It is common knowledge that exercising is good for us and that being physically active brings health benefits. It’s no surprise that it is now prescribed by specialists the same way that doctors prescribe medicine. It enhances our physical health as well as our mental wellness and it is therefore recognized as a valid solution and alternative to medications.
But what does “exercise as prescription” really means and why do specialists resort to it?
What does “exercise as prescription” means and what can it treat?
The expression “exercise prescription” is used when a fitness or rehabilitation specialist develops a specific plan of fitness-related activities for a client or patient for a specified purpose. Because the plan is tailor made, specific and unique needs as well as interests of the client or patient are taken into account focusing on motivation and customization, hence making goals more achievable, successful and beneficial.
Today, many doctors and physiotherapists believe regular exercise can be extremely beneficial against a variety of debilitating diseases and conditions such as:
- Obesity
- Diabetes mellitus
- Hypertension (high blood pressure)
- Peripheral artery disease (PAD)
- Coronary heart disease
- Decreased muscle mass
- Decreased bone density
- Osteoarthritis
- Asthma
- Depression
However, it is important to point out that when a fitness or rehabilitation specialist prescribes exercise to a client or patient, to unlock the full beneficial effects to body and mind, it should go hand in hand with a healthier diet rich in fruits and vegetables and work alongside a strategy to manage stress and enhance inner happiness. This is why at Wellness & Purpose we believe that it’s very important to achieve balance between the four pillars: exercise, nutrition, Cognitive Behavioural approach and financial independence.
Exercise prescription in history
Hippocrates (c. 460 – c. 370 BC) was a famous Greek philosopher and physician of his time. He wrote the Hippocratic Oath, which serves as a foundation for the laws that define good medical practice and ethics such as doctor-patient confidentiality, the responsibilities a doctor should have regarding patients and the duty to treat anyone whether rich or poor. He earned the name “Father of Medicine” and is credited with the quote “Walking is a man’s best medicine”. He believed and argued that disease was not a punishment inflicted by the gods but rather the product of environmental factors, diet, and living habits and that walking and other forms of exercise could prevent and treat disease. (Well done to Hippocrates and shame on modern society for failing to remember that!)
William Heberden (1710 –1801) was an English physician who’s contributions to the medical knowledge of angina pectoris has been hugely impactful. In one of his studies he observed that in patients who had suffered from coronary diseases the prescribed bed rest and limited physical activity actually increased sickness and even mortality. Curiously, he observed that in one patient who had suffered from angina, his condition improved by chopping wood half an hour per day.
Despite this very interesting early data, no much further research or changes took place back then. If you had had a coronary event in the 1930s, you would have likely been prescribed six weeks of bed rest and had you lived in the 1940s you would have been permitted to sit on a chair and after a month, with no further complications, to walk for five minutes.
It was only in the 1990s that a shift came about, when healthcare professionals started to explore and recommend physical activity in order to improve one’s health. A big push came from the American Heart Association (AHA) who reported sedentary lifestyle as the fourth major contributor to coronary heart disease (CHD).
However, for a long time, healthcare professionals still viewed moderate physical activity with scepticism preferring and recommending mainly vigorous physical activity and promoting a prolonged continuous session over small amounts of exercise during the day to be effective. It was in 1995 that the common recommendation changed when the advice for adults became 150 minutes of moderate to vigorous physical activity a week (for example: 30 minutes, 5 days a week).
Despite the evidence and amount of data that we have today, it is somewhat astonishing and baffling that the concept of exercise as prescription to improve a client or patient’s physical and/or mental well-being is still overlooked or even seen with aversion.
How much exercise is recommended?
Being physically active is not beneficial just to the ones that have a particular condition and have been prescribed exercise by their fitness or rehabilitation specialist. Being physically active is beneficial to all.
The current medical advice is that regular physical activity is an effective way of preventing diseases as well as premature death. This is true for people of all ages including people with disabilities and chronic illnesses.
There is no set formula to fit all. The amount and type of exercise depends on our age, general health (whether we have any medical history or condition), our goals and… also… our preferences and interests. The best type of exercise is the one that is tailor made to our needs but the good news is that any physical activity is better than none so even if you can’t afford a personal trainer, don’t be discouraged.
The general rule is that, if maintained, 150 minutes of moderate to vigorous physical activity a week (for example: 30 minutes, 5 days a week) should enable a person to attain most of the health benefits. Evidence shows us that 30 minutes of exercise 5 days a week is better than 30 minutes of exercise 3 days a week but it also shows us that a 10 minutes vigorous intensity session is better than a 10 minutes moderate intensity session.
Exercise blockers
So why is it so difficult to follow the recommended guidelines for physical activity despite the evidence showing the many benefits to body and mind?
First of all, if is very difficult for people with inactive lifestyles to start implementing regular exercise. This is because on top of the physical hardship (physical activity is hard work, muscles can become sore and painful, etc) there is also a mental block (feeling embarrassed, not knowing what routine to start with, busy schedules, previous failed exercise attempts, lack of motivation, not seeing changes, feeling stressed or anxious and having a limited budget to name a few). Furthermore, health improvements are usually more visible at the beginning, making it disheartening when small results are achieved after regular exercise.
The good news is that exercise should not cost a fortune and if motivation or questionable surroundings is your problem or if you are feeling low, we have tips for that too!
Exercising with chronic illnesses
In the past, people who were being treated for long term chronic illnesses such as diabetes or cancer, were often advised to reduce their physical activity and rest. Nowadays, thanks to newer research and evidence, the advice is that it’s best to rest if movements causes pain, rapid heart rate or shortness of breath. Otherwise, exercise is recommended as it can improve physical functionality as well as mental well-being resulting in a better quality of life.
Studies have shown that lack of exercise has devastating effects that can lead to reduced range of motion, muscle weakness and loss of body function. This is why nowadays many cancer care teams are urging their patients to be as physically active as possible during and after cancer treatment. In a study that followed cancer patients undertaking exercise as prescription during and after cancer treatment, patients reported positive physical effects as well as mental effects (i.e. a feeling of positivity and enjoyment, a return to normality and control). It is however very important to remember that, as cancer treatments have huge knock off effects on the level of physical and mental energies, it is important to work with and be supervised by qualified specialists who can offer advice on the type and frequency of the physical activity to help patients start exercising again.
Conclusion
Prescribing physical activity is more than ever used today by fitness or rehabilitation specialists in order to improve a client or patient’s physical and/or mental well-being. In the right dose, physical activity can help to prevent, treat, and manage a range of chronic health conditions that increasingly impact the quality of life and physical function of the individual. However, despite the large amount of evidence and data it is still a very much under-utilized tool for improving wellness.
Safe and effective exercise prescription requires careful consideration for the target individual’s health status, baseline fitness, goals and preferences but, overall, it has been proven to bring many benefits.
Furthermore, evidence shows that being physically active is not beneficial just to those with specific physical and/or mental conditions, but beneficial to all reminding us that exercise should be welcomed like a good friend!
