When I wrote this message, I had the hesitation of whether this would be an academic article that CME points should be awarded for readers. I am sorry to say, however, that this is not the purpose of this message. To be frank, I have a dream that all of us should take some form of healthy exercise, in one way or the other; and to make sure that you can pass this message to your patients, especially those suffering from chronic illness, too. I have three kids and I used to urge them to learn all kind of sports games and swimming to keep them in good physical state. I remembered my daughter once thanked me for encouraging her to learn to swim though she was very reluctant or even resistant in the beginning. When she applied for admission to a University 5 years ago, one of the prerequisites for admission is to know how to swim. And she was admitted.
What is exercise?
The actual definition of exercise is physical activity that is planned, structured, repetitive, and purposeful, usually aimed at improving or maintaining physical fitness, but to make it simpler, exercise is doing programs and workouts to keep fit, for example, running, hiking, bicycling, and any active sport.
Most people around the world do little or no exercise during work or rest hours. Today there aren¡¦t many jobs requiring intense physical activity. Instead of walking, people use automobiles or public transportation. Instead of being physically active, people usually watch TV and surf in the net in their free time.
Exercise is very important and is beneficial both physically and mentally. When you exercise, you feel better about yourself because you are fit or your getting fit and you feel that you have accomplished something that was hard to strive for. The benefits of physical activity is it gives you more energy, it helps you in coping with stress, it improves self-image, and it increases resistance of tiredness.
Exercise does not only keep you fit, it also reduces your chance of heart attack. Various studies have shown that the chance of heart attack is three times more likely to happen to an inactive person than a more active person. It really all adds up because with exercising, you burn off calories, which keeps you at your desirable weight and lowers your risk of heart disease.
There are risks in exercising though. The major risk in exercising is injury to the muscle or joints. This happens when a person exercises too hard for too long, this mostly happens to people that have been inactive for a while. In some situations, people have died while exercising. In these situations, most of the deaths have been by overexertion in people who have had heart problems. For people who are under the age of thirty, these heart conditions are usually from heart defect present at birth. For the people that are over the age of 40, the heart condition is usually ischemic heart disease. A lot of these deaths have followed by warning signs such as chest pain, lightheartedness, fainting, and extreme breathlessness. These are symptoms that should not be ignored and medical attention should be advised immediately.
Exercising too hard is not good for anyone, however, and is especially dangerous for out-of-shape, middle-aged and older people. It is very important for all people to follow a gradual and sound exercise program. If you are wondering how long it would take to be in shape, think about this; look at how long you have been out of shape and it will take about that much time to get back in shape if you exercise properly.
With some of this information earlier stated, exercise seems pretty dangerous, but it is not very dangerous at all, you just need to be careful. No research studies have shown that physically active people are more likely to have sudden, fatal heart attacks than inactive people. As a matter of fact, several studies have shown a reduced risk of sudden death for people who are physically active.
With this message, you might be in a better position to prescribe exercise to your patients. However, most of you are not taught in a proper way to scientifically prescribe an exercise program to your patients or to your selves yet.
In the conclusion of Expert Group Meeting on ¡§Establishing a Strategic Framework on Prevention and Control of Non-Communicable Diseases¡¨ held on 3 September last year hosted by the Department of Health, the priorities for the emerging Non Communicable Diseases are to tackle the behavioral risk factors like physical inactivity. In Hong Kong, the Department of Health conducted a Behavioral Risk Factor Survey in Feb 2004 and found that a mere 35.9% of the 1,715 respondents had done moderate physical activities for at least 10 minutes during the preceding 7 days. This level of physical activity was clearly not enough for optimal health gain.
Physical activity does not need to be intense to provide health benefit. The World Health Organization has the following recommendations:
1. At least 30 minutes of physical activity of moderate intensity on most days of the week is already enough to provide health benefits and reduce the risk of cardiovascular diseases, diabetes, colon cancer and breast cancer;
2. More activities may be required for weight control;
3. Muscle strengthening and balance training can reduce falls and increase functional status among older adults.
Since 2005, the Department of Health has collaborated with various medical bodies including your Union and the Hong Kong Medical Association to see if exercise prescription could be promoted to chronic patients as in most parts of the world. The first batch of doctors (around 100) have finished the First Exercise Prescription course and started the pioneer mission of prescribing exercise to patients since January this year. As a Promoter on Exercise for Health, I would like to inform you that pipe line programs in form of lectures, courses, workshops and practical sessions would begin this June and I hope to see you all to receive professional materials on Exercise Prescription in the courses and help your patients and yourselves in the coming years. Remember, it is never too late to start on exercise and never too late to log into the Exercise Prescription website (http://www.exerciseRx.cheu.gov.hk) for further information.
Dr. Yeung Chiu Fat Henry