Exercise
is Medicine

October NEWS LETTER

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

Chronic Heart Failure and Exercise
Chronic heart failure (CHF) is a life-threatening condition that occurs when the heart no longer effectively pumps blood to the lungs and the rest of the body, causing breathlessness, especially during exercise. Poorly managed heart failure may lead to fluid build-up in the lungs, known as acute pulmonary oedema. This requires urgent medical attention. Fluid may also build up in other areas, causing peripheral oedema (e.g. swollen ankles) and venous congestion (e.g. prominent veins). CHF has many causes, the most common being myocardial infarction (heart attack), hypertension (high blood pressure) and diabetes (high blood sugar). How is CHF treated? For people with CHF, a combination of medical and lifestyle management usually reduces symptoms, improves quality of life, slows the progression of the disease and prolongs life. Controlling cardiovascular risk factors is very important to prevent and manage CHF. This includes lowering levels of blood cholesterol and other fats, lowering blood sugar levels and blood pressure, limiting alcohol intake, stop smoking and engaging in daily physical activity. Patients with CHF are prescribed multiple drugs to reduce blood pressure, slow the progression of disease and improve quality of life. Some patients with severe CHF have surgery to reduce the size of a swollen heart or to fit an extra pump to assist the ventricular pump. Patients need to control their salt and fluid intakes and follow a healthy, low-fat, low-sugar diet with plenty of fresh fruit and vegetables.

How does exercise help?

During exercise, there is an increase in cardiovascular function (VO2peak) that is highly linked to improved clinical outcomes; increased muscle strength and endurance; improved ability to function and undertake activities of daily living; improved quality of life and reduced anxiety and symptoms of depression; improved cardiovascular risk by lowering levels of blood cholesterol and other fats, blood sugar and blood pressure; reduced occurrence and severity of the signs and symptoms associated with CHF; and slower rate at which the disease progresses, which reduces both the number of times patients are hospitalised and the death rate.


Falls prevention and Exercise
Adults over the age of 65 have an increased risk of falling, with even higher rates for people in aged-care facilities and hospitals. Falls are also the leading cause of injury-related death and hospitalization in people of this age group. An older person is over three times more likely to be admitted to a nursing home after a fall than before. Falls can result in permanent disability, restriction of activity, loss of confidence and fear of falling, all of which reduce quality of life and independence. Risk factors for falls include:
  • older age;
  • a history of falls;
  • poor balance;
  • slow reaction time;
  • muscle weakness;
  • poor eyesight;
  • reduced sensation in upper and lower limbs;
  • limitations in activities of daily living (e.g. feeding and dressing oneself);
  • medical conditions (e.g. stroke and Parkinson’s disease); and
  • medication use (e.g. drugs that affect the brain).
Why is exercise important?
There is now good evidence that suggest that exercise prevents falls in older people by decreasing a number of key risk factors. For example, exercise can improve muscular strength, improves proprioception and balance, increases confidence and walking speed. There are also psychological factors such as mental ability and mood that are enhanced through becoming active. Exercise is recommended for all community members. However, the benefits of exercise in frailer people are less certain and multifaceted interventions may be necessary for fall prevention in this group.
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