Health Programs for chronic diseases

 Exercise is the new pill in medicine

“Do you know a pill that work for :”

    Depression
    Improve the social relationship
    Control cholesterol
    Improve glucose metabolism
    Control blood pressure
    Attenuate the decrease in bone density
    Decrease body fat

Physical activity represents a cornerstone in the primary prevention of at least 35 chronic conditions (Booth et al., 2012). However, over the past two decades, considerable knowledge has accumulated concerning the significance of exercise as the first-line treatment of several chronic diseases.

Nowadays exercise has a role as medicine in diseases that do not primarily manifest as disorders of the locomotive apparatus.

Currently, physical inactivity is considered by the most prestigious researchers in the field of health and sports sciences as one of the main public health problems of the 21st century.

The populations that we call “special,” that is, that have characteristics that differentiate them from others, are very sensitive to inactivity.

Overprotection, fear or ignorance make groups such as diabetics, hypertensive or disabled people sedentary who would benefit greatly from a prescription of physical exercise adapted to their characteristics and possibilities.

The benefits of physical activity on health are evident but, not all population groups respond similarly to exercise, so the intervention can’t be planned in the same way

Our team of experts in Medicine and  Exercise will design the type, duration and intensity of the practice of physical exercise more convenient for each age group or specific population group.

If you suffer a chronic disease susceptible to be under prescription of exercise as part of the treatment visit our section of exercise for chronic diseases.

Prescription of Physical activity for chronic diseases

MENTAL HEALTH

  • Depression
  • Anxiety
  • Stress

Anxiety disorders are the most common mental health problem globally. An estimated 5% of the adult population is currently suffering from morbid anxiety. In the course of a year, approximately 7% of the population will experience some form of anxiety disorder, while 15% will experience having an anxiety disorder during their lifetime. Women experience anxiety twice as often as men, with the exception of obsessive-compulsive disorder (OCD) and fear of illness (hypochondria), where the frequency is the same for both sexes.

The main overall anxiety orders are phobias (agoraphobia, social phobia, and specific phobia), panic disorder, and generalized anxiety disorder. There are also special forms of anxiety such as OCD and posttraumatic stress disorder. Anxiety also appears as a symptom in many different physical and mental illnesses.

The exact causes of anxiety are unknown, but it is often a case of a combination of biological vulnerability and stress during childhood or later in life. The severity of the anxiety may vary over time and spontaneous improvement can occur. Without treatment, many people experience long-term or chronic disablement.

Epidemiological studies indicate that regular physical activity helps to prevent symptoms of anxiety, but there are no studies that shed light on whether a causal relationship exists.

Evidence-based physical training 

A meta-analysis from 2010 comprising 40 studies concludes that physical training reduces symptoms of anxiety in people with chronic illnesses, including cardiovascular disease, fibromyalgia, multiple sclerosis, mental disorders, cancer, and chronic obstructive pulmonary disease (Herring et al., 2010).

Possible Mechanism

During physical activity, the heart rate increases and perspiration occurs. Experiencing these physiological changes in the context of normal physical activity may give the anxious individual the significant insight that a high pulse and sweating are not dangerous.

Type of training

The physical training program must be individualized and supervision is beneficial. Experience derives largely from the field of aerobic exercise. Training is best done in small groups. It is recommended to start with low-intensity aerobic physical activity and steadily increase to moderate intensity, with a gradual increase in duration (Herring et al., 2010).

Patients with anxiety may be taking beta blockers and will therefore not experience an increased heart rate, but can instead be monitored using the Borg Scale.

Supervised progressive aerobic exercise is advantageous.

Examples of aerobic exercise include walking/ running, cycling, and swimming. The physical activity should be monitored so that the patient gradually reaches a Borg Scale of 15–16. Initially, the training should be 12–13 on the Borg Scale for 10–20 min with a gradual increase to 15–16 for 30 min in total.

Contraindications

No general contraindications

Stress is a common occurrence in everyday life and repeated or traumatic stress can be a precipitating factor for illnesses of the central nervous system, as well as peripheral organ systems.

Stress alone is not a disease, but long-term stress can lead to illness.

Thus, severe or long-term psychological stress can not only induce depression, a leading illness worldwide, but can also cause psychosomatic diseases such as asthma and rheumatoid arthritis.

It is difficult to measure stress directly. There are, however, a number of physiological changes in the body that occur when it is exposed to stress.

Typically, it is possible to measure elevated levels of cytokines and stress hormones, such as cortisol and catecholamines, which can then serve as stress markers.

High levels of catecholamines can lead to an increase in blood pressure, while high levels of cortisol in chronic stress may contribute to changes in glucose and fat metabolism, as well as in the coagulation system.

People who feel stressed often have undesirable lifestyles in terms of tobacco smoke, alcohol consumption, diet, and exercise. This lifestyle is probably a major direct reason why an increased risk of cardiovascular disease, is found in people suffering from stress.

 

Evidence-based physical training

There is some, though modest evidence that physical training can have a positive effect on psychological stress symptoms. Physically fit individuals exhibit fewer pronounced signs of the physiological activation associated with psychosocial stress

There are divergent research findings in terms of whether to exercise at a high or moderate intensity to avoid stress, but aerobic exercise seems to have abetter effect than strength training.

(Norris et al., 1990) A systematic Review from 2014 (Wang et al., 2014) (Rogers et al., 1996).

 

Type of training

The physical training program needs to be individualized and should be supervised. The training must involve aerobic exercise that begins at a low intensity and gradually increases to moderate intensity, just as the duration of the physical activity should steadily increase. There is no evidence that exercising at a specific intensity is more beneficial than another.

There is some, though modest evidence that physical training can have a positive effect on psychological stress symptoms. Physically fit individuals exhibit fewer pronounced signs of the physiological activation associated with psychosocial stress

There are divergent research findings in terms of whether to exercise at a high or moderate intensity to avoid stress, but aerobic exercise seems to have abetter effect than strength training.

(Norris et al., 1990) A systematic Review from 2014 (Wang et al., 2014) (Rogers et al., 1996).

Type of training

The physical training program needs to be individualized and should be supervised. The training must involve aerobic exercise that begins at a low intensity and gradually increases to moderate intensity, just as the duration of the physical activity should steadily increase. There is no evidence that exercising at a specific intensity is more beneficial than another.