Outdoors in nearby area and in nature was the most frequently reported exercise location in both training groups. This finding is in line with previous studies reporting that older adults prefer to exercise close to home [23, 30] and outdoors . Interestingly, outdoors was the most common exercise location in both warmer and colder months despite the fact that colder months in Norway consist of more snow, higher prevalence of ice and relatively fewer hours of daylight compared to warmer months. The HIIT group had a higher proportion of sessions at a gym and sport facility compared to the MCT group. This finding is likely related to the fact that the HIIT group reported a higher proportion of sessions with exercise types commonly performed at these locations (e.g. swimming and other types of endurance training) compared to the MCT group. Some older adults might feel that it is easier to reach a high-intensity level with activities located at a gym and sports facility compared to outdoors.
One of the rotator cuff strengthening exercises proposed by Kuhn is scaption performed with the thumb down or up. Clinically, this exercise is called the empty-can (thumb-down) or full-can (thumb-up) exercise. When prescribing this strengthening exercise, one should consider the effect that upper extremity position has on the tissues located in the subacromial space. Yanai et al4 showed that impingement forces on the rotator cuff tendons under the coracoacromial ligament were greater with the empty-can exercise than with the full-can exercise. Therefore, the full-can exercise is more appropriate for this patient population.
I must confess: the title of this section is misleading, because while most of us associate the first home workouts with fitness icons Jane Fonda and Richard Simmons, they were not the first ones to bring workouts inside our homes. In fact, before there were VHS tapes, before there were even televised workouts, there were the audio-only vinyl record workouts, nicknamed vinylcise.
Regular aerobic exercise improves symptoms associated with a variety of central nervous system disorders and may be used as an adjunct therapy for these disorders. There is clear evidence of exercise treatment efficacy for major depressive disorder and attention deficit hyperactivity disorder. The American Academy of Neurology's clinical practice guideline for mild cognitive impairment indicates that clinicians should recommend regular exercise (two times per week) to individuals who have been diagnosed with this condition. Reviews of clinical evidence also support the use of exercise as an adjunct therapy for certain neurodegenerative disorders, particularly Alzheimer’s disease and Parkinson's disease. Regular exercise is also associated with a lower risk of developing neurodegenerative disorders. A large body of preclinical evidence and emerging clinical evidence supports the use of exercise therapy for treating and preventing the development of drug addictions. Regular exercise has also been proposed as an adjunct therapy for brain cancers.
One of the main reasons I don't do Pilates very often is that, for me, it gets too boring after a while. Enter this DVD. Made up of five 10-minute workouts, it kept me engaged because I was able to change up the routine often, or, if I only had a few minutes available, I could still squeeze in a workout with just one of the programs. I just might be a Pilates convert after all.
It’s not an exact science, but when you hear the term plyometric, you can go ahead and think jumping and breathlessness. Examples would include squat jumps, box jumps, broad jumps, and burpees. One of the main purposes of these explosive exercises is increasing power, says Laferrera. Having more power means you can recruit muscle fiber faster and more efficiently, which pays off when you’re moving heavy objects or working on sprinting drills in the gym, adds Lefkowith. Plus, because these moves get your heart rate up, they’re big calorie-burners. Here are seven plyometric moves you can do at home.
This gymnastics move is for the advanced CrossFitter. Hailing from gymnastics, the ring muscle-up is one of the hardest moves a CrossFitter can complete. HOW TO DO IT: Start with either a false grip or regular grip. For the false grip, hook your wrists into the ring. This position, while uncomfortable, shortens the lever of the arm, creating less distance for you to travel. Most CrossFitters kip this move because of its degree of difficulty, but it can be done strict as well. Swing your body back to gain momentum and thrust your hips into the air while pulling with all your upper body strength (similar to a pull-up) so that the body raises to ring height or above. Always keep the rings as close to your body as possible to have the most control and strength on the rings. Once you are at ring height, quickly push your head and chest through the rings into a dip position. Then push up out of the dip position with a kip from the legs or from strict strength. MUSCLES USED: Back, shoulders, core and triceps.
Stability moves train your core to stay strong and steady. They also target your transverse abdominis, the deep ab muscle that does a 360 around your waist and draws it in, says Brent Brookbush, president of the Brookbush Institute of Human Movement Science in New York City. Try this stabilizer: Hold a dumbbell in your right hand and balance on your left leg. Squat on your left leg as you lower the weight toward your left foot. (More moves to try: grab a Bosu ball and challenge your core with this stability workout. Or you can snag one of these balance boards to work on your core as you watch your favorite TV show.)
The world population is ageing and the number of older adults with chronic health conditions and physical limitations is expected to increase. This, in turn, could lead to an increased burden on healthcare services . Regular physical activity is an important component of successful ageing and reduces the risk of developing several age- and lifestyle related diseases such as cardiovascular disease, dementia and type 2 diabetes [2–7]. However, making older adults exercise and keeping them in exercise programs is a major challenge . Understanding how older adults prefer to exercise may help developing tailored exercise programs and increase sustained exercise participation in ageing populations.
I did the original P90X and gained a lot of upper body strength. The one issue with the original P90X is that, after weeks and weeks of doing the videos, you start to realize how much Tony talks and how much time you're wasting -- standing there with your weights -- waiting for him to start the exercise. What I love about the + videos is that he cuts most of that out. It's straight to the exercise and he barrels through. It's a little disorienting in the beginning, as you don't know how to do the exercises at first, but it's so nice knowing that I can be finished with the workout in 30 minutes, instead of 60 for most of the regular P90X DVDS.
How much time are you willing to devote (realistically) to working out? – Another question that being brutally honest with yourself is necessary. Pretending you will devote 2 hours to working out every day isn’t practical unless you do that in some form NOW. Most people can’t keep up a two hour a day workout program unless they are professional fitness trainers or competitors. Exercise videos come in all lengths and intensity levels. Some are very short; others may be 60-90 minutes long. Knowing how much time you have to devote to working out will help you choose an exercise video that provides what you need in the time frame you have available. This will also encourage you to continue using it.
... Consequently, it was suggested that when determining LT in trained subjects, at least 8-min stages should be used ( Foxdal et al., 1996;Weltman et al., 1990). However, using such a stage duration would not allow maximal tasks to be assessed, since the duration of the whole procedure could result in an excess of fatigue or motivation ( Buchfuhrer et al., 1983). This was shown to compromise the V Á O 2max and maximum work-rate achievements (Bentley et al., 2007). ...
Don’t blink or you just might miss this seven-minute, high-energy dance workout with Vixen Dance for Elle.com. Featuring Janet, Shanut, and Carolina, this dance cardio session will have you sweating in no time. The Vixen Workout website describes its style as “a dance fitness format that uses commercial choreography, killer music remixes, and stage lighting so you can experience yourself as a performer.” This fast-paced routine will definitely burn some calories.
Exercise and physical activity fall into four basic categories—endurance, strength, balance, and flexibility. Most people tend to focus on one activity or type of exercise and think they’re doing enough. Each type is different, though. Doing them all will give you more benefits. Mixing it up also helps to reduce boredom and cut your risk of injury.
Wall sit while you brush your teeth. You should be brushing your teeth for two minutes at least twice a day, so take advantage of that precious time by doing some wall sits. At first, you'll probably only last for around 20 seconds, but make it a goal to work up to wall sitting for the whole two minutes that you're brushing your teeth. You might surprise yourself!
In 1890, English-born American physician Edwin Checkley published ‘A Natural Method of Physical Training’ in which he presented his MMB philosophy. Checkley’s exercise method was non-competitive, did not encourage physical or mental exhaustion, and did not require equipment. The aim was ‘to feel naturally light and strong and to have an effective body.’9 Checkley E. A natural method of physical training. New York (NY): William C. Bryant & Co.; 1890. [Google Scholar] Checkley expressed his dismay toward the vigorous and ‘unnatural’ athletic training methods utilized in the gymnasiums at the time, as well as toward the new mechanized ‘muscle-molding schemes’ he referred to as ‘straining’ more than ‘training.’ He criticized the ethics of aggressive performance-enhancing gymnastic and athletic training techniques claiming they were not natural, therefore harmful for the body and mind. In comparison, Checkley described animals in nature that sustain a lifetime of health, fitness, and beauty by performing seemingly effortless movements on a regular basis.9 Checkley E. A natural method of physical training. New York (NY): William C. Bryant & Co.; 1890. [Google Scholar] Perhaps ironically, Checkley’s philosophy and exercises famously ‘converted’ Alan Calvert, the weightlifting pioneer who founded the Milo Bar-bell Company in 1902 and started Strength Magazine in 1914 (Figures 1, 2).12 Beckwith KA. Building Strength. Alan Calvert, the Milo bar-bell company, and the modernization of American weight training; PhD thesis. Austin: The University of Texas; 2006. [Google Scholar]
Around 1900, Tasmanian-born Australian professional reciter and theatrical producer Frederick Alexander developed a novel methodology to harmonize full-body functional movements. As a child, Alexander suffered respiratory ailments, leading to the initial purpose of developing the method – to normalize his personal voice function in order to materialize a stage performance dream. In 1902, Alexander established the Sydney Dramatic and Operatic Conservatorium and in 1904, moved to London to spread his teaching method. During the first years, Alexander focused on teaching ‘full chest breathing’ techniques mainly to stage artists and people with breathing pathologies.19 Staring J. Frederick Matthias Alexander 1869-1955. The Origins and History of the Alexander Technique. A medical historical analysis of F.M. Alexander’s life, work, technique, and writings. Nijmegen: Radboud Universiteit; 2005. [Google Scholar] However, he soon discovered that retrieving the natural ‘conscious control’ via mindful postures and movements resulted in benefits not only for the vocal health and performance but also the health and performance of the whole body and mind.20 Alexander FM. Man's supreme inheritance. London: Methuen; 1910. [Google Scholar] This holistic evolvement transformed the newly formed ‘Alexander Technique’ into a general remedy and preventative tool suitable for all populations. Alexander explained in his 1910 book ‘Man’s Supreme Inheritance:’20 Alexander FM. Man's supreme inheritance. London: Methuen; 1910. [Google Scholar]
The “Lying Bicycle” is one of the “gold standards” of abdominal moves according to Marie. “If it’s performed correctly, you will be targeting all areas of your abdominals and core for a tinier, tighter waistline.” To do it: Lie on your back on a mat, placing both hands at the base of your head to lightly support your head and neck (do NOT “yank”). In one continuous motion, bring one knee up to your chest and crunch up angling the opposite elbow towards that knee. Without pausing, alternate while bringing the other elbow up and toward the other knee. Perform this move in a fluid continuous motion without pausing. Count ten reps on each side. Rest and then begin again. Marie says to be sure not to “yank or turn your head,” as this move is done by the abdominals, not your neck. “Crunch up as much as you can throughout the start and finish,” she says. “Extend your legs completely; don’t just ‘cycle’ your feet.”
Although there is research concluding the effectiveness of the Alfredson protocol, some individuals find the completion of 180 repetitions of exercise daily to be difficult to achieve. A study in the February 2014 issue of the Journal of Orthopaedic and Sports Physical Therapy indicated that a modified version of the Alfredson protocol with a "do as much as tolerated" approach achieved similar positive results as the full 180 repetition protocol.
This section outlines the shared characteristics of the six aforementioned MMB pioneers. They all elaborated in length on their philosophy and exercises from a personal perspective, leading to a similar notion that the innate ability to stand and move harmoniously as a normal manner provides multiple advantages. These include physical and mental health, reduced movement-based symptoms, prevention and optimal injury and sickness recovery, enhanced physical performance, retention of the natural human form, and the ability to control the harmonious body rather than acquired movement impairments.
Natalie Jill is a very popular fitness trainer who you will see guest starring on some of the other sites and channels found in this list. Her best videos can be found on her personal fitness blog which shares workouts for weight loss, exercise ball routines, jump rope workouts, booty belt workouts, body weight exercises and more. Natalie also shares great healthy recipes and useful nutrition tips on her site.
Fran: Don't let the sweet name fool you. Perhaps CrossFit’s most famous workout, Fran is a 21-15-9 rep scheme of thrusters (95 pounds for men, 65 for women) and pull-ups. For those keeping track at home, that’s 21 thrusters and 21 pull-ups, followed by 15 thrusters and 15 pull-ups, and so on. Elite CrossFitters can finish this monstrosity in less than three minutes, but don’t expect to break twice that during the first try.
Each reliability session took place on a Monday, Wednesday and Friday morning at the same time and within the same week. All subjects were given written instructions to drink 35 ml of water per kilogram of body weight, sleep for at least 7 h, refrain from the consumption of alcohol, and avoid any vigorous exercise the day before each visit. Participants were also instructed to avoid any caffeine and nicotine for at least 3 h before testing. Finally, subjects were instructed to consume a set breakfast (2 slices of toast spread with margarine or butter, 250 ml of orange juice, and a banana) 1 h before all testing sessions. At each visit to the lab, subjects were asked to complete a pre-test checklist to ascertain that they had complied with the instructions given to them, and were asked to report any pain or soreness experienced in their leg (to check for the presence of previous session-induced muscle damage). None of our subjects reported leg muscle pain or soreness at the beginning of each session.
SOURCES: American College of Sports Medicine web site. Michael R. Bracko, EdD, FACSM, chairman, American College of Sports Medicine's Consumer Information Committee. Rita Redberg, MSc, chairwoman, American Heart Association's Scientific Advisory Board for the Choose to Move program. Cedric Bryant, PhD, chief exercise physiologist, American Council on Exercise. Stephanie Siegrist, MD, orthopedic surgeon, Rochester, N.Y. Sal Fichera, exercise physiologist; owner, Forza Fitness, New York.
It’s like preparing for the birth marathon, or any marathon for that matter. The more you can prepare your body for what it’s about to experience, the better you feel and the better your body responds. Implementation of our foundational techniques is a perfect way to set up for a successful pregnancy and postpartum phase. We want to keep you doing what you love to do, so no need to rush and cancel your memberships at other studios. You can incorporate our “basics of Bloom” into any workout you desire. Through this, you’ll not only be setting up your body for a more comfortable pregnancy but you’ll also be able to amp up your current workout for more efficiency and better results.
Athletic trainers and physical therapists play important roles in the management of individuals with RCIS. When caring for this patient population, an athletic trainer or physical therapist performs a comprehensive initial examination. Information obtained from the examination is used, in part, to (1) identify impairments believed to be contributing to the individual's pain and functional limitations and (2) develop an impairment-based rehabilitation program. We believe that the prescription of specific evidence-based interventions designed to address the relevant contributory factors might be more appropriate than administering the same exercise program to everyone with RCIS. Ideally, individuals with RCIS would be classified into impairment-based subgroups and prescribed interventions specific to that subgroup. Although no treatment classification for patients with RCIS exists, this approach has been used to treat individuals with low back pain and has resulted in superior outcomes when compared with a general treatment approach.2
Anyone who watched Jackie Warner on Bravo's Work Out knows she takes a tough-love approach to fitness. And, clearly, if you've checked out her abs lately, it works. She shares her signature circuit-training workout in this high-energy DVD that gives the option of four different 15-minute workouts or one 40-minute total body circuit, and left me feeling like I just had an up-close-and-personal training session with the exercise guru.
Conclusions: Rediscovering the Western mind–body exercise movement is hoped to facilitate official healthcare establishment recognition of this kind of training as an integral entity. This may widen research opportunities and consolidate approaches toward: optimal musculoskeletal rehabilitation and injury prevention, promotion of a healthy active lifestyle environment in the modern world, and enhancement of the natural pain-free human athletic look, feel, and performance.
Finally, although performing the lower trapezius strengthening exercise as described by Kuhn (standing with the arms at the sides and moving the shoulders into extension against resistance of an elastic band) is appropriate for individuals with moderate to high pain levels or altered scapulothoracic movement patterns, other exercises have demonstrated5 greater electromyographic activity levels of the lower portion of the trapezius muscle. The prone “Y” exercise (arm raised in line with the fibers of the lower trapezius) produces high levels of lower trapezius electromyographic activity and might be more effective for strengthening this muscle.5 After an individual's pain resolves and scapulothoracic movement patterns normalize, an athletic trainer or physical therapist might progress the individual to a more challenging position, such as the prone “Y” exercise.
Our methodology, classes + 1:1 training incorporate what a lot of fitness methods are missing [regardless of pregnancy]. So while we provide you necessary tools and guide you to a strong + functional core and body, we won’t just teach you to “kegel” or “pull your belly button to your spine” because those techniques need to stay in the past. Instead, we create a balance in your pelvic floor and core that will continue to support you for life, preparing you for your birth marathon and motherhood with every pulse, hold, and full range move we guide you through.
The daily practice of the mind–body exercises took only a few minutes, to blend in with modern life rather than to dominate it. The exercises could be performed in private with no competitive, commercial, or political emphasis or personal ignominy. The MMB pioneers were against unnatural purpose-made exercise machinery, which was viewed as unnecessary and even dangerous. An exception was Pilates and his equipment. However, the revolutionary devices were designed (and succeeded) to improve the effect of Contrology exercises and philosophy, and to enhance the method’s natural experience and acceptance.
Cardiovascular activity. Start by doing an aerobic activity, like walking or running, for a sustained 20-30 minutes, four to five times a week, says Bryant. To ensure you're working at an optimum level, try the "talk test": Make sure you can carry on a basic level of conversation without being too winded. But if you can easily sing a song, you're not working hard enough.
We've said it before, but HIIT really does the job when you want to trim ab fat: A study published in the Journal of Sports Medicine and Physical Fitness found that people who did two HIIT and two strength sessions a week lost more visceral fat (11 percent of the dangerous kind around your organs)—about an extra inch from their waist—than those who ran twice and did two strength sessions. Plus, many of those speedy intervals, such as sprints, are total-body moves that engage your abs big time. Do speed bursts on a cardio machine or try three-minute boxing rounds (another transverse tightener) with a minute of active recovery in between. This unique HIIT workout incorporates some boxing moves and some weight training for double the benefits. (Don't get along with HIIT training? Studies show adding music will make it more enjoyable.)
Leg muscle pain, defined as “the intensity of hurt that a subject feel in his quadriceps muscles only” , was measured during the incremental test (at the end of each minute) and during the time to exhaustion tests (at the end of the warm-up and every 30 s) using the Cook scale . Standardized instructions for the scale were given to each subject before the warm-up. Briefly, subjects were asked to rate the feelings of pain specifically in their quadriceps and not to report other pains they may have experienced (e.g., seat discomfort). Subjects were also asked to not use this rating as an expression of perceived effort .
In addition to determining the optimal position from which to initiate an exercise based on the patient's related impairments and level of pain, exercise dosage and progression are important aspects of a rehabilitation program. Intervention details, such as number of repetitions and sets, exercise order, and work-to-rest ratios, should be tailored to each patient based on his or her specific needs. The proposed protocol does not describe a method to determine the initial exercise intensity or the criteria for modification or progression. Using a criterion-based method to determine the initial intensity and progression would individualize these guidelines of the exercise program. In their randomized controlled trial designed to address the effectiveness of exercises to treat RCIS, Lombardi et al6 used a 6-repetition maximum load to establish the starting intensity of strengthening exercises. They6 also recommended a reevaluation every 2 weeks to make necessary adjustments to exercise intensity. Although we do not know whether the 6-repetition maximum-load criteria used in their study is optimal, it is an excellent example of a criterion-based method to determine initial exercise intensity and progression. Future research on exercise for the treatment of RCIS should include criterion-based methods to determine the optimal exercise dosage and progression.
The overhead squat requires strength and flexibility. HOW TO DO IT: You can take the bar from a squat rack by snatching it overhead or by cleaning and jerking it. The arms should be wider on the bar, very similar to a snatch grip. The feet should be a little outside of shoulder-width. Brace your core, and send your butt back into a squat position while keeping your arms locked overhead. A good cue to think of is “show me your pits” or bending the bar, which automatically externally rotates the shoulders and locks them into a strong position. Once you have reached below parallel, drive your knees out, squeeze your glutes and stand the bar back up. MUSCLES USED: Glutes, quads, hamstrings, calves, core, shoulders and back.
^ Jump up to: a b Szuhany KL, Bugatti M, Otto MW (October 2014). "A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor". J Psychiatr Res. 60C: 56–64. doi:10.1016/j.jpsychires.2014.10.003. PMC 4314337. PMID 25455510. Consistent evidence indicates that exercise improves cognition and mood, with preliminary evidence suggesting that brain-derived neurotrophic factor (BDNF) may mediate these effects. The aim of the current meta-analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms. We conducted a meta-analysis of 29 studies (N = 1111 participants) examining the effect of exercise on BDNF levels in three exercise paradigms: (1) a single session of exercise, (2) a session of exercise following a program of regular exercise, and (3) resting BDNF levels following a program of regular exercise. Moderators of this effect were also examined. Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise (Hedges' g = 0.46, p < 0.001). Further, regular exercise intensified the effect of a session of exercise on BDNF levels (Hedges' g = 0.59, p = 0.02). Finally, results indicated a small effect of regular exercise on resting BDNF levels (Hedges' g = 0.27, p = 0.005). ... Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans.
Raphael AJ. Natural childbirth in twentieth century England; PhD thesis. London: Queen Mary University of London; 2010. To create the method, Randell, (whose brother Francis William Randell and wife Jessie experienced two failed births in 1907 and 1913)24 Wildings & Thurleys, Cantophers & McConnells [Internet]. Hatches, matches and dispatches only. 2008 Nov 11 [cited 2015 Sep 23]. Available from: http://website.lineone.net/~hstjw/p32.htm#i549. [Google Scholar] was inspired by Ling’s philosophy and exercises of preventative medicine.22 Polden M, Mantle J. Physiotherapy in obstetrics and gynaecology. 2nd ed. Oxford: Butterworth Heinemann; 2004. [Google Scholar] Her repertoire included full-body movement exercises in the lying, sitting, and standing positions.25 Randell M. Training for childbirth from a mother's point of view. 4th ed. London: J. & A. Churchill Ltd.; 1949. [Google Scholar] The objectives of the pre-natal exercises were ‘to improve the physical and mental well being of the patient – encourage a cheerful and confident outlook towards her confinement and so to help herself effectively during labour’. Pre-natal training included education, stretching, relaxing, and deep breathing with many free arm movements to improve circulation. The daily home exercises were designed to improve muscle tone, increase flexibility, and control of movement. The post-natal exercises were designed to improve the condition of relaxed muscles, in particular the abdominal muscles, so that the figure is restored to normal after confinement.26 Wellcome Library [Internet]. Rodway H. Training for childbirth - and after (1940). 2015 Sep 24 [cited 2015 Oct 3]. Available from: http://wellcomelibrary.org/player/b16729006#?asi=0&ai=0. [Google Scholar] As a reflection of the women’s suffrage movement, Randell encouraged female students to use their knowledge and healthy physical ability to gain self-empowerment and help others to do the same. She encouraged women to teach spouses to perform and to teach the exercises calmly and confidently; to reinforce the teamwork between parents and to be of practical assistance during childbirth.25 Randell M. Training for childbirth from a mother's point of view. 4th ed. London: J. & A. Churchill Ltd.; 1949. [Google Scholar]
Choose clothes that suit your activity. In general, wear clothes that won’t restrict your movement or blood flow. For some forms of exercise, like biking, you might want to wear form-fitting clothes, but they still shouldn’t be too tight. Looser workout clothes are better for strength training, brisk walking, and sports such as basketball or soccer.
Ken Hutchins' analysis is not just book theory; it is based on real experience training many, many thousands of subjects over a span of decades. He trained everyone from amateur and professional level athletes and bodybuilders to little old ladies with osteoporosis and also a great many genetically normal/average folks. He assisted Arthur Jones and Ellington Darden at Nautilus Sports Medical Industries where he first refined the Superslow method during a 5 years long clinical trial, the Nautilus Osteoporosis Study at The University of Florida Medical School in Gainesville (the study is mentioned in chapter 8 of the 1990 edition of "The Nautilus Book" by Ellington Darden, a book I highly recommend for beginning HIT practitioners). Hutchins' writing is as dry and clinical as one would expect to find in any textbook about medicine or engineering. It is also filled with rich insight into the intellectual processes and long history of carefully controlled experiments at Nautilus (and later Hutchins' own facilities) that brought Ken Hutchins to his current level of knowledge. His understanding of anatomy, biology, physics, engineering, psychology, history and sociology are all put to good use in this book and should enthrall any reader that possesses solid critical-thinking skills. Understanding the arguments for a distinction of "Exercise vs. Recreation", "The First Definition of Exercise" and "Requirements for Functional Ability" are crucial for everyone that cares even the slightest about the subject of human health, fitness, longevity or quality of life. These are not trivial matters.