EIM (Exercise in Medicine) Presentation

Exercise is
®
Medicine
Australia
What is Exercise is Medicine
• A global initiative
• Managed in Australia by Exercise & Sports
Science Australia (ESSA).
• Encouraging health care providers to
review and assess every patient’s physical
activity levels
• Counselling patients on exercise
• Providing patients with an exercise
prescription or referral
• AEP
Exercise is Medicine is not a 12 week
challenge, or a weight loss program.
Regardless of the condition of an
individual, we advocate for
appropriate physical activity that is
sustained for the long term.
Mortality and morbidity
statistics
Data from Australian Bureau of Statistics, World
Health Organisation and Medibank Private
23 and a half hours
http://www.youtube.com/watch?v=
aUaInS6HIGo
Dr Mike Evans
For more visit
exerciseismedicine.org.au
For more visit
exerciseismedicine.org.au
Inactivity: Effect of low cardio
respiratory fitness (CRF) on mortality.
Br J Sports Med. 2009; 43:1-2.
18
16
Contributing factors for All-Cause deaths
Study of 40,482 men and 12,943 women
14
12
10
8
6
4
2
0
Men
Women
It’s not all about
weight loss
Physical activity is
very beneficial to
an individual’s
health, whether
or not they lose
weight.
Blair S. (2009). 'Physical inactivity: the biggest
public health problem of the 21st century',
British Journal of Sports Medicine, 43:1-2.
Moderate vs. Vigorous
• Moderate activity e.g. brisk walking
(like you’re late for the bus), steady
cycling. You can talk but can’t sing
• Vigorous activity makes you ‘huff and
puff’ e.g. running, fast cycling. You
can’t carry on a conversation during
vigorous activity
Moderate intensity
cardio
30 -60 minutes a day,
5 days a week
OR
Vigorous intensity
cardio
20-40 minutes a day,
3 days a week
Strength training
8 to 10 exercises,
8 to 12 reps of
each exercise
2 days a week
PLUS
AND
Balance exercises
minimum
3 days a week
Exercise is Medicine® Australia
support the utilisation of the
Australian Physical Activity and
Sedentary Behaviour Guidelines
2014.
Accredited Exercise
Physiologists are…
Allied health professionals, providing
exercise and lifestyle therapies for the
prevention and management of chronic
disease, injury and disability.
essa.org.au
Typical AEP treatment
model
• Support for better self-management
• 2-5 consultations over initial 12 weeks
• Multi-disciplinary approach (GP, dietician
etc)
Week
1
Initial Consultation &
Assessment
2
Program follow-up
3
Program follow-up
7/8
Program Review & upgrade
11/12
Program Review & upgrade
Case Study - Jill
• 61 year old female
• Diagnosed with Osteoporosis with right side tremor in 2010
• Long history of chronic pain from structural scoliosis, in both
neck and lower back,
• No history of exercise, long term passive treatment for pain.
• More recent left knee pain
Her GP identifies that she is at a high risk of a fall and fracture
due to her bone density complicated by her scoliosis, therefore
refers her to an Exercise Physiologist (AEP) to improve her
balance, chronic pain management and bone density.
Case Study - Jill
Initial measurements showed that Jill
had:
• Significant structural scoliosis concave
to left in the thoracic, to the right in
the lumbar
• Associated muscular imbalances
• General poor fitness levels unable to
complete 10 min on stationary bike
without discomfort
Case Study - Jill
Longitudinal program (started Jan 2012)
Exercise intervention only in limited EPC
sessions
Initial phase – control of scoliosis, self pain
management
Second phase – increased CV fitness and
general strength
Third phase – increase functional strength in
preparation for next phase
Fourth phase – osteoporosis phase,
intermittent dynamic loading
Case Study - Jill
• Increase from 10 minute cycle to able to
attend classes for fitness, including
cycling, attending training in local facility
of own choice
• Pain in knee controlled and managed
• CLBP and chronic neck pain is controlled
with exercise
• Weight loss ~5-6 kg over time of
exercise, currently stable
• Bone density increased by 6 % in 12
months [DEXA]
Start the conversation
Are you aware of the general benefits of
exercise?
Do you know how exercise can specifically
impact on your medical condition / health?
What do you think will happen if you maintain
your current lifestyle?
Plant the seed! Don’t feel like you need to
have an outcome in the 1st consultation
Common misconceptions
• “Need to use a gym to get fit”
• “Too old to begin structured physical
activity”
• “Need to use sophisticated
equipment to perform strength
training”
Provide options
Physical activity advice (factsheets)
AND
Specific exercise prescription
OR
Referral if required (EIM prescription
form)
Grant McKechnie
Ballarat Sports & Exercise
Rehabilitation Centre
ESSA AEP
The only address you need
when prescribing exercise
exerciseismedicine.org.au
Ready?
exerciseismedicine.org.au | facebook.com/EIMAustralia
[email protected] | (07) 3862 4122

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