Exercise is Medicine: It should be prescribed properly.

There is enough scientific evidence to support the use of exercise in the prevention, management and maintenance of different cardiovascular, pulmonary, musculoskeletal and metabolic conditions among others. If we agree exercise is medicine, then shouldn’t we prescribe it well to our patients to achieve the desired effects?

If a patient with hypertension is given medication, and the condition doesn’t improve, we review the medication; either we change the medication or up the dosage. What about exercise?

Most of the patients will be encouraged to go and exercise or be physically active. Isn’t it similar to telling patients to go and just take pills?

With prescription medication, we include dosage and frequency. For example, it could be PCM 1*3. Exercise should be prescribed too.

Prescription of medicine and exercise.

Specificity: Each medical condition requires a specific drug or group of drugs for effective management, so is exercise. The exercise prescription for a hypertensive patient and a patient with osteoarthritis is completely different both with different goals.

Dosage: a high dosage of pills risks toxicity, too low, we risk the patient not benefiting. The same happens to exercise. Too little and the benefits won’t be achieved, too much and we risk musculoskeletal injuries, electrolyte imbalance, cardiac problems and even hypoglycemia. The phrase, “go and exercise as much as you can” shouldn’t be used in exercise prescriptions.

Composition: The components of the drug should facilitate absorption for the desired effects to be achieved. For that to happen, the patient should take the medication first. medication for children is sweetened to encourage consumption. The same should apply to exercises. For our patients to exercise, the exercise should be enjoyable and fun at the same time while achieving the desired goals.

Components of exercise prescription

A good exercise program should include both aerobic and strength exercises. It should be structured to meet the desired effects. This means it should follow the FITT principle.

Frequency: This is simply the number of days in a week the patient should exercise. The WHO recommends 5 days a week. However, it should be evaluated on case to case basis. “Exercise as much as you can” is a phrase of the past.

Intensity: This can be light, moderate or vigorous. In light intensity exercise, one can sing while performing the exercise. this can be a simple walk. In moderate, one can talk but can’t sing, this can be brisk walking. While in vigorous-intensity one can’t perform either, like in running.

Time: How long should each session last? how long should each set last? and how long should each repetition take? This should be clearly prescribed. depending on the type of exercise, desired effects and the patient factors.

Type: What type of exercise are you prescribing? both aerobic and strengthening exercises are recommended. In some instances, a patient will benefit from isometric exercises or stretching exercises. Each patient should be evaluated individually in relation to their condition and the patient ability to perform the exercise.

The Principle of Rest in exercise

In exercise prescription we include rest. This is to allow for recovery. a patient can exercise for two consecutive days and rest on the third day and repeat the same regularly. alternatively one can exercise on alternate days. Patience evaluation should be key in determining the amount of rest required.

Rest is also included in between sets. it’s evaluated depending on the type of exercise and patient factors.

The principle of progress

Just as medications are reviewed, exercise should be reviewed to achieve the desired effect. For progress to occur, either frequency, time, intensity or type of exercise or both can be reviewed.

There are numerous conditions that can benefit from exercise, we just need to prescribe it properly.

reference: https://www.exerciseismedicine.org/