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Activity
Boosts Fitness In Elderly Patients
Primary care physicians have an important role to play in
encouraging older adults to get fit, according to a study
published in the American Journal of Preventive Medicine
(Vol. 24, No. 4: 316-322).
"Being active at any age can help improve quality of
life, decrease risk of disease, and probably most important
for the elderly, help improve balance and reduce falls,"
said Colleen Doyle, director of nutrition and physical activity
for the American Cancer Society.
Both the American Cancer Society and Canadian Cancer Society
recommends getting regular
physical activity as part of a healthy lifestyle.
Yet a substantial number of older Canadians and Americans
don't get regular physical activity.
Specific Instructions, Goals
In the new study, researchers in Canada found that a detailed
prescription for exercise can help elderly patients become
more active, and more fit.
Robert J. Petrella, MD, PhD, and colleagues from the University
of Western Ontario, studied 284 people over age 65 who did
not have a regular exercise program. At the beginning of
the study in 1998, all the participants were given a treadmill
fitness test to measure their aerobic capacity (the amount
of oxygen flowing through the blood; higher oxygen levels
indicate greater physical fitness).
The participants were then divided into two groups. The
first group was given a "Step Test Exercise Prescription"
or STEP. These patients were given another fitness test
(stepping up and down two small steps 20 times) and instructions
from the doctor about aerobic capacity, heart rate, and
what kind of exercise they should be doing. The doctors
also taught the patients how to measure their heart rate,
and discussed how frequently they should exercise, how long
each session should be, and how intensely they should exercise.
In the second group (the control group), the patients were
given the doctor's usual counseling on exercise and told
about the benefits of regular activity. Both groups were
given a list of nearby facilities available for physical
activity, and both groups kept a log of their weekly exercise.
Six months later, the participants were given another fitness
test. Those in the STEP group saw their fitness levels increase
by 11%, while those in the control group had a 4% increase
in fitness. After a year, the STEP group improved by 17%,
while the control group improved by just 3%. The STEP participants
also had reduced their blood pressure and lost weight over
the course of the year.
Doctors' Advice Carries Weight
The researchers attribute the results to the specificity
of the recommendations given to the STEP group, and to the
influence of the physicians.
"Primary care physicians represent a large pool of
professionals who have credibility with their patients,"
they write.
Doyle agrees. "I think there's no question that for
many segments of the population, their health care provider
is the most trusted source of information. I think it's
critical for physicians to be talking to their patients
about things like nutrition, physical activity, weight control,
and tobacco cessation, for instance."
But the nature of the health care system can make this type
of counseling difficult to provide, said Gregg Walker, director
of health care initiatives for ACS.
Doctors have a limited amount of time to spend with each
patient, and most of that time is spent dealing with the
specific complaints of the patient. Many physicians may
not have the extra minutes needed to provide the kind of
intensive instruction STEP requires. (The STEP counseling
took about 12 minutes on average, while the standard counseling
took half as long.) And typically, physicians aren't reimbursed
by insurance companies for these types of initiatives.
The researchers acknowledge the obstacles to this type of
intensive counseling, but they note that regular office
visits can "provide an ideal opportunity to introduce
exercise advice to a large group of patients at risk."
Article Source: Yahoo Health
Article Author: N/A
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