A new, important vital sign: exercise
The Exercise is Medicine initiative seeks to make movement a part of prescribing process.
We know the vital signs drill. Roll up a sleeve for blood pressure, get on the scale (that’s always fun) and watch as the nurse takes a pulse. But then comes the question: “How often do you exercise?” What?
It could be that your primary-care physician already asks this question. If so, feel lucky, because more and more evidence shows that exercise can and should be counted as one of our vital signs. According to the growing Exercise is Medicine initiative, appropriate exercise can and should be prescribed. Just like cough medicine.
“The vision is that healthcare providers would prescribe the right dosage of exercise to reduce the risk of and treat obesity, high blood pressure, depression and some 40 chronic health conditions,” said Stacey Kendrick, health educator at Vanderbilt University Medical Center.
The initiative, which began in 2007, has several arms, one of which is to help health professionals understand how this works and get comfortable with prescribing exercise. The Exercise is Medicine website said it hopes to fill that gap focusing on physical activity counseling, prescription and referral strategies that link healthcare and community-based resources.
It’s a work in progress.
“In medical school, we had maybe one or two lectures on nutrition and exercise,” said Leon Scott, M.D., assistant professor of clinical orthopaedics and rehabilitation and physician at Vanderbilt Bone & Joint in Spring Hill. “But we spend years on medicine. That is our comfort zone.”
Most doctors are also pushed for time. “It takes more discussion with the patient and that takes time,” he said. But to Scott, it’s worth every minute.
Fighting an ‘inactivity epidemic’
A fact sheet about the Exercise is Medicine initiative cites the alarming lack of physical activity in the United States and around the world, calling it an “inactivity epidemic.”
“Exercise, appropriately prescribed, is one of the most effective tools for treating depression, fibromyalgia and heart disease risk factors,” Scott said. From his standpoint, as a physician who sees knee problems, back pain and more on a daily basis, Scott said many chronic conditions are preventable.
“And, they are often modifiable with tools that are within the power of the patient,” he said. “They can own it.”
“It’s my experience that this level of exercise, when combined with a functional strengthening program can eliminate the aches and pains that come with age and arthritis,” Scott said. “By prescribing exercise I’m hoping one day I can even put myself out of business.”
The CDC recommends 150 minutes of moderate intensity exercise per week. That equals a 30-minute workout 5 days a week. (Find lots of ways to get moving here.)
Some doctors don’t get the recommended amount of exercise themselves, so prescribing it for a patient feels foreign, said Kendrick, citing Exercise is Medicine statistics.
Once a practice is connected with local fitness centers and physical therapists, a doctor could comfortably say maybe they aren’t the expert, but refer the patient. For doctors, Scott would like to see the comfort threshold lowered through more education and connections.
If you’re not sure about your provider’s familiarity with the Exercise is Medicine movement, just ask. Taking a pill is always easier than motivating for a moderate-intensity workout. So, in the end, it is in the patient’s control.
“It starts with a patient saying, ‘I want to make a change,’” said Scott.