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exercise prescreption

by Dr.Sami alzahrani
by

Sami Moqna

on 26 November 2013

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Transcript of exercise prescreption

Do you exercise?!
How many times a week ?
What type of exercise do you prefer?
Exercise Prescription
Dr. Sami Hamdan Alzahrani

Objectives
Definitions of basic exercise terms.
Its Importance.
Benefits of Exercises.
Current Exercise Recommendations.
What is an exercise prescription and how do you write one.( F.I.T.T. principle ).

Definition
Physical activity and Exercise are not similar terms:
Physical activity

is defined as bodily movement produced by the contraction of skeletal muscle that increases energy consumption above the basal level.
The term "Exercise"
is a form of physical activity that is planned, structured, repetitive, and purposeful.
Do your patients have symptoms of exercise deficiency?
Low mood.
Poor self esteem.
Weight gain.
Poor sleep.
Muscle wasting.
Constipation.
Cognitive decline.
In practice of
10,000
patients, about
6,600
will require exercise.
If Exercises were
a drug would you prescribe it for your patients?!
BENEFITS OF EXERCISE
35%
reduced risk in CVD, CHD and Stroke.
35%
reduced risk in type 2 Diabetes.
35%
reduced risk in Hip Fracture.
80%
reduced risk in Disability from Osteoarthritis.
30%
reduced risk of Colon cancer.
20%
reduced risk in Breast cancer.
reduced risk of Alzheimer's Disease.
30%
reduced risk of Death Comparing most active with least active.
BENEFITS OF EXERCISE
Reduces
All-Cause Mortality 30% (Inactivity is Attributable risk for all-cause mortality )
Reduces
Hypertension (Cohort studies; inactive individuals have a 35% to 53% greater risk of developing hypertension)
Reduces
Dyslipidemia (increase HDL and decrease TG & vLDL)
Reduces
Obesity (Physically active people are less likely to gain weight)
improves
Mental Health (Reduces anxiety and depression)
www.uptodate.com
www.uptodate.com
Diabetes
The relative risk
reduction
for developing diabetes in Patients with impaired GTT :
Exercise:
51%
Diet:
30%
Diet and Exercise:
51%
Anti-diabetic drugs:
30%

Exercise delays the onset of diabetes for
average of 6.3 years.
Hip Fracture
160 women, half prescribed exercise, half control group; followed for 7 years:
Salkeld et al BMJ 2000; 211:14
Exercise Group
:
0
hip fractures.
Death rate =
0.003
/1000/year
Control Group
:
5
hip fractures.
Death rate =
0.03
/1000/year
Gillies et al BMJ 2007; 334:19
Li g. Lancet 2008; 371:1783-89
" If we had a pill that conferred all the proven benefits of
exercise
, Physicians would
prescribe
it to every patient and our healthcare system would find a way to make sure every patient had access to this
wonder drug
"
So,,,
Exercise
is a
Medicine!
EXERCISE PRESCRIPTION
EXERCISE PRESCRIPTION
Exercise

parameters
Frequency
Intensity
Types
Time or Duration
2 hours and 30 minutes (
150
minutes)

of
Moderate-Intensity Aerobic Activity
(i.e., brisk walking) every week
AND
Muscle-Strengthening Activities
on
2
or more days a week
that work all major muscle groups
http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html
EXERCISE PRESCRIPTION
EXERCISE PRESCRIPTION
1 hour and 15 minutes (
75
minutes)
of
vigorous-intensity aerobic activity
(i.e., jogging or running) every week
OR
Muscle-Strengthening Activities
on
2
or more days a week
that work all major muscle groups

AND

150 minutes
each week sounds like a lot of time, but you don't have to do it all at once.
Not only it is best to spread your activity out during the week, but you can break it up into smaller chunks of time during the day. As long as you're doing your activity at a moderate or vigorous effort for at least
10 minutes
at a time.
There are
1,440 minutes in every day
. So schedule 30 of them for physical activity!
http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html
EXERCISE PRESCRIPTION
"Approach"
Assess exercise habits at every clinical visit:
every
patient -
every
visit -
every
treatment
Record physical activity as a
"vital sign"
On average how many days per week do you engage in moderate or greater physical activity ?
On those days how many minutes do you engage in activity at this level?
I don't have time
How to Approach Roadblocks
We’re only talking about three 30 minute sessions each week.
Can you do without three television shows a week?
EXERCISE PRESCRIPTION

I am usually too tired to exercise
How to Approach Roadblocks
Regular activity will improve your energy level. Try it and see for yourself

The weather
is too bad
How to Approach Roadblocks
There are many activities you can do in your home, in any weather

EXERCISE PRESCRIPTION
EXERCISE PRESCRIPTION

I get sore when I exercise

How to Approach Roadblocks
Muscle soreness after physical activity is common when you are just starting. It should go away in 2 to 3 days.
EXERCISE PRESCRIPTION

I do not enjoy exercise
How to Approach Roadblocks
Don't “exercise.” Start a hobby or an enjoyable activity that gets you moving
EXERCISE PRESCRIPTION
Exercise in Diabetes Mellitus
“Benefits”
Control hyperglycemic events.

Improves peripheral insulin sensitivity.

Promotes weight reduction.

These effects are lost if exercise is discontinued for more than 3 days.

Be Aware of Hypoglycemia S&S:-
shakiness, feeling lightheaded, weak, or confused; or extreme hunger.
Solutions:
Monitor the blood glucose level.
Don’t exercise on an empty stomach.
Avoid exercising too close to bedtime.
Adjust medications if there are episodes of low blood sugar before, during or after exercise.
Finally,
Exercise is
the best Medicine

and we must prescript it to all patients.
Exercise Prescription
Dr.Sami ALzahrani

Did you ever prescribe exercise for your patient?
Royal College of Physicians (Physical activity recommendations jun 2012)
A cross-sectional study of 2176 adult Saudis in Al-Hassa, Saudi Arabia, attending urban and rural primary health care centers concluded that the prevalence of physical inactivity is

80% in Adult Saudis.
( Al Khoudair AS, Al Harbi MA PMID: 22502700 [PubMed - indexed for MEDLINE] )
(A cross-sectional study of 1616 Saudis in Riyadh, Saudi Arabia by Hazzaa Al-Hazzaa KSU-Exercise physiology Lab)
(A cross-sectional study of 1616 Saudis in Riyadh, Saudi Arabia by Hazzaa Al-Hazzaa KSU-Exercise physiology Lab)
Physical intensity
Metabolic Equivalents (METs) are commonly used to express the intensity of physical activities.
MET is the ratio of a person's working metabolic rate relative to their resting metabolic rate.
when being moderately active (3-6 METs) and more than six times higher when being vigorously active (>6 METs).
Physical intensity
WHO 2013
WHO 2013
Supervisor
Dr.Fayza Rayes
Full transcript