Exercise Counseling Improves Level Of Fitness; Physicians Need More Guidance

Main Category: Sports Medicine / Fitness
Article Date: 27 May 2009 - 6:00 PDT

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Exercise and behavioral intervention improves fitness and lowers systolic blood pressure, according to a study presented today at the 56th American College of Sports Medicine (ACSM) Annual Meeting in Seattle. The findings are consistent with ACSM's Exercise is Medicine™ ™ (EIM) program, which recommends physical activity as a standard health care component.

Research showed that patients who were given atailored exercise prescription and behavior change counseling program by their family physician, rather than an exercise prescription alone, had a higher level of fitness and physical activityand lower systolic blood pressure. A study of 360 healthy men and women, aged 50-85 years,was designed to determine the impact of exercise prescription for older sedentary adults in family practice. One group of participants received a customized exercise prescription and behavior change program from their family physician. Participants in the control group received an exercise prescription, but no further instructions, from their physician.

"We found that giving out an exercise prescription isn't always enough," said Robert J. Petrella, M.D., Ph.D., FACSM, lead author of the study. "To really make an impact, patients need a personalized exercise plan or a recommendation to a qualified professional who can guide them along the way."

Two additional studies presented today at the Annual Meeting also reinforced the importance of exercise prescriptions and counseling.

One study of 126 physicians in varying specialties found that while physicians are discussing exercise with their patients, they are not prescribing the appropriate amount of physical activity to them.In addition, only 5.5 percent of those surveyed admitted to providing written prescriptions for exercise to their patients. Among the physicians in the study, only 23 percent meet the 2007 Physical Activity Recommendations from ACSM/American Heart Association Guidelines themselves, therefore serving as an inadequate example to their patients.

"We have to spread this idea better amongst physicians to see if we can increase the amount of people exercising regularly in the general population," said Francisco O. Nascimento, M.D., lead author of the study.

The problem may lie with a lack of knowledge, another study suggested. A research team led by Ahmed Q. Aidoo, M.D., M.P.H., found that while resident physicians are more active than the general public, they do not have sufficient knowledge of current physical activity recommendations and proper exercise counseling practices. More than 40 percent of survey respondents in the study were not able to correctly identify aerobic exercise intensity recommendations, and 70 percent could not accurately note minimum recommendations for strength training.

These findings suggest that medical residency training curriculum should place additional emphasis on topics such as physical activity recommendations and the implementation of physical activity counseling to patients.

This counseling aspect was further emphasized during an Exercise is Medicine™ presentation by Robert E. Sallis, M.D., FACSM, chair of EIM, who spoke on "Exercise Is Medicine: Global Perspectives on How to Mobilize and Utilize Health Care Providers to Prescribe Exercise" at the Annual Meeting. EIM calls on all health care providers to counsel patients on exercise at every office visit.

"The core of EIM is based on physicians prescribing exercise to their patients," said Sallis. "We are also advocating that these health care providers recommend their patients to certified health and fitness professionals for proper exercise counseling. This education for health care providers needs to start prior to practice-in residency curriculum or even earlier."

EIM toolkits, videos, handouts and other resources are available for download online at http://www.exerciseismedicine.org.

ACSM guidelines support the 2008 Physical Activity Guidelines for Americans, which recommend that adults participate in at least 150 minutes of moderate-intensity physical activity, which can be achieved in 30-minute segments five days a week. To get started with an exercise program, visit http://www.acsm.org/physicalactivity to take ACSM's pre-exercise assessment quiz and find other valuable resources.

Source
American College of Sports Medicine