Prescribing Exercise for Good Health

Increasing physical activity has proved effective in improving patients’ overall health and preventing and managing chronic diseases and complications, such as obesity, coronary artery disease, diabetes mellitus, arthritis, and osteoporosis, according to the American College of Sports Medicine (ACSM). A recent ACSM survey showed that one fourth of patients seek advice on exercise and physical activity from their physician, even before they try fitness and health Web sites, and 4 of 10 physicians talk to their patients about the importance of exercise. However, physicians do not always offer suggestions on how to perform exercise for good health. The survey also showed that close to two thirds of patients would be more interested in exercising to stay healthy if their physician provided advice and resources.

To help make physical activity and exercise a standard part of disease prevention and treatment, the ACSM joined forces with the AMA to launch Exercise Is Medicine, a new physician and patient awareness program. Patients are encouraged to incorporate physical activity and exercise into their daily routine and physicians are encouraged to prescribe exercise for their patients.

The major goals of this national initiative include the following:

•Create broad awareness of the notion that exercise is good medicine.

•Include "level of physical activity" as a standard vital sign question in each patient visit.

•Help physicians become consistently effective in counseling their patients about their physical activity needs and making appropriate referrals.

•Initiate policy changes in the public and private sectors that support physical activity counseling and referrals in clinical settings.

•Produce an expectation in patients that their  physician will ask about and prescribe exercise.

•Encourage physicians to be physically active.

 Key elements of the Exercise Is Medicine program will include making tools, training, and referral mechanisms available for physicians; strengthening the evidence supporting theefficacy of exercise prescription in health care settings; pursuing policy interventions that support the program;staging patient advocacy and marketing campaigns; building coalitions and partnerships; identifying,developing, and disseminating "what works" models for patients and communities;and creating a Web site with support strategies, content, and functions.The Exercise Is Medicine site contains educational materials and tool kits for physicians to use in their practices and information for patients,the media, and policy makers.Educational models will be developed for use in medical schools so that students can learn the importance of prescribing exercise for patients early in their careers.

The ACSM and AMA have issued an action plan that includes the following 5 points:

1. Increase the number of physicians who are prescribing exercise and increased physical activity for their patients.

2. Build the science and evidence base connecting physical activity with health, as well as physical inactivity with chronic disease, and accelerate the transfer of this knowledge into routine medical practice.
3. Increase collaborations among physicians and exercise professionals to benefit patients for whom exercise and increased physical activity may prevent or manage chronic diseases.
4. Educate the public on the health benefits of exercise and physical activity and encourage patients to talk to their physician about their physical activity needs.
5. Encourage greater leadership and action by persons and organizations to make the discussion between physician and patient about physical activity and health commonplace and effective.

Able patients will be advised to participate in at least 30 minutes of physical activity and 10 minutes of stretching and light muscle training 5 days a week. Health care organizations, physicians, and other professionals will be asked to assess, advocate for, and review every patient's physical activity program during every comprehensive visit.

For more information about the Exercise Is Medicine program and educational materials and tools that can be used in practice, visit the Web site at http://www.exerciseismedicine.org. Or, visit the ACSM Web site at http://www.acsm.org or contact the organization at PO Box 1440, Indianapolis, IN 46206-1440; telephone: (317) 637-9200; fax: (317) 634-7817.