"Physical inactivity is the fourth leading cause of morbidity and mortality worldwide. Regular physical activity is highly beneficial for the primary, secondary and tertiary management of many common chronic conditions. There is considerable evidence for the benefits of physical activity for cardiovascular disease, diabetes, obesity, musculoskeletal conditions, some cancers, mental health and dementia. Yet there remains a large evidence-practice gap between physician's knowledge of the contribution of physical inactivity to chronic disease and routine effective assessment and prescription of physical activity."
I think there will be little argument with this statement from the article "Exercise: an essential evidence-based medicine" published in the Medical Journal of Australia on the eve of the Gold Coast 2018 Commonwealth Games held in April.
Despite all the evidence, most doctors typically do not regularly assess or prescribe physical activity and exercise.
And even when they do address it, the advice seems to be off-the-cuff, not specific and superficial.
Lip service. Without conviction and the use of simple behaviour modification techniques, the "sale" of exercise is unlikely to be completed.
The article makes the point that a clinician's attitude and willingness to prescribe physical activity is likely heavily influenced by personal experiences of physical activity and exercise.
In addition, the lack of undergraduate training, and I would add, postgraduate training, on this subject leads to a lack of confidence and ability in such prescription.
So, most doctors remain ill-equipped to provide this fundamental non-drug intervention.
This has to change of course.
Rheumatologists, in particular, need to ask about physical activity, assess the actual physical activity, provide more specific advice, and then actually provide written specific exercise prescription as they do for medications.
Advice to "just walk" is not really sufficient for most of the patients I have to help.
For those doctors who do not feel confident in exercise prescription, they should refer to skilled allied health professionals, including physiotherapists and exercise physiologists.
I am lucky that at BJC Health, I work with a team of these highly skilled professionals. Our exercise physiologists are skilled in providing appropriate whole-body exercise routines for a diverse range of conditions including inflammatory arthritis, spondyloarthritis, fibromyalgia and osteoarthritis.
Exercise Right Week involves a national campaign to get more people talking about exercise and the work that Exercise Physiologists do. BJC Health celebrates this event with our existing clients and works to raise awareness.
Between May 21-27, BJC Health are offering a complimentary 30min session with an exercise physiologist, with that time spent in risk screening for either:
- Falls Risk
- Injury/MSK Risk
- Cardiovascular Risk