Samenvatting Sport & Health
Lecture 1 – Exercise is Medicine
Pandemic
• Physical inactivity should be described as a pandemic in view of the
prevalence, global reach, and health effect.
• Low fitness kills more people than ‘smokadiabesity’; sitting is the new
smoking.
Physical inactivity
• Physical inactivity is a risk for heart disease; sedentary bus drivers and
telephonists were at a higher risk of cardiac events than the more active
conductors and postmen peers.
• Dallas bed rest study; 3 weeks op bed rest caused a decline in VO2max.
3 weeks of bed rest has the same effect as 40 years of ageing.
• Physical activity in hospital:
- 90% of time in room, bed has central position
- 60% of time lying in bed, 35% sitting, and 5% active (standing, walking)
- 67% can move around independently
• A low cardiorespiratory fitness (CRF) is associated with a high risk of
cardiovascular disease, all-cause mortality, and mortality rates are
contributable to various cancers.
• Cardiorespiratory fitness is the only major risk for cardiovascular disease and
mortality that is not assessed in clinical practice.
• As shown in the graph below, trained individuals reach the ‘dependent barrier’
later than sedentary individuals do. Therefore trained individuals have more
healthy life years.
,Physical activity guidelines
• According to the World Health Organization (WHO) you need at least 150 to
300 minutes moderate-intensity physical activity, or 75 to 150 minutes of
vigorous-intensity physical activity.
• Top 3 excuses for not being physical active:
- No time
- Makes me tired
- Makes me sweat
Exercise is medicine
• Oath of Hippocrates: safest way to health is the right amount of nourishment
and exercise.
• Evidence for prescribing exercise as medicine: in 26 different chronic
diseases:
- Psychiatric and neurological disease
- Metabolic disease
- Heart disease
- Lung disease
- Musculoskeletal disease
• An active lifestyle is the most effective way in to reduce the incidence of type
2 diabetes in comparison with a drug:
- Active lifestyle: 58% reduction
- Metformin: 31% reduction
• In populations with hypertension, different types of exercise interventions
appear to be as equally effective as most antihypertensive medications.
• Exercise is important for cancer prevention and also helps with treatment:
- Less fatigue
- Less fear and depression
- Improvement of physical function
- Improvement of quality of life
, • Exercise as a treatment for depression:
- Physical exercise is an effective treatment for unipolar depression
- Exercise is comparable to psychotherapy and antidepressants for
depression
- Exercise may serve as an alternative to established treatments and waiting
list.
• Exercise as a treatment for osteo-arthritis:
- Less pain
- Improved function
- Less painkillers, surgery and sickness leave
• Exercise as a treatment for pain:
Physical activity is an intervention with few adverse events that may improve
pain improve pain severity and physical function, and consequent quality of
life.
Interactions with other treatments
• Prehabilitation; exercise before surgery to improve cardiorespiratory fitness
and strength leads to a better treatment outcome and less complications.
• Exercise has a positive impact on the immune system and also on tumor cells.
Side effects of exercise
• Injuries could occur during exercising, for example musculoskeletal injuries.
• A very rare side effect: sudden cardiac death.
The benefits of exercise are much bigger than the risk of sudden cardiac
death.
, Warnings/precautions
• Start low, go slow
• 1 hour after meal
• Combine with healthy foods, plenty of water and enough sleep
• Do not combine with smoking
• Be careful in the heat
• Be careful you don’t get addicted to exercising
Contra-indications and screening
• Exercise is great for most people and most people can exercise without
visiting a doctor first.
• Points to consider before starting to exercise or increasing intensity level:
- Current activity level
- Signs/symptoms of certain diseases
- Planned exercise intensity
• Risk factors are age, family history (heart attack etc.), smoking, sedentary
lifestyle, obesity, hypertension, and pre-diabetes.
Exercise journey after hospital visit
• Exercise in hospital
• Exercise in Healthcare
• Therapeutic exercise in own environment
• Guided exercise in own environment
• Independent exercise in own environment
• Many stakeholders involved:
- Healthcare professionals
- Sport & exercise professionals
- (Local) Government
- Patients
Lecture 1 – Exercise is Medicine
Pandemic
• Physical inactivity should be described as a pandemic in view of the
prevalence, global reach, and health effect.
• Low fitness kills more people than ‘smokadiabesity’; sitting is the new
smoking.
Physical inactivity
• Physical inactivity is a risk for heart disease; sedentary bus drivers and
telephonists were at a higher risk of cardiac events than the more active
conductors and postmen peers.
• Dallas bed rest study; 3 weeks op bed rest caused a decline in VO2max.
3 weeks of bed rest has the same effect as 40 years of ageing.
• Physical activity in hospital:
- 90% of time in room, bed has central position
- 60% of time lying in bed, 35% sitting, and 5% active (standing, walking)
- 67% can move around independently
• A low cardiorespiratory fitness (CRF) is associated with a high risk of
cardiovascular disease, all-cause mortality, and mortality rates are
contributable to various cancers.
• Cardiorespiratory fitness is the only major risk for cardiovascular disease and
mortality that is not assessed in clinical practice.
• As shown in the graph below, trained individuals reach the ‘dependent barrier’
later than sedentary individuals do. Therefore trained individuals have more
healthy life years.
,Physical activity guidelines
• According to the World Health Organization (WHO) you need at least 150 to
300 minutes moderate-intensity physical activity, or 75 to 150 minutes of
vigorous-intensity physical activity.
• Top 3 excuses for not being physical active:
- No time
- Makes me tired
- Makes me sweat
Exercise is medicine
• Oath of Hippocrates: safest way to health is the right amount of nourishment
and exercise.
• Evidence for prescribing exercise as medicine: in 26 different chronic
diseases:
- Psychiatric and neurological disease
- Metabolic disease
- Heart disease
- Lung disease
- Musculoskeletal disease
• An active lifestyle is the most effective way in to reduce the incidence of type
2 diabetes in comparison with a drug:
- Active lifestyle: 58% reduction
- Metformin: 31% reduction
• In populations with hypertension, different types of exercise interventions
appear to be as equally effective as most antihypertensive medications.
• Exercise is important for cancer prevention and also helps with treatment:
- Less fatigue
- Less fear and depression
- Improvement of physical function
- Improvement of quality of life
, • Exercise as a treatment for depression:
- Physical exercise is an effective treatment for unipolar depression
- Exercise is comparable to psychotherapy and antidepressants for
depression
- Exercise may serve as an alternative to established treatments and waiting
list.
• Exercise as a treatment for osteo-arthritis:
- Less pain
- Improved function
- Less painkillers, surgery and sickness leave
• Exercise as a treatment for pain:
Physical activity is an intervention with few adverse events that may improve
pain improve pain severity and physical function, and consequent quality of
life.
Interactions with other treatments
• Prehabilitation; exercise before surgery to improve cardiorespiratory fitness
and strength leads to a better treatment outcome and less complications.
• Exercise has a positive impact on the immune system and also on tumor cells.
Side effects of exercise
• Injuries could occur during exercising, for example musculoskeletal injuries.
• A very rare side effect: sudden cardiac death.
The benefits of exercise are much bigger than the risk of sudden cardiac
death.
, Warnings/precautions
• Start low, go slow
• 1 hour after meal
• Combine with healthy foods, plenty of water and enough sleep
• Do not combine with smoking
• Be careful in the heat
• Be careful you don’t get addicted to exercising
Contra-indications and screening
• Exercise is great for most people and most people can exercise without
visiting a doctor first.
• Points to consider before starting to exercise or increasing intensity level:
- Current activity level
- Signs/symptoms of certain diseases
- Planned exercise intensity
• Risk factors are age, family history (heart attack etc.), smoking, sedentary
lifestyle, obesity, hypertension, and pre-diabetes.
Exercise journey after hospital visit
• Exercise in hospital
• Exercise in Healthcare
• Therapeutic exercise in own environment
• Guided exercise in own environment
• Independent exercise in own environment
• Many stakeholders involved:
- Healthcare professionals
- Sport & exercise professionals
- (Local) Government
- Patients
