OVERCOMING
THE GLOBAL BURDEN OF DISEASES
OF AFFLUENCE;
THE ROLE
OF PHYSIOTHERAPY
A Paper
Presented to
The Association of Senior Civil Servants of Nigeria, Bayelsa State Chapter,
On the
event of her 2014 Annual Seminar (11th December, 2014 :: 10:00 am)
At NUJ Press Centre, Yenagoa LGA, Bayelsa State.
By
NYSC Corp
Member :: BY/14A/0222 :: Onyeso K.K. Ogochukwu (08060905846::kzetfrank@yahoo.com)
Physiotherapy
Department, Government House Clinic, Yenagoa.
Introduction
A sedentary lifestyle is undeniably
an environmental disease in its own right-with countless unpleasant signs and
symptoms, which all leads to early grave.1 Diseases of affluence is
mostly chronic Non Communicable Diseases (NCD) and other physical health
conditions for which personal lifestyle and socioeconomic condition are
believed to be an important risk factors.2 Initially it was thought
to be a disease of the rich; who eat a lot of junks, take high caloric drinks
and relax under excess comfort and luxury, wallowing away in inactivity. Recently
the thinking has changed. It was perceived that these conditions dwell more
among the poor, especially in the developing countries of Africa.
Statistically, every week spent inactive is roughly equivalent to smoking a
packet of cigarettes.3 However, unlike smoking, sedentary lifestyle
leads to more than 40 medically recognized chronic diseases, such as coronary
heart disease, diabetes type 2, hypertension,
stroke, dementia, cancer and obesity.1 It also leads to reduces
quality of life and perhaps most importantly unhappiness. Physical inactivity is the 4th leading
risk factor for global mortality, patients deserve to know the facts, 3 frequent and
regular exercises boost the immune system and helps prevent the diseases of
affluence. 4 The solutions lie within our whims and caprices as
Physiotherapists to prescribe suitable aerobics and the readiness of our
clients to change lifestyle. Aerobic exercise is any physical activity that
uses large muscle groups and causes the body to use more oxygen than it would
while resting5. Aerobics include: cycling, swimming, brisk walking,
skipping rope, rowing and hiking. The goal of aerobic exercise is optimum
cardiovascular health.
(Key Words:
Diseases, Physiotherapy, Exercise, Aerobics)
Exercise and Health
Physical
exercise is important for maintaining physical fitness, healthy weight,
building and maintaining healthy bone density, muscle strength, and joint
mobility, promoting physiological well-being, reducing surgical risks, and
strengthening the immune system. Developing research has demonstrated that many
of the benefits of exercise are mediated through the role of skeletal muscle as
an endocrine organ. That is, contracting muscles release multiple substances
known as myokines which promote the growth of new tissue, tissue repair, and
multiple anti-inflammatory functions, which in turn reduce the risk of
developing various inflammatory diseases7. Physiotherapists have
both ethical and legal obligation to assess and prescribe exercises, inform
patients of the risks of inactivity and recommend proper amounts of physical
activity essential to health. The benefits of exercise in the prevention and
treatment of disease has been clearly established. Irrefutable evidence for
exercise in the primary and secondary prevention of: diabetes mellitus, 4
cancer (breast and colon), 6 hypertension, 3, 5
depression, osteoporosis, dementia and coronary artery disease3.
There is a linear relationship between physical activity and health status.
Inactivity is a powerful and modifiable risk factor for chronic disease and
premature death.
Exercise is
medication: Physiotherapists should prescribe it, Patients should take it!
Exercise
is the long sought vaccine to prevent chronic disease and extend life. If we
had a medication that conferred the proven health benefits of exercise,
physicians would prescribe it to every patient and healthcare systems would
find a way to make sure every patient had access to this wonder drug3.
Unfortunately, it does not exist. Exercise is the only way.
Why Has the Medical Community Neglected Physical Activity as a Treatment?
It is
easier for physician to issue a prescription to reduce BP, cholesterol or
glucose. Medication adherence is very low (1 in 6 take meds as prescribed).
Reliance on pills transfers responsibility for health to doctor resulting in
lower patient physical activity. Why not refer to a physiotherapist? There is
widespread presumption that it is hard to change physical activity habits.
However, evidence exist that brief counseling and pedometer programs can
increase physical activity3. Use of physical activity as vital sign
to remind all patients to get 30 minutes of moderate exercise, 5 days per wk.
Message should be the same from every medical provider. We must begin to merge
the fitness industry with the healthcare Industry. We should take the massage
to firms, industries and offices.
The Exercise Prescription “Think
FITT”
F = Frequency: Most days of the week; 3-5 or more.
I = Intensity: Moderate; 50-70% of max HR or use
“Borg scale” test.
T = Type: Aerobics.
T = Time: 30 minutes.
• 150 min per week is goal – not
starting point; so start small:
• 1-2 days per week
• Three 10-min bouts
• Simple recipe for getting your
exercise:
• AM; park car 10 min from office, walk
in
• Lunch; walk 5 min out, eat, walk back
• PM; Walk 10 min back to car
• Breaking Down the Barriers
• Make weekends count!
• Change mindset; weekends are for
fitness
• Walk 60 min on Sat or Sun, only need
90 more minutes during week
• Bump up the intensity!
• 25 min of vigorous exercise (jog)
done 3x per week
• 30 min of moderate (brisk walk) done
5x per week
• More ideas:
• Find an exercise partner
• Get good shoes and nice workout
clothes
• Set goals (fun run or walk, sprint
triathlon)
Common Barriers to Exercise
Competing demands (work/kids/spouse), not enough time, too
tired, physical limitations, too boring, sedentary habits, breaking down the
Barriers, make exercise a habit, not an option.
Summary
Physical
inactivity is the major public health problem of our time. Physiotherapists
have a responsibility to assess lifestyle, inform patients of risk and
prescribe proper exercise. An Exercise Vital Sign is an easy way to bring a
discussion on physical activity into the exam room3. Even brief
advice can have a significant affect. Exercise is medication that we need to
take and get patients to take!
References
1. Weller,
R. & Stamatakis, E. (2011). Laziness will send us to an early grave. BBC
NEWS, Health. Retrievable on: m.bbc.com/news/health-11442101.
2.
Ezzati,
M., Vader, S. & Lawes, C.M. (2005). ‘’Rethinking the ‘diseases of
affluence’ paradigm: global pattern of nutritional risks in relation to
economic development”. PLoS Med. 2 (5): e133.
3.
Sallis,
R.E. (2011). Exercise Is Medicine:
Understanding and Utilizing the Health Benefits of Physical Activity. ACOFP 48th
Annual Convention and scientific seminars. March 17-20. San Antonio. Texas.
4.
Manson,
H.F.B., Stampfer, J.E., Colditz, M.J., Liu, G., Solomon, S., Willett, C.G.
(2001). "Diet, lifestyle, and the risk of type 2 diabetes mellitus in
women". The New England Journal of Medicine 345 (11): 790–797.
5.
Wilmore
J., Knuttgen H. (2003). "Aerobic Exercise and Endurance Improving Fitness
for Health Benefits". The Physician and Sportsmedicine 31 (5): 45.
7.
Muscle
as a secretory organ. Pedersen BK. American Physiological Society. Compr
Physiol 3:1337-1362, 2013. http://www.inflammationmetabolism.dk/index.php?pageid=21&pmid=23897689
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