What’s Up Doc?: Regular exercise can relieve symptoms of chronic conditions

By Medicine Hat News on December 11, 2018.

There is one drug that can be free, safe and readily accessible. It is called exercise. Every person should be encouraged to take this drug to be happy and healthy.

That is the message in an article published in the Canadian Medical Association Journal (Prescribing exercise interventions for patients with chronic conditions, CMAJApril 19 2016)

Experts believe exercise is under prescribed and frequently overlooked often in favour of medications or surgery. Patients find taking painkillers is an easy way out than finding time for regular exercise. We are very busy making a living and raising a family. Finding time for regular exercise means making choices and sacrifices.

What are the benefits of regular exercise?

Studies have shown regular exercise plays a big role in prevention of coronary heart disease, stroke rehabilitation, treatment for heart failure and prevention of diabetes. Benefits of exercise are substantial for conditions that are not life threatening, like chronic back pain and osteoarthritis.

Outcomes for which exercise is effective

The authors of the CMAJ article reviewed evidence for the effectiveness of exercise for the following conditions:

Arthritis of the hip and knee, chronic nonspecific low-back pain, prevention of falls, heart failure, coronary heart disease, chronic obstructive pulmonary disease (COPD), chronic fatigue syndrome, and type 2 diabetes.

Evidence is clear. Exercise helps.

To make sure the exercise program works for a patient the health care provider should monitor the progress in conjunction with the exercise specialist. Without appropriate guidance exercise is unlikely to achieve the desired outcomes.

Not all patients need to see an exercise specialist. Some of these exercises may be prescribed by family physicians. These are largely self-actioned by a patient (for example for falls prevention), whereas other interventions require a referral to a health care professional with expertise in exercise prescription (e.g., cardiac rehabilitation, exercise for chronic back pain or knee osteoarthritis and pulmonary rehabilitation for COPD).

For example, a person with chronic non-specific lower back pain should see an exercise specialist to guide through a properly planned exercise therapy.

According to the CMAJ article, a typical program would comprise 20 hours of individually supervised sessions over 8-12 weeks and a home program.The type of exercise (e.g., yoga v. graded activity) seems less important than the quality of implementation (e.g., supervision, inclusion of a home program and duration of the program have been shown to improve treatment effect).

Exercise programs normally include an education component, incorporation of psychological principles, such as pacing or goal setting, and progress in functional activities, says the article.

The authors believe exercise is an effective but neglected treatment for many chronic conditions. Exercise is beneficial for many chronic conditions and can offer benefits that are comparable to taking painkillers.

Under normal circumstances how much should the average adult exercise every day?

Regular exercise is important for everyone. This is a well-known fact. Everybody knows it. But most people have trouble finding time or are confused about the type of exercise they should do.

It is recommended that adults accumulate at least 2.5 hours of moderate to vigorous physical activity each week and children and youth accumulate at least 60 minutes per day.

Regular exercise strengthens your heart, lungs, bones and muscles. It givesyoumore energy and strength, and helps control your weight and blood pressure. All the things we always want in life … besides money!

Dr. Bharwani is a general surgeon, freelance writer, budding photographer and author of A Doctor’s Journey and Doctor B’s Eight Steps to Wellness. His latest book is available at Shoppers Drug Mart and Coles Book Store (Medicine Hat Mall), Nutter’s (Dunmore Road), http://www.nbharwani.com. You can discuss this column and other columns on his website: nbharwani.com and sign up for RSS feed, Twitter or get on the email list.

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