Exercise therapy – the public health message

Abstract

Non-communicable chronic diseases (NCDs), such as cardiovascular disease, diabetes, and cancer, are currently responsible for 65% of all deaths worldwide and are projected to cause over 75% of all deaths by 2030. A substantial accumulation of epidemiological and experimental evidence has established a causal relationship between NCDs and well-known yet preventable risk factors (e.g., physical inactivity and obesity). Given that physical activity has both direct and indirect effects on the mortality and morbidity of NCDs via other risk factors (e.g., obesity, diabetes, and hypertension), it is now undeniable that sedentary lifestyles are one of the most significant public health problems of the 21st century. In 2007, the American College of Sports Medicine (ACSM) and American Medical Association (AMA) launched the Exercise is Medicine® (EIM) initiative in recognition of the fundamental importance of physical activity to health and well-being. EIM is on the forefront of a global movement to reduce sedentary lifestyles, foster implementation of exercise counseling into clinical practice, and disseminate exercise therapy on a global scale. If the devastating human losses and financial burden of inactivity-induced chronic disease are to be ameliorated, the wide-ranging cost-effective health benefits and financial feasibility of physical activity interventions must be appreciated and promoted.

Sport and exercise as contributors to the health of nations

“…48 We appreciate the need for ongoing transformational change in training of clinicians with respect to the greater evidence that now exists for exercise as therapy. 32 We also support calls for changes in systems for delivery of medical care so that physical activity counselling and referral are expected, documented, and reimbursed.…”

“…30 By contrast with sport as a means of health and social development, the health benefi ts of exercise are very well documented. 19,32 Especially cogent summaries have been published in the Swedish Physical Activity book, 33 the Physical Activity Guidelines for Americans, 34 and elsewhere. 19 The data for benefits of exercise are not reviewed here, but serve to underscore the potential benefits to population health through sport and exercise.…”

La Actividad Física en El Currículo Universitario Español De Los Grados De Medicina Y Ciencias De La Actividad Física Y Del Deporte Como Recurso en La Prevención Y Tratamiento De Las Enfermedades Crónicas

“…Por cualificación académica y profesional, los médicos especialistas en medicina del deporte son los profesionales más preparados para evaluar la condición física de los pacientes y prescribir programas de ejercicio físico que deberán desarrollar los profesionales de CAFYD. Las prescripciones individualizadas sobre cada persona con una ECNT deben incluir el tipo, la carga y la periodicidad del ejercicio físico a realizar, para utilizar el ejercicio físico como instrumento preventivo y de tratamiento en lugar de emplear consejos generalizados para la amplia gama de pacientes que poseen los centros de Atención Primaria (36). En España, se han desarrollado programas preventivos educacionales para adecuar y aumentar la práctica de ejercicio físico en pacientes con diabetes tipo II que han tenido resultados satisfactorios (37).…”

Promoting physical activity for health. A survey of knowledge, confidence and role-perception in final-year UK physiotherapy students

“…Reduced regular physical activity is established globally as a significant independent risk factor for a range of chronic conditions including coronary heart disease, type-2 diabetes, and some cancers. Sedentary lifestyles are set to contribute to one of the most significant public health problems of the 21st Century [5].…”