The “10,000 steps a day” benchmark is widely known, but it doesn’t consider individual differences in cardiorespiratory fitness (CRF), movement competency, health status, and lifestyle. Personalized exercise prescription, especially in medical practice, accounts for these variations and provides a more tailored approach to physical activity. Here’s how it integrates:

1. Individualized Assessment

• Cardiorespiratory Fitness (CRF): People vary greatly in their aerobic capacity or CRF, which influences their ability to engage in sustained physical activity. For instance, an individual with low CRF may find 10,000 steps exhausting or unsafe, while someone with high CRF might need more intense exercise for improvement. Medical professionals and fitness trainers assess CRF and create personalized exercise plans to gradually improve it, whether through walking, cycling, or other aerobic activities.
• Based on a meta-analysis, Zheng and colleagues estimate that 8 MET hours/week of walking (approximately 30 minutes/day, 5 days/week, consistent with PA recommendations is associated with a 19% reduction in coronary heart disease (CHD) risk (1)
• Evidence from high quality studies supports efforts of primary and secondary prevention of CVD in economically advanced as well as in rapidly developing countries (2)

• Movement Competency: Not everyone has optimal movement patterns. Some individuals have musculoskeletal limitations, poor coordination, or past injuries that prevent them from safely walking 10,000 steps. Physiotherapists assess movement competency, identifying dysfunctional patterns, and prescribe exercises to improve movement efficiency before progressing to higher activity levels.

2. Tailored Goals

• Functional Fitness Overstep Counting: For some, the goal might not be about the number of steps but improving specific functions like walking gait, balance, or strength. Personalized exercise plans consider the quality of movement as well as quantity, focusing on exercises that correct movement deficiencies and build CRF progressively.

• Personalized Cardiovascular Goals: Instead of prescribing 10,000 steps, healthcare providers might focus on individualized cardiovascular markers, such as improving oxygen uptake (VO2 max) or heart rate recovery. These markers are more relevant to CRF and can guide the intensity and duration of exercise.

3. Adaptability for Different Populations

• Tailoring to CRF Levels: Someone with low cardiorespiratory fitness may benefit from a starting point of fewer steps or lower-intensity activities such as seated exercises, aquatic therapy, or cycling. Conversely, those with higher CRF might engage in more vigorous exercise routines like interval training or endurance activities.

• Movement Competency Considerations: A person with poor movement competency (e.g., improper squat form, limited range of motion) might first focus on corrective exercises before increasing physical activity. Physiotherapists ensure exercises align with the individual’s movement capacity, making adjustments as competency improves.

4. Behavioral and Motivational Support

• Sustainable Habits Based on Fitness Levels: If someone’s current CRF or movement competency doesn’t allow for 10,000 steps, they might feel defeated and give up. Personalized exercise plans help set realistic and progressive goals, whether that’s improving walking distance, speed, or movement quality. This approach encourages long-term adherence and motivation.

• Positive Reinforcement through Progress: As movement competency and CRF improve, individuals experience tangible benefits like less pain, more stamina, and easier movement. This positive feedback loop keeps them motivated to continue, even if they’re not reaching arbitrary step goals.

5. The Role of Clinicians and Trainers

• Educating on CRF and Movement: Clinicians and trainers assess both CRF and movement competency to ensure personalized exercise prescriptions are safe, effective, and aligned with health goals. They educate patients on how increasing CRF can reduce disease risk, improve overall health, and enhance quality of life, and how improving movement competency reduces injury risk and enhances functional independence.

• Customized Progressions: Healthcare providers monitor progress in CRF and movement competency and adjust exercise prescriptions accordingly. For example, as a person’s cardiovascular fitness improves, the intensity or duration of aerobic exercise may increase, or as movement competency improves, more complex or demanding exercises may be introduced.

Incorporating cardiorespiratory fitness and movement competency into personalized exercise prescriptions allows for a more comprehensive approach. It ensures that exercise recommendations are safe, achievable, and beneficial, helping individuals reach their unique health and fitness goals regardless of whether they walk 3,000 or 10,000 steps a day.

Reference List

1. Walking – the first steps in cardiovascular disease prevention – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098122
2. Physical activity and risk of cardiovascular disease–a meta-analysis of prospective cohort studies – https://pubmed.ncbi.nlm.nih.gov/22470299/