Make Exercise a Vital Sign

For many of us, a brand new year means vowing to do more exercise. Well now ... your doctor just might hold you to it. There's a movement afoot to turn your commitment to exercise into a vital sign just like your blood pressure. I love the idea.

The program is called Exercise as a Vital Sign. When you arrive at the doctor's office, clinic or hospital, you get your blood pressure, heart rate, breathing rate and temperature measured.  At that time, the nurse or other health professional asks you and records how many minutes a week you exercise.  Your doctor takes that information and identifies which patients would benefit from more exercise and discusses with you which activities are best suited to your needs.  They might recommend anything from mall walking to jogging, yoga and tai-chi.  

Why make exercise a vital sign? Vital signs are universal - meaning everyone gets a set of vital signs when they got to the clinic or hospital - no exceptions. That says exercise is for everyone regardless of their physical limitations.  Vitals are done every time you enter the health care system. That sends a strong message that you should be exercising all the time.  It's all part of a big push to make exercise the most important thing you can do to improve your health and longevity.  Studies have shown that just 30 minutes of regular exercise every day helps you feel better, live longer and be less likely to be hospitalized.  It gives seniors a better quality of life and can help stave off the effects of Alzheimer's.  It is also very helpful for mental health problems such as depression, anxiety and insomnia.

Several large health care providers in the US have adopted the Exercise as a Vital Sign program.  Kaiser Permanente was one of the first, putting it in place as part of a pilot program at four Kaiser clinics in northern California between April 2010 and October 2011. In a study published in the Journal of General Internal Medicine, the program was associated with weight loss in overweight patients and improved blood sugar control in diabetes patients - without resorting to increased diabetes medications. Other studies have demonstrated the validity of the approach. There are plenty of stories of patients who avoid heart attacks & strokes just by exercising.  As well, patients with conditions like arthritis and back strain had better mobility. 

Clever health professionals have glommed onto other tricks doctors to motivate their patients to exercise on a regular basis. More and more doctors are whipping out their script pad and writing the patient an prescription for exercise.  The trend is unmistakably upward.  According to a report by the US Centers for Disease Control or CDC, in 2010, 1 in 3 adults who saw a doctor or other health care professional was advised to increase their physical activity as a means of maintaining or improving their health. That's up from the year 2000, when fewer than one in four adults were told by their doctor to shape up.  The upward trends are especially noticeable in patients who are overweight, age 85 and older, as well as patients with one or a combination of chronic health problems like type 2 diabetes and high blood pressure.

I believe this movement has no where to go but up.  In the UK, the National Health Service or NHS has a program in which a doctor's prescription for exercise scores a patient a ten week membership in a gym -- where patients can participate in aerobics, weight training, yoga and swimming free of charge or a a substantial discount.  The program is aimed at patients who are overweight and at risk of heart disease and strokes, back pain, osteoporosis and diabetes.  As well, seniors who have had falls and related injuries are also being encouraged to hit the gym free of charge.  Authorities there figure it costs around $150-200 a patient - an outlay the the system can more than make up by preventing admissions to hospital for heart attacks, strokes and other conditions related to a sedentary lifestyle. 

Some may think $200 is too rich for the provinces to spend. Call it an investment in good health - one that will pay back 10 or even 20-fold later on in reduced health care costs. 


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