healthcare – SEMS-journal

exercise is medicine

Physical Activity Promotion in Health Care Settings: the “Exercise is Medicine” Global Health Initiative Perspective

Physical inactivity constitutes the fourth leading cause of death globally. Health systems are being called to respond to the epidemic of non-communicable diseases (NCDs) and help deliver on the promise of prevention approaches. Substantial evidence exists in support of multi-prong physical activity counseling, prescription and referral strategies, in particular those linking clinical and community-based resources, to help increase physical activity (PA) levels. In late 2007, the “Exercise is Medicine” (EIM) initiative was established by the American College of Sports Medicine to institutionalize PA promotion into the US healthcare system.

exercise is medicine

“Exercise is Medicine” in Latin America: training health care professionals in physical activity prescription

Health care professionals (HCPs) play an important role promoting healthy habits to patients, yet they lack knowledge, training and self-efficacy to effectively prescribe physical activity (PA). In 2011, the “Exercise is Medicine” Latin American Regional Center developed a one-day (8 hours) in-person course on PA and exercise prescription for HCPs, with theoretical and practical components. Contents include evidence-based health benefits of PA, screening for major risk factors, key behavioral change strategies, basic exercise testing, and prescription and referrals principles.

exercise is medicine

Exercise in Medicine in Russia

Noncommunicable diseases, mainly cardiovascular diseases and cancers, and external causes account for more than 80% of mortality in Russia. The leading causes of death and disability are directly associated with behavioural risk factors, physical inactivity being one of them. Until a few years ago, a clear standard recommendation on physical activity (PA) counselling for general practitioners did not exist in Russia. In 2010, the guidelines on physical activity counselling for primary health care providers were developed. On the basis of these guidelines the national recommendations on PA were developed in 2011.

exercise is medicine PA promotion sports and society

Physical activity promotion in primary health care in Slovenia

In Slovenia, the role of general practitioners in counselling physical activity for prevention of cardiovascular disease (CVD) is well recognized. The role of general practitioners in advising healthy lifestyle for individuals who are at risk of developing CVD is formally defined in the National Program for Primary Prevention of Cardiovascular Disease, which has been running since 2001. Part of the program is counselling on healthy lifestyle including physical activity, performed in all health centres across the country. First a screening and medical examination is performed. In case of higher risk for CVD (>20%) the physician should give advice on the particular risk factor and direct patients to health-education centres, where they can participate in healthy lifestyle workshops lead by health professionals.

exercise is medicine PA promotion sports and society

Exercise Referral in Germany

Primary care physicians in Germany are potentially in a pivotal position to provide physical activity counselling and exercise referral for their patients. The preventative prescription scheme dates back to the late 1970s. This scheme called “green prescription” (Grünes Rezept), however, could not be established as exercise referral scheme in primary care on a regular and systematic basis. After the German Medical Association (Bundesärztekammer), the German Association for Sports Medicine and Prevention (Deutsche Gesellschaft für Sportmedizin und Prävention) and the German Olympic Sports Federation (Deutscher Olympischer Sportbund) had developed the standardized national quality criteria of Physical Activity on Prescription in a joint effort, the German Medical Association has adopted them in 2011 and now recommends them to the Medical Associations of the Federal States for implementation.

exercise is medicine PA promotion physical education sports and society

Experiences in physical activity promotion in health care settings for primary prevention in the UK

In addition to the delivery of primary care services, recent changes to the NHS in the United Kingdom have placed increasing responsibility on GPs for the commissioning of the full range of health services from prevention through to clinical interventions and rehabilitation. Whilst historically there has always been an expectation that primary care professionals were ideally placed to provide support for prevention as well as treatment, their active engagement in the promotion of physical activity has remained largely superficial.

exercise is medicine PA promotion sports and society

Physical activity promotion in the health care setting in Switzerland

The role of regular physical activity for population health has been clearly documented. Improvements in population levels of physical activity require long-term implementation of a combination of measures, including the evidence based approaches described in the “seven best investments for physical activity” (www.globalpa.org.uk): whole-of-school programmes, transport, urban planning, integration of physical activity promotion into primary health care systems, public education, community-wide programmes, sport for all. The health care setting has a particular role in this context, particularly in its access to physically inactive individuals.

exercise is medicine PA promotion sports and society

The Evolution of Physical Activity on Prescription (FaR) in Sweden

In 1996, the first Report of the US Surgeon General on Physical Activity and Health provided an extensive knowledge overview about the positive effects of physical activity (PA) on several health outcomes and PA recommendations. This contributed to an enhanced interest for PA in Sweden.