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Recommending Physical Activity as PreventionPublished: 2009-12-03 10:51:57By: Will Evans | ChiroACCESS | December 1, 2009 Although a link between chronic disease and lack of PA is well established, many are unaware that chronic spine problems and obesity/sedentary lifestyles are highly co-morbid as well.3,4 Unfortunately, both back problems and physical inactivity are also becoming more and more prevalent in adolescents.5,6 According to one study, PA levels begin to drop sharply in adolescence.6 These declines typically begin in the 7thgrade and progress from there. Even though they may hold the greatest benefits from PA, vigorous levels of exercise decline at a sharper rate than moderate levels in both girls and boys. A recent study on cardio respiratory fitness (CRF) looked at over 3,400 women and 16,800 men.7 This study found PA levels necessary to sustain healthy CRF levels started to decline at an accelerated rate after 45 years of age. Being physically active, not smoking and maintaining a low body mass index were all associated with higher CRF scores across the adult lifespan. According to a study of US women reported on in 2008, 47-62% of premature deaths in America can be attributed to a combination of smoking, being overweight, lack of PA, and low diet quality.8 Additionally, it is estimated that between 164,000-222,000 deaths can be attributed directly to physical inactivity.9 In a 25 year prospective study of over 2,000 men (mean age 72) regular exercise was associated with a 30% lower risk of mortality.10 Authors concluded that enhanced lifespan with good health and functioning during older age (after age 90) was specifically associated with not smoking, blood pressure control, weight management, and regular vigorous exercise. The results indicated benefits of vigorous exercise in those >75 years after controlling for better general health at baseline. It is clear that PA levels must become a routine part of preventive medicine for all health care providers. A recent study of graduating interns found that most (>85%) said they planned to promote health as part of their routine chiropractic practice.11 When asked if they planned on counseling “all patients” on healthy exercise levels, 93% of females and 95% of male interns said they planned to do this. However, a study of patients who had seen medical doctors (MDs), chiropractors (DCs), and physical therapists (PTs) for chronic back or neck pain found that only 48% were prescribed PA. Of those, 29% of patients who saw MDs, 21% of those seeing DCs, and 46% of those seeing PTs said they were provided prescriptions for exercise.12 In an analysis of the National Health Interview Survey (NHIS) looking at a 2005 adult sample and those reporting various health promotion advice as being received from their health care provider, those seeing a DC only within the previous 12 months were more likely to report being physical active than those only seeing an MD.13 They were also less likely to be obese when having only seen a DC. This is in line with a study by Jamison on what DCs seem to be comfortable with concerning health promotion advice where 91% were prepared to offer advice on exercise compared to 35% prepared to offer advice on smoking cessation for example.14 PA levels need to be maintained across the lifespan. All health care providers should do what they can to promote increases in PA for their patients and those patients’ families. The US Department of Health and Human Services’ 2008 guidelines on PA state that there is a direct linear relationship between increasing levels of PA and longevity.15 Most benefits for adults come within 150 minutes of combined PA per week. This can be accomplished with a brisk walk several days a week or with more sustained aerobic activity when indicated. Both PA levels that will challenge muscular fitness and aerobic levels of fitness should be included as well as exercises that strengthen bone health. According to the 2008 Physical Activity Guidelines for Americans (www.health.gov/paguidelines) regular PA can significantly reduce; cardio-vascular disease, stroke, hypertension, diabetes risks, abnormal blood lipids, metabolic syndrome, obesity, musculoskeletal health conditions, and risks of falls in older adults to name a few. Full story |
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