CCC 2013: Don’t Fear the Exercise Prescription

October 2013

Andrew Pipe, MD
Andrew Pipe, MD

Regular physical activity is one of the most beneficial things a person can do to prevent heart disease or support their rehabilitation after a heart attack or cardiac surgery. A study recently published in the British Medical Journal found that exercise can be as good or better than drug therapy for preventing cardiac events in certain individuals with cardiovascular disease and for preventing death in stroke patients.

Exercise has a profound impact on the risk factors for vascular disease and substantial benefits can be achieved with moderate levels of regular physical activity. Not only is physical health improved, mood and psychological well being are also enhanced, and some intriguing evidence is emerging suggesting that an active lilfestyle in middle-age may forestall the development of dementia, observed Andrew Pipe, MD, Chief of Prevention and Rehabilitation at the Heart Institute, as he spoke on the topic of prescribing exercise.

Most important, he emphasized in his address to health professionals, is to recognize that physical activity is safe for the overwhelming majority of individuals. A concern for safety was understandable, he continued, but exercise at an intensity at which an individual could carry on a conversation has been shown to be both safe and effective in enhancing health. The so called “talk test” could be applied to individuals with a variety of health conditions and be used to guide daily physical activity. Safety is only a concern for a small subset of patients. For the remainder, the benefits of physical activity are vast and varied.

For cardiac patients, exercise-based rehabilitation improves quality of life, can lead to a reduction in symptoms, and reduces rates of hospital readmission. Patients with other forms of vascular disease – stroke or peripheral vascular disease – can gain similar benefits. Resistance training not only can dramatically improve strength, coordination and balance and permit independent living in the home, it can easily be integrated into exercise routines.

For sedentary patients, walking on a daily basis is an excellent approach to significantly enhancing fitness. “Take your dog for a walk every day, even if you haven’t got one,” suggested Dr. Pipe. Most importantly, he observed, physical activity should be “fun, feasible (easily integrated into a daily routine)…and forever. We want everyone to wear out…not rust out!”

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