Common Names
- Walking
- Swimming
- Biking
- Rowing
- Dance
- Resistance training
- Low-intensity aerobics
- Movement practices like tai chi and yoga
For Patients & Caregivers
Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.
What is it?
Because low-intensity exercise is low-impact, it avoids stress on the joints while still providing therapeutic benefits that come from deeper breathing, coordinating movements, and other forces like weight and resistance. Although it may take longer to see results with low-intensity over high-intensity exercise for things like weight loss or physical conditioning, these activities have important added benefits like reducing risk for injury and helping to improve mobility, stamina, and stability. For example, because resistance training increases strength, it improves balance which reduces fall risk.
What are the potential uses and benefits?
Anxiety and mood
In patients receiving chemotherapy, home-based low-intensity exercise improved anxiety and mood, especially in those who had worse symptoms at baseline.
Balance
Regular practice of yoga and tai chi have been shown to improve balance.
Fall and fracture risk
Activities including walking and tai chi have been shown to reduce fall and fracture risk.
Fatigue
In a study of cancer survivors, light-intensity activity improved fatigue, cardiorespiratory fitness, and physical functioning, while slowing functional decline.
Heart health
Regular physical activity is known to benefit heart health, and emerging evidence also shows light-intensity activity can reduce heart disease risk. Although more study in this area is needed, it highlights the fundamental importance of maintaining regular activity.
Pain and treatment-related symptoms
Clinical trials of yoga and tai chi indicate these practices are useful for reducing pain and inflammation. In patients undergoing chemotherapy, both a low-intensity home-based program and moderate-to-high-intensity exercise improved fitness and functioning, and reduced nausea and pain versus usual care.
Reducing cancer risk
A meta-analysis determined that both light and high-intensity exercise significantly reduced breast cancer risk, although high-intensity exercise was slightly more protective.
Sleep
Regular practice of yoga and tai chi have been shown to improve sleep quality.
What else do I need to know?
What Is It:
Activities done at a comfortable pace such as walking, swimming, biking, rowing, dance, resistance training, using an elliptical machine, other low-impact aerobics, or mind-body movement practices can be considered low-intensity exercise.
Most data are on moderate to vigorous activity, but low-intensity exercise also improves mood, mobility, and cardiorespiratory fitness, while reducing fatigue, pain, and risk for injury.
Certain types of low-intensity exercise like tai chi, qigong, and yoga also reduce fall risk and improve sleep quality in cancer survivors.
Low-intensity exercise can be an important bridge to American Cancer Society recommendations of at least 150 minutes of moderate activity and 2 days of resistance training weekly. And activities can be performed at more intense levels later, as physical condition gradually improves.
Practice, patience, and choosing activities you enjoy can help you stick to your exercise regimens.
Importantly, cancer patients should check with their healthcare professionals about what they can do, what to avoid, and to get appropriate referrals to help maintain or improve physical activity. It’s also important to listen to your body. Exercising with cancer fitness experts and others who have like-minded goals can also help keep up your physical activity safely.
Special Point:
- Low-intensity exercise is always low-impact, meaning it minimizes how much stress you put on your joints. However, not all low-impact exercise is low-intensity. For example, low-impact high-intensity cardio works the heart at a higher rate while still avoiding joint stress.
- Even seasoned athletes regularly use low-intensity exercise to reduce injury risk and prepare the body for more intense activity.
Is It Safe:
Low-intensity exercises are generally safe and appropriate for most fitness levels, with the added benefit of reducing risk for injury and improving recovery time. Patients with joint pain, balance problems, or injuries can particularly benefit from low-intensity forms of exercise. Still, cancer patients who are undergoing active treatment or have just had surgery should check with their healthcare provider to determine when to safely resume activity and which types of exercises are safe to perform.
Who Can Provide this Service:
In addition to physical rehabilitation, hospitals may offer online videos, workshops, or continuing courses with clinical fitness specialists to help patients safely maintain or return to regular activity. These experts may focus on particular areas of concern such as regaining shoulder mobility after surgery, safely increasing flexibility and heart rate, or addressing muscle weakness. Some videos may also demonstrate multiple levels of the same exercise so that both a person who cannot stand and another person who needs more weight resistance can benefit from the same demonstration.
Where Can I Get Treatment:
MSK offers exercise classes at all levels for our patients and caregivers. Free introductory courses to get started can be found on our MSK YouTube Channel. We also offer single and series workshops focusing on specific types of exercise and mind-body practices. And our online membership program, Integrative Medicine at Home, offers low-cost virtual classes to help support the recovery and well-being of cancer patients everywhere.
For Healthcare Professionals
Clinical Summary
Many activities done at a comfortable pace can be considered low-intensity exercise.
Low-intensity exercise can help reduce
- Fatigue
- Pain
- Functional decline
- Fall and injury risk
- Disease risk
It can also help improve
- Balance
- Sleep
- Mood
- Quality of life
- Recovery time
Practice, patience, and choosing more enjoyable activities can help patients stick to their exercise regimens.
Low-intensity exercise and risk reduction
Large cohort studies indicate that regular physical activity including light-intensity activity reduces risks for heart disease, death, and fractures, including hip fractures (1) (2). Even as few as 4400 steps daily was significantly related to lower mortality rates compared with 2700 steps daily, with no clear relation to intensity (3). Other epidemiological studies indicate that after adjustment for total daily steps, greater step intensity was not significantly associated with lower mortality (4). In addition, higher amounts of leisure-time physical activity in later adulthood were associated with lower mortality, suggesting that midlife is not too late to start exercising (5).
Reduced fall risk, pain, and inflammation + better sleep
For older adults with low levels of physical functioning, low-intensity exercise can also help reduce fall risk (6) (7), and a large study supports walking for exercise in people with knee osteoarthritis to reduce and prevent knee pain (22). In addition, clinical trials of yoga and tai chi indicate these practices are useful for improving sleep and reducing inflammation and pain (8) (9) (10) (11) (12).
Additional improvements for cancer survivors
In a trial of patients receiving chemotherapy, walking and resistance training improved anxiety and mood, especially among those with worse symptoms at baseline (13). Light-intensity activity also improved fatigue, cardiorespiratory fitness, and physical functioning, while slowing functional decline (14) (15), and like higher intensity exercise, can reduce nausea, pain, and time to work return (16).
Some measures like hand-grip strength, lower body muscle function (17), and health-related quality of life (23) were also similar across exercise intensities, although higher intensity exercise had larger long-term effects and is slightly more protective against breast cancer risk (17) (18).
An important bridge for recovery
Even as most evidence has focused on moderate to vigorous activity for cancer prevention, low-intensity exercise can be an important bridge to American Cancer Society recommendations of at least 150 minutes of moderate activity and 2 days of resistance training weekly, to help maintain independence, improve blood flow, and reduce muscle wasting, fall risk, and injury (19) (20).
Reaching and engaging high-risk patients
More studies are needed on how to reach and engage high-risk patients (24). In a pilot of mindful walking (MFW) and moderate walking (MW) for breast cancer survivors, different inner resources appeared to be accessed: MFW encouraged a conscious, mindful, self-caring approach, while MW strengthened self-efficacy and empowerment (25). A cultural dance program to reduce CVD risk among Native Hawaiians with uncontrolled hypertension had high retention and greater risk reduction versus education-only waitlist control (26), suggesting culturally-based versus medical or behavioral interventions are more likely to resonate and be sustainable.
Making it stick and avoiding injury
Practice, patience, and choosing more enjoyable activities can help patients stick to their exercise regimens. Importantly, cancer patients should receive guidance from their healthcare professionals about what they can do, what to avoid, and appropriate referrals to help maintain or improve physical activity. Patients should also be encouraged to develop awareness of and listen to their body. Exercising with cancer fitness experts and others who have like-minded goals can also help patients keep up physical activity safely.
Purported Uses and Benefits
- Anxiety
- Balance
- Fall prevention
- Cancer risk
- Fracture risk
- Fatigue
- Heart health
- Mood
- Pain
- Sleep
- Treatment-related symptoms
Mechanism of Action
Most studies have focused on moderate to vigorous physical activity (PA), so research on mechanisms behind low-intensity exercise is limited but emerging. In a large prospective cohort of older women, light PA measured by accelerometry was associated with a dose-responsive, independent reduced risk of CHD and CVD events (1). Biological plausibility for these associations have also been suggested by a large cross-sectional study in race- and ethnically-diverse older women, where even after adjustment for intensity and other confounders, lighter intensity PA was still associated with benefits in cardiometabolic markers such as high-density lipoprotein, triglyceride, glucose, C-reactive protein, BMI, and waist circumference (21). In addition, both high- and low-to-moderate intensity exercise can induce benefits on peak oxygen uptake and strength due to the increase in daily activities (17). Regular PA may also attenuate age-related reductions in bone mineral density and improve range of motion and balance to reduce both fall and fracture risk (2).
Mechanisms by which yoga, tai chi, and qigong confer benefits have also been elucidated, and include increased blood flow to the brain, release of endogenous dopamine, reductions in blood pressure, and other therapeutic benefits that come from deeper breathing, coordinated movements, and forces like weight shifting and resistance to improve awareness, postural control, balance, stamina, and strength (see respective monographs).
Contraindications
Although low-intensity exercises are generally safe and appropriate for most fitness levels, cancer patients who have just had surgery or are in active treatment should check with their healthcare provider to determine when to safely resume activity and which types of exercises are safe to perform.
Adverse Reactions
Low-intensity exercises are generally safe and appropriate for most fitness levels, with the added benefit of reducing risk for injury and improving recovery time. Patients with joint pain, balance problems, or injuries can particularly benefit from low intensity forms of exercise.
Practitioners and Treatments
In addition to physical rehabilitation, hospitals may offer online videos, workshops, or continuing courses with clinical fitness specialists to help patients safely maintain or return to regular activity. These experts may focus on particular areas of concern such as regaining shoulder mobility after surgery, safely increasing flexibility and heart rate, or addressing muscle weakness. Some videos may also demonstrate multiple levels of the same exercise so that both a person who cannot stand and another person who needs more weight resistance can benefit from the same demonstration.
MSK offers exercise classes at all levels for our patients and caregivers. Free introductory courses to get started can be found on our MSK YouTube Channel. We also offer single and series workshops focusing on specific types of exercise and mind-body practices. And our online membership program, Integrative Medicine at Home, offers low-cost virtual classes to help support the recovery and well-being of cancer patients everywhere.