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Fitness & Exercise for Senior Citizens
Some Seniors May Get Prescriptions for Exercise from
Their Physician
New paper urges doctors to play role in getting
patients active
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Walk
around block 2 times per day.....Your Doc |
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April 5, 2007 – Some senior citizens may soon be
getting a written prescription from their doctor that won't cost them or
Medicare a nickel to fill. It will just take a little effort and
determination. Two physicians have written a paper urging other doctors
to prescribe exercise for inactive patients. The paper also presents
some ideas for making it easier for patients to get started.
Physicians and their patients alike know that
physical activity is an important component of a healthy lifestyle, but
what is less clear is what kind of a role doctors should have in
increasing their patients’ activity levels.
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Senior Citizen Fitness & Exercise |
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The new paper by two family physicians from the
University of Michigan Health System provides a practical guide for
primary care clinicians to help their sedentary patients become more
active.
The paper says that physicians play an important
role in communicating the benefits of exercise and encouraging physical
activity among their patients, even though limited data are available to
support a specific approach or to quantify the effect of such
counseling.
“We know from experience that there are a number of
useful strategies for talking to patients about physical activity in a
clinical setting,” says Caroline R. Richardson, M.D., co-author of the
paper, which appears in the current issue of the Journal of Clinical
Outcomes Management.
“The key step is to help patients assess their
current physical activity level and identify those who are both
sedentary and willing to consider starting an exercise program,” says
Richardson, assistant professor in the Department of Family Medicine at
the U-M Medical School and research scientist at the Veterans Affairs
Health Services Research and Development at the VA Ann Arbor Healthcare
System.
Some helpful techniques include specifically making
a connection between the patient’s sedentary lifestyle and medical
problems he or she is experiencing, providing a written prescription for
exercise and following up with patients to make sure they stay on track.
“Sitting still is making people sick. We know that
a sedentary lifestyle contributes to chronic diseases and conditions
such as diabetes, heart disease, obesity, major depression and even some
types of cancer,” says co-author Thomas L. Schwenk, M.D., the George A.
Dean, M.D. Family Medicine Chair at U-M.
“Primary care physicians have a responsibility to
our patients to help them find ways to become active,” Schwenk says,
“and to help them increase their chances of succeeding as they start on
the path toward physical activity.”
Other approaches include a patient-centered
collaboration with the physician and patient working together to create
an exercise plan; empowering patients to take on the responsibility for
beginning an exercise program by highlighting his or her skills and
expertise; and a counseling technique known as “motivational
interviewing,” in which the physician helps patients explore their
barriers to behavior change and to find ways to overcome these barriers.
The paper notes that many people perceive barriers
to exercise, such as lack of time and convenience. Richardson and
Schwenk suggest that physicians can offer the following tips for such
patients:
1. Take a 10-minute walk during your lunch break.
2. Organize a walking group with friends or family members on the
weekends.
3. Walk on a treadmill while watching your favorite TV show.
4. Walk to work, if feasible, or park a mile away and walk in when the
weather is nice.
5. Work out at home with exercise DVDs.
6. Walk inside at a local mall, many of which open early for community
walking clubs. School district swimming pools also may offer community
hours.
7. Explore the cost and availability of private and community-based
recreation facilities.
8. Find a safe building, perhaps at work, with stairwells or longer
hallways that is available for lunchtime walks.
A pedometer, which counts a person’s steps, also
can be a powerful motivator, Richardson notes. Pedometers can help
people to set goals to increase their daily step count, and they also
can be used in the exercise prescription from the doctor to the patient
– e.g. start with 3,500 steps on Monday, Wednesday and Friday, and
gradually increase to 5,000 steps a day, five days a week.
For patients concerned about the possible health
risks of exercising, the authors note that the greatest risk for
cardiovascular events, such as heart attacks, stems from not exercising
rather than pursuing a physical activity regimen.
Walking, for instance, “is a moderate-intensity
physical activity, and, for most patients, screening isn’t necessary
before they begin a walking program,” Richardson says. “Studies have
shown that sudden cardiac death during moderate-intensity physical
activity such as walking is extremely rare, while cardiac arrest among
high-risk patients who remain sedentary is not.”
Richardson and Schwenk also say that screening and
intervention for high blood pressure, diabetes, high cholesterol and
smoking should be done routinely as part of the preparation for starting
an exercise program.
Editor's Notes:
Funding for the paper was provided by a grant
from the National Heart, Lung, and Blood Institute of the National
Institutes of Health, and a program grant from the Robert Wood Johnson
Foundation Physician Faculty Scholars program.
Reference: Journal of Clinical Outcomes
Management, Vol. 14, No. 3, March 2007.
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