ Dr.James Meschino. Benefits of Aerobic Exercise. Available from: https://www.youtube.com/watch?v=IbIfHDlBoHs [last accessed 5/5/2020]
- ↑ Cifu DX, Lew HL. Braddom s Rehabilitation Care: A Clinical Handbook E-Book. Elsevier Health Sciences; 2017 Jun 8. (Chapter: Acute medical condition)
- ↑ Seidenberg P, Beutler AI. The sports medicine resource manual. Elsevier; 2008 Jan 1. (Chapter:Testing for Maximal Aerobic Power)
- ↑ Blumenthal JA, Emery CF, Madden DJ, George LK, Coleman RE, Riddle MW, McKee DC, Reasoner J, Williams RS. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. Journal of gerontology. 1989 Sep 1;44(5):M147-57.
- ↑ Niu Y, Zhou D, Ma Z. Effect of aerobic exercises on students’ physical health indicators. Science & Sports. 2018 Apr 1;33(2):e85-9.
- ↑ Mayoclinic Aerobic exercise Available from:https://www.mayoclinic.org/healthy-lifestyle/fitness/basics/aerobic-exercise/hlv-20049447 (last accessed 23.10.2020)
- ↑ verywellfit Bruce treadmill test Available from:https://www.verywellfit.com/the-bruce-treadmill-test-protocol-3120269 (last accessed 22.10.2020)
- ↑ Jump up to:9.0 9.1 9.2 American College of Sports and Medicine. (2014) ACSM’s Guidelines for Exercise Testing and Prescription. Available from: http://antoinedl.com/fichiers/public/ACSM-guidelines-2014.pdf [2020-5-5].
- ↑ Gerald et al. American heart association. Exercise Standards for Testing and Training. Available from: https://www.ahajournals.org/doi/full/10.1161/hc3901.095960[2020/5/5].
- ↑ World health organization. Cardiovascular diseases (CVDs). Available from: https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) [last accessed:2020/5/5].
- ↑ Schroeder EC, Franke WD, Sharp RL, Lee DC. Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: a randomized controlled trial. PloS one. 2019;14(1).
- ↑ Jump up to:13.0 13.1 Sigal RJ, Armstrong MJ, Bacon SL, Boule NG, Dasgupta K, Kenny GP, Riddell MC. Physical activity and diabetes. Canadian journal of diabetes. 2018 Apr 1;42:S54-63.
- ↑ Morres ID, Hatzigeorgiadis A, Stathi A, Comoutos N, Arpin‐Cribbie C, Krommidas C, Theodorakis Y. Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta‐analysis. Depression and anxiety. 2019 Jan;36(1):39-53.
- ↑ Hinman SK, Smith KB, Quillen DM, Smith MS. Exercise in pregnancy: a clinical review. Sports health. 2015 Nov;7(6):527-31.
- ↑ Kramer MS, McDonald SW. Aerobic exercise for women during pregnancy. Cochrane database of systematic reviews. 2006(3).
- ↑ Di Mascio D, Magro-Malosso ER, Saccone G, Marhefka GD, Berghella V. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. American journal of obstetrics and gynecology. 2016 Nov 1;215(5):561-71.
- ↑ Kulkarni, Shweta & Shaikh, Rahat & Yeole, Ujwal. Effects of Aerobic Exercises on Balance And Gait In Geriatric. Int J Recent Sci Res.2018 Jan 9(1):22878-81.
- ↑ https://www.who.int/news/item/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more
- ↑ Zan Gao, Zachary Pope, Jung Eun Lee, David Stodden, Nida Roncesvalles, Denis Pasco, Charles C. Huang, Du Feng,Impact of exergaming on young children’s school day energy expenditure and moderate-to-vigorous physical activity levels. Journal of Sport and Health Science,Volume 6, Issue 1,2017,Pages 11-16,ISSN 2095-2546,https://doi.org/10.1016/j.jshs.2016.11.008.
- ↑ Archer, Trevor. (2014). Health Benefits of Physical Exercise for Children and Adolescents. Journal of Novel Physiotherapies. 04. 10.4172/2165-7025.1000203.
- ↑ U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018