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« "Ways to play" - Chris Langridge and Heather Olver via BADMINTON England | Main | Health Equals Fitness, Fitness Equals Health (Part 1) »

Health Equals Fitness, Fitness Equals Health (Part 2)

Guest blog by Dr. Ben Fung, Physical Therapist, Doctor of Physical Therapy

Continued from “Health Equals Fitness, Fitness Equals Health (Part 1).”

In Part 1, we explored three key physical fitness measures which definitively predict overall health, longevity, and well-being. These three qualifiers are gait velocity, speed of sit-to-stand, and the ability to rise from the floor. It should be noted that these measures are generally valid for much of the population, however, special considerations should be made for those with special needs as well as orthopedic and neurologic limitations. With that said, this article aims to recommend exercise programs and activity guidelines by which these three fitness activities can be strengthened, optimized, and maintained. Should exercises require modification for individual needs, it is highly encouraged to consult your physiotherapist, physician, and/or exercise professional. 

Optimizing Gait Velocity

Gait is truly an amazing feat. It is the primary mode of organic, human locomotion. It has been described as everything between “controlled falling” and the “Sixth Vital Sign.” So how do we strengthen this sixth vital sign? 

As walking itself is already considered exercise, I can best recommend building on the many resources of cardiovascular health already out there by expanding on the variability and intensity of your gait. Primarily, the surfaces you choose and the velocity of which you achieve. Personally, I’m a big fan of hiking and sprinting for simple reasons. In regards to hiking, the change of terrain, altitude, and sloping paths also strengthens ones balance, calves, and gluteals. In essence, “hiking” is walking through variety; intervals of speed, steepness, difficulty, and scenery. After all, we could all use a little dose of sunshine.

Regarding sprinting: It is gait velocity we are focused on, after all. Not only does sprinting require an enormous amount of strength, flexibility, balance, and coordination, it has also been shown to be quite beneficial for the cardiovascular system when done in intervals1. This is quite encouraging since a recent exposé regarding running actually stated that too much running was associated with a shorter lifespan; suggesting the repeated wear and tear of the activity as too strenuous for the body, washing away any cardiovascular benefit with the damage being dealt from the activity2. Regardless, it is encouraging to know that short bouts of running can give both the desired effects of maintaining one’s gait velocity while gleaning cardiovascular benefits for which many aim to claim through such exercise. 

Strengthening Sit-To-Stance

The ability to sit and stand repeatedly as measured by musculoskeletal tests such as the Short Physical Performance Battery aim to reflect the fitness in this area to the related functional tasks of daily life. As we’ve learned from specialties such as physiotherapy, physical medicine, and other allied rehabilitation professions, the more functional one is, the more independent one will be – and – the more independence one has, the healthier they are.

As mentioned in Part 1, sitting and standing is essentially squatting. I can recommend no better exercise to strengthen squatting than… well… squatting! However, I would highly suggest that one considers the kettlebell swing as an accelerator of squat, stance, and balance – a three in one exercise which also incorporates cardiovascular benefits3. Additional recommendations in this family of exercise include dead lifts, lunges, and leg presses. However, if you truly want to challenge yourself for functional movement, I would suggest you attempt the Functional Wall Squat

Mastering Floor Recovery

Getting up off the floor is important. The same motions translate to the ability to recovery from a fall, and, getting in and out of bed. There are many exercises that can help master this task and elevate one’s level of fitness. Such exercises include rolling, bridges, planks, side-planks, and push-ups. 

However, there are two exercises that I feel encompass the ability to rise from the floor better than any variations out there: the Turkish Get-Up and the Burpee. If these two exercises seem too extreme, there are ways to modify the exercise for lower intensity and similar benefits. For the Turkish Get-Up, you can simply perform the exercise a light dumbbell. For the Burpee, you can sequentially achieve each position, limb-by-limb. 

Both these exercises are floor recovery tasks which require high levels of fitness, which incidentally, is precisely what we are trying to achieve through exercise – optimum health and well-being. 

Check out the awesome video by Dr Ben Fung on the TGU and Burpee here:


Health Equals Fitness, Fitness Equals Health

I hope this discourse on utilizing musculoskeletal fitness as a primary influence of health has been encouraging to you. The science is certainly well established, and, most of the recommended exercises to strengthen the movements for best fitness can be conveniently performed in the home environment. The promotion of health through physical activity is a worthy task; few interventive and preventive measures can claim such clinical efficacy and economic benefits. If you wish to achieve excellent health, you must pursue fitness through exercise. After all, Exercise Works! 


  1. Macpherson RE et al. Run sprint interval training improves aerobic performance but not maximal cardiac output. Med Sci Sports Exerc. 2011 Jan;43(1):115-22. 
  2. http://www.webmd.com/fitness-exercise/news/20140401/too-much-running-tied-to-shorter-lifespan-studies-find 
  3. Fung B, Shore S. Aerobic and Anaerobic Work During Kettlebell Exercise: A Pilot Study. Medicine and Science in Sports and Exercise, Volume 42:5 Supplement: S588-S589. June 2010. 
  4. Kuys SS et al. Gait speed in ambulant older people in long term care: a systematic review and meta-analysis. J Am Med Dir Assoc. 2014 Mar;15(3):194-200. 
  5. Fritz and Lusardi. White Paper: "Walking Speed: the Sixth Vital Sign." Journal of Geriatric Physical Therapy: 2009 - Volume 32 - Issue 2 - p 2–5 
  6. Studenski S et al. Gait speed and survival in older adults. JAMA. 2011 Jan 5;305(1):50-8. 
  7. Fischer et al. Short Physical Performance Battery in hospitalized older adults. Aging Clin Exp Res. 2009 Dec;21(6):445-52. 
  8. Bohannon RW. Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders. Percept Mot Skills. 2006 Aug;103(1):215-22. 
  9. de Brito LB et al. Ability to sit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol. 2012 Dec 13. [Epub ahead of print] 
  10. https://www.youtube.com/watch?v=MCQ2WA2T2oA


Blog moderated by Ann Gates, Founder and Director of Exercise Works!

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