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December 05, 2019 Thursday 03:21:31 PM IST

MONITORED EXERCISES AS TREATMENT

Health Monitor

These words, attributed to the father of modern medicine more than 2000 years ago, still hold good in today’s era of fancy medical gadgets and cutting edge therapeutics. A large proportion doctors, practitioners of modern medicine,  (and in a sense descendants of Hippocrates) though skilled at prescribing medications and performing complex procedures, still lack the requisite expertise in guiding patients through an exercise program designed to improve their health and perhaps alleviate suffering. This factor, coupled with general lack of awareness among lay public, perhaps explains partly why such resources are underutilised. Despitepopular media and even many cinema stars now promoting general fitness, exercises and a healthy life-style, many patients, especially elderly individuals or those with specific medical conditions, may not be able to carry out these calisthenics and need a specially designed and monitored exercise program as part of their disease management strategy.

Beneficiaries of monitored exercise program

Some conditions are completely treatable with medications alone (eg. infections) or surgery (eg.tonsillitis) But modern living practices, dietary habits, chronic stress and certain addictions like smoking have given rise to the current pandemic of lifestyle related health problems like cardiovascular diseases, stroke, chronic obstructive pulmonary disease, diabetesand atherosclerosiswhich are all multi-dimensionalproblems and not adequately treated with medications or surgery alone. Indeed one of the causes of the ubiquitous prevalence and recurrence of such non-communicable diseases is the failure by modern medical practitioners to ensure that every strategy in the therapeutic armamentarium is adequately deployed.  Rising life expectancy has come with its own problems like ageing, frailty, osteoporosis, arthritis and spondylosis which have no specific treatment and need only be managed adequately. Progress of science has enabled medical professionals to perform transplant surgeries, angioplasty, cardiac bypass, dialysis and wonderful new drugs are able to cure many cancers and even HIV. However each of these conditions can leave a person drained of energy and unable to perform many activities that they would wish to which may not be addressed by prescribing medications alone. Exercises, designed and prescribed for such individuals, can work wonders in acquiring a more energetic and purposeful existence.

 


Benefits of exercise program 

  • Reduces risk of developing heart disease, stroke, metabolic syndrome (increased blood pressure, blood sugar and reduced good cholesterol) and obesity
  • Improves heart and lung function
  • Increases blood circulation to various body organs and tissues.
  • Improves body image, reduces depression and anxiety, relieves stress and improves sleep.
  • Improves balance and co-ordination and reduces risk of fall
  • Increases muscle strength and bone density
  • Improves flexibility and increases joint range
  • Increases activity and boosts energy levels thus enabling participation in many pleasurable activities and lead a more fulfilling life.

Components of monitored exercises

These are a set of activities done to achieve a particular target and maintain it in a group of individuals suffering from some of the above mentioned health conditions. For instance, people who have undergone cardiac procedures or suffer from chronic lung disease or have a chronic medical ailment, need to first be evaluated by a competent medical professional, specifically trained in prescribing, monitoring and executing such an exercise program. The first step is to determine the safe level at which persons with medical conditions can exercise. This is usually done in the hospital or clinic under controlled conditions and watchful medical supervision with specialised equipment. Following this, a program is designed suited for such an individual, taking into account her medical condition, and then for the next few weeks carried out in the medical facilityitself to achieve a particular level of fitness, which is also monitored and regularly adjusted so as to enable the exercising person to achieve pre-determined targets. Once such targets are achieved, a home program might be given which she may carry out so as to help her to continue such exercises, hopefully lifelong. This gives confidence to an individual that they may safely exercise, helps them understand what they must or must not do and what is permissible for such a person. It also promotes healthy behaviour in terms of not only exercise but dietary advice and psychological support, which are generally offered as a part of such a monitored exercise program. In certain cases, advice and help to quit smoking or other addictions may also be proffered. In designing such a program, individual preferences and pain causing conditions may be considered and exercises modified accordingly.

Future prospects


Exciting new gadgets like smartphone applications and smart watches are a boon in this field. They help one monitor an exercise program, see if targets are met, motivate an individual by regular alerts and help maintain a record of daily activities. Certain advanced gadgets can also monitor heart rate and ECG and give instant feedback in case of any problems. In the future, such devices may communicate with a remote healthcare provider or facility and give instant feedback or corrective measures. The emerging field of artificial intelligence has perhaps the potential to transform our old ways. Imagine a device (or a robot) which monitors you real time for your activity and takes appropriate actions based on the feedback that it has received from your body or your doctor! In some western countries, insurance companies insist that individuals with certain health conditions compulsorily undergo a monitored exercise program if they wish to retain their insurance benefits. With government agencies and even private individuals availing health insurance services, the day is not far off when such a requirement may be mandatory in our country as well. Designing and conducting such a program may also potentially be an exciting career choice for a young professional in the health-care field.

Conclusion

Exercises are the only part of treatment which cannot be passively done – no one can do it for you, one has to do it for oneself.  Correctly done, they can achieve tremendous results which may help us manage our medical condition optimally. Monitored exercises are done under appropriate medical supervision for certain conditions to achieve a particular fitness level safely and effectively. Thus it may enable a person to perform many activities which may otherwise be a limiting factor due to illness or a medical condition. Many modern rehabilitation facilities offer such programs and the benefit of these may be availed by patients in consultation with their caregivers. 



Dr. Nitin A Menon

Dr Nitin A Menon, MD, is a consultant in department of physical medicine and rehabilitation at Rajagiri Hospital, Aluva.

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