Exercise
is Medicine

APRIL NEWS LETTER

“Movement is a medicine for creating change in a person's physical, emotional, and mental states.”
Carol Welch

INTRODUCTION: Exercise is Medicine® (EIM), a global health initiative managed by the American College of Sports Medicine (ACSM), encourages primary care physicians and other health care providers to include physical activity when designing treatment plans and to refer patients to qualified exercise professionals for evidence-based exercise programs.

The belief that physical activity promotes optimal health, is integral in the prevention and treatment of many medical conditions and should be regularly assessed and included as part of over all health care.

Prescribing physical activity in the right “dosage” is highly effective in the prevention, treatment and management of the most common chronic health conditions encountered. Health care providers, particularly those in primary care, are encouraged to assess patients’ physical activity records during their visits and to conclude the visit with an exercise "prescription" where needed.
In Namibia, Biokineticists are the qualified providers of scientifically based exercise programs. Some patients will benefit from the guidance and monitoring provided by cardiac or pulmonary rehabilitation programs. Other patients need treatment and individualized exercise for musculoskeletal or neuromuscular conditions prior to engaging in a broader physical activity program. The co-work of physiotherapists, occupational therapists and athletic trainers play an important role here.

Exercise is Medicine® Australia published these scientifically based facts on how increased physical activity can benefit health?

  • Reduces mortality and the risk of recurrent breast cancer by almost 50%
  • Reduces the incidence of high blood pressure by almost 50%
  • Lowers the risk of stroke by 27%
  • Reduces the incidence of diabetes by almost 50%
  • Lowers the risk of colon cancer by over 60%
  • Decreases depression as effectively as medications or behavioural therapy
  • Reduces the risk of heart disease by 40%
  • Reduces the risk of developing Alzheimer’s disease by one-third

These are just some of the important benefits of exercise. The list is a lot more extensive when it comes to postural corrections, management of pain, conditions such as arthritis and osteoporosis, sport specific injuries or conditioning, exercising during pregnancy and work-place wellness, to name a few.

In newsletters to follow, the most important conditions to be treated with the contribution of specifically designed physical activity programs will be discussed. The inclusion of exercise and physical activity in a patient’s treatment plan, is scientifically proven to be an integral part of a patients over all well being and quality of life, and it all starts with the prescription to do so.

Arthritis (osteoarthritis) and exercise:
Osteoarthritis (OA) is a common chronic disorder of the joints that predominantly affects older people but can also affect younger individuals following joint injury. In normal joints, cartilage covers the surfaces of the joints and helps to absorb shock and allows smooth movements. In OA, the cartilage of the affected joint wears down until little or none remains, and the opposing bones rub together. This leads to symptoms of pain and restrict joint movement.

How is osteoarthritis diagnosed? A health professional can generally diagnose OA on the basis of reported symptoms and physical examination of the joint. Several tests can aid in diagnosis. X-rays may show narrowing of the joint space (from cartilage loss), bony outgrowths, thickening of the bone under the cartilage or joint misalignment. An MRI (magnetic resonance imaging) scan can demonstrate early changes in the cartilage that cannot be seen on X-rays, and changes in other joint structures such as ligaments. A full blood count might be normal, but these measures can be important to rule out other inflammatory conditions.

How does exercise help? All clinical guidelines recommend exercise to manage OA. Overall, exercise might be as effective in relieving symptoms as are pain medications and anti-inflammatory drugs. However, exercise has fewer side effects. The most basic, but important role of exercise:
  • reduce pain
  • increase muscle strength
  • improve the range of joint motion
  • improve balance
  • improve confidence in body’s abilities
  • prevent de-conditioning (loss of fitness and muscle wasting)
  • improve physical function
  • improve well-being
Osteoporosis and exercise:
Osteoporosis is a condition where bone tissue weakens, so the bones are more likely to fracture. The spine, hips and wrists are most often affected. Osteoporosis will affect around two in three women and one in six men over the age of 60. Gradual bone loss begins around 30-40 years of age. The rate of loss accelerates for women at the time of menopause. Certain medical conditions and lifestyle behavior such as inactivity and inadequate dietary calcium and vitamin D intake also increase the risk. Loss of balance and muscle strength with age and disuse, increases the risk of falls. Many osteoporotic fractures, including over 90% of hip fractures, occur as a direct result of a fall.

How does exercise help?

In children and inactive adults with low bone mass, adding regular exercise improves mass. In normally active adults, exercise helps to prevent typical age-related loss of bone. Exercise can improve the shape and quality of bones to make them stronger. Exercise increases muscle strength and improves balance, which reduce the risk of falling and consequent complications.
How does exercise influence bones? When bones are exposed to loads that are greater than normal, the loaded bone deforms slightly. The slight bending acts as a signal to the bone to modify its shape and/or size so that this additional bending is minimized during future loading, as to prevent injury. Varying the types of loading/ activities is therefore necessary to ensure that exercise continues to stimulate positive bone adaption.

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